Spirituality: A Cultural Strength for Young People Living with HIV

Purpose: The empirical evidence of the relationship between religion and spiritual beliefs on health outcomes, including adjustment to chronic illness, continues to grow. While spirituality is considered important for a significant percentage of the population, it is surprising that there remains a paucity of research on spirituality and HIV in adults.  Fewer still have examined the role of spiritual beliefs and practices in the lives of young adults with HIV.  The research on spirituality and HIV in adults has been very minimal and even less has been done on the impact spirituality has on young adults with HIV. The specific aims of this study were to understand (a) the impact of spirituality in young adults with HIV and (b) the factors that influence spirituality in young adults with HIV.  This study also seek to understand the spiritual experiences of young adults with HIV, specifically the use of spiritual beliefs as a coping mechanism in their efforts to find meaning in their diagnosis.  Understanding the meaning of spirituality and HIV for young adults may also increase clinicians understanding of how young adults effectively manage their chronic illness. 

Methods:  A grounded theory approach to this phenomenon generated new understandings of how young adults appraised the meaning of HIV and offered explanation and insight on how their spiritual beliefs guided them in this appraisal in a way that was meaningful to them.  In addition, use of grounded theory facilitated sharing of situational meaning (i.e. facilitates the researchers sharing of the meanings of situations as such situations are viewed by participants).   A grounded theory approach provided insight on how young adults responded to a diagnosis of HIV during a heightened time of social development.  This method of data collection offered greater potential of capturing the lived experiences of young adults as they constructed meaning about their spiritual beliefs and HIV.  Grounded theory also provided study participants with a sense of autonomy and ownership of personal information, thereby facilitating participants’ disclosure of lived experiences and transcription of these oral accounts.

Results: This grounded theory study recruited 19 young adult males with (three) second interviews for a total of 22 interviews.  Participants age ranged from 19 -25.  Participants were equally diverse in representation with six Hispanic, six African Americans, five Caucasian and two Bi-racial.  The time of HIV diagnosis till time of interview ranged from four months - six years. With the exception of one, all participants experienced some form or organized religion during childhood or youth and none admitted to currently participating in organized religion.  All participants however, admitted to believing in a higher power or spiritual being.  Three participants felt spirituality could benefit those that believed but was not for them and four participants felt their HIV status was something God allowed to happen to them.  African American and Hispanics admitted to practicing or relying on their spiritual beliefs greater than Caucasian participants. African American experienced or perceived to have experienced greater stigma from the church than Hispanics and Caucasians.  Spirituality was found to be a cultural strength among African American and Hispanics.

Conclusion: This study of young adult males used grounded theory methods to provided rich descriptions of how spirituality influenced medication adherence, instilled a sense of  normalcy and being able to cope with and accept their HIV diagnosis and status.  The flexibility of grounded theory allowed for and encouraged the participants to tell their stories in a way that was meaningful to them yet provided insight on how others may benefit form employing their spiritual beliefs as a mechanism for coping with HIV.  Participants felt their spiritual beliefs offered hope and made it possible to cope with their diagnosis.