The results of our study mostly aligned with our first hypothesis, since we observed significant intraindividual variability in daily PTG and PTD, PA and NA, and perceived HIV/AIDS stigma levels among participants. Our findings can significantly contribute to the literature on PLWH’s daily function, an understudied subject, without restricting our analysis to coping with HIV infection, having examined PLWH’s everyday life . Specifically, previous studies on this topic have focused on rather narrow aspects of PLWH’s function, predominantly addressing HIV symptoms, substance abuse use, or adherence to treatment [e.g., 38, 39, 40, 41]. In other words, previous studies have been conducted under the implicit assumption that PLWH’s lives are entirely preoccupied with their HIV-positive status and its associated distress . Nevertheless, great progress in treatment has changed HIV infection from a fatal to a chronic, manageable health condition . Thus, health status remains important but is not necessarily the main cause of PLWH’s stress and well-being [31, 43]. In other words, despite sharing a source of distress—that is, their HIV-positive status—these patients’ psychological functioning may fluctuate daily, and these fluctuations may be associated with significant individual differences in their psychological functioning over time . An intensive longitudinal design, assessing behaviors as they occur in real time in an individual’s natural surroundings, may increase ecological validity and provide a unique chance to monitor individual differences among this patient group [12, 31].
Within the PTG literature, our study is the first to identify daily manifestations of this positive phenomenon in the clinical population. Previously in the related research, only Blackie et al.  showed significant within-person variability in daily state-level PTG among a sample of college students after adverse life events. Measuring PTG daily may offer an important contribution to the longstanding debate on PTG’s real versus illusory nature, which has been predominantly assessed via retrospective questionnaires [4, 7, 14]. Particularly, whether any stable changes (positive or negative) really occur after trauma remains largely unknown—particularly whether these changes can occur in daily life and be revealed retrospectively in self-reports. More research assessing PTG daily is needed to prove whether PTG is just a trait-like tendency to retrospectively declare positive changes following adversity or whether it can be operationalized as a state-like term that manifests in trauma survivors’ day-to-day behaviors [6, 13].
The results of the current study also aligned with our second hypothesis to an extent. On the one hand, we found respectively positive and negative relationships between resilience levels and average PTG and PTD levels among participants. A similar association was observed for affective well-being—that is, a positive relationship with PA and a negative relationship with NA. However, we noted that resilience levels were important for affect alone, such that higher resilience was linked to higher, stabler PA and lower, stabler NA. Concerning PTG and PTD, we found no such stabilization of day-to-day changes as a result of resilience. Also, no relationship between daily HIV/AIDS stigma intensity and resilience was observed. Our findings can serve as an important contribution to the long-term debate on the status of psychological resilience [e.g., 18, 19, 44]. Particularly, whether resilience should be operationalized and measured as a static trait versus a dynamic state remains unknown, as do the consequences of these operationalizations for the association between resilience and well-being across various samples after stressful and adverse life events . These ambiguous findings are partially linked to the measurement limitations of resilience studies—that is, the dominance of cross-sectional design focusing on significant life challenges only and an almost total lack of research on the association between resilience and daily stressors and well-being outcomes . Previously, only Ong et al.  had found that psychological resilience assessed on the trait level is related to intraindividual variability in daily emotional responses to stress among older adults, with higher trait resilience predicting faster recovery from daily stress due to a high level of experiencing positive emotions. Ong et al.  claimed that, although positive emotions are a fundamental feature of trait resilience, they cannot be reduced to a simple by-product of resilience . Highly resilient individuals were found to often adopt positive emotion-eliciting coping strategies, such as benefit finding and positive reappraisal, which regulate negative affective experiences . Overall, high resilience seems to enable individuals greater access to momentary positive emotional resources, which are also stabler over time, thus protecting them better from daily stress compared to less resilient people . Additionally, resilience may influence levels of emotional complexity—that is, promoting greater differentiation, control, and separation between PA and NA during stress in daily life .
Finally, our study is the first to observe the relationship between resilience assessed on the trait level and PTG operationalized daily. It may offer an important contribution to the ongoing debate on the association between resilience and PTG, particularly among PLWH, an issue for which various authors have provided mixed views [see: 48, 49, 50]. On the other hand, the lack of a link between trait-level resilience and daily stigma may suggest that HIV/AIDS stigma is a dynamic and transient phenomenon that is not rooted in the individual, stable characteristics of PLWH but, rather, associated with external social conditions . In other words, regardless of intrinsic factors, stigma among these patients is highly situational or environmental. This finding may suggest possible interventions, such as focusing less on addressing a person’s individual traits and more on promoting positive social support and a patient’s external environment, as well as removing the social stigma and harmful prejudice associated with living with HIV.
Strengths and Limitations
This study benefitted from several strengths, including its two modes of variable measurement (trait- and state-level), intensive longitudinal design, and clinical sample of PLWH. However, a few limitations should be underscored. First, although we followed an intensive, longitudinal design, this study is correlational, so we cannot draw any cause-and-effect explanations. Second, this study’s highly explanatory character complicates any discussion of its implications for the wider context of PLWH’s lives. Third, we controlled for a relatively small amount of sociodemographic and HIV-related clinical variables. And based on clinical factors, we can conclude that our participants should be seen as highly functional PLWH. Future studies should focus on more heterogeneous samples of PLWH with respect to their socioeconomic variables and their progression in HIV infection.
Calls for Further Research
The results of our study suggest the need for further advancements in PTG operationalization and measurement, which should particularly focus on identifying PTG’s daily manifestations in real life and its intraindividual variability [5, 6]. Such research may discover whether PTG is just a trait-like tendency to retrospectively declare positive changes following adversity or can be operationalized as a state-like phenomenon that manifests in trauma survivors’ day-to-day behaviors. In this study, we have already outlined some potential associations between resilience and daily PTG or PTD fluctuations; nevertheless, further scientific inquiry is necessary to differentiate between the stable and situational factors that may promote or hinder stable positive changes amid adversity.
From PLWH’s perspective, our results call for further studies on the still neglected subject of PLWH’s daily functioning that are not restricted to coping with HIV infection but also focus on various areas of functioning . In this process, researchers should employ more of an intensive longitudinal design to better identify dynamic individual differences in these patients’ well-being.