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Psychosocial correlates of health-related quality of life among people living with HIV in China

the mediating role of resilience

Zhao, Quna; Mao, Yuchenb; Li, Xiaominga,b; Qiao, Shanb; Zhou, Yuejiaoc; Shen, Zhiyongc

doi: 10.1097/QAD.0000000000002180
Supplement Articles

Objectives: The current study aims to examine associations between psychosocial factors and health-related quality of life (HRQoL) and the role of psychological resilience in mediating the relationship between perceived social support (PSS) and HRQoL.

Design: A cross-sectional study was conducted among people living with HIV (PLHIV) in Guangxi, China. A sample of 2987 PLHIV (1876 men and 1111 women) was included in the current analysis.

Methods: Hierarchical multiple regression models were employed to assess the association of HRQoL with stigma, three types of PSS (informational, emotional and tangible), and resilience as well as to identify the possible role of resilience in mediating the effect of PSS on HRQoL

Results: HRQoL was negatively associated with stigma (β = −0.27, P < 0.001), but positively associated with emotional PSS (β = 0.13, P < 0.001). After resilience was added to the model, HRQoL remained negatively associated with stigma (β = −0.20, P < 0.001), but positively associated with resilience (β = 0.38, P < 0.001). A mediating effect of resilience was found between emotional PSS and HRQoL (Sobel's Z = 16.87, P < 0.001).

Conclusion: Interventions that consider enhancing resilience through building social support, especially emotional social support, will likely improve HRQoL among PLHIV.

aSchool of Law & Public Affairs, Nanjing University of Information Science & Technology, Nanjing, China

bDepartment of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, South Carolina, USA

cInstitute of HIV/AIDS Control and Prevention, Guangxi CDC, Nanning, China.

Correspondence to Xiaoming Li, PhD, Health Promotion, Education, and Behavior, South Carolina SmartState Center for Healthcare Quality (CHQ), University of South Carolina, Arnold School of Public Health, Columbia, SC 29208, USA. Tel: +1 803 777 8874; fax: +1 803 777 6290; e-mail:

Received 21 August, 2018

Revised 6 February, 2019

Accepted 7 February, 2019

Copyright © 2019 Wolters Kluwer Health, Inc.