Social support status and associated factors among people living with HIV/AIDS in Kunming city, China

Human immunodeficiency virus (HIV) damages patients’ normal physiological functioning, thus putting them in a difficult life and economic situation. Social discrimination causes people living with HIV/AIDS to suffer from difficulties in interpersonal relationships and social environments. For patients whose early symptoms were not obvious, their psychological impact was far greater than their physical pain [1]. Therefore, people living with HIV/AIDS not only require effective treatment to alleviate their physical discomfort but also require social support to help them solve their life difficulties and relieve their psychological anxiety and uneasiness.

Social support refers to the system of spiritual or material support from all aspects of society, including parents, relatives and friends [2]. As a multifunctional social system, social support improves an individual’s physical and mental health. It plays an important role in coping with and recovering from diseases [3]. Social support could moderate the negative effects of stressful events [4], and it is one of the most effective ways to cope with stress [5]. Research indicates that the social support network is of great significance to help people living with HIV/AIDS maintain good physical and mental health [6]. Therefore, it is important to research the current social support system among people living with HIV/AIDS and improve their social support status. Our study aims to determine the factors influencing social support for people living with HIV/AIDS in Kunming and provide a basis for developing targeted interventions in the future.

Our study found that the total score for social support for people living with HIV/AIDS was 12–57 (26.45 ± 8.70), which was lower than the domestic norm (34.56 ± 3.73). The difference was statistically significant as well (t = 29.308, P = 0.000), which was consistent with the results of Guo Zihan in Guangzhou [11]. The social support level among people living with HIV/AIDS was relatively low.

In this study, subjective support scores among females were higher than those among males. This may be because females are more inclined to share their unpleasant experiences with their relatives, friends or colleagues to reduce psychological pressure. Men are more likely to choose to endure setbacks or face difficulties, hoping to overcome and reduce their psychological burden through their own efforts. This reflects that we should pay more attention to males living with HIV/AIDS and encourage them to participate in various forms of activities and share their inner thoughts and feelings with others.

The lowest utilization of social support was among HIV/AIDS patients aged 50–59 years. Social support among older adults with HIV/AIDS mainly comes from their families. They may not have children around them, and their use of social support is relatively lower. The results of this study are consistent with those of Ma Li et al. [12]. We should encourage middle-aged and older HIV/AIDS patients to participate in healthy cultural activities and create a supportive social environment. To promote the physical and mental health of the middle-aged and older HIV/AIDS, full consideration should be given to the importance of social support, family support and psychological support for the elderly should be enhanced, their enthusiasm should be fully mobilized, they should participate in more social activities and their attitude towards life should be improved. Encourage them to seek help and support from their families and communities. In this way, infected people may be optimistic in facing HIV, actively cooperate with treatment, improve their quality of life, and prolong their life span.

The objective support score for married or cohabitant individuals was higher than that for unmarried, divorced or widowed HIV/AIDS patients, which was consistent with previous studies [13]. Spouses and family members are the main sources of social support for people living with HIV/AIDS. The help of spouses or family members of those with HIV/AIDS will help them develop more confidence in life. Social support from spouses and families of those with HIV/AIDS should be strengthened. For unmarried people, support mainly from family members, such as parents, brothers and sisters, should be an area of greater focus.

In this study, monthly income affected the scores on objective support and the total scores for social support. After patients develop AIDS, they may experience a decline in physical functioning, which is more likely to result in opportunistic infections and other AIDS-related infections. Then, they may experience increased medical costs. Due to the decline in the HIV/AIDS labour force and the lack of employment opportunities, all these situations affect their psychological status. Those with a higher income can shoulder the cost of therapy and have better physiological and psychological status. On the other hand, people with higher income tend to receive more support and help from their families.

Compared with injection drug abuse and heterosexual transmission, people who become infected with HIV/AIDS by male-to-male transmission have more objective support and utilization of support. There are few related reports in China. This may be attributed to the fact that they can supported by their homosexual partners. Because of the particular HIV infection route, drug addicts and sexually infected people seldom receive social support from family and friends. Social discrimination contributes to their isolation from society, which leads to decreased social support scores. We should establish a comprehensive care system and pay attention to the special groups of individuals with HIV/AIDS.

With comprehensive measures for AIDS prevention and control, people’s awareness of AIDS has constantly improved, and various anti-discrimination actions have been advocated to reduce the degree of social discrimination [14]. In addition, with the implementation of the “Four Frees and One Care” policy, the proportion of AIDS patients receiving free univariate therapy in China is relatively high, resulting in relatively high social support [15]. In this study, the HIV/AIDS patients who received univariate therapy received higher scores on objective support, the utilization of support and total social support than did those who did not receive univariate therapy or who dropped out of treatment, which reflected that national care and assistance policies such as univariate therapy played an important role in improving social support for HIV/AIDS. The research shows that nurses serve as an important social support system for individuals with HIV/AIDS and can provide the most direct and effective emotional and informational support [16]. Emotional support refers to an individual being respected and accepted by others. Informational support refers to helping people explain, understand and respond to problematic events [17]. Therefore, we should fully distribute the social support from medical and nursing staff to individuals with HIV/AIDS and create a positive social environment for AIDS prevention and control.

This study identified that the social support level among people living with HIV/AIDS in Kunming was relatively lower than the domestic norm and that some factors affect social support among those living with HIV/AIDS. Based on our findings, appropriate measures should be introduced to increase social support. We should pay attention to those living with HIV/AIDS who are elderly, are injection drug users, are divorced and have a low economic level. The government should provide more financial support and strengthens AIDS-related medical services to improve social support for those living with HIV/AIDS.