Family Relationships, Resilience, and Quality of Life in People Living with HIV and Their Family Members: An Actor-Partner Interdependence Mediation Model

ObjectivesTo explore the association between family relationships and quality of life (QoL), and the mediating role of resilience among people living with HIV (PLWH) and their family members (FMs).MethodsBaseline data were drawn from an ongoing study in Guangxi, China, including 783 PLWH-FM dyads. The actor-partner interdependence mediation model examined how individuals' family relationships/cohesion affect their own (actor effects) and their partners' QoL (partner effects), and the mediating role of resilience.ResultsA significant actor-direct effect was observed for FMs' family relationships on their own mental QoL (β = 0.136, P < 0.001), while no such effect was found for PLWH. Resilience functioned as a mediator between PLWH's family cohesion and PLWH's QoL (physical: β = 0.109, mental: β = 0.089, P < 0.001) and between FMs' family relationships and FMs' QoL (physical: β = 0.062, mental: β = 0.075, P < 0.001). Regarding partner effects, FMs' resilience mediated the association between PLWH's family cohesion and FMs' QoL (physical: β = 0.036, mental: β = 0.044, P < 0.01).ConclusionFindings underscore that future interventions should target the family as a unit to strengthen family ties and improve the cross-dyadic role of resilience, particularly that of FMs.