Abstract:
Few African studies have focused on resilience factors related to engagement in HIV-related care among people
living with HIV; instead, many studies have identified health risk factors and barriers within this population.
Informed by the Disability-Stress-Coping Model of Adjustment, a qualitative study was conducted to develop
a better understanding of psychosocial factors that can promote positive behaviours and subjective wellness for
people living with HIV in Accra, Ghana. Thirty patients from the two largest HIV clinics in Accra participated in
in-depth individual interviews. Using a thematic analysis approach, three individual-level factors related to resilience
and subjective wellness were identified: (1) holding positive attitudes towards the pathway from HIV testing and
diagnosis to healthy living with HIV; (2) placing appropriate (but not absolute) levels of trust in the clinical care
environment; and (3) judicious disclosure of their HIV status to key individuals. Findings support a resilience
framework that focuses on individual strengths and positive adaptations to HIV diagnosis in order to enhance
understanding and promote the HIV care continuum for people living with HIV in this context. Development of
resilience-focused approaches to public health intervention is particularly important in low-resource settings such as
Ghana where research tends to focus on deficiencies and healthcare inadequacies for people living with HIV.
