Please Don't Make Me Ask for Help: Implicit Social Support and Mental Health in Chinese Individuals Living with HIV

Thesis (Master's)--University of Washington, 2013

China faces a growing HIV epidemic. Government resources have initiated successful efforts to curb transmission and provide medical care; however, psychosocial needs of HIV-positive individuals remain largely unaddressed. China is a setting with high HIV-stigma and few mental health resources. Research is needed that innovatively addresses this gap between patient mental healthcare and lack of sufficiently trained professionals, in a culturally acceptable manner acknowledging the environment of high societal stigma. The present study involves 120 HIV-positive Chinese-speaking adults receiving care at Beijing Ditan Hospital, who responded to measures of demographics, perceived explicit (which involves active disclosure of a problem and request for assistance) and implicit (no active disclosure) forms of social support, and mental health symptoms of depression, anxiety, quality of life, and overall mental health. Multiple linear regression was conducted controlling for various demographic variables, to predict mental health outcomes with subscales of social support. Based on existing literature on social support use among Asian-American and other Asian populations, we hypothesized and found that after controlling for gender, age, and socio-economic status, implicit social support predicted mental health outcomes while explicit social support did not. Our results suggest a positive impact of implicit social support on the mental health outcomes of this population. The findings encourage recommendations for research on interventions focused on utilizing implicit social support (deliverable by peers, family, or paraprofessionals), which circumvents both issues of high stigma and low professional resources.