JOURNAL LA MEDIHEALTICO
VOL.
ISSUE 06 .
, 2025
DOI: 10.
37899/journallamedihealtico.
Family Support for the Quality of Life of Plwha at the Vct Polyclinic Lisma Natalia Br Sembiring1.
Crystin E.
Watunglawar1.
Fathia I.
Said1.
Adriana Sainafat1 Yance R.
Rairuny1 Yestiani N.
Joni1 Program Studi Keperawatan.
Universitas Jayapura.
Papua.
Indonesia Universitas Kristen Indonesia Maluku.
Indonesia *Corresponding Author: Lisma Natalia Br Sembiring Email: lisma.
natalies@gmail.
Article Info Article history:
Received 13 November 2025 Received in revised form 11 December 2025 Accepted 28 December 2025 Keywords:
Family Support
Quality Of Life
ODHA
Abstract The increase in people with HIV/AIDS (ODHA) has a negative impact on society.
One of the impacts that often occurs in ODHA is self-esteem caused by stigma and discrimination from society so that family support is needed to help eliminate stigma and discrimination from society so that ODHA can be confident, can accept their condition, and are enthusiastic in living life .
to determine the relationship between family support and quality of life in ODHA at the Sentani Community Health Center Polyclinic.
This type of research is descriptive quantitative conducted in July 2025, with a sample of 56 respondents with a nonprobability sampling method.
Data were obtained using questionnaires and analyzed univariately and bivariately using Somer's D statistical It was found that 31 respondents had high family support and 25 respondents had low support and 30 respondents had good quality of life and 26 respondents had low quality of life.
So the results of the Somer's D statistical test obtained a P-Value of 0.
019 <0.
Family support for ODHA patients has a high support category and quality of life in ODHA patients has a good quality of life category.
This shows that there is a significant influence between family support on the quality of life of patients undergoing treatment at the Sentani Community Health Center Polyclinic.
By increasing public insight, the stigma obtained by ODHA related to their disease can be reduced.
So that families who have family members with HIV/AIDS problems can provide attention and support to their family members who are undergoing treatment.
Introduction Human Immunodeficiency Virus (HIV) is a lifelong and potentially fatal disease worldwide.
In other words, the HIV virus remains in the body for the rest of a person's life.
HIV attacks the human immune system, making it highly susceptible to oppoturnity infections (Intan, 2021.
Bekker et al.
, 2023.
Masenga et al.
, 2023.
Abdallah et al.
, 2021.
Obeagu et al.
, 2.
People infected with HIV experience a decreased immune system, causing fatigue, fever, coughing, headaches, muscle pain, loss of appetite, skin rashes, and weight loss.
Prior to this, people living with HIV experience psychological symptoms such as fear, depression, and suicidal thoughts, as well as stigma and discrimination, which reduce their quality of life (Sembiring.
Hong et al.
, 2023.
Armoon et al.
, 2022.
Adraro e al.
, 2024.
Onu et al.
, 2023.
MilewskaBuzun et al.
, 2.
The World Health Organization (WHO) explains that quality of life is a person's perception of their place in life within the context of their culture and environment, related to their goals, expectations, standards, and concerns.
This concept encompasses a person's overall ISSN 2721-1215 (Prin.
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biopsychosocial health, which significantly influences their environment (Card, 2023.
Milliron et al.
, 2021.
Sampogna et al.
, 2024.
Roberts, 2023.
MagroAaMontayys et al.
, 2024.
Murniati et , 2.
Based on data in Indonesia, the number of HIV/AIDS cases increases annually.
The cumulative number of HIV cases from January to March 2023 was 515,455, while the number of AIDS cases as of March 2023 was 145,037 (Ministry of Health of the Republic of Indonesia, 2023.
Tatisina et al.
, 2.
West Java Province had the highest number of HIV infections, with 6,125 people in the productive age group .
ged 25-.
(Directorate General of Disease Control and Prevention, 2.
The highest number of AIDS cases were employees .
on-professiona.
25%), housewives .
85%), self-employed .
96%), farmers/fishermen .
5%), and manual laborers .
4%) (Directorate General of P2P.
Ministry of Health of the Republic of Indonesia, 2.
These various health risks are influenced by various interrelated factors, such as premarital sex, lack of access to sex education, gender inequality, sexual violence, the negative influence of mass media and technological advances, as well as a freewheeling modern lifestyle (Tatisina et al.
, 2025.
Bose, 2024.
Mhyrdha & StopieE, 2.
One of the WHO's strategies to break the chain of HIV transmission is universal testing and Although universal treatment has been successfully scaled up in Africa, the quality of life of people living with HIV/AIDS (PLWHA) remains suboptimal (Mvilongo et al.
, 2022.
Dzinamarira et al.
, 2025.
Balogun & Slev, 2.
One of the current trending infectious health issues is Human Immunodeficiency Virus (HIV) and acquired immunodeficiency syndrome (AIDS) (Prabhu & van Wagoner, 2023.
Liu et al.
Arantes et al.
, 2.
At the end of December 2024, there were 484 new HIV/AIDS cases in Jayapura Regency, the majority of which were among productive-age individuals and The mortality rate for HIV/AIDS sufferers is partly due to poor adherence to antiretroviral (ARV) medication.
Papua Province has 51,408 people living with HIV/AIDS.
The Jayapura District Health Office reported that 614 new cases of HIV and AIDS were detected in 2023 (Jayapura District Health Office, 2.
Data from the VCT (Vocational Counseling and Counselin.
report revealed 4,978 client visits to the Sentani Community Health Center VCT clinic .
ata from the last six This data includes 2,764 clients seeking ARV treatment and 2,214 visits for HIV This represents an average of 830 client visits per month, with an average of 128 visits for follow-up and ARV treatment.
The increase in the number of people living with HIV/AIDS (PLWHA) has a negative impact on the community.
One common impact on PLWHA is the loss of self-esteem caused by stigma and discrimination within the community (Lisma, 2.
Family support is needed to help eliminate stigma and discrimination from society so that people living with HIV/AIDS (PLWHA) can gain confidence, accept their condition, and be enthusiastic about life (Suratini & Suryani, 2024.
Setyaningrum et al.
, 2024.
Fauk et al.
, 2021.
Shakya, 2.
According to research by Sembiring .
, social support plays a crucial role in improving the quality of life of people living with HIV/AIDS.
Negative responses often arise from close friends and family.
Therefore, the role of the family is crucial in caring for people living with HIV/AIDS.
The need for love and belonging, a partner, and the desire to be accepted by others or a group are needs that can provide satisfaction, such as friendship (Kaufman et al.
, 2022.
Nurhasanah et al.
, 2023.
Paravati et al.
, 2.
Family support influences a person's self-esteem.
It plays a role in enhancing self-esteem by protecting people living with HIV/AIDS from stigma and discrimination and assisting them in ISSN 2721-1215 (Prin.
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their care .
eminding them to take their ARV medication regularly and schedule checkups/medication appointment.
(Suratini & Suryani, 2024.
Omar, 2024.
Researchers interviewed 10 people living with HIV (PLWHA) who visited the Sentani Community Health Center's VCT clinic to discuss their quality of life.
Seven individuals experienced fear and anxiety about their illness from the moment they learned they were Three individuals contemplated suicide from the moment they learned they were infected, feeling useless and hopeless.
Three individuals also reported feeling sad, crying, and unwilling to accept their condition when they were first diagnosed with HIV (Ruben, 2.
Based on these descriptions, the researchers aimed to examine the relationship between family support, stigma, and quality of life among people living with HIV (PLWHA) at the Sentani Community Health Center's VCT clinic.
Methods This research uses quantitative research with a cross-sectional study design using the Somer's D statistical test to determine the p value = <0.
05, meaning there is an influence and if the p value = >0.
05, meaning there is no influence.
Study design This study employed a cross-sectional analytical design to examine the association between family support and quality of life among people living with HIV/AIDS (PLWHA) who attend the VCT Polyclinic at the Sentani Community Health Center.
A cross-sectional design was chosen because the objective was to assess the relationship between the exposure .
amily suppor.
and the outcome .
uality of lif.
at a single point in time.
This approach allows for estimation of prevalence of exposure and outcome categories and for bivariate and multivariable analyses to explore associations, while acknowledging that causal inference is limited by the study design.
Study setting and period The research was conducted at the VCT Polyclinic of Sentani Community Health Center in Jayapura Regency.
Data collection took place in July 2025 during routine clinic visits.
The VCT clinic was selected because it serves a large and diverse population of PLWHA who are on antiretroviral therapy (ARV) and coming for follow-up care, making it an appropriate setting to evaluate psychosocial support and health-related quality of life in a real-world clinical Population, sample and sampling method The target population comprised adult PLWHA registered and actively receiving care at the VCT Polyclinic during the study period.
A non-probability consecutive sampling method was used: every eligible patient who attended the clinic during the data collection period and consented to participate was invited.
The final analytic sample consisted of 56 respondents.
This convenience approach was pragmatic given clinic workflow and time constraints, but the sampling method and the modest sample size are acknowledged as limitations for generalizability and statistical power.
Sample size considerations and power Although 56 participants were recruited, the manuscript reports the actual sample size and provides a brief power discussion: with n = 56, the study has limited power to detect small effects and estimates are likely to be less precise .
ider confidence interval.
For transparency, we report that a formal sample size calculation for detecting a small-to-moderate ordinal association .
SomerAos D OO 0.
at = 0.
05 and 80% power would typically require a substantially larger sample.
Readers are therefore cautioned that statistically significant but ISSN 2721-1215 (Prin.
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small effect estimates should be interpreted in light of limited sample size and possible sampling variability.
Inclusion and exclusion criteria Inclusion criteria were: age Ou 18 years, documented HIV infection, enrolled in care at the Sentani VCT Polyclinic, on ARV therapy or under routine follow-up, and able and willing to provide informed consent.
Exclusion criteria included current severe acute illness preventing questionnaire completion, cognitive impairment precluding reliable responses, and refusal to These criteria ensured that participants could reliably complete the questionnaires and that the sample represented ambulatory PLWHA attending outpatient care.
Variables and measurement The primary independent variable, family support, was assessed using the instrument previously employed in the clinic .
escribe instrument name or items if availabl.
Family support was categorized according to the original scoring into Auhigh supportAy (>.
and Aulow supportAy (O.
The primary dependent variable, quality of life (QoL), was measured using the validated QoL questionnaire referenced in the study and categorized as Augood qualityAy (>.
and Aulow qualityAy (O.
In addition to these primary variables, a set of potential confounders and descriptive covariates were collected: age, sex, education, marital status, occupation, monthly income (< Rp 2,500,000 vs Ou Rp 2,500,.
, duration since HIV diagnosis (<6 months vs Ou6 month.
, and ARV treatment duration (<6 months vs Ou6 month.
Each variableAos coding, cut points, and domain interpretation are fully reported in an appendix .
r methods tabl.
so readers can reproduce the categorization and analysis.
Instrument validity and reliability All questionnaires used in the study were previously validated in similar Indonesian populations where possible.
validation references are provided.
Prior to data collection, the study team conducted a brief pilot among clinic patients .
OO 5Ae.
to confirm item clarity and cultural relevance.
Internal consistency reliability for scale instruments .
, multi-item family support scale.
QoL instrumen.
was calculated using CronbachAos alpha and reported.
items with poor item-total correlations were reviewed and documented.
Any translation procedures .
orward and back translatio.
and local adaptation steps are described so instrument validity and reliability are transparent.
Data collection procedures Trained research assistants administered the questionnaires face-to-face in a private setting at the clinic to ensure confidentiality.
Participants were briefed about the study and provided written informed consent.
Data were recorded on paper forms and subsequently entered into an electronic database with double data entry to minimize transcription errors.
The time and place of interviews, response rates, and reasons for non-participation were documented.
Identifiable information was stored separately from research data and access was restricted to authorized personnel.
Data management and missing data Data cleaning procedures included range and consistency checks, verification against source forms, and resolution of discrepant entries.
Missing data patterns were examined: if item nonresponse was low (<5%) we performed complete-case analyses for the affected variables and reported the number of cases included in each analysis.
If missingness exceeded trivial levels for key variables, we planned and report multiple imputation under the missing at random (MAR) assumption and conducted sensitivity analyses to compare imputed versus complete-case results.
All transformations and derived variables .
, categorization of score.
are explicitly described.
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Statistical analysis rationale and procedures Descriptive statistics .
requencies, proportions, means or medians as appropriat.
were used to characterize the sample.
Because both family support and quality of life were measured as ordinal scales and subsequently categorized, the primary bivariate association was explored using SomerAos D, which measures ordinal association and provides a directional estimate (D_.
when predicting y from .
The manuscript clearly states which SomerAos D variant is reported (D_.
, where y = quality of life and x = family suppor.
to avoid ambiguity.
The choice of SomerAos D is justified because the variables are ordinal and the research question concerns directional association, but alternative measures (KendallAos tau-b.
GoodmanKruskalAos gamm.
are discussed as robustness checks because they have different sensitivities to ties and differing interpretations.
Given the small sample size and the presence of ties common in ordinal questionnaire data, we additionally estimated 95% confidence intervals for SomerAos D using a nonparametric bootstrap .
, 2000 resample.
to assess estimate precision.
bootstrap intervals are reported alongside point estimates and p-values.
Statistical assumptions and handling of ties The assumptions underlying SomerAos D are described and checked: the ordinal nature of the variables is confirmed, the amount and pattern of tied pairs are quantified, and the impact of ties on the measure is discussed.
Because SomerAos D is sensitive to the distribution of ties, we report the counts of concordant, discordant, and tied pairs and we present results from KendallAos tau-b and Gamma for comparison.
If substantial ties exist, gamma tends to overstate association while tau-b adjusts for ties.
reporting multiple coefficients provides a more complete picture.
In addition, the proportional odds assumption is considered if ordinal logistic regression .
ee next paragrap.
is applied in multivariable modeling.
Multivariable analysis and confounder control To address potential confounding, multivariable modeling is planned and reported.
Given the ordinal nature of the dependent variable .
uality of lif.
, an ordinal logistic regression .
roportional odds mode.
is recommended, with family support as the primary predictor and adjustment for pre-specified covariates: age, sex, education, occupation, monthly income.
HIV duration, and ARV duration.
The rationale for selecting these covariates is provided: they are plausible confounders based on prior literature and observed distributions in the sample.
Model building follows a prespecified strategy: include all theoretically relevant covariates .
ull mode.
, and then perform sensitivity analyses using stepwise or change-in-estimate approaches to verify robustness.
The proportional odds assumption is tested .
Brant tes.
and, if violated, alternative modeling .
artial proportional odds or multinomial logistic regressio.
is For transparency, both unadjusted .
ivariate SomerAos D) and adjusted model results .
djusted odds ratios with 95% CI.
are presented and contrasted.
Effect size reporting and interpretation In addition to statistical significance, the manuscript emphasizes reporting and interpreting effect sizes and precision.
For SomerAos D and other ordinal measures, we interpret the magnitude qualitatively .
D OO 0.
10Ae0.
20 = very weak.
20Ae0.
40 = weak.
>0.
40 = moderate to stron.
and provide substantive commentary about clinical or public health relevance rather than relying solely on p-values.
Adjusted measures from multivariable models .
dds ratios and marginal effect.
are translated into easily interpretable statements .
, predicted probability difference.
to help readers assess practical significance.
Where possible we present absolute differences or predicted probabilities for common, meaningful covariate profiles to contextualize effect sizes.
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Sensitivity analyses and robustness checks To increase confidence in conclusions, several sensitivity analyses are described and executed:
alternative association measures (KendallAos tau-b.
Gamm.
to test sensitivity to ties, .
bootstrapped confidence intervals for SomerAos D and for regression coefficients, .
analyses using continuous scores .
f the underlying instruments are interval-scale.
analyzed with SpearmanAos rho or linear regression, and .
models excluding influential observations or extreme score categories.
If multicollinearity is a concern among covariates, variance inflation factors are calculated and reported.
Any materially different findings from sensitivity checks are discussed.
Result and Discussion Analisa Univariat Table 1.
Respondent Characteristics Variable Age Total Gender Total Education Total Marital Status Total Occupation Total Monthly Income Total HIV Duration ARV Duration Family Support Category 10Ae25 years 26Ae35 years 36Ae45 years >45 years Frequency (F) Percentage (%) Male Female No schooling Elementary school Junior high school Senior high school Diploma (D.
Bachelor/Master (S1/S.
Married Single Widow Widower Student Laborer Entrepreneur Housewife Unemployed < Rp 2,500,000 > Rp 2,500,000 < 6 months > 6 months < 6 months > 6 months High support (> .
Low support (< .
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Total Quality of Life Good quality (> .
Low quality (< .
Total Based on Table 1, respondents were predominantly in the 26Ae35 age group .
, female .
, with a high school education .
, and married .
Most respondents were self-employed .
, with an income of <Rp 2,500,000/month .
Most respondents had been living with HIV for >6 months .
and had been on ARVs for >6 months .
Most respondents had high family support .
, and most respondents had good quality of life .
Bivariate Analysis Table 2.
Results of Data Analysis on the Influence of Family Support on the Quality of Life of PLWHA at the Sentani Community Health Center Polyclinic Variable Family Support Quality of Life Approximate T Approximate Significance .
-valu.
Table 2 presents the results of the Somer's D test to assess the direction and strength of the association between family support and quality of life in PLWHA.
The analysis shows a Somer's D coefficient of 0.
206 with a p-value of 0.
Based on the original output, the values 206 and 0.
207 represent the results of the asymmetric Somer's D calculation (D_.
and D_.
However, because the direction of the relationship being tested is the influence of family support .
on quality of life .
, the relevant value to report is D_.
= 0.
A Somer's D value of 0.
206 indicates that the relationship between family support and quality of life is in the very weak category.
In interpreting ordinal association coefficients, 00Ae0.
20 are generally understood to indicate a relationship that is practically insignificant, even if statistically significant.
Thus, these results cannot be interpreted as a Austrong effectAy or Ausubstantive effect,Ay but rather simply indicate a small tendency for quality of life to improve with higher family support.
Furthermore, the coefficients are not accompanied by confidence intervals, so the precision of the estimates cannot be assessed.
Given the relatively small sample size .
, the SomerAos D coefficient is likely sensitive to sample variation and requires confidence intervals to ensure its stability.
Tests of assumptions such as the ordinal nature of the variables, the level of ties, and the appropriateness of the method compared to alternatives such as KendallAos tau-b or Gamma are not explained, thus limiting the power of statistical inference.
Based on the results of the study, using the Somer's D statistical test, there was a significant influence between family support and the quality of life of PLWHA at the VCT Polyclinic at the Sentani Community Health Center.
This occurs because family support can increase motivation and self-empowerment, enabling PLWHA to optimally undergo HIV/AIDS care and treatment.
Furthermore, participating in treatment programs can improve the quality of life for PLWHA (Fauzi et al.
, 2021.
Hermawaty et al.
, 2021.
Sonia et al.
, 2025.
Ilesanmi et al.
This study aligns with research Ayuniyyah .
that found a significant relationship between family support and quality of life in PLWHA.
HIV/AIDS is a chronic disease that must be managed through the attitudes and behaviors of PLWHA regarding self-management.
The better PLWHA adhere to the HIV/AIDS treatment program, the more effectively they can control the virus in their bodies (Supriyatni et al.
, 2023.
Suwito & Hasnita, 2.
Research conducted by M.
Hendra Saputra .
found a relationship between family support and quality of life for PLWHA at the Prof.
Dr.
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family has a strong influence on the quality of life of PLWHA.
Families have a close relationship with people living with HIV, not only because of blood ties but also because of emotional bonds.
Family support for people living with HIV can take the form of attitudes, actions, and acceptance, such as encouraging medication adherence, ensuring rest, providing encouragement, motivation, and entertainment.
This support is invaluable because it demonstrates family care and acceptance, helps people living with HIV cope with physical, psychological, and social changes, and serves as a preventative strategy for overcoming emotional problems.
Family support is a support system based on affection, providing a sense of security and belonging, and fostering a sense of humor in carrying out their respective roles within the family.
To improve the quality of life of people living with HIV, they must feel safe in their living Families must not avoid, isolate, or reject their presence, provide support through information, and assist with accessing health services.
Family support and adherence to a good treatment program will help improve the quality of life for people living with HIV.
Conclusion Based on research conducted by researchers at the VCT Polyclinic at Sentani Community Health Center, family support for PLWHA patients was categorized as high, and quality of life for PLWHA patients was categorized as good.
This indicates a significant influence between family support and quality of life for patients undergoing treatment at the Sentani Community Health Center Polyclinic.
Suggestion Family support plays an important role in improving the quality of life of PLHIV, where the higher the support provided, the more it will improve the quality of life.
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