How is family functioning associated with depressive symptoms among women living with HIV in China? Findings from a 4-year longitudinal study.

BACKGROUND

Women living with HIV (WLWH) experience often poorer mental health. Family plays a central role in Chinese society and family influence would be particularly salient for Chinese WLWH. Current literature predominantly focuses on how family influences on mental health. Little is known about how mental health affects family functioning, and specifically, this reciprocal dynamic within this population.

AIMS: To examine the reciprocal relationship between family functioning and depressive symptoms among Chinese WLWH over a 4-year period.

METHODS

A three-wave longitudinal study was conducted among Chinese WLWH, at baseline, 2-year, and 4-year follow-up. Data were collected via individual face-to-face interviews, using structured questionnaires. Cross-lagged panel model (CLPM) was performed in data analysis.

RESULTS

A total of 382 participants (Mean age: 36.77 years) were included at baseline; 379 (99.2%) and 372 (97.4%) completed the 2-year and 4-year follow-ups, respectively. Bivariate correlations indicated that family functioning and depressive symptoms were significantly and negatively correlated at each wave. Results from CLPMs revealed a consistent unidirectional relationship: higher family functioning at both baseline and the 2-year follow-up significantly predicted reduced depressive symptoms at the subsequent time point (β = -0.13, p < .05) among WLWH. Conversely, neither depression at baseline nor 2-year follow-up were significant in predicting subsequent family functioning.

CONCLUSION

The findings highlight the protective role of family functioning in reducing depressive symptoms among Chinese WLWH over time, suggesting that family support can serve as a buffer against depression. The development of tailored family-based interventions to enhance family dynamics is strongly warranted for this population.