Conference Presentation

1. Social Support Among Women in
Trinidad and Tobago who are
HIV Positive
By
Debra Joseph MSW
8th Biennial Conference of Caribbean & International Social
Work Educators
Debra Joseph 2007 1

2. Introduction
• The Caribbean region is the second most affected region in the world after
Africa, with an HIV prevalence of 1.6% . (UNAIDS 2006).
• There were 330,000 persons living with HIV in the Caribbean at the end of
2005. Around 22,000 were children under the age of 15. (UNAIDS 2006). (This
emphasises the fact that mainly adults are infected with the virus).
• Adult women make up 51% of the total number of people living with HIV in
the region. (UNAIDS 2006). Women are more vulnerable to HIV,
physiologically, economically, socially and by gender-based violence
(Negroni 2001).
• AIDS related illnesses is the leading cause of death among adults aged
15-44 and claimed an estimated 27,000 lives in 2005.
• In Trinidad & Tobago national HIV prevalence is estimated at 2.6% with
young women particularly affected. Girls in their late teens (15-19) are 6 times
are likely to be infected with HIV as their male counterparts.
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3. Women as Share of Adults Living
with HIV/AIDS by Region, 2006
Global 48%
Sub-Saharan Africa 59%
Caribbean 50%
Middle East/North Africa 48%
Oceania 47%
Latin America 31%
Eastern Europe/Central Asia 30%
East Asia 29%
South/South-East Asia 29%
Western/Central Europe 28%
North America 26%
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Source: UNAIDS, 2006 AIDS Epidemic Update, December 2006.

4. Social Support Definition & Theory
• I
Definition: nformation that prompts the individual to believe that
he or she is cared for, loved, esteemed and valued and is a member of
a network of common and mutual obligation (Cobb 1976).
• Considerable evidence suggests that positive social support helps
people maintain their health and welfare under difficult
circumstances (Hudson, Lee, Miramontes & Portillo 2001).
• It has been suggested that absence of social support makes a
person more vulnerable to the effects of adverse life events and
thus indirectly to the reduction in immune function (Kaplan
1991).
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5. Social Support Definition & Theory
• The social services literature supports the view that social
support increases the physical and mental health and stress
coping abilities of HIV+ individuals (Vaux 1988).
• Another researcher (Gielen et al. 2001) describes the
relationship between psychosocial factors and health related
quality of life among HIV-positive women. They found that
women with larger social support networks reported better
mental health and overall quality of life.
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6. Study Aims
To examine:
• The types of informal support (parents, siblings, and extended
family, regular sexual partners, religious or spiritual leaders or
advisers and friends).
-Emotional- Affective support, family commitment and family
acceptance (intangible support).
• Formal social support (medical professionals, mental health
professionals, social service professionals, and community
organisations).
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7. Methodology
• Recruitment of these women (N=16) was from two Non-
Governmental Organisations in Trinidad, namely Community Action
Resource (CARe) and South AIDS Support in San Fernando. Women
were also recruited from the Medical Research Foundation of the
Government of Trinidad and Tobago.
• Study Participants criteria:
- HIV Positive
- 18-55 years
- Citizen of Trinidad & Tobago
• Semi-Structured Questionnaire was administered.
• Data Analysed using EZTEXT Qualitative Software.
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8. Findings- Informal Support
Voices of the Women
• Mothers & Fathers- Nine (9) out of 16 women disclosed to their
mothers, however only 7 received positive emotional support.
- Positive emotional Support helped to:
- reduce fear and stress about HIV health issues
- assisted in having a positive outlook on life.
- Feelings of acceptance and belonging in the family even
though HIV+
- eased the fear of being hospitalised.
- Negative Social Support helped to:
- Increase the fear of facing their own diagnosis.
- increase sadness, rejection
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9. Findings- Informal Support
Voices of the Women
• Fathers- Two women disclosed to their fathers 2-3 years later after
disclosing to others as they did not have a close relationship with
them.
• In this study, very few of the women mentioned fathers, as the
fathers were not part of the households that consisted of mothers,
sisters, grandmothers and brothers.
• The main support for these women came from the females in the
family.
• Spouses & Partners- Five women had spouses or partners and
disclosed to them before their mothers. They received:
- Care and concern
- Safe loving environment
- Care giver when ill
- Parenting support
- Sharing of household tasks
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10. Findings- Informal Support
Voices of the Women
• No Family Support- Three women chose not to disclose to any
family member.
• Reasons:
- Non confidentiality- Family will tell neighbours.
- Stigma and Discrimination.
- Fear of rejection.
• Friends- Seven women told their friends. They received emotional
support & encouragement.
- Eight women did not tell their friends as they feared
rejection, stigma and discrimination & breaches of
confidentiality.
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11. Findings- Informal Support
Voices of the Women
• Religious Leaders- Four (4) women disclosed, others did not for fear
of being ridiculed and the onset of discrimination. However most of
the women believed that God will help them cope with their status.
• Jenkins (1995) reported that religious and spiritual coping
have more effect than other methods, for example, problem
solving and interpersonal support in reducing illness-related
diseases by assisting participants to reframe their situations
and focus on the positive aspects of what may be fatal.
• On the Job- 5 out of 7 women that worked did not disclose.
– Reasons: fear of discrimination and losing their jobs.
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12. Findings- Formal Support
Voices of the Women
• :
Gov’t Agencies 11 women received free medication while 14
attended the clinic.
– Women were satisfied with the service they received as the
personnel understood the disease and accepted them despite
their status.
– Women were also satisfied with the care they received from the
NGOs
Welfare- 10 women were on welfare and were grateful for the intervention
despite the limited amount.
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13. Gaps in Informal Support
• Fear of Stigma and Discrimination from friends, family members
religious leaders and employers.
• The women felt the need for a more caring environment from the
above, open lines of communication re: HIV/AIDS and
unconditional love.
• As Smith et al. (1985:65) noted “Social support makes patients
feel accepted regardless of their condition, acts as a buffer
against the intense, negative emotional effects of the disease;
and provides enduring interpersonal relations that can be
relied on to provide emotional assistance and feedback.”
Walk in these women’s shoes for a moment and feel their
experiences. How will you react if one was a member of your
family, a friend, a co-worker, or a sister in the Church?
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