The meaning of the life of married people with HIV/AIDS (PLWHA) in Salatiga

• Wiwit Novi Febrianti
• Arthur Huwae

Vol. 4 No. 1: April 2023 | Pages: 39-48

DOI: 10.47679/makein.2023118   Reader: 1091 times PDF Download: 291 times

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Abstract

INTRODUCTION

According to the Indonesian Ministry of Health in 2014, HIV (Human Immunodeficiency Virus) is a disease that infects white blood cells and weakens the immune system. On the other hand, AIDS (Acquired Immune Deficiency Syndrome) is an effect of HIV infection. It can also be viewed as a collection of disease symptoms resulting from the decreased immunity induced by HIV infection (Erida et al., 2019). It is not surprising that HIV/AIDS is a chronic disease that can claim human life, given that the deterioration in the immune system caused by HIV/AIDS increases the chance of contracting other diseases and death by a factor of three (Kusumawati, 2019). In 2018, the World Health Organization (WHO) reported 37.9 million HIV patients and 1.8 million newly infected individuals. 21% of HIV-positive individuals are unaware of their infection, and as many as 770,000 people have been pronounced dead. An estimated 5.9 million people in Asia have been diagnosed with HIV, and 200,000 people with HIV have died.

The data from the Ministry of Health of the Republic of Indonesia and the Directorate General of Disease Prevention and Control in Indonesia demonstrated that 498 out of 514 regencies/cities in Indonesia reported HIV/AIDS cases between January to March 2021. There were 7,650 HIV-positive individuals in each province, 71.3% of whom were between the ages of 25 and 49, and 69% were male from January to March 2021. As many as 27.2% of the identified risk factors were from homosexual people, 25.3% were from the LSL group, and 0.9% were transgender. According to the 2019 United Nations Programme on HIV and AIDS (UNAIDS) report, it has the third-highest number of HIV/AIDS patients in the Asia-Pacific, after Afghanistan and Bangladesh. This score suggests that Indonesia has a relatively rapid rate of HIV/AIDS transmission (Kusumawati, 2019).

In January - March 2021, 7,650 people were living with HIV in each province, with an age range of 25-49 years of 71.3% and primarily male sex (69%). as many as 27.2% of the risk factors found were from individuals who were homosexual, as many as 25.3% were from the lsl group and 0.9% were transgender. UNAIDS, 2019 notes that Indonesia is the third-ranked country with the highest number of HIV/AIDS patients in the Asia pacific after Afghanistan and Bangladesh. This ranking indicates that Indonesia is a country with a relatively fast rate of transmission of HIV/AIDS (Kusumawati, 2019).

According to the central java provincial health office, the number of people infected with HIV/AIDS in 2021 was around 52,677. However, only about 70% of the data collected, or roughly 35,238 records, were confirmed and inspected. According to cumulative data from the KPA (Aids Prevention Commission), during the past five years in Salatiga, 156 people were infected with HIV, 187 people were infected with AIDS, and 77 were proclaimed dead. According to available statistics from the KPA (AIDS Prevention Commission) in Salatiga, 215 people were infected with HIV/AIDS in the last five years owing to homosexual behaviour, 48 people due to heterosexuality, 1 (one) person due to bisexuality, 65 people due to IDU, and 6 (six) people for perinatal. According to new data from the KPA (AIDS Prevention Commission) in Salatiga, there were 3 (three) people infected with HIV, 3 (three) males infected with AIDS, 2 (two) females infected with AIDS, and 2 (two) people proclaimed dead between January and May 2022. Based on the most recent data from January to May 2022, 1 man and 3 (three) females were infected with HIV/AIDS since they were heterosexual, 2 (two) males were infected since they were homosexual, and 2 (two) males were infected since they were bisexual.

Becoming a PLWHA carries a substantial risk to one’s existence, which has biological, social, economic, and psychological repercussions. PLWHA have many concerns, not limited to physical health alone; however, being a PLWHA presents significant psychosocial issues (Windarti et al., 2021). Being labelled as a PLWHA and living in society is not simple. People must not only contend with medical issues about their condition but also with sociocultural issues involving stigma and prejudice from the surrounding community. This stigma and discrimination cause psychological problems in PLWHA due to a lack of self-confidence and a sense of helplessness over the difficulties they confront (Triratnawati, 2021). The perceptions and responses of the surrounding community toward individuals who test positive for HIV/AIDS infection are likewise quite negative; often, society labels PLWHA as imperfect humans, rejects them and shuns them. Typically, these individuals’ treatment will result in marginalisation, exclusion, and prejudice, worsening the mental health of PLWHA (Nuwa et al., 2019).

Individuals infected with HIV/AIDS will endure apparent physical changes over time, and HIV will damage the physical health of PLWHA by attacking their immune systems (Astuti et al., 2010). According to Bastaman, 1996, these material changes can affect the psychological of PLWHA, causing them to experience disappointment in themselves, rejection of HIV/AIDS in their bodies, anger at the circumstances that have transpired, and even sadness and dissatisfaction (in Yulianti, 2020). Individuals infected with HIV/AIDS who experience these emotions retreat and isolate themselves from their surroundings since they view themselves as worthless (Yulianti., 2020). As a result of societal stigma, PLWHA with HIV/AIDS will experience psychological issues, causing them to feel frightened, helpless, and concerned about their lives and families (Triratnawati, 2021). PLWHA believe that to survive and continue with their lives, they must have a meaningful purpose, goals, and excitement for living under the existing conditions.

Individuals who can perceive from their perspective how far they can live and live the life they are living can comprehend the meaning of life (Frankl, 2000). Diverse facets, such as life objectives, life satisfaction, freedom, attitudes toward death, suicidal thoughts, and deservingness to live, can shed light on the meaning of life (Frankl, 2000). In every circumstance of an individual’s existence, whether standard or joyful, as well as suffering, disease, living with guilt, and death, the individual must also find meaning (Hapsari, 2014). If individuals can interpret all life processes, PLWHA will have the motivation and responsibility to carry out daily duties, situate themselves in a community setting and continue to give and receive affection from others (Setyo et al., 2018).

Individuals with a low meaning in life demonstrate an inability to find and fulfil the true meaning of life; this loss of one’s life meaning causes the individual to feel that life is meaningless, empty, arid, has no purpose in his life, thinks that his life is no longer there, which translates to feelings of boredom and apathy (Setyo et al., 2018). With such a shared sense of purpose, the individual will lose the incentive to continue living and address current issues. Therefore, PLWHA must have a meaningful existence to have the motivation to continue positively developing themselves.

The study’s results (Kiriwenno et al., 2021) indicated that research subjects with HIV/AIDS shared a sense of purpose after learning they were HIV-positive. People with HIV reportedly have a diminished sense of meaning due to a lack of self-acceptance and an unfavourable response from the surrounding environment. Individuals feel prejudiced due to disparities in the treatment they experience, such as rejection in the family in the form of cutlery separation and other forms of treatment.

The authors did a preliminary study with the coordinator of one of the PLWHA communities in Salatiga regarding the meaningfulness of life for PLWHA with families in Salatiga to determine the phenomena that occur. Based on the interviews, the coordination of PLWHA in Salatiga stated that the causes of HIV/AIDS infection among PLWHA were diverse. According to the development trend, the causes of HIV/AIDS transmission also change; in 2007, HIV/AIDS transmission was due to injecting drug users; in 2007-2013, the information was due to heterosexual behaviour; and in recent years, the majority of cases of transmission were due to homosexual behaviour. Nonetheless, in adults with families, HIV/AIDS is frequently transmitted through sexual behaviour involving prostitutes (Commercial Sex Workers) or being infected by their partners. According to the coordination of the PLWHA community, data collection on infected individuals and HIV/AIDS screening of individuals with complications from other diseases were identified. They needed to conduct HIV/AIDS testing at the hospital, blood tests on the outcomes of blood donations, and screening by a specially assigned team; thus, the authorised government agency could obtain information on everyone in Salatiga suspected of being HIV-Positive.

The coordinator of the PLWHA community in Salatiga stated that after PLWHA found they had been infected with HIV/AIDS, they began to face psychological issues such as sadness and fear of the afterlife. Aside from that, a viral infection in their bodies necessitates that they seek treatment, therapy, and drugs regularly, and they are subject to discrimination and societal punishments. So, according to the organiser of the PLWHA community, this is the reason they eventually shut down and hide their sickness; they do not want treatment and do not wish to be open about their status. This sanction makes PLWHA susceptible to adulthood and those with married status easily to depression since they must consider the fate of family life, particularly when they have young children, the economic conditions of the family that they must bear, and the discriminatory social conditions. This ultimately enables PLWHA who undergo behavioural changes, such as a tendency, to become more reserved to accept their circumstances. Individuals infected with HIV/AIDS are physically weakened, preventing them from performing their daily tasks. According to the coordinator of the PLWHA community, one of the PLWHA was finally unable to provide for his family and was forced to rely on his wife for financial support.

This research is necessary since individuals who have HIV are subject to discrimination from society. Consequently, folks are concerned about the patient nature of the PLWHA designation on these individuals. This can be psychologically distressing for PLWHA since it leads to sadness, loneliness, and limits in daily activities. Faced with psychosocial issues, PLWHA is uncertain about what attitude to maintain, especially for those with responsibilities as the family’s leader. PLWHA must consider the fate of the continued social and economic existence that must be borne. In addition, a viral infection in the body imposes restrictions on PLWHA’s ability to work and interact with the community.

The results of the preceding explanation provide an overview of the issues faced by PLWHA and the significance of establishing a meaningful existence for PLWHA. As a result of their circumstances, PLWHA faces various complex problems, not limited to their physical condition, such as psychological, social, and economic difficulties. The PLWHA becomes depressed and unable to make sense of their existence. Therefore, PLWHA needs to strive for success and discover meaning in life. By effectively attaining a meaningful existence, PLWHA can confront their challenges, accept their situation, and yet engage in activities and experience satisfaction.

METHOD

Married people with HIV/AIDS (PLWHA) who had the status of family heads and were responsible for the survival of their families in Salatiga and were willing to become research subjects by providing informed consent comprised the participants in this study. This study employed a qualitative, phenomenological research methodology. Participants in this study were chosen using a technique of purposive sampling. The writer employed observation and interview procedures organised according to the relevant parts of life and the factors of the meaning of life to collect data. This interview will be performed face-to-face under health regulations. The probing approach was employed while submitting queries to get more in-depth knowledge on the topic. The equipment utilised in the interviews were books, stationery, and tape recorders, which were used to record and document the results of the interviews, which were then examined. In this study, interactive data analysis approaches were utilised. According to Miles and Huberman (in Fadli, 2021), interactive data analysis methodologies consist of four analysis process components. The initial step will involve data collecting through in-depth interviews and observations of research subjects. The following step is data reduction, summarising, selecting the most critical information, and focusing on the essential details. Data display (data presentation) describes the data acquired as a narrative or a description. In addition, conclusions (concluding), i.e., drawing conclusions and confirming the outcomes of the provided data.

The research is conducted periodically and systematically for two months, which will enable the researcher to monitor the data's development over time and identify trends or patterns that emerge in the subjects. This can help the researcher to analyze the data more accurately. Additionally, by conducting periodic meetings, the researcher can also ensure that the research subjects are actively involved in the research process and understand the goals and benefits of the study. The research subjects selected are individuals infected with HIV/AIDS and who are heads of households, as the researcher aims to understand how the HIV/AIDS virus can affect the daily lives of those who have family responsibilities. Furthermore, this research is conducted to gain a deeper understanding and explore the psychological, psychosocial, and economic impacts experienced by the research subjects and their families.

RESULT AND DISCUSSION

Participant 1 Description

Participant 1 is a 39-year-old family head. Participant 1 married in 2002 and had a son. he was infected with HIV/AIDS in 2005 due to injecting drug use. The condition of participant 1, when he was declared infected with HIV/AIDS, was deteriorating; thus, he had time to lock himself in his room. The condition of participant 1, who was declared infected with HIV/AIDS, caused problems in his relationship with his wife; thus, he decided to stay at his parents' house and get support from his parents during his downtime. After eight years of maintaining a marriage relationship, in 2010, participant 1 divorced his first wife and remarried in 2012. in his second marriage, he was blessed with a child. Currently, participant 1 is stable, and he continues to be diligent in taking vitamins assisted by social support from his wife and children. Participant 1 had worked at an NGO (Non-Governmental Organisation) and the National Narcotics Board. Participant 1 in his work focuses on assisting friends who are infected with HIV/AIDS.

Participant 2 Description

Participant 2 is a 33-year-old household head. Participant 2 wed a woman he had known since 2003 in 2007. Participant 2 is the proud parent of an 8-year-old boy. In Salatiga, participant 2 is employed by a Non-Governmental Organisation (NGO). This organisation is relocating to accommodate HIV/AIDS-infected friends. In 2009, participant 2 tested positive for HIV/AIDS and began treatment in 2010. He contracted HIV/AIDS as a result of using drugs. After self-examination with the doctor owing to diarrhoea, he discovered he had HIV/AIDS. Upon realising he had HIV/AIDS, participant 2 suffered sadness. This leads to a disorganised p2 state of mind that hinders daily activities. Aware of participant 2's illness, participant 2's wife was constantly around to follow and assist participant 2; thus, she may lead an everyday life.

The Meaning of Life

The meaning of life can be viewed as a situation in which an individual can understand from his perspective how much he can live and appreciate the meaning of life being lived (Frankl, 2000). In determining the extent to which one can interpret one's life, there are unquestionably supportive factors, namely life goals, life satisfaction, freedom, attitude toward death, suicidal thoughts, and life decency.

Purpose of Life

TN (P1)

Even though TN was at his lowest point when he was diagnosed with HIV/AIDS, he claimed that he had persevered through these difficult times since he still desired to live longer. In addition, based on the observation results, TN still appears to have a strong sense of purpose in life and a determination to continue living with high spirits and productivity. This shows that despite the extremely difficult health condition faced, the research subject is able to maintain a good quality of life and continue to struggle in facing life's challenges. "Yes, I have a single objective in life thus far. I desire to live longer”.

DY (P2)

DY stated that one of the reasons to maintain a positive attitude and accept one's circumstances was for the sake of one's family. Since his family was his life's objective, he was responsible for his survival and that of his family as the leader of the household. From the observation results, the research subject still has a sense of purpose in life as they are aware that their family still needs them, and they understand that there are still children who depend on them. "My current objective is to maintain the will to live and make peace with the situation for the sake of my family”.

Life Satisfaction

TN (P1)

TN experienced he was never satisfied, even though TN human beings have always experiences sufficient and content as long as they live. However, on every journey of his life, and as an individual in general, he was never happy with what he had and obtained; he desired to live a better life through his accomplishments. Based on what was seen from the observation results, it indicates that although the research subject has a low level of life satisfaction, they still have the motivation to continue striving to improve their quality of life. "There is no satisfaction for human. I only want to live better than before”.

DY (P2)

DY believed that he was not yet at a point of contentment since life has its dynamics. Life is not always enjoyable; however, difficult moments will also occur; thus, for DY, life was satisfying if he could appreciate the dynamics of life that continue to emerge. According to what was seen from the observation results, the life satisfaction of the research subject is indeed limited, but they still choose to enjoy the phases of their life with enthusiasm and happiness, and do not give up in the face of the disease that afflicts them. "Yes, that’s life, there are phases when we're happy, when we're sad, it's called life, it's spinning, so we just enjoy those phases”.

Freedom

TN (P1)

Independence in running life is crucial for everyone, despite those with HIV/AIDS. Although in society, the stigma for people with HIV/AIDS is frequently negative and results in discriminatory behaviour, such that those who are discriminated against believe they cannot lead everyday lives. Despite being infected with HIV/AIDS, TN thought the community's attitude toward him was unchanged. TN believed that he could live freely such as other people by continuing to live. Based on the observation conducted, the research subject did not appear to receive any different treatment from those around them and they continued to positively contribute to the community. "No, Ms. Even though most people view HIV/AIDS-infected individuals negatively. But for me, I can still live freely like everyone else. I never feel like people are shunning me or anything”.

DY (P2)

Freedom to conduct daily activities is a right for every living thing. Similarly, although DY’s physical state was frequently seen poorly by society, he nonetheless pleased with the same freedom as everyone else. DY stated that he could still associate with his buddies without fear of exclusion. DY stated that he lived a carefree lifestyle as he should; thus, it benefits his buddies. The observation conducted showed that the research subject has the freedom to live their life without discrimination, allowing them to continue their daily activities and interact with others. "No, it's the same, it's just more natural, yeah, I think this is a life adventure. There's nothing that indicates I keep my distance from my friends. I accept them when they come, so it's the same as before”.

Attitude towards death

TN (P1)

TN must simultaneously deal with health and social issues due to his difficult living conditions. TN was in poor health when he realized he was HIV/AIDS positive. This was since the information in the community indicates that those infected with HIV/AIDS do not survive long or will decease shortly. Subsequently, this was what prompts the belief that TN would pass away soon. The observation results showed that TN actually feels anxious about facing the reality of death, but they have accepted the fact that death is a part of life and remain calm in facing it. "Yes, I have felt depressed, because I believed I would pass soon, given my condition”.

DY (P2)

The most challenging time for him was when he discovered his body was infected with HIV/AIDS; thus, he had unpleasant emotions. With the infection within him, he believed his life was no longer lengthy. This made him think he was doomed to decease with no future. This thought finally hindered him from escaping danger and engaging in activities as before he contracted HIV/AIDS. The observation conducted showed that the research subject has various attitudes and thoughts about death, which eventually led them to take the opportunity to reconsider the meaning of life and give it a better sense. “For attitude, just be silent and think about what you're about to do. I had no future whether I died or not... sure, there were a lot of unpleasant things to think about at the moment, which is why I was puzzled about what to do. That is also one of the obstacles”.

Thoughts of Suicide

TN (P1)

TN had reached his lowest moment after realising that his body was afflicted with HIV/AIDS; thus, he shutted himself in the house and refused to leave. These circumstances precipitated TN's urge to commit suicide. From the observation results, the subject showed a tendency to have suicidal thoughts due to feelings of despair, hopelessness, and difficulty in coping with their health condition. However, they also realized that suicide is not the solution. "When I initially discovered my problem, I was able to shut myself up, so I never wanted to leave the house, Ms. Yes, I shut myself in because of my situation and wanted to commit suicide”.

DY (P2)

DY was not concerned about what would occur after discovering he has HIV/AIDS. His health condition limits his lifespan; therefore, he fears that he will die, his life will stop, and he will be forced to abandon his wife and children. Based on the observation conducted, it is evident that the subject has contemplated suicide, but they still exhibit a sense of responsibility towards their family. "There is nothing to worry about. It’s only dying; that's how his life ends. I believe that is the only thing I can leave my wife and children”.

The Decency of Life

TN (P1)

Even though he had HIV/AIDS, TN believed he deserved to live everyday life. As the household leader, TN wanted to live even longer since he experienced responsible for the existence of his family. From the observation results, it is evident that TN has a high sense of living decency, as they appear to strive to fulfill the needs of their family, and their ability to carry out their responsibilities towards their family is remarkable. "Yes, I feel that I deserve to live. I desire a longer life span. And I still have responsibilities as a family head”.

DY (P2)

Consisten with the leader of the family who selects to be responsible for his family, DY believed he still deserved to live as an average individual. As the head of the family, he must remain alive to ensure the survival of his small family. Based on the observation, it is evident that DY has a high sense of living decency as they recognize their role as the head of the family responsible for ensuring their family's survival. They are seen to strive to obtain medical care and maintain good health. "Yes, I still feel acceptable. Because I am the head of the family. I must also consider my family, so if die, what about my family?".

Factors that support the Meaning of life

According to Bastaman (2007), the factors that define achieving a meaningful life are self-understanding, the meaning of life, changing attitudes, self-commitment, directed activities, and social support.

Understanding

TN (P1)

TN recognises the condition of his body after enduring a harrowing trip through life over the previous several years. TN focuses on acquiring God-ordained sustenance due to his responsibilities as the family's chief executive officer. In addition, from the observation results, it is evident that TN has a strong self-awareness of their condition. This strong self-awareness indicates that the subject has good self-management and improves their overall quality of life. "Yes, I am aware that I have HIV/AIDS and that my life expectancy is short. Yes, despite it being so, I am also certain that family sustenance is never in error. Yes, even though I was depressed in the past since I realised, I could not accept the condition at that time. However, currently you realise, you must maintain your zest for life while being a PLWHA”.

DY (P2)

He experienced a change in his physical state the first time he was proclaimed infected with HIV/AIDS, such as being weary rapidly, tired, lazy, and occasionally unstable thinking. However, after he could make peace with his living situation, he experienced his physical condition was back to before. The observation results indicate that DY has made peace with themselves and accepted their condition, which helps them obtain a strong self-awareness of their situation and improve their overall quality of life. "Physically initially, sure, because the condition of the body is not yet very steady, not very healthy. I may tyre easily, and my mind may not be stable. I'm too lazy to be tired; however, everything returns to normal once we've made peace with ourselves”.

Meaning of Life

TN (P1)

Currently, TN's life objective has been to discover the meaning of life, which has helped him endure terrible situations. The meaning of life, currently TN understands he has HIV/AIDS, is how he can be significantly more helpful than before. The observation results indicate that a strong sense of meaning in life can help the subject overcome the stress caused by HIV/AIDS and improve their self-esteem and life goals. "For me, yeah, if that's the point of life, how to be a much more useful individual than I was before".

DY (P2)

DY understanding of life prioritises family by delivering the best, especially for his children and wife. Observing his family's support during difficult times has inspired him to maintain his enthusiasm throughout the day. Having a family that is happy and healthy is essential to him. Based on the observation results, the subject has a stronger sense of meaning in life by living with their family in happiness, despite being infected with HIV/AIDS. "The meaning of life is that my family and children are happy”.

Alteration

TN (P1)

Since TN's existing self-acceptance causes difficulties previously regarded as serious, TN now believes that no conduct or action should be regretted or remedied. TN behaved without hypocrisy. On the other hand, TN believes that no matter how hard he tries to modify his mindset, he will not be able to avoid future temptations, no matter how hard he tries. From the observation results, it appears that the subject lacks initiative in changing their attitude, as they tend to be passive and less proactive in dealing with their situation. "Yes, the mentality to be able to change oneself isn’t there, for me. Yes, because I believe that temptation is constantly present”.

DY (P2)

DY did not reveal a change in his attitude; however, he believed his life to be better than before he contracted HIV/AIDS. This was since he received fresh opportunities and experiences from HIV/AIDS-afflicted friends and non-governmental organisations (NGOs), which provide possibilities to share and motivate one another. Based on the observation results, over time and with the support received, the subject begins to show signs of positive change. The subject becomes active in seeking information and support sources to help them cope with their problems, including participating in support groups and following HIV/AIDS prevention programs. The subject also begins to show a more positive and enthusiastic attitude in daily life and strives to live more independently and confidently. "In the same way. Before and after, my feelings are the same; there is no change. People may have thought this way before and after the event; there must be a difference. However, it turns out that what I witnessed with my friends happened before and after that, and that what is life, the process of life, seems better currently than it did in the past”.

Commitment

TN (P1)

TN decided to better himself and move on with his life. According to the interview results, TN was also stable. He maintained that this episode was not a catastrophe; however, rather a chance to better himself and be consistent in his behaviours. Furthermore, from the observation results, the subject has a commitment to living a better life despite facing difficult conditions. The subject appears to be diligent in maintaining their health by regularly taking prescribed medication, living a healthy lifestyle, and avoiding things that could worsen their HIV/AIDS condition. "Yes, let it flow. How to better, and how about I commit to my health by taking vitamins daily”.

DY (P2)

The attitude of DY was consistent with his life objective of making his family happy by going forward and rectifying mistkaes that have been created. It is also evident that he had a higher purpose in life, as he is dedicated to achieving a life goal for his family. Based on the observation results, the subject appears to have a strong commitment to living their life with the goal of providing the best for their family, including taking care of family members in need, providing emotional support, and maintaining harmonious relationships with all family members. The subject also appears to prioritize the health and well-being of their family, including taking care of their own health and ensuring that their family is protected from the risk of HIV/AIDS. "Yes, continue to look forward while correcting previous mistakes, and then prioritise and be consistent with life goals for your family, sister”.

Directed Activities

TN (P1)

TN decided to leave his employment for some reason some time ago. Therefore, TN did not engage in consistent daily activities. However, TN frequently filled his days with socialising with his buddies. Moreover, before leaving the National Narcotics Board, TN actively shared with friends infected with HIV/AIDS. Based on the observations conducted, it can be seen that the subject lacks motivation to fill their free time. However, it is evident that the subject still has potential that can be developed. "Yes, there is now no action. Unemployed workers. However, I served as a consultant for HIV-positive friends at The National Narcotics Board”.

DY (P2)

DY disclosed that he worked in an active community service centre that supports and facilitates HIV fighters in health and nutrition facilities. Besides that, from the observation results, it is apparent that in their activities, the subject appears to be very enthusiastic and passionate in assisting and providing support to the community affected by this disease. I see that this activity provides clear meaning and purpose in the subject's life, as well as an opportunity for the subject to develop new skills and experiences. "Yes, I'm busy working at a community service centre, particularly with HIV-positive individuals”.

Social Support

TN (P1)

Since TN (participant 1) was diagnosed with HIV/AIDS, his parents and other loved ones supported his illness. TN's parents provided support by bringing him to the doctor and caring for him, while TN's second wife and child provided support by reminding him to take his medication and maintain a healthy physique. Since TN's family recognised that TN's physical condition differs from that of those without HIV/AIDS. Based on the observation results, the subject's family appears to be very caring and attentive to the subject's condition, and always provides moral and emotional support to the subject. I see that the subject's family is also actively involved in the subject's healthcare, such as monitoring medications and maintaining a healthy diet. "Yes, my parents supported me when I first learned I was infected with HIV/AIDS; Yes, I was cared for; Ms Miss brought the term to the doctor. If my wife and children remind me, I always remember to take my vitamins, and I'm also reminded to maintain your health”.

DY (P2)

DY's extended family had prejudiced against him owing to a lack of knowledge regarding how to treat HIV/AIDS patients. However, after being informed, his family gradually began to accept his condition. Throughout his journey in combating the virus in his body, his wife and children provided him with constant support and cared for him during the difficult moments he had endured up to this point. The observation results show how family plays a significant role in providing support for the subject to rise above the negative response from the society. "I didn’t get support from the community, but yeah from my family. They provided me many thing when they first knew about myself, such as places to eat, cutlery, towels, and soap, the daily basics we use, which we provide ourselves; thus, we may do it together. Initially, they did not comprehend, as time goes by, they understand it”.

DISCUSSION

Based on an examination of the data gathered from the research results, the authors determined differences or similarities between the research participants in experiencing the meaning of life after being diagnosed with HIV/AIDS as family members. In this study, the two individuals had distinct life goals when attempting to determine the meaning of their lives. Despite their difficulties and stigma, PLWHA has plans and a passion for life.; thus, PLWHA can overcome these obstacles and select what new life goals will serve as their foundation. Then, PLWHA will be able to shift the condition of their self-esteem from having no meaningful life to having a meaningful life, allowing them to continue to experience love and happiness as a result of their life achievements (Setyo, 2018).

The two participants have not yet reached the stage of life satisfaction, where life satisfaction is defined as the emotion an individual has while evaluating his life and activities, i.e., how much he can enjoy and experience satisfaction in the life he is living (Frankl, 2000). However, both individuals are content since they appreciate all aspects of their lives. The two participants are attempting to respect the current phase of their lives; thus, they can feel satisfied with their accomplishments. Bastaman (2007) contends that when an individual recognises the meaning of his life, he is on the path to life fulfilment and pleasure. The meaning of life is associated with the search for a vision of life, hope, and motivation to continue living.

Regarding freedom for both participants, most people continue to hold erroneous beliefs about their conditions. However, the two individuals can continue to live without discrimination from the surrounding environment. They can continue to live normally, with no one avoiding them or withdrawing from their surroundings. The participants’ definition of freedom does not imply unrestricted or unrestrained existence; instead, the freedom of life referred to here is subject to societal standards (Windarti, 2021). According to Frankl (2000), freedom is an individual’s perception of his life and activities and the extent to which he can enjoy and be satisfied.

Regarding views about death, the two participants diagnosed with HIV/AIDS were acutely aware that their life expectancy was significantly less than that of healthy individuals. Since, as is known, no cure for HIV/AIDS has been discovered (Astuti & Budiyani, 2010). Consequently, this will result in the creation of negative views about mortality among research participants. This idea ultimately impeded their ability to engage in other tasks. However, as time passed, the research participants regained self-awareness and resumed their everyday actions, such as searching for food.

After learning that they had HIV/AIDS, the two individuals had time to remain silent and avoid social interactions while they entertained suicidal thoughts. Consequently, this led to the two individuals having unfavourable views about the state of their bodies, and the desire to end their lives arose. With time, however, the two participants may make peace with one another and return to their everyday lives. Suicide-related thoughts might develop when an individual’s health is unfavourable and significant challenges arise. However, those with a purpose in life will try to avoid suicidal thoughts or have never considered it (Windarti, 2021).

Both participants believed they deserved to live since they were responsible for the survival of their families. The two participants, who are also the heads of their respective families, have the right to continue living since they are responsible for themselves and their families. This obligation will make PLWHA aware that they deserve to live despite being diagnosed with HIV/AIDS, so suicidal ideas do not even cross their minds (Astuti & Budiyani, 2010).

Both participants had a clear grasp of their physical status as PLWHA. The two participants also knew that, besides being PLWHA, they were responsible for the existence of their family, so they attempted to make peace with themselves and concentrate on earning a living for their family’s survival.; thus, an individual’s self-understanding plays a significant role in his life since it can assist him in overcoming his life challenges and meeting his requirements or achieving his objectives (Prasetya, 2018).

Regarding the meaning of life, participant 1 believes that his future actions will be superior to his past activities. Participant 2 thought his life would be significantly more meaningful if he could see his family happy. The purpose of life is related to the search for a vision of life, the existence of hope in life, and the existence of compelling reasons for individuals to continue to live. Doing good deeds and exhibiting disciplined attitudes and conduct that promote a high sense of moral obligation are also essential aspects of the purpose of life (Astuti & Budiyani, 2010).

Regarding changing themselves, the participants believed that, after being diagnosed with HIV/AIDS, they had not altered their attitudes. Despite this, the two research participants thought that their lives had improved after becoming infected with HIV/AIDS. This is ostensible since they can join the NGO community (non-governmental organisations) and get new life experiences, possibilities, and lessons. Self-change is the desire to be better; in this state, an individual is motivated to modify previously poor behaviour to become better at recognising and coping with difficulties (Bastaman, 2007).

In terms of commitment, both participants had strong and consistent life objectives. In contrast, a PLWHA and the head of a family had life goals and obligations to care for and provide for their families, which enabled the two participants to commit to their future actions. In addition, both participants’ physical ailments necessitated taking drugs to maintain their body’s immunity; thus, they committed to consistently ingesting prescription drugs.

Two participants were selected to work actively in non-governmental organisations (NGOs) in time-filling focused activities. They could join NGOs (non-governmental organisations) to share their stories and encourage their peers who had also tested positive for HIV/AIDS. Both parties engage in mutually beneficial activities. Life can be enriched by directed actions that benefit oneself and others. Required actions are the efforts individuals undertake to attain the purpose of life by cultivating their good potential, interests, and skills (Bastama, (2007).

The relatives of both participants provided social support for both participants. According to the participants, although this support was little, it was substantial and might contribute to a meaningful life and a desire to live longer. When social support is readily available, individuals perceive that they are liked, appreciated, and cared for. Personal worry will be reduced, and optimism for a longer life will be bolstered by the attention and support of others. When PLWHA have favourable experiences regarding their existence in society, they will rapidly comprehend the meaning of their life (Ramiza, 2018).

Study Limitations

There is room for improvement in the writer’s research due to restrictions inherent in the research process. Participant information is limited due to the confidential nature and status of the study’s participants. Furthermore, partisans must be more forthcoming when sharing their feelings and experiences. This is since the conditions and quality of partisans in society are typically kept secret, and the standards for involvement have solidified, making it challenging to investigate the emotions and situations of actual participants in depth.

CONCLUSION

The study’s findings demonstrated that married PLWHA (People Living with HIV/AIDS) in Salatiga enjoy a meaningful existence. Even though being diagnosed with HIV/AIDS is not simple, it entails enormous difficulties and hazards in life that harm survival. PLWHA have various problems, not limited to physical health alone; however, they also face substantial psychosocial, psychological, and economic issues. They are primarily accountable for their family’s survival as head of the household. The study’s results demonstrate that the two individuals have interpreted their life. According to Frankl, they have satisfied all aspects and factors contributing to life’s meaningfulness (2000). Both participants had a sense of the purpose of life, as evidenced by the fact that they could have life objectives, respond to suicidal impulses, and identify why they deserved to live. In addition, the two participants could comprehend their condition, so they knew what was required of them. Their commitment to continue their lives with the assistance of relatives who give social support demonstrates that both individuals have meaningful lives. It can be said that the two participants who are heads of families can interpret their lives and are responsible for the survival of their families since the results of the study strongly suggested that responsibility as the head of the family could encourage participants to overcome adversity and seek the meaning of life for their survival and that of their families.

Consequently, PLWHA is expected to be able to make sense of their lives; thus, they can live their next life with definite goals and survive for their own and their family’s survival. It is also intended that the community will recognise the existence of PLWHA, be able to coexist with them and reduce stigma and discrimination towards PLWHA. Respect the rights of PLWHA and assist PLWHA patients when necessary. As well as suggestions from the author for those who wish to continue this research or those who want to research the same topic is to dig into more detail about the meaningfulness of life for married PLWHA and can build rapport with participants; thus, partisans want to describe their situation clearly and under what is expected. It is being encountered.

Acknowledgement

The researchers would like to thank to the participants and Salatiga City health office for their invaluable assistance and participation throughout the research process. Thank you for your time, support, and contributions.

DECLARATIONS

ETHICS APPROVAL AND CONSENT TO PARTICIPATE

Researchers have obtained research permits from the Salatiga City health office and have also obtained consent from the research participants prior to conducting in-depth research.

CONSENT FOR PUBLICATION

I fully agree that this thesis can be published for academic purposes and I am ready to provide support and additional information needed to facilitate the publication process.

AVAILABILITY OF DATA AND MATERIAL (ADM)

All of the data and materials used in this research have been collected well and are available for those who need them, both for academic purposes and further research.

COMPETING INTERESTS

The authors declare no conflict of interest.

FUNDING

In this research process, the researcher used personal funds to support the continuity of the research.

AUTHORS' CONTRIBUTIONS

The author's contributions to this research include planning, data collection, analysis, and report writing. All of these contributions would not have been possible without the support of the parties who have assisted in the research process.

Copyright and Licenses

Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under an Attribution-ShareAlike 4.0 International (CC BY-SA 4.0) that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.

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