Stigma Consciousness, Coping Strategies And Cd4 Counts Of Persons With Hiv/aids

Furthermore, this study found that there was strong evidence to support that problem coping exerts influence on immunity of people living with HIV/AIDS. Those people living with HIV/AIDS that focus on problem tended towards having more immunity when their CD4 counts were compared with those who avoid problem. The implication is that focusing on problem is beneficial to people living with HIV/AIDS. People living with HIV/AIDS should focus on problem by following plans of actions as provided by healthcare workers and work hard at them in order to have control over psychological devastation caused by experience of living with HIV/AIDS.

Those who avoid problem by just hoping that the situation would one day go away are at risk of rendering their immune systems inactive since their thoughts of living with HIV/AIDS are not anchored on realistic coping. Also, people living with HIV/AIDS should not go on as if nothing happened without actually focusing on the problem by seeking social support and information on medication.

Recently, O’Cleirigh and his colleagues (2007) demonstrated that slower disease progression could be realistic through favourable coping profiles such as more active and less avoidant coping. The findings of this study are in agreement with O’Cleirigh et al but makes difference by rather a comparison between PLWHA who focus on problem and those who avoid problem.

Another important finding of this study was that cognitive therapy Gluhoski (1996) proved effective as intervention measure in dealing with the problem of stigma consciousness, social support, information, and problem copings among PLWHA. In a follow up study those who experienced Gluhoski (1996) cognitive therapy tended toward low stigma consciousness, high social support, information seeking and problem focus when compared with their counterparts who did not experience cognitive therapy. One can safely attribute the reasonable outcome to positive response of PLWHA to cognitive therapy.

Generally, the findings of this study are in agreement with immunocompetence model (Jemmott, 1985; Jemmott & Lock, 1984), the ability of immune system to protect the body at any given time and the principle that negative psychosocial variables lower immune system functioning. This suggests that the outcome of this study supported immunocompetence model and works on the principles that biological responses of CD4 counts are actually connected with psychosocial conditions of stigma consciousness, social support, information, and problem copings, and so, if changed negatively can lower immune system responses of PLWHA. Thus, high stigma consciousness, low social support, information avoidance, and problem avoidance copings are implicated in lowering immune system function as measured in CD4 counts among the people living with HIV/AIDS used in this study, and can be improved by using cognitive therapy as intervention measure.

Contrary to prediction, there were no interaction effects of stigma consciousness, social support, and information coping or problem coping in their influence on CD4 counts of people living with HIV/AIDS (PLWHA) used in this study. The plausible outcome implies that the variables are independent of one another in affecting CD4 counts among the population of PLWHA used in this study. Thus, the variables can be studied independent of one another with regards to immune system changes among PLWHA.

Even after entering for statistical control using treatment as fifth independent variables, stigma consciousness, social support and information coping were still significant but not problem coping. However, there were no interaction effects after all. This outcome can be explained on the ground that focusing on problem or seeking information could lead to discovering possible treatment to apply in managing HIV/AIDS. And once this is achieved more attention is paid to treatment than problem coping. Therefore, treatment can be interchanged with problem coping in a study of this nature.

Stigma consciousness, social support, information and problem copings are implicated in immune system as indicated in CD4 counts. Therefore, cognitive therapy that reduced stigma consciousness and increased social support of PLWHA will be effective in improving their immune system function. Further, using cognitive therapy to instill information coping and problem focus on HIV/AIDS seropositive individuals will improve immune system function among PLWHA. The implication is that Gluhoski (1996) is effective in helping HIV/AIDS seropositive individuals in managing their lives.

With the findings of this study discussed thus, there are enough evidences to support immunocompetence model (Jemmott, 1985; Jemmott & lock, 1984). This model argued that psychosocial variables affect immune system efficiency. Although, immunocompetence model was demonstrated using psychosocial variables example, stress caused by death of loved one, this study made difference by demonstrating other psychosocial variables such as stigma consciousness, social support, information coping, and problem coping which could produce the same effect on psychological condition as stress among people living with HIV/AIDS.

With the implication of psychosocial variables such as stigma consciousness and application of coping strategies in immune system functioning among PLWHA, this study considered the use of cognitive therapy (Gluhoski, 1996) as intervention measure to improve their immunocompetence levels. Thus, the implications and recommendations of this study were presented in the sections that follow.

Implications of the Study This study has far-reaching implications for the population of people living with HIV/AIDS, healthcare workers, psychologists/counsellors, scholars in general and policy makers in healthcare programme. The findings of this study inform those HIV/AIDS seropositive individuals the need to adopt measures that will lower their stigma consciousness as to help them overcome the influence of stigma consciousness in their lives and have positive view of themselves, seek health concerns, and develop healthy relationships with their relatives and friends. This can be achieved by PLWHA changing their cognitions of living with HIV/AIDS by believing that HIV/AIDS is not the end of life and hopeful that cure will come one day. And that, since they can still carry on with life activities, much has not eluded them.

Also, the findings of this study inform the healthcare workers the idea of helping PLWHA to reduce stigma consciousness and building in appropriate coping strategies, such as information and problem copings, that will be beneficial in improving their immunity. This can be achieved by incorporating the findings of this study in healthcare programme.

To psychologists/counselors, there will be the awareness that the problem of living with HIV/AIDS is not just stigma (undesirable characteristics possessed by individuals or group) but stigma consciousness (a psychological internal state that disposes PLWHA to believe that he/she will be stereotyped by others because of HIV/AIDS seropositive status). With this, attention of psychologists/counselors interested in rehabilitating PLWHA will be drawn to achieving decrease in stigma consciousness by using cognitive therapy.

Scholars are informed of the need to open up more researches with regards to influence of stigma consciousness and coping strategies on CD4 counts among PLWHA. This is necessary since stigma consciousness and coping strategies were implicated in immune system function among the population used in this study. And finally, policy makers in HIV/AIDS control will see the need to consider inclusion of measures to reduce stigma consciousness and not just stigma among PLWHA in healthcare policy.

Recommendations and Conclusion There are increasing needs to improve the psychological conditions of individuals living with HIV/AIDS by psychologists/counselors. This can be realized by psychologists if people living with HIV/AIDS are helped to modify their self views, easing health concerns, improving relationship issues, develop better views of the future, and finding positive meanings into present situations through cognitive processes. The appropriate cognitive therapy to achieve this objective is the Gluhoski (1996) cognitive therapy for HIV/AIDS positive individuals. This cognitive therapy was actually proposed to help people living with HIV/AIDS modify self view, easing health concerns, improve relationship issues, develop better view of the future , and finding meanings into future life. Although, the full processes of Gluhoski cognitive therapy is not the concern of this study, the researcher strongly recommends applications of cognitive therapy for rehabilitating PLWHA. The outcome of this study could be considered, to be incorporated in primary medical healthcare for PLWHA.

Finally, it can safely be concluded that lowering stigma consciousness and increasing high social support improve CD4 counts, a measure of immune system functioning. Also, seeking information and focusing on problems are necessary in improving immune system functioning among people living with HIV/AIDS in Anambra state. To this effect, psychologists should concentrate on application of cognitive therapies, to reduce stigma consciousness, increase provision of social support, and step up information seeking and problem focus behaviour on people living with HIV/AIDS.

Limitations of the study No study could claim to be free of limitations. Therefore, this study has some limitations. As a result of that, the main limitation of this study was that the study focused on the 10-item stigma consciousness, 15-item social support, 5-item information coping, and 8-item problem coping domains.

Second, the study was delimited to Anambra state due to financial cost of covering the whole Nigeria, and so had problem of external generalization. Third, although few residents of rural communities in Anambra state visit urban communities for anti retroviral therapy, this study could not include enough of the population of people living with HIV/AIDS that reside in rural areas.

Suggestions for further studies. It is suggested that further studies in this direction should consider developing a wider scale primarily for use in studying stigma consciousness among people living with HIV/AIDS. Such scale would encompass more domains of stigma consciousness. This idea also, applies to social support, information and problem copings.

Also, future studies can be designed to cover more areas or parts of Nigeria. This will improve external generalization. Other researchers may design studies to explore the lots of problems of people living with HIV/AIDS in the rural areas, more of whom this study did not capture. Finally, scientists may investigate the relationship between stigma consciousness and hormonal changes that may have contributed to differences in immune systems of people living with HIV/AIDS.