Social Work and the Welfare of Persons Living with HIV in Rural South South Nigeria: Evidence from Akwa Ibom and Cross River States

Rural persons living with HIV in South South Nigeria face a convergence of stigma, poverty, and service inaccessibility that severely compromises their welfare and treatment adherence, demanding an analytically grounded social work response. This study examines the welfare conditions and social work service utilisation patterns of persons living with HIV in rural communities of Akwa Ibom and Cross River States. A cross-sectional explanatory design employs a survey of 210 persons living with HIV in rural health facility catchment areas alongside 25 qualitative interviews with social workers and community health workers. Logistic regression and thematic analysis are applied. The study finds that HIV-related stigma, distance from treatment facilities, poverty, and lack of transport are the principal barriers to welfare service access and antiretroviral treatment adherence. Persons living with HIV in communities with a social work presence show higher treatment adherence and better psychosocial functioning scores. Applying social work's biopsychosocial model to HIV welfare, the study identifies disclosure counselling, stigma reduction community work, and treatment adherence support as the most impactful social work contributions. Recommendations include deploying community-based social workers as HIV adherence and welfare support specialists at rural health facilities, developing HIV social work training modules, and strengthening community stigma reduction programmes co-facilitated by persons living with HIV and social workers. Keywords: HIV, persons living with HIV, social work, rural communities, stigma