Living with HIV in developed nations: Subjective wellbeing and the human-animal bond

In this thesis, the author looks at wellbeing amongst adults living with HIV in developed nations, and proposes that the human-animal relationship may beneficially contribute to wellbeing for some people with HIV. In the early 1980s the emergence of HIV and AIDS in developed nations created an ‘epidemic of stigma’ (Herek & Glunt, 1988) unprecedented in modern day medicine. The advent of antiretroviral therapy in the mid 1990s transformed HIV from a terminal illness to a manageable but incurable condition. However, challenges still remain for those living, and ageing, with HIV in the twenty-first century, with some reports that HIV retains a stigma that can complicate disclosure, and impact on the types of support a person receives. There are also reports that many people, irrespective of health status, love their pets and view the human-animal relationship as an important source of physical, social and emotional support. These two observations provided the framework for the research presented here. The mixed-methods project comprised three parts. A questionnaire was used to explore: (1) wellbeing and stigma, operationalised as ‘unsupportive social interactions’, amongst 274 HIV-positive adults in Australia and USA (Part A); and (2) wellbeing and pet ownership amongst 128 HIV-positive adults in Australia (Part B). Part C was a series of semi-structured interviews about the experience of pet ownership when living with HIV conducted amongst 30 members of the Australian sample. Wellbeing was operationalised as ‘subjective wellbeing’, measured by the Personal Wellbeing Index (International Wellbeing Group, 2006), and ‘HIV-related emotional wellbeing’, measured by the Emotional wellbeing/Living with HIV subscale of the Revised Functional Assessment of Human Immunodeficiency Virus Infection (Peterman, Cella, Mo & McCain, 1997). Experiences of HIV-specific unsupportive social interactions were measured by the Unsupportive Social Interactions Inventory (Ingram, Jones, Fass, Neideg, & Song, 1999). In Part A, subjective wellbeing amongst participants was considerably below the Western population normative range, and unsupportive social interactions were a significant negative challenge to wellbeing. Results from Part B indicated significant differences between pet owners and non-pet owners on the measures of HIV-related emotional wellbeing and experiences of unsupportive social interactions, and indicated that pet ownership may beneficially contribute to wellbeing when living with HIV. The interview data from Part C provided a greater understanding of the meaning of pet ownership when living with HIV, and ways that the relationship may contribute to the owner’s wellbeing. The results of this research have implications for the individual living with HIV, service providers and the wider community. It draws attention to the ongoing need to monitor and maintain wellbeing amongst people with HIV, and remain vigilant to the subtle stigmatising behaviours perceived in others that can negatively impact this wellbeing. Further, results from Parts B and C provide empirical support for the beneficial contribution that pets can make to the lives of their HIV-positive owners, and reinforces the need to validate and support this relationship to maintain the welfare of both human and animal.