Stigma Consciousness, Coping Strategies And Cd4 Counts Of Persons With Hiv/aids

that can infest anybody and decide to seek information on treatment, intervention, and supports whereas others may perceive it as an end to life and become hopeless. According to Carver (1998, as cited in Chukwudozie, 2008) such differences in perception could be among the strongest determinants of how individuals fare in situations of stressful or life-threatening experience, for example living with HIV/AIDS. These may determine how PLWHA fare with regards to their health as measured by CD4 count, which is the indicator of immune system.

There are many dimensions of coping, which people can adopt while in different experiences of life. To Lazarus and Folkman (1984, 1980) and Kalichman et al (2006) there are two broad dimensions of coping which include problem-focused and avoidant coping. This involves taking direct action to solve the problem or making efforts to reduce the negative emotional reactions to stress, for example, by distracting oneself from the problem, or relaxing and information seeking and avoidant coping which refers to seeking information that will be relevant for the solution of the problem or avoid information that will cause harm or emotional problem or distress. Such coping measures have psychological implications on immune system functioning. Scholars have argued that coping is not a generalised disposition that is aroused by situations that threaten people, but a specific behaviour that varies in the substance of people’s problems and social roles that they dispense.

Thus, the effectiveness of coping choice is not only determined by how well they solve our problems and hardships, but also how well they prevent the hardships from resulting in damaging emotions (Scheck & Kinicki, 2000). Damaging emotion can affect health condition of PLWHA by reducing their immune systems as indicated in CD4 counts. Stigma consciousness and inappropriate application of coping strategies can cause damaging emotions among PLWHA, hence affecting their health by making immune system inactive.

It is possible that stigma consciousness could interact with coping strategies, for instance, social supports available to the individuals living with HIV/AIDS to influence their immune systems. Social support is the physical and emotional comfort given to people by their family, friends, co-workers and others. It is knowing that one is part of a community of people who love and care for one, and value and think well of one (Wikipedia, 2008). Social support can act as a moderating factor in the development of psychological and/or physical disease, for example, clinical depression, hypertension, and HIV/AIDS’ stigma consciousness as a result of stressful situations they produce. Two types of social support have been identified (Davison & Neal, 2001). These include structural social support which refers to a person’s basic network of social relationships, for example marital status and a number of friends; and functional social support which has to do with the quality of a person’s relationships, for example, whether the person believes he/she has friends to call on in time of need (Cohen & Wills, 1985). In a study, Pryor and his colleagues (2004) found high proportion of family and friends being aware of serostatus of a person living with HIV/AIDS not to be associated with enacted stigma, that is actual experience and with lower perceived stigma, that is the feeling of anticipated stigma (stigma consciousness). Also, in the same study, men were found to report less perceived stigma than women. The authors noted that women tend to have higher levels of depression and anxiety than men regarding their HIV/AIDS status. And young women living with HIV/AIDS would appear to benefit from targeted interventions that help them cope with feelings and fears about HIV/AIDS infections. But, whether stigma consciousness will be implicated in influencing immune system among PLWHA remains unexplored in literature. Also, few studies have examined application of coping strategies such as social support, information coping, and problem coping as influencing the health condition of PLWHA by affecting their immune systems.

Statement of the Problem

Current statistics showed that reasonable population of Nigerians is living with HIV/AIDS. For instance, Society for Family Health (2009) reported that the population of 39.9 million Nigerians was living with HIV/AIDS. These people living with HIV/AIDS need to be rehabilitated psychologically. No doubt, Anambra State has some proportions of that figure, hence its choice as area of study. As we know, stigma is attached to HIV/AIDS. People living with HIV/AIDS who internalize stigma will be vulnerable to stigma consciousness. Stigma consciousness is likely to exacerbate the CD4 counts of those living with HIV/AIDS thereby reducing their immune systems. Therefore, management of HIV/AIDS will continue to pose problems unless psychosocial variables such as stigma consciousness, social support, information and problem copings are x-rayed and matched with appropriate intervention measures, for example Gluhoski (1996) cognitive therapy. Of course, investigations of psychosocial variables affecting immune system as measured in CD4 counts and matching them with appropriate intervention measures are the concern of this study.

Psychologists have noted that individuals are unique. And as such, no two persons are exactly alike with respect to experiences relating to stigma consciousness. This implies that even PLWHA can differ in their level of stigma consciousness. Nevertheless, it is unclear whether stigma consciousness will influence immune system among PLWHA. To the best knowledge of the researcher, this problem has remained unstudied with respect to health implication among PLWHA with regards to their immune system, using CD4 count as measure. It is clear that when an individual is infected with life-threatening illness, he/she will experience negative emotion or mood that will affect his or her immune system. Thus, the individual is bound to apply one or more coping strategies to shockabsorb psychological and physical devastation associated with such illness.