Examining Provider Perception of Loneliness in People Living with HIV (PLWH): An Emphasis on Social Environments Affecting Lived Experiences
Open Access
- Author:
- Guay, Laura Michelle
- Area of Honors:
- Biobehavioral Health
- Degree:
- Bachelor of Science
- Document Type:
- Thesis
- Thesis Supervisors:
- Joshua Morrison Smyth, Thesis Supervisor
Helen Marie Kamens, Thesis Honors Advisor - Keywords:
- Loneliness
HIV
Provider Perception
Social Environments
Dakar Senegal
Central Pennsylvania United States - Abstract:
- Loneliness is a universal phenomenon; however, it is experienced differently based on one’s identities and specific country context (Bekhet et al., 2008; Masi et al., 2011). Loneliness is relevant to the study of human immunodeficiency virus (HIV) because people living with HIV (PLWH) experience stigma-related social rejection, oftentimes associated with negative effects, including lowering adherence to treatment to control their infection (Ratanashevorn & Brown, 2021; Rokach, 2014). The purpose of this study is to present primary data collected through interviewing health professionals, accompanied by an in-depth literature review, to learn about provider perception of loneliness in PLWH in two different areas of the world: Dakar, Senegal and Central Pennsylvania (PA), United States. This insight will allow a greater understanding of reported and observed loneliness in PLWH by providers, specifically focusing on the subset of the population engaged in care. It will show how feelings of loneliness are perceived to still exist despite contact with the medical community, how stigma and different social environments are perceived to impact this experience, and what interventions exist. Through performing interviews in two different areas of the world, the differences in providers’ perspectives on the lived experience of loneliness in this minoritized group will shine through. Examining this topic through a health professional’s perspective, in a qualitative manner, allows a variety of lived experiences as explained by health professionals to be shared and provide greater depth than a survey. The primary data collection involved conducting 11 semi-structured interviews with health professionals working with PLWH in Dakar and 12 throughout Central PA. After findings in Senegal indicated the importance of viewing these results through an intersectional lens, the Central PA interviews dissected the lived experiences of two intersecting identities with HIV status: LGBTQ and people who inject drugs (PWID). Three major themes emerged from this data in Dakar: 1.) non-acceptance; 2.) cascade of care; 3.) fear of disclosing status. These findings both reflect the multidimensionality of loneliness, highlight its impact at the personal level, and show the influence of social and political factors. Four major themes emerged from this data in Central PA: 1.) internal processing; 2.) trauma; 3.) healthcare system; 4.) relationships. Here, the impact on the individual, as well as how health professionals respond, is emphasized, as well as how key population differences between LGBTQ and PWID affect this experience. Overall, the findings from this international comparative study show that social interaction, emotional support, societal stigma, and acceptance were commonly identified perceived factors by providers that impacted the lived experiences of their clients living with HIV. These findings ultimately show how policies exacerbate feelings of loneliness, but these interviews with providers point to how they are perceived to work in conjunction with the social environment.