Adversity and Resilience: The Stories of People Living With HIV in Ecuador.

Abstract

People living with HIV (PLHIV) in Ecuador experience challenges including discrimination, violence, and limited access to healthcare, which impacts their mental health and well-being. However, research shows that PLHIV also rely on social resources to foster resilience. In the Ecuadorian context, there is no literature exploring these narratives, which results in a lack of qualitative data to improve the reality of PLHIV in the country. To gain a deeper understanding of these stories, 15 semi-structured interviews were undertaken (15 verbatim hours) within the context of a peer- and professional-led support group for PLHIV and were analyzed through a thematic approach based on Skovdal and Daniel's conceptual framework on resilience and adversity. Findings suggest that PLHIV face multifaceted challenges across the home, community, and political-economy spheres. Families and communities can elicit pain and fear, leading individuals to avoid discussing their diagnosis due to ongoing rejection. Further, discrimination perpetuated within the public health sector, as well as societal violence, exacerbates adversity. Nevertheless, participants stress the indispensable role of family support, community networks, and accessible healthcare in fostering resilience. Specifically, support, emotional reassurance, and willingness to learn enabled PLHIV to build resilience. These findings emphasize the need for approaches that counter discrimination, enhance well-being, ensure integral and intersectional healthcare access, and promote knowledge around HIV.