Middle Eastern Journal of Disability Studies

Abstract
Background & Objectives: AIDS is one of the main risk factors for health and affects all aspects of a person's life. AIDS lowers self–esteem and increases feelings of vulnerability, physical symptoms, and disturbing thoughts. A community–based model focuses on changing an individual's behaviors to reduce the risk factors in a community. The community–based model in this study sought to change the behaviors of the intervention group as part of the HIV–infected population and to use the study's results for a larger community of patients. To this end, recognizing the barriers to disease acceptance as an effective factor in reaching for treatment, on the one hand, and a lack of knowledge on cultural and health system barriers in Iran, on the other hand, lead us to determine the predictive share of the community–based model of coping strategies for positive prevention based on perceived deterioration mediated in HIV–positive patients. Therefore, this study aimed to determine the contribution of community–based adjustment approaches in positive prevention based on the perceived deterioration mediated by coping strategies in HIV–positive patients.
Methods: This study was an applied research using correlational plans. The study population included all HIV–positive patients living in Tehran City, Iran, between March 2019 and March 2020. Of the mentioned population, 250 individuals referred to positive clubs under the supervision of the Welfare Organization were selected by available sampling. The inclusion criteria for patients in the study were as follows: being between 18 and 50 years old, having at least a high school diploma, having been diagnosed with the disease for one year, lacking diagnosed with another chronic physical illness before the HIV diagnosis, and lacking diagnosed with a severe mental disorder. In this study, patients were informed about the study and its purpose. All participants were also informed that their participation in the study was voluntary and that their information would remain confidential. The following questionnaires were applied for data collection: the Coping Styles Questionnaire (Lazarus and Folkman, 1980), the Psychosocial Adjustment to Illness Questionnaire (Derogatis, 1986), and the Brief Illness Perception Questionnaire (Broadbent et al., 2006). The proposed model was evaluated using structural equation modeling, and to examine the correlation between research variables, the Pearson correlation coefficient was used using AMOS version 21 and SPSS software.
Results: Descriptive findings showed that participants' mean ± SD age was 37.9±5.48 years. The highest level of education was high school (77 people, 30.8%), and the lowest was university education (16 people, 6.4%). The highest marital status was divorced (89 people, 35.6%), and the lowest was single (28 people, 11.2%). The results of the Pearson correlation test showed a significant correlation between psychosocial adjustment variables and perceived severity and coping strategies. Specifically, there was a significant inverse relationship between the variables of negative emotion–focused coping strategies and psychosocial adjustment (p<0.05). Evaluation of direct pathways of perceived deterioration on psychosocial adjustment (β=0.346, p=0.001) and coping strategies on psychosocial adjustment (β=0.287, p=0.002) in HIV–positive patients indicated a direct effect. Indirect estimation of the model using the bootstrap method and according to the standardized values (β) confirmed the indirect path of perceived deterioration on psychosocial adjustment mediated by coping strategies in HIV–positive patients.
Conclusion: This study showed that perceived deterioration predicts psychosocial coping strategies in HIV–positive patients. Furthermore, we showed the mediating role of various factors in predicting coping strategies.