Background: Psychological resilience is a measure of the ability to properly adapt to stress and adversity, with low resilience being linked to clinical depression and anxiety. Questions from the validated Connor-Davidson Resilience Scale (CD-RISC 10) were included in the STIGMASurveyUK2015; we investigate how resilience can impact upon the level of stigma felt by people living with HIV (PLHIV).
Methods: The STIGMASurveyUK2015 was co-designed by PLHIV, clinicians and researchers. People were recruited through >120 cross-sector community organisations and 47 HIV clinics to complete an anonymous online survey about their experience of living with HIV. A resilience score was calculated for participants who had answered >7/10 questions about resilience, the mean of all completed responses was taken to impute the score for missing responses.
Results: The mean resilience score of the 1,568 participants who completed the survey was 26.5 (SD 8.2), this is comparable with similar studies among PLHIV. Through cluster analysis, 429 (27%) were classified as having low, 611 (39%) medium, and 528 (34%) high resilience. Resilience scores were correlated with time since HIV diagnosis, with those diagnosed prior to 2005 likely to have lower resilience than those diagnosed in more recent years (53% vs 39%, p< 0.001). Those with low resilience were more likely than those with high to have been diagnosed with depression (71% vs 22%) and to have experienced stigma through discrimination (verbal/physical abuse and exclusion) (46% vs 23%), anxiety (53% vs 24%) and/or avoiding social/sexual experiences (54% vs 32%)
(all p< 0.001), furthermore, avoidance was more likely to be attributed to their HIV (34% vs 19%, p=0.001). No significant link was observed between resilience score and age, gender, sexuality or ethnicity. Thematic analysis of participants'' experiences of living with HIV identified that those with low resilience most commonly reported “social isolation” and “negative experiences”, whereas those with high resilience focussed on “adopting healthier behaviour” and “empowering experiences”.
Conclusions: The majority of PLHIV in the UK scored highly on resilient measures. Participants with low resilience were more likely to experience stigma and to report negative experiences of living with HIV. This tool could be useful as a screening tool in clinical settings.