The association between HIV disclosure to family members and quality of life among people living with HIV/AIDS: The indirect effects through social support

HIV disclosure to family members might be associated with the health-related quality of life (H-QoL) among people living with HIV/AIDS (PLWH). However, previous findings of the association were mixed, and few empirical studies had explored the potential mediating mechanisms underlying the relationship. This study aimed to examine the association between disclosure to family members and H-QoL, and the role of social support in the relationship. A cross-sectional survey was conducted among 1104 PLWH (58.70% male, average age 37.05 years old) in Guangxi, China. Participants provided information on HIV disclosure to family members, perceived social support, H-QoL including physical and mental health dimensions (scored as Physical health score [PHS] and Mental health score [MHS]), and social-demographic characteristics. Descriptive statistics, bivariate analysis, and path analysis were applied to examine our hypotheses. Bivariate analysis demonstrated that HIV disclosure to family members was positively correlated with social support but not with PHS and MHS statistically. Social support was positively correlated with PHS and MHS. Path analysis revealed that the direct effects of disclosure on both physical and mental H-QoL were not significant. In contrast, the indirect effects of disclosure on both mental and physical H-QoL through social support were significant, despite of small effect size. The potential mediating role of social support was highlighted in improving PLWH’s well-being. Future interventions targeting H-QoL promotion might incorporate disclosure management and communication skills that are likely to elicit social support and invite patients’ family members to participate in the interventions as appropriate.