The Effectiveness of Adaptation Theory based Peer Support Groups on Cortisol Levels and Viral Load in People Living with HIV/AIDS: Systematic Review
Main Article Content
Abstract
Introduction: People Living with HIV/AIDS (PLWHA) are exposed to chronic psychosocial stress associated with neuroendocrine homeostatic disruption, increased cortisol secretion, and accelerated HIV disease progression. Although peer support groups improve psychological well-being and treatment adherence, evidence grounded in a comprehensive theoretical framework remains limited. Roy’s Adaptation Theory offers a biopsychosocial approach to enhance adaptive coping and reduce stress-related physiological dysregulation.
Objectives: This systematic review aims to synthesize scientific evidence on the effectiveness of peer support groups based on Roy’s Adaptation Theory in reducing stress among PLWHA, as measured by changes in cortisol levels and HIV viral load.
Methods: A scoping review was conducted following the “PRISMA 2020” rules to make sure comprehensive and structured analysis. Comprehensive searches were performed across five databases PubMed, CINAHL, PsycINFO, Scopus, and Web of Science for research papers released from 2020 to 2024. Using approved procedures, two reviewers independently selected studies and extracted data, and methodological quality was assessed using standard tools. Narrative synthesis and thematic analysis were applied..
Results: Out of 309 identified records, 12 high-quality studies met inclusion criteria. Peer support groups grounded in Roy’s Adaptation Theory demonstrated significant effectiveness through psychoneuroimmunological mechanisms, including epigenetic modulation of ADRB2, OXTR, and FKBP5 genes, reduced pituitary-adrenal axis hypothalamic activity, and reduced cortisol levels. Resilience-based, multilevel interventions improved viral suppression by up to 78% and enhanced adherence to antiretroviral therapy through the strengthening of individual, family, and health system supports.
Conclusions: Peer support groups based on Roy’s Adaptation Theory effectively reduce physiological stress and improve HIV clinical outcomes. Culturally adapted integration into comprehensive health care systems is essential for optimal holistic management.