Spirituality/Religiosity: A Cultural and Psychological Resource among Sub-Saharan African Migrant Women with HIV/AIDS in Belgium

RESEARCH ARTICLE Spirituality/Religiosity: A Cultural and Psychological Resource among Sub-Saharan African Migrant Women with HIV/AIDS in Belgium Agnes Ebotabe Arrey1*, Johan Bilsen1, Patrick Lacor2, Reginald Deschepper1 a11111 1 Department of Public Health, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium, 2 Department of Internal Medicine and Infectious Diseases-AIDS Reference Center, Universitair Ziekenhuis Brussel, Brussels, Belgium * Abstract OPEN ACCESS Citation: Arrey AE, Bilsen J, Lacor P, Deschepper R (2016) Spirituality/Religiosity: A Cultural and Psychological Resource among Sub-Saharan African Migrant Women with HIV/AIDS in Belgium. PLoS ONE 11(7): e0159488. doi:10.1371/journal. pone.0159488 Editor: Fiona Harris, University of Stirling, UNITED KINGDOM Received: June 22, 2015 Accepted: July 4, 2016 Published: July 22, 2016 Copyright: © 2016 Arrey et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: Due to ethical restrictions related to protecting patient confidentiality, data cannot be made publicly available. Data requests can be submitted to the Corresponding Author. The authors confirm that all relevant data necessary to replicate the findings of this study will be made available upon request. Spirituality/religion serves important roles in coping, survival and maintaining overall wellbeing within African cultures and communities, especially when diagnosed with a chronic disease like HIV/AIDS that can have a profound effect on physical and mental health. However, spirituality/religion can be problematic to some patients and cause caregiving difficulties. The objective of this paper was to examine the role of spirituality/religion as a source of strength, resilience and wellbeing among sub-Saharan African (SSA) migrant women with HIV/AIDS. A qualitative study of SSA migrant women was conducted between April 2013 and December 2014. Participants were recruited through purposive sampling and snowball techniques from AIDS Reference Centres and AIDS workshops in Belgium, if they were 18 years and older, French or English speaking, and diagnosed HIV positive more than 3 months beforehand. We conducted semi-structured interviews with patients and did observations during consultations and support groups attendances. Thematic analysis was used to analyse the data. 44 women were interviewed, of whom 42 were Christians and 2 Muslims. None reported religious/spiritual alienation, though at some point in time many had felt the need to question their relationship with God by asking “why me?” A majority reported being more spiritual/religious since being diagnosed HIV positive. Participants believed that prayer, meditation, regular church services and religious activities were the main spiritual/religious resources for achieving connectedness with God. They strongly believed in the power of God in their HIV/AIDS treatment and wellbeing. Spiritual/religious resources including prayer, meditation, church services, religious activities and believing in the power of God helped them cope with HIV/AIDS. These findings highlight the importance of spirituality in physical and mental health and wellbeing among SSA women with HIV/ AIDS that should be taken into consideration in providing a caring and healthy environment. Funding: This study was funded by grant number 1901215N LV from Fonds Wetenschappelijk Onderzoek (FWO) to AEA. The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. PLOS ONE | DOI:10.1371/journal.pone.0159488 July 22, 2016 1 / 22 Spirituality/Religiosity among Sub-Saharan African Migrant Women with HIV/AIDS Competing Interests: The authors have declared that no competing interests exist. Introduction Spirituality and religion can influence the way patients perceive health and disease and their interaction with other people [1–6]. Many patients are spiritual, and religious needs related to their disease can affect their mental health, and failure to meet these needs may impact their quality of life [7]. It is argued that it may be confusing to distinguish between spirituality and religion because of the ambiguous and personal meanings accorded to these concepts [4]. Spirituality is a broad concept with many perspectives and there is no consensus on a definition of this concept, only ambiguity as to how this concept is defined [8]. Spirituality is an inherent component of being human and it is subjective, intangible, and multifaceted. Spirituality and religion are often used interchangeably, but the two concepts are different. Some authors contend that spirituality involves a personal quest for meaning in life, while religion involves an organized entity with rituals and practices focusing on a higher power or God. Spirituality may be related to religion for certain individuals, but not, for example, for an atheist or yoga practitioners [8]. Similarly, some authors contend that spirituality refers to the “nearly universal human search for meaning, often involving some sense of transcendence” [9,10]. On the other hand, religion is “a set of beliefs, practices and language that characterises a community that is searching for transcendent meaning in a particular way, generally based upon belief in a deity”[10,11]. Spirituality/religion can take individual as well as collective forms. The concepts of spirituality and religiosity are not mutually exclusive and can overlap or exist separately[12]. However, prayer and meditation are often performed in solitude. Regular church attendance, religious belief or the influence of religious institutions are dwindling fast in recent years and there is also a tendency for people to believe without belonging to any religious affiliation in Western Europe and much of the developed world, irrespective of race and ethnicity [13,14]. Crockett & Voas (2006) and Voas & Crockett (2005) further assert that there is a generational decline in belief as well as religious belonging and attendance in Western Europe and much of the developed world.[13,14] On the other hand, in sub-Saharan Africa, many people still believe and belong to spiritual/religious institutions and religious plurality is common [15,16]. An increasing number of studies have examined the complexity and interdisciplinary connection between spirituality/religiosity, health and quality of life [17–19]. Recent global research and surveys have also shown that the spirituality and religious dimensions of patients’ lives need to be an integral part of patient management [20]. Spirituality/religion may differ for each person and may have a double-edged capacity that can enhance or damage health and wellbeing, especially among patients with chronic (...truncated)