Does Social Support Ensure Coping with HIV/AIDS Stigma and Wellbeing? Examining Poor Women's Experience in Bangladesh

Background/Objective

The existing literature shows that both men and women with HIV/AIDS suffer from stigma, however women suffer disproportionately than men, especially in developing countries. Studies also reported that available social support help to cope with HIV-related stigma and ensure wellbeing (Paudel & Baral, 2015). Gender inequality is pervasive in Bangladesh where women wield considerably less power than men in social and economic spheres (Hossain, 2018; Morshed & Haque, 2015). The existing inequality widens and further alienates women when they are infected with HIV/AIDS, struggle with the HIV-related stigma, and attempt to cope with both the physical disease and its social consequences. Since patriarchal cultural norms dictate many social doctrines (i.e. access to health care, employment, decision making etc.) towards women, Bangladeshi women living with HIV/AIDS (BWLWHA) is hardly different in terms of stigma they encounter in accessing health and mental health care. Several studies in developing countries argued that HIV-related stigma makes women living with HIV/AIDS (WLWHA) vulnerable to severe mental health problems (UNAIDS, 2017). There is barely any study that explores how social support affects women’s ability to cope and ensure wellbeing in alleviating their HIV-related stigma in Bangladesh. This study delves into this issue.

Methods

The study sought to examine the association between social support, coping with HIV stigma and wellbeing women living with HIV and AIDS (WLWHA) in Bangladesh. A cross-sectional research design was utilized to collect data from WLWHA (N=200). A nonprofit organization that provides direct services to the people living with HIV/AIDS was selected to recruit participants. Apart from demographic information, standardized instruments including Social Support (Sherbourne & Stewart, 1991), Beck Depression Inventory (Beck et al., 1961), India HIV-related Stigma Scale (Steward et al., 2008), Rosenberg Self-Esteem (RSE) (Rosenberg, 1979), Coping Self-Efficacy (Chesney et al., 2006), Knowledge, Attitudes and Behavior toward HIV/AIDS (DiClemente, Zorn, & Temoshok, 1986) and Religiosity (Haj-Yahia, 1998) were utilized to collect the study data. All of these scales were validated within the local context.

Results

Correlation analysis revealed that social support was negatively associated with depression (r= -.33, p <.001), and positively associated with coping self efficacy (r= .34, p <.001). Low social support was a significant predictor of depression. The results of the Canonical Correlation Analysis also showed a statistically significant correlation between the demographic and other factors’ variate (knowledge and attitudes towards HIV/AIDS, coping strategies and social support) and wellbeing variate (depression and self-esteem) (Wilks’ Lambda= .68, (𝐹[𝑑𝑓=8,388], p <.001). In brief, the findings shows that WLWHA in Bangladesh may access variety of social support from their families, friends and relatives that may enhance their coping with HIV-related stigma and ensure their overall wellbeing.

Implications

The study findings add knowledge to social work education and practice on wellbeing of WLWHA. Educational interventions and mental health services (e.g. counseling) might strengthen women’s coping with HIV in Bangladesh. Human service providers including social workers, counselors and public health professionals may consider further interventions to promote wellbeing of HIV/AIDS-positive individuals.