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. Author manuscript; available in PMC: 2020 Jan 11.
Published in final edited form as: AIDS Care. 2019 Jan 11;30(SUP5):S6–S17. doi: 10.1080/09540121.2018.1515470

Table 2.

Literature review findings of multilevel resilience resources among Persons Living With HIV (PLWH) on HIV-related health behaviors and outcomes

First Author, Year How Was Resilience Defined? What was the adversity? Research Design (Longitudinal, Cross-Sectional) Location Sample Resilience is independent or other variable Resilience Measure Level of Resilience Resource HIV Health Behavior or Health Outcome Key findings between resilience & outcome measure
Solano, et al. (1993) Resilience not specifically mentioned, however, the article refers to personality features (i.e., fighting spirit or positive mood) in relation to chronic disease survival Living with HIV Longitudinal Italy 100 PLWH; 74 males and 26 females; IV Social support: Social Support Scale; Hardiness: Hardiness Scale; Psychological Attitudes - Fighting Sprit using three stories ML (I, Int) Clinical Evolution (i.e., unchanged/symptomatic): CD4 obtained from blood samples At 12 months, fighting spirit was higher in unchanged participants. There was an interaction between immunological factors and hardiness control subscale scores such that low hardiness was higher in symptomatics who had low CD4 at baseline.
Friedman, et al. (2016) Resilience mentioned but not defined Living with HIV, psychosocial syndemics (e.g., depression, condomless sex) Longitudinal USA, Illinois, Pennsylvania, California, Maryland 712 PLWH; 100% male; 14.9% Hispanic, 59.3% White, 24.7% Black IV, moderator Social support- Functional Social Support Int Viral load: Obtained from blood draws Compared to men with low levels of social support, men with medium and high levels of social support had lower viral loads and were more likely to have viral load suppression. Social support moderated the effects of syndemic indicators on higher viral load; among this subgroup, those reporting higher social support had more viral suppression over time.
Simoni MJ, et al. (2002) NR Living with HIV Cross-sectional USA,New York 50 PLWH; 31 women and 19 men; 52% African American (52%) and 30% or Puerto Rican IV and mediator Social Support: Modified UCLA Social Support Inventory; Self-efficacy: Self-efficacy to adhere to prescribed medications. ML (I, Int) ART adherence: AACTG medication adherence and a self-report measure of acknowledged nonadherence Receipt of social support was not associaed with adherence, thus examination of self-efficacy as a mediator of this relationship was not conducted. Self-efficacy was positively associated with time adherence and inversely correlated with acknowledged nonadherence. Self-efficacy mediated the relationship between need for social support and acknowledged nonadherence.
Catz, et al. (2000) NR Living with HIV Longitudinal USA, Wisconsin 72 PLWH; 87% men and 13% women; Race/ethnicity 36% African Americans, 56% Caucasians and 8% other IV Social support: Social Attachment subscale of the Social Provisions Scale; Self-efficacy: Treatment adherence self-efficacy; Uncategorized: Adherence self-promotion strategies ML (I, Int) ART adherence: self-reported ART Adherence Low social support and low treatment adherence self-efficacy were associated with increased odds of missing medication doses. There were no significant differences in adherence self-promotion strategies between adherers and non-adherers to ART.
Trevino, et al. (2007) NR Living with HIV Cross-sectional and longitudinal USA, Washington DC, Pennsylvania and Ohio 429 PLWH; 85.5% male; Race/ethnicity: 52.7% African American and 47.3% Caucasian IV HIV Mastery: HIV/AIDS-Targeted Quality of Life scale; Social Support: Brief Interpersonal Support Evaluation; Spirituality/Religion: Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale Expanded, Duke Religion Index, and Brief RCOPE; Self-esteem: Rosenberg Global Self-Esteem Scale ML (I, Int) CD4: Obtained from medical records None of the resilience resources were predictive of CD4.
Colbert, et al. (2013) NR Living with HIV, health literacy Cross-sectional USA, Pennsylvania and Ohio 302 PLWH; 70.5% male and 29.5% female; Race/ethnicity: 41.4% White and 58.6% African American IV, mediator Self-Efficacy: HIV Self-Efficacy Scale for Medication Taking, beliefs subscale I Adherence: ART medication adherence measured using electronic event monitoring and a self-report daily diary There was a signifcant positive association between medication-taking self-efficacy and medication adherence.
Ironson, et al. (2006) NR Living with HIV Longitudinal USA, NR 100 PLWH; 64% male and 36% female; Race/ethnicity: 27.3% Hispanic White, 29.3 White, non-Hispanic; 38.4% African American, 5.1% other IV Religiousness/Spirituality: Increase in religioussness/spirituality after finding out about HIV+ status measure and at various times in one’s life measure; Social Support: ENRICHD Social Support Instrument; Coping- COPE; Optimism - Life Orientation Test; Proactive behavior: E.g., fighting spirit, self-initiated action-oriented behavior ML (I, Int) Disease progression: CD4 and viral load obtained by blood draws Increase in religiousness/spirituality and church attendeance predicted greater preservation of CD4 over time. Increase in religiousness/spirituality predicted lower increase in viral load over time.
Ironson, et al. (2005) NR Living with HIV Longitudinal USA, NR 177 PLWH; 30% female and 70% male; 31% White, 36% African American, 28% Hispanic, 5% Other IV and mediator Optimism - Life Orientation Test (LOT) and the LOT-R; Coping - COPE scale; Proactive behavior: Self-reports of proactive behavior (e.g., fighting spirit, self-initiated action-oriented behavior) I Disease progression: CD4 and viral load obtained from blood draws Optimism at baseline predicted increases in CD4 over 2 years and slower viral load increase. Proactive coping, depression, and avoidant coping mediated the relationship between optimism and CD4 change. Depression and avoidant coping also mediated the relationship between optimism and viral load.
Cha E, et al., (2008) NR Living with HIV and depression Cross-sectional USA, NR 215 PLWH; 64.7% male; Race/ethnicity: 62.3% White IV, mediator, and outcome variable Social support: Interpersonal Support Evaluation List; Self-efficacy: HIV Medication-Taking Self-Efficacy Scale ML (I, Int) ART adherence: Morisky Self-Report Medication Taking Scale When each study hypothesis was examined separately: (1) low medication taking self-efficacy partially mediated the relationship between greater depressive symptoms and low medication adherence; (2) There was only an indirect effect of perceived social support on medication adherence via medication taking self-efficacy; and (3) depressive symptoms partially mediated the association between social support and medication taking self-efficacy
Harzke, et al. (2004) NR Living with HIV among drug users Cross-sectional USA, NR 137 PLWH; 100 men and 37 women; Race/ethnicity: 100% African American IV Social Support: Perceived Social Support scales; Impact of ART on feelings about HIV/AIDS: positive emotions scale; Relationship with care provider: Perceived quality of relationship with primary care provider ML (I, Int) Adherence: Self-reported adherence to ART None of the resilience measures were associated significantly with ART adherence.
Leserman, et al. (2002) NR Living with HIV Longitudinal USA, North Carolina 96 PLWH, 100 male Race/ethnicity: 78% white; 22% non-white IV Social support - Sarason Brief Social Support Questionnaire Int HIV disease progression: Blood draws to obtain lymphocyte subsets (e.g., CD4) to determine CDC defined AIDS, clinical AIDS, and mortality Lower cumulative average social support was predictie of higher risk of HIV disease progression as measured via the CDC classification and clinical condition.
Reif et al. (2013) NR HIV, substance use, and mood disorder Cross-sectional USA, North Carolina 154 PLWH; 64% Male, 36% Female, 1% Transgender; race/ethnicity: 82% African American, 13% Caucasian, 5% Multiracial, 2% Hispanic IV and moderator Self-efficacy - HIV Self-efficacy Questionnaire I Adherence: Center for Adherence Support Evaluation (CASE) Adherence Index for medication adherence Combined HIV self-efficacy was associated positively with ART adherence. Among participants with a mood disorder, higher combined HIV self-efficacy was associated with greater adherence to HIV medication. Among those without a mood disorder, there was no significant relationship between combined HIV self-efficacy and ART adherence.
McCoy, et al (2009) NR Living with HIV and alcoholism Cross-sectional USA, North Carolina 216 PLWH; 40.3% women and 59.7% male; 70.4% Black, 21.3% White, 8.3% other IV Social support: modified Medical Outcomes Study Social Support Scale Int Time from HIV diagnosis until entry into care: obtained from state and medical records The relationship between low positive social interaction and delayed time to care was moderated by history of alcoholism.
Berg, et al. (2004) NR Living with HIV among substance users Longitudinal USA, New York 113 PLWH; 43% female and 57% male; Race/ethnicity: 66% Hispanic, 22% African American and 12% White IV Social support: Social network measure adapted to include HIV-specific factors ML (Int, C) ART adherence: Medication event monitoring systems caps record Not belonging to any HIV support groups was associated with worse adherence for both men and women.
Marshall, et al. (2013) NR Living with HIV Cross-sectional USA, Maryland, Michigan, New York, and Oregon 433 PLWH;: 66% male; Race/ethnicity: 58.7% African American, 24.3% White, 14.3% Latino, 2.8% other IV Patient activation: Patient Activation Measure (e.g., self-efficacy, locus og control) I Adherence: Self-reported ART; CD4 and viral load: Obtained from medical records Higher patient activation score was associated significantly with CD4 count > 200 cells/mL and viral suppression. ART adherence partially mediated the association between patient activation and viral suppression.
Murphy, et al. (2004) NR Living with HIV Cross-sectional USA, Los Angeles County, California 115 PLWH; Men and women (breakdown NR); Race/ethnicity: 50% African American/Black; 24% White/Caucasian; 20% Latino/Hispanic; 2% Asian/Pacific Islander/ 2% Native American; Alaska Native; 2% mixed race/ethnicity IV Social support - Social Provisions Scale; Provider-patient relationship Int Adherence - modified AACTG ART adherence measure and dose and schedule adherence Associations of social provisions subscales on ART adherence were mixed. The social attachment subscale was inversely associated with three-day adherence, overall social support was inversely associated with past week adherence whereas reliable reliances with others susbscale was positively associated with past week adherence. Finally, reassurance of worth was positively related to past month adherence. Participants with better communication with providers was positively associated with three-day adherence.
Wolf, et al. (2007) NR Literacy Cross-sectional USA, Illinois and Louisiana 204 PLWH; 79.9% Male; Race/Ethnicity: 45.1% African American Mediator Self-efficacy: Patient Medication Adherence Questionnaire to properly take and manage HIV medication I Adherence: Patient Medication Adherence Questionnaire Low medication self-efficacy mediated the relationship between low literacy and medication nonadherence.
Colasanti J, et al. (2017) NR Living with HIV Retrospective case-control study USA, Georgia 59 PLWH; 32% female; Race/ethnicity: 88% African American DV Self-efficacy: General Self-Efficacy Scale; Social support: Multidimensional Scale of Perceived Social Support; Resilience: Connor-Davidson Resilience Scale ML (I, Int) Retention in HIV Care Resilience and self-efficacy scores did not sgnificantly differ between continuously retained and unretained groups. Higher social support was observed among the continuously retained group compared to the unretained group.
Weaver, et al. (2005) NR Negative Mood Longitudinal USA, Florida 322 PLWH: 188 men and 134 women; Race/ethnicity: 59.9% African American, 22.8% non-Hispanic White, and 12.5% Latino/Hispanic. Exogenous and endogenous variable Social Support: Interpersonal Support Evaluation List; Coping: COPE Inventory ML (I, Int) Adherence: ACTG measure of ART adherence and MEMS cap data; Viral load: Obtained via blood draws Social support was not directly related to adherence. The effects of social support on adherence were mediated by avoidance-oriented coping such that lower social support was associated with greater avoidance coping. In turn, avoidance-oriented coping was related to lower medication adherence, and in turn, higher viral load. Approach-oriented coping was not predictive of ART adherence.
Waldrop-Valverde, et al. (2014) NR Low health literacy and HIV-associated cognitive Impairment Longitudinal USA, Florida 210 PLWH; 52.8% female, 0.95% transgender, 46.1% male; Race/ethnicity: 82.86% Black or African American, 10.48% Hispanic, 4.29% White Non-Hispanic, 0.95% American Indian o Alaska Native, 1.43% Other IV, moderator Social Support: Social Support Questionnaire (support since becoming HIV positive); Patient-Provider Communication: Attitude Toward HIV Health Care Providers Scale and the Engagement with Health Care Providers Scale Int Adherence: Attendance at scheduled HIV care outpatient visits obtained via medical records Individuals with cognitive impairment who had greater use of social support were less likely to miss medical visits.
Attonito, et al. (2014) NR Neurocognitive impairment and substance use Cross-sectional USA, Florida 246 PLWH: 66% were male; Race/ethnicity: 77.3% Black and 14.9% White, and 13.5% reported Hispanic ethnicity IV Social support: Medical Outcomes Study tangible support subscale Int Viral load: participant provided documentation Social support was not directly related to viral load; thus, ART adherence did not mediate this relationship. However, a signficant path of marijuana use moderating the relationship between social support and viral load was evidenced.
Williams, et al. (1997) NR Living with HIV Cross-sectional USA, Connecticut 92 mothers living with HIV; 100% female; Race/ethnicity: 19% Hispanic, 56% African American, 24% White and 1% other DV Social Support: Norbeck Social Support Questionnaire Int Use of healthcare services: Self-report and medical chart review There were no significant differences in entire network social support between mothers who did not delay care and those who did delay care. There were also no significant differences in social support specific to network members aware of the mother’s HIV status.
Cook, et al. (2017) NR Living with HIV Longitudinal USA, Colorado 53 PLWH; 75.5% male; 45.3% White, 26.4% Latino/Latina, 15.1% African American, 3.8% Native American, 3.8% Multiracial, 5.7% other/unspecified; IV Control Beliefs: Diary of Ambulatory Behavioral States Control Beliefs Scale and the Adherence Attitude Inventory; Coping: Assessment of Daily Coping Scale and Brief COPE; Social Support: Diary of Ambulatory Behavioral States Scale and Multidimensional Scales of Perceived Social Support ML (I,Int) Adherence: ART Adherence using Medication Event Monitoring System Trait-level control beliefs had direct effects on daily ART adherence.
Cook, et al. (2017) NR Living with HIV Longitudinal USA, Colorado 87 PLWH: 68 men and 19 women. Race/ethnicity included White (43), Latino/a (21), African American (15), Native American (5), and Other/Unknown (3) IV Coping: Assessment of Daily Coping; Control beliefs: Diary of Ambulatory Behavioral States; Social Support: Diatry of Ambulatory Behavioral States ML (I, Int) Adherence: ART Adherence using Medication Event Monitoring System Control beliefs and social support had indirect effects on ART adherence via motivation.
Bogart, et al. (2015 NR Living with HIV and HIV enacted stigma Longitudinal USA, California 147 PLWH; 24% female and 5% transgender; Race/ethnicity 100% Black IV and moderator Social support: MOS Social Support Survey and Social Network Assessment ML (Int, C) Adherence: Medication Event Monitoring System was used to measure medication adherence. Neither measure of social support was significantly associated with ART adherence. However, the interaction of structural social support with stigma significantly related to ART aderence such that there was an inverse association between stigma and adherence for participants who decreased the frequency of their interactions with people in their social network.
Milam et al. (2004) NR Living with HIV Longitudinal USA, California 412 PLWH; 88.1% male; Race/ethnicity: 38.8% White, 40.3% Hispanic, 14.8% African American, 6.1% Other IV Optimism - Life Orientation Test Revised I Viral load and CD4 counts - medical records ART adherence - self-report There was a curvilinear relationship between optimism at baseline and CD4 counts at follow-up; those with moderate levels of optimism had the highest CD4 counts. Higher optimism was associated with greater likelihood of achieving 95% or higher ART adherence. ART adherence did not mediate the effects of optimism on CD4.
Johnson, et al. (2006) NR Living with HIV Cross-sectional USA, California 551 PLWH; 2.4% transgender, 16.5% female, 80.8% male; 32.5% Black/African American, 6.3% Hispanic/Latino, 51.6% White, 9.6% Other Exogenous and endogenous variables Social support - Social Provisions Scale; Positive affect: Positive States of Mind Scale; Social Problem-Solving: Social Problem Solving Inventory Revised ML (I, Int) Adherence: Self-reported ART Adherence ACTG measure There was an indirect effect of social problem solving on ART adherence via psychological health (e.g., social provisions scale, positive states).
Huynh, et al. (2013) NR Living with HIV Cross-sectional USA, California 202 PLWH; 49% female, 1% transgender, 50% male; Race/ethnicity: 56% African American, 28% White, 10% Latino, 6% other IV Social support - Medical Outcome Study Social Support Survey Int Adherence: Self-reported ART adherence via the HIV Cost and Services Utilization Study measure Social support was significantly positively associated with optimal ART adherence; however, this relationship was no longer significant once mental health symptoms were entered into the model.
Power, et al. (2003) NR Living with HIV Cross-sectional USA, California 73 PLWH; 53% male, 47% female; Race/ethnicity: 23% African American, 4% Asian American, 60% Caucasian, 10% Hispanic and 3% other IV Social support: UCLA Social Support Inventory; Int Adherence - ACTG Medication Adherence Only social support from one’s partner was significantly associated with lower odds of missing medication doses.
Turan, et al. (2016) NR Living with HIV; psychosocial factors (e.g., stigma, avoidance coping, attachment related anxiety) Cross-sectional USA, Alabama 109 PLWH; 100% male; Race/ethnicity: 59 Black and 50 White IV Self-efficacy: HIV Treatment Adherence Self-Efficacy Scale and experience sampling method measure of HIV treatment self-efficacy; Coping: revised Ways of Coping List; Social Support: Interpersonal Support Evaluation List-Short Form and experience sampling method measure of HIV-related social support ML (I, Int) HIV visit adherence, viral load, and CD4: Obtained from clinic records; ART Adherence: Self-reported adherence to ART Average HIV treatment self-efficacy (measured via experience sampling method), predicted greater odds of medication adherence, high CD4 count, and suppressed viral load, and predicted higher visit adherence. Among PLWH with higher avoidance coping with HIV, psychosocial stressors and recent social support predicted higher current treatment self-efficacy (as measured via experience sampling method).
Nokes, et al. (2012) NR Living with HIV Cross-sectional USA (10 states) and Puerto Rico 1414 PLWH: Gender - 71.1% male, 26.3% female and 2% transgender. Race/ethnicity - 4.3% Asian/Pacific Islander, 39.5% African American/Black, 24.3% Hispanic/Latino, 20% Native American, and 26.1% White/Anglo. IV, mediator Self-efficacy - HIV Adherence Self-Efficacy Scale (HIV-ASES); Social Capital - Social Capital Instrument (I, Int, C); Social Support - Perceived Social Support Measure ML (I, Int, C) ART Adherence: Visual Analog Scale for Medication Adherence and the 30-day Adherence Rating HIV adherence self-efficacy was associated with ART adherence. Social support and social capital were also associated with adherence. In the model with all exposure variables, only HIV adherence self-efficacy retained significance.
Chen et al., (2013) NR Living with HIV Cross-sectional USA, Canada, Puerto Rico, Namibia, China 2,182 PLWH; 28.6% female, 70.3% men, and 2.4% transgender/gender queer; Race/ethnicity: 36.8% African/African-American, 21.4% White, 20.2% Hispanic, 16.1% Asian/Pacific Islander, and 3.1% Native American IV and Outcome Variables Self-efficacy: HIV Treatment Adherence Self-Efficacy scale; Self-esteem: Rosenberg self-esteem scale; Engagement with Health Care Providers: Engagement with Health Care Providers Scale ML (I, Int) ART adherence: ACTG HIV medication adherence measure Medication adherence self-efficacy and ART adherence were positively related with higher health care provider engagement. Self-esteem was inversely associated with health care provider engagement.
Thornton, et al. (2000) NR Living with HIV Longitudinal United Kingdom, England 143 PLWH, 100% male; Race/ethnicity: 92% white IV Coping: Coping Orientations to Problems Experienced; Social Support: Interpersonal Support Evaluation List ML (I, Int) AIDS-Related Complex (ARC)/AIDS diagnosis: CD4 and Viral Load obtained from blood samples and medical records Compared to men scoring in the upper tertile of the COPE acceptance scale, the risk of ARC or AIDS was nearly 5 times higher for men scoring in the lower tertile
Södergård, et al. (2006) NR Living with HIV Cross-sectional Sweden 946 PLWH: 63.4% male; Race/ethnicity NR IV Social support: social support for medication-taking Int Adherence - Self-reported ART adherence via Morisky Medication Adherence Scale Social support for medication taking was not significantly related to medication adherence
Kekwaletswe, et al. (2017) NR Living with HIV Cross-sectional South Africa 304 PLWH; 98 males and 205 females; Race/ethnicity: NR Exogenous and endogenous variables Self-efficacy - HIV Treatment Adherence Self-Efficacy Scale; Social support - Medical Outcomes Study (MOS) Social Support Survey ML (I, Int) Adherence: Self-reported ART adherence ACTG measure, CASE Adherence Index, and 1 month adherence Social support was positively associated with ART adherence via a direct path. An indirect positive relationship between social support and ART adherence also existed by way of depression and self-efficacy beliefs. Self-efficacy beliefs fully mediated the relationship between depression and ART adherence. Adherence self-efficacy beliefs partially mediated the relationship between alcohol use and ART adherence.
Wouters, et al. (2009) NR Living with HIV Longitudinal South Africa 268 PLWH; 34.7% male IV Social support: having a treatment buddy, having a community health worker, and participation in HIV/AIDS support group ML (Int, C) CD4 and viral load: Obtained from medical records All three types of support were associated with higher CD4 cell count and viral suppression at 6, 12, and 24 months.
Tomakowsky, et al. (2001) NR Living with HIV Cross-sectional and longitudinal NR 78 PLWH; 100% male; Race/ethnicity 69.2% Caucasian and 30.6% African American IV and mediator variable Optimism: Explanatory style optimism - Expanded Attributional Style Questionnaire and Dispositional style optimism - Life Orientation Test; Coping: The COPE scale I CD4: CD4 counts obtained from blood samples and medical records In cross-sectional analyses, explanatory style optimism was inversely associated with CD4. Prospective analyses indicated that explanatory style optimism was associated with decline in CD4 counts at 2-year follow-up. Coping was not related to explanatory optimism or baseline/follow-up CD4 counts
Kremer, et al. (2013) NR Living with HIV Longitudinal NR 177 PLWH; 30% female; Race/ethnicity 36% African American, 31% White (non-Latino), 28% Latino; IV Compassionate Love (Giving, Receiving, Self): Coding of transcripts and assignment of Likert Scale ratings. ML (I,Int) Adherence: Self-reported ART Adherence ACTG measure; CD4 and Viral Load: Obtained fom blood. Compassionate love directed towards oneself was associated with undetectable VL at baseline, predicted 4-year cumulative undetectable viral load (was n.s. after controlling for compassionate love receiving), and predicted CD4 preservation after controlling for compassionate love giving.
Afolabi, et al. (2013) NR Living with HIV Cross-sectional Nigeria 379 PLWHA; 60.7% female and 39.3% male; Race/ethnicity: 86.3% Yoruba DV Social Support: Perceived Social Support-Family Scale; Family Functioning: Family Adaptability, Partnership, Growth, Affection, and Resolve (APGAR) measure Int Adherence: Self-reported adherence to HAART and pharmacy pill count Compared to PLWH who were non-adherent to ART, those who were adherent to ART had normal family functioning APGAR scores and stronger perceived social support.
Poudel, et al. (2015) NR Living with HIV Cross-sectional Nepal 233 PLWH: 52.4% male and 47.6% female. Race/ethnicity NR IV Social Support - Nepali Family Support and Difficulty Scale Int Adherence - Self-reported ART adherence Compared to those with low levels of emotional support from familyt, medium and high levels were associated with lower risk of ART nonadherence.
Sagarduy. et al. (2017) NR Living with HIV Cross-sectional Mexico 172 people living with HIV; 61.6% male and 38.4% female; Race/Ethnicity: NR Endogenous variable Social Support: Duke-UNC Functional Social Support Questionnaire adapted for Mexico Int ART adherence: Psychological Variables and Adherence Behaviors Questionnaire; CD4 and Viral Load: Obtained from medical redords Social support was not associated with the hypothesized endogenous variable, medication adherence, and was thusly excluded from analyses.
Zachariah, et al. (2007) NR Living with HIV Longitudinal Malawi 1634 PLWH; 65% female and 35% male IV Community Support - Community activities linked to HIV care (e.g., patient referrals, defaulter tracing, community centers, support to family carers) C Adherence and CD4 count: Obtained by review of patient master cards and ART patient register PLWH in areas with greater community support were more likely to be alive and on ART and had higher CD4 count.
Peltzer, et al. (2010) NR Living with HIV Cross-sectional South Africa 519 PLWH: 26.6% male and 73.4% female. Ethnicity - 98.8% Zulu and 1.2% Other IV Social Support - Social Support Questionnaire; Spirituality - the Spirituality subscale of the WHOQOLHIV BREF ML (I, Int) ART adherence - 30-day Visual Analog Scale; the AACTG adherence measure Higher social support scores was associated with higher odds of medication adherence (Visual Analog Scale). Spirituality/religion/personal beliefs were associated with lower odds of medication adherence Visual Analog Scale).
Kamau, et al. (2011) NR Living with HIV Cross-sectional Kenya 354 PLWH; 71.47 women; Race/ethnicity: NR IV Coping Self-Efficacy: Coping Self-efficacy Survey ML (I, Int) Adherence: Self-reported ART Adherence ACTG measure Coping Self-Efficacy was positively and significantly associated with ART adherence. However, only the “stop unpleasant emotions and thoughts” coping self-efficacy subscale had a statistically significant association with ART adherence.
Kioko, et al. (2017) NR Living with HIV Cross-sectional Kenya 301 PLWH; 37.2% Male, 62.7% Female; Race/Ethnicity: NR IV Social support -Perceived Social Support (measured at the interpersonal and community levels) ML (Int, C) Aherence: Self-reported ART adherence and pill count In the full model, perceived social support was not significantly associated with increased odds of adherence.
Pandey, et al. (2017) NR Living with HIV Cross-sectional India, Chhattisgarh 200 PLWH Exogenous and endgenous Hardiness - Psychological Hardiness Scale; Social suport - Social Support Scale ML (I, Int) CD4 - CD4+ T- lymphocyte count Hardiness was associated positively with CD4. Social support partially mediated the relationship between hardiness and CD4 cell count.
Luszczynska, et al. (2007) NR Living with HIV Cross-sectional India 104 PLWH; 63.5% female; Race/ethnicity: NR IV, mediator Social support- Berlin Social Support Scales; Self-efficacy - General self-efficacy scale; Finding benefit in being an HIV patient: Benefit Finding Scale ML (I, Int) Adherence: Self-reported adherence to ART Self-efficacy was directly related to adherence; benefit finding partially mediated this relationship. Self-efficacy also mediated the relationship between social suport and adherence.
Mo, et al. (2009) NR Living with HIV Longitudinal Hong Kong 102 PLWH: 87.3% male, 12.7% female. Race/ethnicity NR DV Adherence self-efficacy - Adult AIDS Clinical Trial Group (AACTG) Adherence Measure). Coping - Brief COPE; I Adherence - Self-reported ART adherence using the AACTG adherence measure Compared to participants who were classified as unintentional or intentional non-adherers all adherers to ART had high adherence self-efficacy.
Molassiotis, et al. (2002) NR Living with HIV Cross-sectional Hong Kong 136 PLWH; 92.5% male and 7.5% female Race/ethnicity: 88.3% Chinese, 9.6% Caucasian, and 2.2% Thai/Indian IV Multidimensional Health Locus of Control Scale; Mental Adjustment to HIV Scale (coping and adjustment to HIV); Adherence self-efficacy; Family/friends support for medication taking ML (I, Int) Adherence - Self-reported ART adherence using the AACTG and additional study-specific adherence questions Predictors of adherence included high self-efficacy, more internal health locus of control, denial-avoidant coping, and less family support for remembering to take medication.
Safren, et al. (2014) NR Living with HIV Longitudinal Haiti, USA, Brazil, India, Malawi, Peru, South Africa, Thailand and Zimbabwe 1568 PLWH; 52.9% male and 47.1% female; Race/ethnicity NR IV Social support: general satisfaction with social support Int Adherence: Medication adherence via ACTG QOL061 adherence questionnaire and pill counts; Viral Load (treatment failure) - HIV-1 RNA In multivariable analyses, satisfaction with social support was not predictive of medication non-adherence, pill count, or treatment failure.
Corless, et al. (2017) NR Living with HIV Cross-sectional Canada, Namibia, Thailand, USA and Puerto Rico 1811 PLWH; 71% male and 29% female; Race/ethnicity: 23.6% White IV Engagement with healthcare provider: Engagement with healthcare provider scale; Self-esteem: Rosenberg self-esteem scale; Social capital: revised Social capital scale; Sense of coherence: Sense of coherence scale; Self-efficacy: HIV adherence self-efficacy scale and Chronic disease self-efficacy scale; Self-compassion: Neff self-compassion scale ML (I, Int, C) Adherence: 30-day Visual Analog Scale for Medication Adherence Higher self-efficacy scores were associated with lower odds of being in the non adherence (0%), low adherence, and medium adherence categories.
O’Cleirigh, et al. (2007) Focus is on conscientiousness, with the hypothesis that it may be related to “slower disease progression”…”through greater resilience to distress (e.g., less catastrophic disease-related stressor appriasals and lower levels of depressive symptomatology).” Living with HIV Longitudinal USA, NR 119 PLWH: 67% male; Race/ethnicity - 26.9% non-Hispanic White; 42% African American; 28.6% Hispanic; 2.5% other IV, mediator Conscientiousness: 12-item scale of the NEO-FFI (IV); Coping - Carver, Scheier, and Weintraub’s COPE scales (Mediator) I CD4 and Viral Load: Blood draws to obtain Conscientiousness predicted significant increases in CD4 number and significant decreases in viral load at 1 year. Conscientiousness was related positively to active coping. Active coping did not mediate the relationship between conscientiousness and CD4 or viral load change
Pecoraro, et al. (2016) “Resilience, the ability to resist negative psychological responses when confronted with stress or trauma.” Living with HIV Cross-sectional Russia 240 PLWH: 58% male and 42% female. Race/ethnicity included 99% White DV Coping: Proactive Coping Inventory; Spirituality: The View of God Inventory ML (I, Int) Engaged-in-Care or Lost-to-Care. Care measures assessed by ART adherence and clinic attendance PLWH Engaged-in-care (EICs) had higher proactive coping scores, social support, less avoidance coping, described themselves as more spiritual, had stronger spirituality/religious beliefs, and positive views of God and engaged in more spiritual/religious activities.
Dale, et al. (2014) “A combination of personality characteristics and successful coping that allows an individual to function adaptively in the face of or following adversity.” ..”Process of bouncing back from an adversity, as an adaptive outcome…, and/or as a trajectory over time that consists of adaptive functioning.” Living with HIV, abuse history (e.g., sexual, physical) Cross-sectional USA, Illinois 138 PLWH; 100% female; Race/ethnicity: 4.3% White/non-Hispanic, 4.3% White/Hispanic, 87% African-American/non-Hispanic, 0.7% African-American/Hispanic, 1.4% Other/Hispanic, 0.7% Asian/Pacific Islander, 0.7% Native American/Alaskan, 0.7% Other IV Resilience: Connor-Davidson Resilience Scale I Adherence: Self-reported ART adherence; HIV disease progression: CD4 count and HIV RNA load Higher resilience scores were associated with increased odds of having ART adherence >/= 95% and having undetectable viral loads. The association between resilience and ART adherence was moderated by abuse histories. Resilience did not significantly relate to ART adherence for women without abuse histories.

NR = Not Reported; IV = Independent Variable; WHOQOLHIV BREF = World Health Organization Quality of Life HIV BREF; I = Individual Level; Int = Interpersonal Level; C = Community Level; ML = Multilevel; ART = antiretroviral