African Journal of AIDS Research is co-published by NISC (Pty) Ltd and Routledge, Taylor & Francis Group
African Journal of AIDS Research 2015, 14(1): 1–12
Printed in South Africa — All rights reserved
Copyright © NISC (Pty) Ltd
AJAR
ISSN 1608-5906 EISSN 1727-9445
http://dx.doi.org/10.2989/16085906.2014.961940
Introduction
Psychosocial wellbeing, in the context of this study, deals
with the combined occurrence of intrapersonal, interper-
sonal and social criteria of daily functioning. This concept
originates from the ‘Complete State’ of wellbeing model
(Keyes 2002, 2005) and refers to emotional wellbeing
(intrapersonal feelings), psychological wellbeing (private
and personal criteria of everyday functioning) and social
wellbeing (social coherence, social actualisation, social
integration, social acceptance and social contribution)
and the interaction of these aspects in the behaviour
that operationalises psychosocial wellbeing. Keyes et
al. (2008) later introduced it as two compatible traditions
that reflect subjective wellbeing. One focuses on feelings
towards life (hedonic, emotional wellbeing) and another
focuses on functioning in life (eudemonic wellbeing). The
hedonic tradition describes emotional wellbeing (EWB)
with maximised short-term positive feelings and overall
long-term life satisfaction. The eudemonia tradition results
in positive functioning in life and is measured in terms of
psychological and social wellbeing. This approach suggests
continuous assessment of the presence of mental health,
described as flourishing; and the absence of mental
health, described as languishing. Moderate mental health
describes a condition where people are neither flourishing
nor languishing (Keyes et al. 2008). The work of Keyes
(2002, 2005) offers theoretical grounding for the psychoso-
cial wellbeing aspects of this study.
Other authors in this field, like Ryan and Deci (2001)
and Ryan (2009), find that psychosocial wellbeing is not
a euphoric feeling of happiness, but a state of vital and
full functioning based on an ongoing mindfulness and
psychosocial self-regulation. Fishbein and Ajzen (1975)
introduce behaviour, as predetermined by attitude, into
the discussion; similar to prejudice. This interplay poses a
critical challenge for those living with HIV (PLWH) (Varni
et al. 2012) or people living close to them (PLC), in the
form of coping as part of psychosocial wellbeing. These
researchers concluded that peoples’ ability to cope with
HIV stigma depended on their ability to cope with everyday
stress relating to interaction with others and the context
Changeover-time in psychosocial wellbeing of people living with HIV and
people living close to them after an HIV stigma reduction and wellness
enhancement community intervention
H Christa Chidrawi
1
, Minrie Greeff
1
*, Q. Michael Temane
1
and Suria Ellis
2
1
Africa Unit for Transdisciplinary Health Research (AUTHeR), North-West University, Potchefstroom, South Africa
2
Statistical Consultation Services, North-West University, Potchefstroom, South Africa
*Corresponding author, email: minrie.greeff@nwu.ac.za
HIV stigma continues to affect the psychosocial wellbeing of people living with HIV (PLWH) and people living close
to them (PLC). Literature unequivocally holds the view that HIV stigma and psychosocial wellbeing interact with
and have an impact on each other. This study, which is part of a larger research project funded by the South Africa
Netherlands research Programme on Alternatives in Development (SANPAD), responds to the lack of interventions
mitigating the impactful interaction of HIV stigma and psychosocial wellbeing and tests one such intervention. The
research objectives were to test the changeover-time in the psychosocial wellbeing of PLWH and PLC in an urban
and a rural setting, following a comprehensive community-based HIV stigma reduction and wellness enhancement
intervention. An experimental quantitative single system research design with a pre- and four repetitive post-tests
was used, conducting purposive voluntary sampling for PLWH (n = 18) and snowball sampling for PLC (n = 60). The
average age of participants was 34 years old. The five measuring instruments used for both groups were the mental
health continuum short-form scale, the patient health questionnaire, the satisfaction with life scale, the coping
self-efficacy scale and the spirituality wellbeing scale. No significant differences were found between the urban–
rural settings and data were pooled for analysis. The findings show that initial psychosocial wellbeing changes after
the intervention were better sustained (over time) by the PLC than by the PLWH and seemed to be strengthened by
interpersonal interaction. Recommendations included that the intervention should be re-utilised and that its tenets,
content and activities be retained. A second intervention three to six months after the first should be included to
achieve more sustainability and to add focused activities for the enhancement of psychosocial wellbeing. PLWH
and PLC are to be encouraged to engage with innovative community mechanisms to make psychosocial wellbeing a
way of life in the community at large.
Keywords: life satisfaction, depression, spirituality, mental health, coping