The Influences of Stress and Social Support on Adherence to Health Promotion Strategies by People Living with HIV/AIDS in Dar es Salaam, Tanzania

Abstract

In Tanzania, about 7% of the adult population is HIV-infected. Given limited pharmaceutical options, adherence to strategies that foster health and well-being is vital to reducing both new and repeated HIV exposure. We investigated the influences of HIV/AIDS-related stress and social support on adherence to health promotion strategies by people living with HIV/AIDS in Dar es Salaam, Tanzania. In-person interviews were conducted with 212 individuals who were clients of local AIDS service organizations. Regression analyses indicated that HIV-associated stress had a direct, negative effect on adherence, decreasing the practice of health-maintaining behaviors and increasing engagement in sexual risk behaviors. Informal social support moderated the relationship between stress and sexual risk but did not buffer the impact of stress on health-enhancing behaviors. No moderation effect was found for formal social support. The implications of our findings for social work and public health practice are discussed.

KEYWORDS:

• adherence
• Africa
• HIV/AIDS health promotion
• social support
• stress
• Tanzania

The authors thank Drs. Gary Koeske and Elaine Rubinstein at the University of Pittsburgh for their helpful suggestions about the data analysis. We also acknowledge the assistance we received from Dr. Kaijage's colleagues at the Institute of Social Work and the staff of WAMATA (Walio katika Mapambano na AIDS Tanzania, meaning “people in the frontline against AIDS in Tanzania”) and SHDEPHA (Service Health and Development for People Living Positively with HIV/AIDS) as well as the enthusiasm and diligence of the interviewers. Finally, we thank the clients who were interviewed. There would not have been a study were it not for their willingness to share their thoughts and experiences.

Notes

^a Square transformation.

^b 1 = Low risk, 2 = Higher risk.

*p < .05, **p < .01.

^a 1 = Female, 2 = Male.

^b 1 = Primary or less, 2 = More than primary.

^c 0 = No, 1 = Yes.

^d Square transformation.

^e 1 = Low risk, 2 = Higher risk.

*p < .05, **p < .01, ***p < .001.