Social Environment As A Determinant Of Coping Self-Efficacy In Men And Women Living With HIV Under The Auspice Of A Large Healthcare Provider In Kenya

Abstract

Kenya faces a severe, generalized HIV epidemic that continues to have a devastating impact on men and women living with HIV and, generally, all sectors of the population. HIV-related stress based on living with HIV, fear of progression of HIV to AIDS or to death, stigma, and discrimination among others are constant stressors afflicting people living with HIV. There are two ways to help people face these stressors - changing the internal characteristics of a person or changing the social environment.

A major healthcare provider engages a therapeutic coping model based on stress, appraisal, and coping theory that aims not only directly at changing internal dynamics of the person, but also changing these dynamics by altering the environment of men and women living with HIV. The interplay of a person’s effort with a socially supportive environment is believed to foster coping self-efficacy (CSE). However, the efficacy of this therapeutic model has not been assessed and documented.

The purpose of this study was to determine the role of the social environment in shaping CSE among men and women living with HIV enrolled in the treatment and care program under the auspices of a large healthcare provider in Kenya. Three types of social support are: 1) emotional, which reduces anxiety and promotes self-esteem; 2) informational, which provides needed knowledge and skills useful in solving problems; and 3) belonging, which helps to distract a distressed person from disturbing thoughts significantly predicted CSE. The results support interventions that strengthen a person’s character while encouraging family members, friends, and other social ties to act and react favorably, thereby creating a supportive environment. Implications, limitations, and future directions are discussed.