Skip to main content
Download PDF

Resilience and social isolation in people living with HIV: a case study in Iran

BMC Research Notes volume 18, Article number: 7 (2025) Cite this article

Abstract

Objective

People living with HIV (PLHIV) often face increased vulnerability due to factors like social isolation and reduced resilience. These factors can negatively impact health outcomes, quality of life, and well-being for both PLHIV and their families. Therefore, healthcare providers should carefully assess these variables when providing care for PLHIV. This study evaluated the levels of resilience and social isolation among PLHIV.

Results

PLHIV demonstrated high levels of resilience (77.16 ± 18.78) and moderate levels of social isolation (52.77 ± 6.63). Additionally, a strong inverse correlation was found between resilience and social isolation (r = -0.60, p < 0.001). Given the results, it is imperative for health policymakers, healthcare providers, and psychologists to prioritize strategies that enhance resilience and reduce social isolation among PLHIV.

Peer Review reports

Introduction

Living with HIV presents significant psychological and emotional challenges for individuals [1, 2]. One of the primary psychological challenges for people living with HIV (PLHIV) is the high level of perceived stress associated with factors such as diagnosis, disclosure, breach of confidentiality, and treatment course [3,4,5]. Stressful experiences among PLHIV can have detrimental consequences, including decreased adherence to antiretroviral drugs, increased mortality, opportunistic infections, substance abuse, and risky sexual behaviors, all of which are risk factors for individual health, family well-being, and public health [6]. However, individual responses to stress vary widely. Some individuals may develop psychiatric problems such as posttraumatic stress disorder, while others may experience transient psychological symptoms. Additionally, some individuals may not report any symptoms at all. These varying responses can be attributed to individual differences in adaptability and resilience [7].

Resilience, characterized by adaptability and the ability to navigate challenges, is a dynamic process triggered by adversity that leads to positive outcomes [8,9,10]. Based on the Resilience in Illness Model (RIM) on chronic patients, resilience is affected by both protective and risk factors. If protective factors cannot withstand adverse events, resilience will decrease; on the contrary, resilience will sustain balance and even improve. Social support, courageous coping, spiritual perspective, hope, and family environment are as important protective factors of resilience, and illness-related distress (uncertainty and symptom distress) and defensive coping are known as the risk factors that can negatively affect resilience [11].

Individuals with higher resilience are better equipped to cope with traumatic events and emotional distresses than those with lower resilience [12]. According to RIM, resilience can serve as a protective factor against the negative effects of disease diagnosis and labeling [11]. Employing resilience strategies enables individuals to respond better to threatening and unpleasant events [13]. Resilience not only protects PLHIV by enhancing positive health behaviors such as active engagement in healthcare and adherence to antiretroviral treatment but also mitigates anxiety, trauma, and stress, leading to improved mental health and physiological function [14].

PLHIV often face stigma and rejection from friends and family, contributing to their social isolation [13, 15]. Social isolation occurs when PLHIV lose communication and interactions with others, leading to reduced participation in formal and informal groups [5, 16]. This isolation can have negative consequences such as disconnection from healthcare, disease progression, and the spread of infection [17]. Additionally, social isolation and low resilience can impact PLHIV’ physical health, mental well-being, and overall quality of life [7, 18], hindering the achievement of 90-90-90 goals [19].

A review of the literature in different settings and cultures has shown varying levels of resilience [7, 13, 20] and social isolation among PLHIV [21, 22]. Studies have found that enhancing resilience in PLHIV can reduce stress levels and social isolation [8]. Research has linked social isolation to higher mortality rates of PLHIV, highlighting the urgent need for resilient interventions [17]. Additionally, researchers have shown that social support, strong marital and familial relationships strengthen the resilience of PLHIV when facing the challenges associated with the disease [23,24,25].

PLHIV often face vulnerability due to social stigma and isolation. Resilience and social isolation are important factors influencing the physical health, mental well-being, and overall quality of life for PLHIV. These factors can be influenced by environmental and cultural conditions. However, limited studies have addressed the correlation between resilience and social isolation among PLHIV in Iran. Conducting studies in different societies can provide comprehensive information about resilience and social isolation among PLHIV. Moreover, the results of such studies can be used to discover the health-promoting factors and design appropriate interventions for enhancing resilience and alleviating social isolation of PLHIV. Therefore, this study evaluated the correlation between resilience and social isolation among PLHIV.

Materials and methods

Study design and setting

This study was conducted at a behavioral disease counseling center affiliated with Kerman University of Medical Sciences in southeastern Iran. We chose a cross-sectional study design due to its relatively low cost, quickness, ability to provide information on multiple variables from a population at a single point in time. This design can also guide public health planning.

Sampling

The target population included all PLHIV who were actively receiving care at the specified center (N = 176). The inclusion criteria were a minimum of six months since diagnosis, the ability to read and write, and an age of 18 years or older, while the exclusion criteria included immigration, death, and incomplete questionnaires. Sampling techniques was convenience sampling, which involves selecting participants from the target population based their accessibility. A sample size of 123 participants was estimated considering the test power of 80%, d = 0.05, and α = 0.05.

Measurement tools

Demographic questionnaire

This questionnaire included 12 items (see Table 1).

Table 1 Demographic information of the PLHIV
Full size table

The Connor-Davidson resilience scale (CD-RISC)

Connor and Davidson (2003) [26] developed the CD-RISC with 25 items and five subscales: perception of individual competence, high standards, and tenacity, trust in one’s instincts, tolerance of negative affect, and strengthening effects of stress, positive acceptance of change and secure relationships, control, and spiritual influences. Each item is scored on a Likert scale ranging from zero (not true at all) to five (true nearly all of the time), with total scores ranging from 0 to 100. To facilitate comparisons with other studies, we categorized scores as follows: 0–34 as low resilience, 35–68 as moderate resilience, and above 68 as high resilience. The reliability of the original CD-RISC was confirmed through test-retest correlation (r = 0.87) and internal consistency (α = 0.89), while its validity was confirmed through construct and convergent validity.

We utilized the Iranian version of the CD-RISC. Iranian researchers reported a Cronbach’s alpha of 0.94 for the reliability and exploratory and confirmatory factor analyses to validate the psychometric properties of the CD-RISC [27].

The University of California at Los Angeles loneliness scale (UCLA loneliness scale)

The scale consists of 20 items and is rated on a 4-point Likert scale (never, rarely, sometimes, and always), with the scores of ten items (1, 5, 6, 9, 10, 15, 16, 19, and 20) being reversed. The total score ranges from 20 to 80. To facilitate comparisons with other studies, we categorized scores as follows: 20–40 as low social isolation, 41–60 as moderate social isolation, and above 60 as high social isolation. Researchers established the reliability of original scale through test-retest methods (r = 0.87) [28]. We utilized the Iranian version of the scale, which has been validated through Cronbach’s alpha (86%), expert opinions, and construct and convergent validity [29].

Data analysis

Data were analyzed by SPSS 21. The normality of the variables was examined using the Kolmogorov–Smirnov test. Descriptive statistics such as frequency, percentage, mean, and standard deviation (SD) were used to deal with the PLHIV’ demographic characteristics, resilience and social isolation. The Pearson correlation coefficient was applied to investigate the correlation between resilience and social isolation.

Results

A total of 123 PLHIV with a mean age of 45.34 ± 9.13 years participated in the study (Table 1).

According to the scale scoring, PLHIV demonstrated high levels of resilience (77.16 ± 18.78) and moderate levels of social isolation (52.77 ± 6.63) (Table 2).

Table 2 Scores of resilience and social isolation in PLHIV
Full size table

Resilience and its subscales demonstrated strong inverse correlations with social isolation (r = -0.60, p < 0.001), indicating that higher levels of resilience were associated with lower levels of social isolation (Table 3).

Table 3 Correlation between resilience and social isolation in PLHIV
Full size table

Discussion

The study found that PLHIV in this sample exhibited high levels of resilience, consistent with findings from previous research [7, 13, 20]. However, some researchers have reported low resilience among participants [30, 31]. Resilience is a crucial resource for PLHIV, as it enhances health-promoting behaviors such as healthy eating, regular exercise, and adherence to treatment. Individuals with high resilience can better understand the long-term purposes of successful HIV management and are motivated to achieve these goals [13, 32]. Various factors can contribute to resilience including self-soothing techniques, friendships, intimate relationships, support, problem-solving skills, and emotional regulation [33,34,35,36].

The study found that PLHIV experienced moderate levels of social isolation. Social isolation differs from social integration, which involves having a supportive social network [37]. Research has consistently shown moderate levels of social isolation among PLHIV [21, 22]. Human interactions and communication are essential for understanding the significance of social life and coping with life challenges [38]. Strong social networks can reduce risky behaviors and prevent negative appraisals, making social support a protective factor against PLHIV [39].

The results revealed a strong inverse correlation between resilience and social isolation, which aligns with findings from several studies [38, 40]. Another study reported that social support was positively related to resilience. According to the RIM, it seems that whenever a person engages in emotional and avoidant coping, he/she tries to manage these emotional situations with courageous coping strategies. Moreover, perceived social support as a protective factor can effectively regulate a person’s mental pressure and improve their physical and mental health, and in turn develop resilience in an individual [11]. Resilience is crucial for coping with challenges and negative events, as it reflects internal and interpersonal resources that facilitate effective adaptation. Resilient individuals often employ active coping mechanisms, benefit from social support and understand when to seek help [41]. Research has shown that Factors such as stigma, lack of support, and adverse economic conditions can increase stress among PLHIV, leading to isolation as a coping mechanism [42]. A robust support network can reduce stress and psychosocial issues, providing a sense of social empowerment [43].

Our results may be similar to or different from previous research due to differences in study design, setting, sampling method, data collection tools, and population characteristics. However, the results highlight practical implications for improving the health outcomes of PLHIV through interventions, policy changes, and future research. Healthcare providers should develop integrated psychological and social care services in behavioral disease counseling center to promote positive health outcomes for PLHIV. Additionally, PLHIV should be encouraged to engage with the community by increasing access to healthcare services that enhance resilience and prevent social isolation.

Limitations

This study has several limitations, including its cross-sectional design and potential biases such as self-report bias, confounding cultural factors, small sample size, and convenience sampling, which may impact the generalizability of the results. Since no specific tool was found to assess the resilience and social isolation among PLHIV, longitudinal studies with stronger designs are recommended to address these limitations, considering cultural differences and using specialized, valid, and reliable tools to assess resilience and social isolation of PLHIV in Iran.

Conclusions

The results revealed that PLHIV experienced high resilience but moderate social isolation, and there was a strong inverse correlation between resilience and social isolation. Resilience training can help PLHIV reduce social isolation and prevent psychosocial harm. Policymakers, social workers, healthcare providers should prioritize resilience training to decrease social isolation among PLHIV and their families. Healthcare providers should encourage PLHIV to engage in self-care programs to promote physical and mental well-being and enhance their ability to cope with challenges. Future research should investigate the effectiveness of these interventions for PLHIV.

Data availability

The data supporting the findings of this study are available from the corresponding author on reasonable request.

Abbreviations

RIM:

Resilience in Illness Model

PLHIV:

People living with HIV

CD-RISC:

The Connor-Davidson Resilience Scale

UCLA:

Loneliness Scale, University of California at Los Angeles Loneliness Scale

References

  1. Lotfalizadeh M, Miri S, Foroughameri G, Farokhzadian J. The effect of anger management skills training on anger status of the people with HIV. Perspect Psychiatr Care. 2020;56(3):605–13.

    Article  PubMed  Google Scholar 

  2. Morowatisharifabad MA, Movahed E, Farokhzadian J, Nikooie R, Askarishahi M, Bidaki R, Hosseinzadeh M. Antiretroviral therapy adherence based on information, motivation, and behavioral skills model and its association with depression among HIV-positive patients: health promotion strategy towards the 909090 target. J Educ Health Promotion 2019, 8(1).

  3. Huang Y, Luo D, Chen X, Zhang D, Huang Z, Xiao S. HIV-related stress experienced by newly diagnosed people living with HIV in China: a 1-year longitudinal study. Int J Environ Res Public Health. 2020;17(8):2681.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  4. Fauk NK, Merry MS, Mwanri L, Hawke K, Ward PR. Mental Health Challenges and the Associated factors in women living with HIV who have children living with HIV in Indonesia: a qualitative study. Int J Environ Res Public Health. 2022;19(11):6879.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Azhar SV. HIV stigma and gender: a mixed methods study of people living with HIV in Hyderabad. India: The University of Chicago; 2018.

    Google Scholar 

  6. Brown LL, Martin EG, Knudsen HK, Gotham HJ, Garner BR. Resilience-focused HIV care to promote psychological well-being during COVID-19 and other catastrophes. Front Public Health. 2021;9:705573.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Adamu A, Mchunu G, Naidoo JR. Stress and resilience among women living with HIV in Nigeria. Afr J Prim Health Care Family Med. 2019;11(1):1–6.

    Google Scholar 

  8. Liu H, Boyatzis RE. Focusing on Resilience and Renewal from stress: the role of emotional and Social Intelligence Competencies. Front Psychol. 2021;12:685829.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Sarani A, Mousavi SH, Salahi S, Hasani F, Abdar ZE, Sheikhbardsiri H. Emotional intelligence and self-efficacy among deputy’s administrative staff of Kerman University of Medical Sciences. J Educ Health Promotion. 2020;9(1):105.

    Article  Google Scholar 

  10. Sheikhbardsiri H, Sheikhasadi H, Mahani SA, Mohamadi MMD. Emotional intelligence and learning strategies of postgraduate students at Kerman University of Medical Sciences in the southeast of Iran. J Educ Health Promotion. 2020;9(1):66.

    Article  Google Scholar 

  11. Rambod M, Hamidizadeh S, Bazrafshan M-R, Parviniannasab AM. Risk and protective factors for resilience among adolescents and young adults with beta-thalassemia major. BMC Psychol. 2023;11(1):231.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Somasundaram RO, Devamani KA. A comparative study on resilience, perceived social support and hopelessness among cancer patients treated with curative and palliative care. Indian J Palliat Care. 2016;22(2):135.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Norouzi H, SeyedAlinaghi S, Farash N, Roohi S, Rahimi R, Shahbazi M, Ashtiani MF. Mediating role of resilience in a relationship between social support and CD4 count of patients living with HIV in Behavioral Diseases Counseling Center of Imam Khomeini Hospital, Tehran. HIV AIDS Rev. 2024;23(2):178–178.

    Article  Google Scholar 

  14. Dulin AJ, Dale SK, Earnshaw VA, Fava JL, Mugavero MJ, Napravnik S, Hogan JW, Carey MP, Howe CJ. Resilience and HIV: a review of the definition and study of resilience. AIDS Care. 2018;30(sup5):S6–17.

    Article  PubMed  Google Scholar 

  15. Ashaba S, Cooper-Vince CE, Vořechovská D, Rukundo GZ, Maling S, Akena D, Tsai AC. Community beliefs, HIV stigma, and depression among adolescents living with HIV in rural Uganda. Afr J AIDS Res. 2019;18(3):169–80.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Brittain K, Mellins CA, Phillips T, Zerbe A, Abrams EJ, Myer L, Remien RH. Social support, stigma and antenatal depression among HIV-infected pregnant women in South Africa. AIDS Behav. 2017;21:274–82.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Marziali ME, McLinden T, Card KG, Closson K, Wang L, Trigg J, Salters K, Lima VD, Parashar S, Hogg RS. Social isolation and mortality among people living with HIV in British Columbia, Canada. AIDS Behav. 2021;25:377–88.

    Article  PubMed  Google Scholar 

  18. Harrison SE, Xiaoming L, Vermund SH. From surviving to thriving: the role of resilience in meeting global HIV goals. AIDS. 2019;33(Suppl 1):S1.

    Article  PubMed  Google Scholar 

  19. Morowatisharifabad M, Movahed E, Farokhzadian J, Nikooie R, Rahaei Z. Depression and physical activity among HIV-positive people: integrated care towards 90-90-90. Int J hiv-related Probl. 2019;18(2):131–6.

    Google Scholar 

  20. Skalski S, Dobrakowski P, Wasilewska A. Resilience and coping with stress vs. trauma effects in people living with HIV. Kultura i Edukacja 2022(2 (136)):78–95.

  21. Greysen SR, Horwitz LI, Covinsky KE, Gordon K, Ohl ME, Justice AC. Does social isolation predict hospitalization and mortality among HIV + and uninfected older veterans? J Am Geriatr Soc. 2013;61(9):1456–63.

    Article  PubMed  PubMed Central  Google Scholar 

  22. LeGrand S, Muessig KE, Pike EC, Baltierra N, Hightow-Weidman LB. If you build it will they come? Addressing social isolation within a technology-based HIV intervention for young black men who have sex with men. AIDS Care. 2014;26(9):1194–200.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Dale SK, Safren SA. Resilience takes a village: black women utilize support from their community to foster resilience against multiple adversities. AIDS Care. 2018;30(sup5):S18–26.

    Article  PubMed  Google Scholar 

  24. Mo PKH, Lau JTF, Yu X, Gu J. The role of social support on resilience, posttraumatic growth, hopelessness, and depression among children of HIV-infected parents in mainland China. AIDS Care. 2014;26(12):1526–33.

    Article  PubMed  Google Scholar 

  25. Huang J, Zhang J, Yu NX. Close relationships, individual resilience resources, and well-being among people living with HIV/AIDS in rural China. AIDS Care. 2018;30(sup5):S49–57.

    Article  PubMed  Google Scholar 

  26. Connor KM, Davidson JR. Development of a new resilience scale: the Connor-Davidson resilience scale (CD‐RISC). Depress Anxiety. 2003;18(2):76–82.

    Article  PubMed  Google Scholar 

  27. Abdi F, Jamali SB, Ahadi H, Koshki S. Evaluation of psychometric properties of resiliency scale in women with breast cancer. J Res Psychol Health 2019, 13 (2).

  28. Russell DW. UCLA Loneliness Scale (Version 3): reliability, validity, and factor structure. J Pers Assess. 1996;66(1):20–40.

    Article  PubMed  CAS  Google Scholar 

  29. Karami N, Amini N, Behrouzi M, Jafarinia G. The role mediating social isolation in relationships between brain-behavioral systems and HEXACO personality characteristics with distress tolerance in people with substance dependence. Couns Cult Psycotherapy. 2021;12(47):221–58.

    Google Scholar 

  30. Mirmahdi SR, Razaali M. The effectiveness of mindfulness-based cognitive therapy on resilince, emotion regulation and life expectancy among women with diabetes2. Q J Health Psychol. 2019;7(28):167–83.

    Google Scholar 

  31. Bahreini Z, Sanagouye-Moharer G. The effectiveness of mindfulness-based stress reduction therapy on resilience and self-discrepancy among female patients with systemic lupus erythematosus. Salamat Ijtimai (Community Health) 2019, 6(4).

  32. Fletcher FE, Sherwood NR, Rice WS, Yigit I, Ross SN, Wilson TE, Weiser SD, Johnson MO, Kempf M-C, Konkle-Parker D. Resilience and HIV treatment outcomes among women living with HIV in the United States: a mixed-methods analysis. AIDS Patient Care STDs. 2020;34(8):356–66.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Southwick SM, Sippel L, Krystal J, Charney D, Mayes L, Pietrzak R. Why are some individuals more resilient than others: the role of social support. World Psychiatry. 2016;15(1):77.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Sheikhbardsiri H, Tavan A, Afshar PJ, Salahi S, Heidari-Jamebozorgi M. Investigating the burden of disease dimensions (time-dependent, developmental, physical, social and emotional) among family caregivers with COVID-19 patients in Iran. BMC Prim care. 2022;23(1):165.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  35. Machisa MT, Christofides N, Jewkes R. Social support factors associated with psychological resilience among women survivors of intimate partner violence in Gauteng, South Africa. Global Health Action. 2018;11(sup3):1491114.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Nazari M, Movahed E, Soltaninejad M. Survey hospitals preparedness and resilience in Crisis COVID-19 in the South of Kerman Province, Iran. Iran J War Public Health. 2021;13(1):57–61.

    Google Scholar 

  37. Röhr S, Wittmann F, Engel C, Enzenbach C, Witte AV, Villringer A, Löffler M, Riedel-Heller SG. Social factors and the prevalence of social isolation in a population-based adult cohort. Soc Psychiatry Psychiatr Epidemiol 2021:1–10.

  38. Jakobsen IS, Madsen LMR, Mau M, Hjemdal O, Friborg O. The relationship between resilience and loneliness elucidated by a Danish version of the resilience scale for adults. BMC Psychol. 2020;8(1):1–10.

    Article  Google Scholar 

  39. Ehsan S, Batool SS. Perceived Social Support as a Predictor of General Health in HIV + patients: moderating role of gender: Social Support as a Predictor of General Health in HIV + patients. Pakistan J Health Sci 2022:152–6.

  40. Machielse A. Social isolation, meaning-in-life, and resilience. Innov Aging. 2018;2(Suppl 1):25.

    Article  PubMed Central  Google Scholar 

  41. Ozbay F, Johnson DC, Dimoulas E, Morgan Iii C, Charney D, Southwick S. Social support and resilience to stress: from neurobiology to clinical practice. Psychiatry (Edgmont). 2007;4(5):35.

    PubMed  Google Scholar 

  42. Moore KE, Siebert S, Brown G, Felton J, Johnson JE. Stressful life events among incarcerated women and men: Association with depression, loneliness, hopelessness, and suicidality. Health Justice. 2021;9(1):1–15.

    Article  Google Scholar 

  43. Kalantari A, Hosinizadeh A. Investigating the relationship between the level of social isolation and the level of social support received whit the level of expreiecing loneliness. Urban Suciological Stud. 2014;5(16):87–118.

    Google Scholar 

Download references

Acknowledgements

The authors appreciate the PLHIV who generously participated in this study.

Funding

This research received no specific grant from any funding agency in the public commercial, or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Reproductive and Family Health Research Center, Kerman University of Medical Sciences, Kerman, Iran

    Mehri Lotfalizadeh

  2. School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

    Amirreza Sabzi

  3. Nursing Research Center, Kerman University of Medical Science, Kerman, Iran

    Jamileh Farokhzadian

  4. Shahid Rajaei Hospital, Shiraz University of Medical Sciences, Shiraz, Iran

    Nazanin Tabebordbar

Authors
  1. Mehri Lotfalizadeh
    View author publications

    You can also search for this author inPubMed Google Scholar

  2. Amirreza Sabzi
    View author publications

    You can also search for this author inPubMed Google Scholar

  3. Jamileh Farokhzadian
    View author publications

    You can also search for this author inPubMed Google Scholar

  4. Nazanin Tabebordbar
    View author publications

    You can also search for this author inPubMed Google Scholar

Contributions

ML, AS, NT, and JF contributed to conceiving and designing the research. The data were collected, analyzed, and interpreted by ML, AS, and JF. ML, AS, NT, and JF contributed equally to writing and revising the manuscript and approved the final manuscript.

Corresponding authors

Correspondence to Amirreza Sabzi or Jamileh Farokhzadian.

Ethics declarations

Ethics approval and consent to participate

This paper, with a project code of 401000750, received approval from the Ethics Committee of Kerman University of Medical Sciences (IR.KMU.REC.1402.015). The study was carried out in accordance with the Declaration of Helsinki and the Committee on Publication Ethics (COPE). The first author gathered the data after receiving written informed consent from the eligible people living with HIV, explaining the method and confidentiality and anonymity of their information. Their participation was voluntary, and they could discontinue the study at any time without any negative consequences.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lotfalizadeh, M., Sabzi, A., Farokhzadian, J. et al. Resilience and social isolation in people living with HIV: a case study in Iran. BMC Res Notes 18, 7 (2025). https://doiorg.publicaciones.saludcastillayleon.es/10.1186/s13104-024-07076-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doiorg.publicaciones.saludcastillayleon.es/10.1186/s13104-024-07076-0

Keywords

BMC Research Notes

ISSN: 1756-0500

Contact us