Trends and predictors of HIV-positive community attachment among PLWHA

Abstract

Communities most affected by HIV/AIDS have been instrumental in shaping Australia's responses to the threat of the epidemic. There are recent signs that levels of engagement in communities based around HIV-positivity have changed: a diminished sense of an AIDS crisis, the relative success of highly active antiretroviral therapy (HAART), and an increasing individualization of the HIV experience may be contributing to changes in the way HIV-community is experienced. In this paper, we explore levels of engagement in HIV-positive community among a cohort of people living with HIV/AIDS (PLWHA) and seek to explain why some PLWHA engage in an HIV-positive community while others do not. Using multivariate logistic regression, we found that three factors were independently related to feeling part of an HIV-positive community: having been diagnosed with HIV prior to the advent of HAART; having more recently taken Bactrim or Septrin for PCP; and finding it easier to take ‘pills’ on time. Taken together, these results suggest that both historical effects, such as the introduction of HAART, and effects related to living with HIV, such as the experience of an AIDS-related illness, help explain HIV-positive community engagement among PLWHA.

Acknowledgments

We would like to thank the following individuals and organizations for their dedication, time and expertise: all PLWHA participants and interviewers, PLWHA (NSW), PLWHA (VIC), AIDS Council of NSW, Victorian AIDS Council, Australian Federation of AIDS Organisations, National Association of People Living with HIV/AIDS. We thank the Commonwealth Department of Health and Ageing, and the NSW Department of Health for funding the project.

We also thank two anonymous reviewers for their input in improving the paper.

Notes

1. It should be noted, however, that in Australia HIV-positive men are more likely than both HIV-negative and HIV-serostatus unknown men to disclose their status to sexual partners (Van de Ven et al., 2003).

2. All of the analyses involving a chi-square test of independence had no more than 25% of cells with a frequency of five or fewer.