Effects of stress and social support on neurocognitive functioning among HIV positive individuals in Lusaka, Zambia

Abstract

Statement of the problem: Both the medical and psychological literature has indicated that stress impacts people’s wellbeing. HIV positive individuals are among the most heavily stressed people. Stress comes from various sources such as relationships, lack of acceptance by family and friends, as well as other worries of day to day living (Lazarus and Folkman, 1984). However, stress has not been extensively researched in Zambia to examine its effects on neurocognitive functioning among individuals living with HIV and AIDS. Moreover, although social support has been found to reduce disease progression among chronically ill cancer patients, little is known about the interaction effects of social support and stress on neurocognitive functioning among HIV positive individuals. Objective: This study sought to examine the effects of stress and social support on neurocognitive functioning among HIV positive individuals in Lusaka, Zambia. Methods: Sample of the study consisted of 263 men and women (men= 107, women= 156) from six Clinics in Lusaka district. Their age ranged between 20 to 65 years. Their education was at least 5 years of schooling and above. This was a cross- sectional study. The International neurobehavioural test battery was used to assess neurocognitive functioning. It assessed the neuropsychological performance of participants by administering various neuropsychological tests that measure brain function. Other measures included Perceived Stress Scale (PSS- 10) for stress and Medical Outcome Study Social Support Survey (MOS- SS) for social support. ANOVA, T- test and other statistics were used to analyse data with the help of SPSS version 16. Results: The results also indicated that stress has a significant relationship with working memory and verbal fluency, but not with other neurocognitive domains. Social support and its interaction with stress has no effect on neurocognitive functioning. Marital status was also related to stress and social support. The divorced group reported high stress (although the results were not statistically significant) levels and low social support received. The married group reported low stress levels and high social support. The results indicated that stress levels between participants did not differ by gender. Males and females were equally stress.Conclusion: HIV and AIDS affects neurocognitive functioning. Although the sample was mildly stressed, stress was significantly associated with working memory and verbal fluency. It is recommended that future study should consider the chronically stressed individuals to better understand the relationship between stress and neurocognitive dysfunctions. It is also recommended that government and other service providers continue the process of counseling even after the HIV positive individual has started antiretroviral.