Types of social support strategies influence depression rates in PLHIV
Social support in the form of financial assistance and the provision of material goods and services has been associated with reduced rates of depression among people living with HIV (PLHIV) and on antiretroviral treatment (ART). A recent study in rural South Africa, found that this type of ‘instrumental’ social support is more effective than ‘emotional’ social support at reducing rates of depression. Whilst it is well documented the positive affect social support has on PLHIV and on ART, identifying what aspects influence depression will help implementers allocate resources and identify effective health strategies.
The study was carried out in KwaZulu Natal province, where over 20 percent of the adult population is infected with HIV. Depression was found to affect between 33-38 percent of PLHIV. It was known that social support was important for people with depression, however it was only after analysing the different dimensions of social support, did it become clear that some methods were more effective than others. Despite the importance of supporting a patient with empathy and assurance – the study found that providing emotional support alone was insufficient. A lack of instrumental support, in the form of concrete resources to mitigate many of the causes of depression, was associated with higher levels of depression The study also found that individual HIV coping strategies, such as ‘avoidance of being with other people’, was found to increase the chance of depression. Understanding the importance of specific social support strategies can help to alleviate many of the damaging HIV coping strategies that perpetuate depression.
Despite social support being promoted as a strategy for reducing depression among people on ARVs, the type of social support offered influences the likelihood of depression. This study however highlights the importance of treating and supporting PLHIV not only by providing ARVs but also by providing support that aims to improve their mental health.