The impact of life stress, psychological resources, and proactive behaviors on quality of life among people living with HIV

Abstract

Objectives

Quality of life (QoL) is an important consideration for people living with HIV (PWH). We investigated the relationship between stress, psychological resources, and proactive behaviors, on QoL (conceptualized as life satisfaction, successful aging, and depressive symptoms) by testing the hypotheses: (1) greater life stress (stress and functional impairment) is associated with poorer QoL; (2) resources (mastery, resilience, and social support) are associated with better QoL, beyond the influence of stress; and (3) proactive behaviors (medication management and leisure activities) mediate the relationship between resources and QoL.

Methods

Secondary analyses were performed (N = 128 PWH). Participants’ mean age was 52.3, 83.6% were male, and 53.9 identified as white. Multivariate regressions were performed within the context of path analyses.

Results

In series 1, greater stress was associated with poorer life satisfaction (p < 0.001), lower self-rated successful aging (p < 0.001), and greater depression (p < 0.001). Functional impairment was associated with lower successful aging (p = 0.017) and greater depression (p = 0.001). In series 2, which accounted for mastery, resilience, social support, as well as demographic covariates, mastery was associated with greater life satisfaction (p = 0.038). In series 3, stress, functional impairment, leisure activities, and ART management were added to the model and social support was associated with engagement in leisure activities (p < 0.001), which was associated with better successful aging (p = 0.006). Fit indices suggested adequate relative fit. In bootstrapped analyses of indirect effects, social support was indirectly associated with successful aging through leisure activities (p = 0.020).

Conclusions

QoL, as captured by self-rated successful aging, is threatened by stress but positively influenced by social support and engaging in leisure activities. Findings support a model of proactive successful aging for PWH.

Keywords:

• social support
• leisure activities
• Proactivity Model of Successful Aging
• well-being
• quality of life/wellbeing
• positive psychology
• psychological and social aspects

Disclosure statement

The authors have none to declare.

Additional information

Funding

This study was supported by multiple funding sources from the National Institutes of Health including the HIV Neurobehavioral Research Center (P30MH062512), Sustained Training in Aging and HIV Research program (STAHR; R25 MH108389), UCSD Multi-Dimensional Successful Aging Among HIV-Infected Adults Study (5R01MH099987 to D. V. J. and D. J. M.), K01AG064986 (to A. L. N.), and T32DA031098 (to M. A. H.).