Resilience of adolescents living with HIV in the Cape Metropole of the Western Cape

ABSTRACT

Resilience shapes the experiences of adolescents living with HIV (ALWH), enabling them to come to terms with their diagnosis, have hope for the future and maintain meaningful relationships. Yet, little is known about contextual factors associated with resilience resources in South Africa. We aimed to describe individual, relational and community resilience resources, and identify contextual factors associated with resilience. We recruited 385 adolescents, aged 13–18, over a period of 5 months from 11 different public health HIV clinics. The Child and Youth Resilience Measure (CYRM-12) was used to measure resilience resources. Data on demographic variables, psychological attributes, and environmental factors such as HIV-related stigma and stressful life events were collected. ALWH lacked resilience in some aspects of the individual, relational and community domains. For every one-unit increase in the HIV-related stigma and stressful life events scores, resilience decreased by 0.29 (p = 0.01) and 0.37 (p = 0.04) units, respectively. Higher levels of resilience were associated with being virally suppressed (Mann–Whitney U, p = 0.028) although this association was no longer present in the regression model. Efforts to improve resilience amongst ALWH should be focused on fostering individual coping skills, interconnectedness, and positive relationships, to mitigate adverse environmental factors.

KEYWORDS:

• Adolescents living with HIV (ALWH)
• resilience
• HIV
• adolescents

Acknowledgements

We would like to acknowledge the following organisations that provided funding for this study: National Research Foundation (NRF) of South Africa (Grant number 97022); South-2-South through the President's Emergency Plan for AIDS Relief (PEPFAR); Harry Crossley Foundation funding through Stellenbosch University. Opinions expressed and conclusions arrived at, are those of the authors and are not attributed to the funders.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Ethical considerations/compliance with ethical standards

Stellenbosch University Health Research Ethics Committee approval (Ref: S15/03/054) and Department of Health permission (Ref:WC_2015RP53_21) were obtained to conduct the study. Informed consent was obtained for all adult participants before data collection. Adolescent assent and parental consent (either in person or telephonically) were obtained for adolescents younger than 18.

Additional information

Funding

This work was supported by National Research Foundation, South Africa: [Grant Number 97022].