Health Locus of Control in HIV: Healthy Individuals with Low CD4 Cells versus an HIV-positive Comparison Group

by Kuhn, Rachel

Research examining multidimensional health locus of control (MHLOC) beliefs in HIV-positive individuals is limited. While studies in numerous other medical populations have shown relationships between MHLOC and markers of protected health status, no other studies, to our knowledge, have done so in HIV. The MHLOC has four subscales: Internal, Chance, Doctors, and Other People. Each subscale measures the degree of belief that one's health is controlled by one of these four constructs. This study compared the MHLOC beliefs of a rare group of healthy HIV-positive individuals with very low CD4 cell counts (below 50) who were not taking HAART (HLC group), to a group of HIV-positive individuals in the mid-range of disease progression (matched control (MC) group). Two hundred forty-seven diverse participants with HIV completed MHLOC scales as part of a psychosocial battery. Seventy participants from a larger "control" group (N = 177) were matched one-to-one with a participant from the HLC group (N = 70) on four demographic variables (gender, education, ethnicity, and income). The HLC group was found to have significantly lower Internal control beliefs and higher Doctor beliefs in comparison to the MC group. An examination of MHLOC beliefs within each group showed that for both groups, Doctor beliefs were strongest, followed by Internal, Chance and Other People beliefs. Compared to the MC group, individuals with protected health status (HLC group) were more likely to have a combination of "high" Doctor and "low" Internal beliefs and less likely to have a combination of "low" Doctor and "high" Internal beliefs. Finally, affective depression approached significance as a mediator in the relationship between Doctor control beliefs and group status (HLC vs. MC group). Specifically, protected health status was related to higher Doctor beliefs and lower affective depression. Study limitations and implications are discussed.