Sense of Grip on Disease Among Persons Living with HIV: Insights from a Mixed-method Study in a Tertiary Care Hospital of Kolkata, India

Abstract Background: Individuals with chronic disease must comprehend their diagnosis (sense) and gain control over the ailment (grip on disease). However, HIV-AIDS is different due to stigma and discrimination. Yet, persons living with HIV, with a robust sense of grip on disease (SoGoD), can lead satisfying lives. This study aimed to assess the SoGoD status and its associates, and then elicit the perspective of the stakeholders. Materials and Methods: This mixed-method study was conducted among People Living with HIVs (PLHIVs) visiting a tertiary care hospital in Kolkata, India, from November 2023 to January 2024. The quantitative strand of the study was conducted among 120 PLHIVs on antiretroviral therapy (ART), and then the qualitative strand was conducted by in-depth interviews (IDIs) with study participants and key informant interviews (KIIs) with healthcare personnel. SPSS software was utilized for quantitative data analysis, and factors associated with the SoGoD were analyzed using logistic regression models. Qualitative data were analyzed thematically. Results: Among the study participants, 34% have a dynamic grip. Illiteracy (adjusted odds ratio [aOR] = 7.22, 95% confidence interval [CI] = 1.94–10.97), current marriage (aOR = 4.44, 95% CI = 1.61–12.27), no history of substance use (aOR = 2.79, 95% CI = 1.99–7.85), and lesser stigma and discrimination (aOR = 5.41, 95% CI = 1.96–7.86) were significantly associated with dynamic grip. Self-care, family and community support, and integrated institutional care were identified as major ways to enhance disease grip. Conclusion: Since HIV is a heavily stigmatized disease, measures such as early family engagement and counseling, and comprehensive and adaptable institutional care should be undertaken to improve their disease grip.