1) Quality of life for non-affiliated PLHIV
Based on the results of the study, it was found that the quality of life of PLHIV was mostly not good enough for 29 people living with HIV. From the research, it was found that PLWHA who are not included in the Cakap Foundation have a tendency to close themselves, such as when seeking health help they tend to cover up their HIV status by just submitting their complaints and they tend to look for officers they already know before and do not want to be visited. served by others for fear of their condition being discovered. In addition, when they access health services when taking ARV drugs or with other complaints, they tend to hide themselves for fear of meeting people they know. Because of this pressure they will be more depressed so that it affects their health and physical condition, these PLWHA are more likely to experience complaints and health problems, but they do not dare to tell people at home, so there are some whose physical condition has decreased, their weight tends to remain. even down, there are complaints or other opportunistic infections. Because the psychological condition is less stable, the nutritional input will also be reduced which makes it more prone to health problems.
According to Nursalam & Ninuk, 2013 the quality of life of people with HIV-AIDS has many factors that affect it, including physical exercise, psychological, social problems and treatment dependence. This is supported by the research of Hardiansyah et al. 2014 describes the quality of life of PLWHA in Makassar divided into six domains of quality of life, namely the physical domain, the psychological domain, the level of independence domain, the domain of social interaction, the environmental domain and the spiritual domain. The results showed that based on these six domains, the quality of life of PLHIV in Makassar has a good quality of life (47.6%), while the quality of life is poor (52.4%), meaning that there are still many PLHIV who need health care to improve their quality of life.
The decline in immunity is influenced by several factors. The factors that need to be considered by health workers are psychosocial stressors. The first reaction that is shown after a person is diagnosed with HIV is rejection and shock / shock or disbelief. Patients think that HIV is hopelessly suffering throughout their life (Nursalam & Ninuk, 2013).
Another factor that influences the perception of stigma is the characteristics of the individual society itself. Age of the respondent is the age of the individual which is between 26 and 65 years. This age is included in the adult stage. Adulthood is the stage when a person reaches physical and psychosocial maturity and cognitive. Adult individuals feel comfortable with their perceptions and knowledge, are open to receiving suggestions and criticism, trying to solve problems, and are willing to make decisions about the problems at hand (Potter and Perry, 2005).
The existence of stigma and discrimination against PLWHA causes not all PLWHA to open up about it status, so that there is limited movement for participants in carrying out their activities in terms of work, or seeking medical assistance. When they are sick, PLWHA feels awkward to disclose their status to health workers for fear of being rejected so that the health services they receive are also not optimal, according to the actual conditions.
2) Quality of Life for PLHIV who are exercise members of the CAKAP Foundation
Based on the research data conducted at the CAKAP Turen Foundation, it was found that most of them had a good quality of life as many as 28 respondents. From the research results, it was found that PLWHA who are members of the CAKAP Turen Foundation, they tend to have a more stable health condition, because with the activities at the CAKAP Foundation they can share with each other about the conditions and health problems they face. Besides that, there are also other activities that can increase their sense of self-worth so that they feel useful and beneficial to others. Such as gym activities, jogging and other activity, as well as dance and ludruk.
With these activities, it can increase the self-esteem of PLWHA, so that they are more physically awake, because they remind each other if there are problems related to health and social problems or relationships with their environment.
WHO defines quality of life as an individual's perception of life in accordance with the cultural system and values in which they live in relation to interests, life goals, expectations and standards of possibility in life that they want to achieve (WHO, 1996). There are four factors that affect the quality of life, namely physical health factors, psychological health, social relationships, and environmental factors (Rapley, 2003).
This is in accordance with Hardiwinoto (2005; Risdianto, 2009) who states that welfare is one of the parameters for the high quality of life so that they can enjoy life even though their bodies have the HIV virus. According to WHOQOL Group (1994; Ayu Prawesti, et al, 2007) states that quality of life is influenced by physical health, psychological health, social relationships, and environmental aspects. The four domains of quality of life were identified as a behavior, presence status, potential capacity, and subjective perception or experience (WHOQOL Group, 1994). If these needs are not met, problems will arise in PLWHA's life which will reduce their quality of life (Ratna, 2008).
In the Peer Support Group, PLWHA feel they have friends who can be invited to share about their condition, remind each other and encourage each other in the therapy process they are going through.
2) Differences in the Quality of Life of PLWHA
Based on the results of the research that has been conducted, there are differences in the quality of life that occur between PLHIV who are members and who are not at the CAKAP Turen Foundation due to the lack of support received by PLHIV who are not members of the CAKAP Foundation Turen. Because they tend to close themselves and keep the problems they face without other people and even their families to know about it, so that when there is a problem they will try to solve it themselves and feel pressured for fear of other people knowing their condition and status.
According to Widiastuti, Heni (2018) the difference join and non joined of the CAKAP Turen Foundation for AIDS Care Citizens has a significant impact on the quality of life of PLWHA. Nursing care services provided to patients at the Foundation to heal, maintain, maintain and improve physical health, restore health or maximize independence and minimize disability due to illness, mental / emotional patients. Meanwhile, improving the quality of life of PLWHA is needed so that PLWHA whose physical condition is getting weaker, with poor personal relationships, and the absence of opportunities to obtain information can be fulfilled by optimizing ART drug adherence and involving PLWHA in empowerment programs at the CAKAP Turen Foundation.
Based on research conducted by Anis et al (2012), there is the theory of Felce and Perry (1996) which states that psychological well-being includes influence, fulfillment, stress and mental state, self-esteem, status and respect, religious beliefs, and sexuality. In people with terminal illness, including people with HIV-AIDS, a person will experience changes in physical, cognitive, and psychosocial life (Papalia, Olds, & Feldman, 2001; Ariyanti, 2009). The stability of psychological well-being is one of the factors that play a role in improving psychological well-being (Renwick & Brown, 1996). Psychological health refers to positive effects, spirituality, thinking, learning, memory and concentration, self-image and appearance, self-esteem, and negative effects (WHO, 1996; Rapley, 2003).
The conclusion that can be drawn from the explanation above is the results of research that support that PLWHA who are members of the CAKAP Turen Foundation need to be improved and consistently program activities are carried out regularly in order to improve the quality of life of PLHIV in the Foundation.