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Arnold EM, Kamal S, Rotheram-Borus MJ, Bridges SK, Gertsch W, Norwood P, Swendeman D. Factors Associated With Antiretroviral Adherence Among Youth Living With HIV. J Acquir Immune Defic Syndr 2024; 95:215-221. [PMID: 37977178 PMCID: PMC10922292 DOI: 10.1097/qai.0000000000003345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 10/24/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Youth living with HIV (YLH) have an increased risk for psychosocial stressors that can affect their antiretroviral (ARV) adherence. We examined factors associated with self-reported ARV adherence among YLH ages 12-24 years old. SETTING YLH (N = 147) were recruited in Los Angeles, CA, and New Orleans, LA from 2017 to 2020. METHODS YLH whose self-reported recent (30 days) ARV adherence was "excellent" or "very good" were compared with nonadherent YLH on sociodemographic, clinical, and psychosocial factors using univariate and multivariate analyses. RESULTS Participants were predominantly male (88%), and 81% identified as gay, bisexual, transgender, queer, or other. The mean duration on ARV was 27 months (range 0-237 months). Most YLH (71.2%) self-reported being adherent, and 79% of those who self-reported adherence were also virally suppressed (<200 copies/mL). Multivariate analysis indicated being adherent was significantly associated with white race [aOR = 8.07, confidence intervals (CI): 1.45 to 74.0], Hispanic/Latinx ethnicity [aOR = 3.57, CI: 1.16 to 12.80], more social support [aOR = 1.11, CI: 1.05 to 1.18], and being on ARV for a shorter duration [aOR = 0.99, CI: 0.97 to 0.99]. Mental health symptoms, substance use, age, and history of homelessness or incarceration were unrelated to adherence. CONCLUSIONS Enhancing efforts to provide support for adherence to non-white youth, and those with limited social support and who have been on ARV treatment longer, may help increase viral suppression among YLH.
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Affiliation(s)
| | - Susan Kamal
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA
| | - Mary Jane Rotheram-Borus
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA
| | - S Kate Bridges
- Department of Family and Community Medicine, UT Southwestern Medical Center, Dallas, TX; and
| | - William Gertsch
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA
| | - Peter Norwood
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA
| | - Dallas Swendeman
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA
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Tarantino N, Norman B, Enimil A, Asibey SO, Martyn-Dickens C, Guthrie KM, Kwara A, Bock B, Mimiaga MJ, Brown L. HIV symptom severity and associated factors among young people with HIV in Ghana. AIDS Care 2024:1-9. [PMID: 38184890 PMCID: PMC11227599 DOI: 10.1080/09540121.2023.2299332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 12/18/2023] [Indexed: 01/09/2024]
Abstract
ABSTRACTAdolescents and young adults (young people) with HIV (YPWH) often struggle with treatment self-management. Many have symptoms due to HIV disease, medication side-effects, or comorbid conditions. Our study investigated the severity of HIV-related symptoms among YPWH aged 18-24 with detectable viral loads from an HIV clinic in Ghana (N = 60) and potential correlates of severity across a range of factors. Results indicated that YPWH currently experienced, on average, 13 symptoms (SD = 12.33). Six of the 10 most common symptoms were from two domains: fatigue and psychological. The most common symptoms were headaches (62%), weakness (53%), and fear/worries (52%). No differences were observed in number or severity of symptoms between youth based on HIV transmission status. Bivariate correlates of symptom severity were found with six that remained significant or approached significance in a multivariate model predicting severity: living with a parent/guardian, higher perceived access to HIV care, and higher treatment readiness were associated with lower severity while greater travel time to the HIV clinic, psychological distress, and more missed clinic appointments were associated with higher severity. Our findings suggest that interventions to address symptoms among YPWH should be multilevel and include strategies (e.g., telehealth, home care) to increase access to care.
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Affiliation(s)
- Nicholas Tarantino
- Providence College, Department of Psychology, Providence, RI, USA
- Rhode Island Hospital, Department of Psychiatry, Providence, RI, USA
| | - Betty Norman
- Komfo Anokye Teaching Hospital, Kumasi, Ghana
- Kwame Nkrumah University of Science and Technology, Department of Medicine, Kumasi, Ghana
| | - Anthony Enimil
- Komfo Anokye Teaching Hospital, Kumasi, Ghana
- Kwame Nkrumah University of Science and Technology, Department of Child Health, Kumasi, Ghana
| | | | | | - Kate M. Guthrie
- Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, Providence, RI, USA
- Miriam Hospital, Center for Behavioral and Preventive Medicine, Providence, RI, USA
| | - Awewura Kwara
- University of Florida College of Medicine, Department of Medicine, Gainesville, FL, USA
| | - Beth Bock
- Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, Providence, RI, USA
- Miriam Hospital, Center for Behavioral and Preventive Medicine, Providence, RI, USA
| | - Matthew J. Mimiaga
- UCLA Fielding School of Public Health, Department of Epidemiology, Los Angeles, CA, USA
- UCLA Center for LGBTQ+ Advocacy, Research & Health, Los Angeles, CA, USA
| | - Larry Brown
- Rhode Island Hospital, Department of Psychiatry, Providence, RI, USA
- Miriam Hospital, Center for Behavioral and Preventive Medicine, Providence, RI, USA
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Jones MC, Byun JY, Billings R, Shorten A, Kempf MC, Vance DE, Puga F. Tools for Screening and Measuring Anxiety Among Women Living with HIV of Reproductive Age: A Scoping Review. AIDS Behav 2023:10.1007/s10461-023-03990-9. [PMID: 36757556 DOI: 10.1007/s10461-023-03990-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2023] [Indexed: 02/10/2023]
Abstract
Emerging evidence suggests that women living with HIV (WLWH) may experience higher rates of anxiety than men living with HIV and women living without HIV. To date, relatively little knowledge exists on valid anxiety screening and diagnostic tools and how they are used among WLWH, specifically WLWH of reproductive age. Thus, the purpose of this scoping review was to describe what is known in the published literature about anxiety among WLWH and the tools used to measure and screen for anxiety in clinical and research contexts. The Arksey and O'Malley methodological framework was used to guide a scoping review of published articles in PsycINFO, Scopus, Sociological Abstracts, and PubMed databases. Twenty-one measures of anxiety were used across the 52 articles identified in the search. Most measures used were self-report. Inconsistencies in standardized screening tools and cutoff scores were observed across studies. Further, measures to assess anxiety varied among studies focused on WLWH. Based on the results from this review, there is a need for consistent, valid measures of anxiety to advance research and clinical practice to support the well-being of WLWH.
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Affiliation(s)
- Meghan C Jones
- School of Nursing, University of Alabama at Birmingham, 1701 University Blvd, 35294-1210, Birmingham, AL, USA.
| | - Jun Y Byun
- School of Nursing, University of Alabama at Birmingham, 1701 University Blvd, 35294-1210, Birmingham, AL, USA
| | - Rebecca Billings
- UAB Libraries, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Allison Shorten
- School of Nursing, University of Alabama at Birmingham, 1701 University Blvd, 35294-1210, Birmingham, AL, USA
| | - Mirjam-Colette Kempf
- School of Nursing, University of Alabama at Birmingham, 1701 University Blvd, 35294-1210, Birmingham, AL, USA
| | - David E Vance
- School of Nursing, University of Alabama at Birmingham, 1701 University Blvd, 35294-1210, Birmingham, AL, USA
| | - Frank Puga
- School of Nursing, University of Alabama at Birmingham, 1701 University Blvd, 35294-1210, Birmingham, AL, USA
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Gutiérrez-Velilla E, Barrientos-Casarrubias V, Cruz-Maycott R, Perrusquia-Ortiz LE, Alvarado-de la Barrera C, Ávila-Ríos S, Caballero-Suárez NP. Assessment of anxiety in Mexican persons living with HIV using a culturally-adapted version of the GAD-7 test. J Health Psychol 2022; 27:2875-2886. [PMID: 35042393 DOI: 10.1177/13591053211072687] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Our aim was to assess the severity of anxiety in PLWHA in Mexico City and obtain the psychometric properties of the culturally-adapted Spanish version of GAD-7. Thirteen percent of participants presented moderate to severe symptoms. Reliability (α = 0.82) and construct validity (single-factor explained 48.9% of variance) were evaluated in 411 participants. Confirmatory Factor Analysis was performed in a second sample of 527 participants. Model fit adequately (CFI = 0.991; CMIN/DF = 1.924; RMSEA = 0.042; and SRMR = 0.026). The adapted version of GAD-7 was adequate for the assessment of anxiety in Mexican PLWHA.
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Affiliation(s)
- Ester Gutiérrez-Velilla
- Centro de Investigación en Enfermedades Infecciosas (CIENI) del Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas" (INER), Mexico.,Universidad Nacional Autónoma de México (UNAM), Mexico
| | - Vania Barrientos-Casarrubias
- Centro de Investigación en Enfermedades Infecciosas (CIENI) del Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas" (INER), Mexico
| | - Rosa Cruz-Maycott
- Centro de Investigación en Enfermedades Infecciosas (CIENI) del Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas" (INER), Mexico
| | - Lydia E Perrusquia-Ortiz
- Centro de Investigación en Enfermedades Infecciosas (CIENI) del Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas" (INER), Mexico
| | - Claudia Alvarado-de la Barrera
- Centro de Investigación en Enfermedades Infecciosas (CIENI) del Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas" (INER), Mexico
| | - Santiago Ávila-Ríos
- Centro de Investigación en Enfermedades Infecciosas (CIENI) del Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas" (INER), Mexico
| | - Nancy Patricia Caballero-Suárez
- Centro de Investigación en Enfermedades Infecciosas (CIENI) del Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas" (INER), Mexico
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Millon EM, Lehrer PM, Shors TJ. Meditation and Aerobic Exercise Enhance Mental Health Outcomes and Pattern Separation Learning Without Changing Heart Rate Variability in Women with HIV. Appl Psychophysiol Biofeedback 2022; 47:27-42. [PMID: 35040014 PMCID: PMC8763305 DOI: 10.1007/s10484-021-09530-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2021] [Indexed: 01/01/2023]
Abstract
Mental and physical (MAP) training targets the brain and the body through a combination of focused-attention meditation and aerobic exercise. The following feasibility pilot study tested whether 6 weeks of MAP training improves mental health outcomes, while enhancing discrimination learning and heart rate variability (HRV) in a group of women living with human immunodeficiency virus (HIV) and other stress-related conditions. Participants were assigned to training (n = 18) or no-training control (n = 8) groups depending on their ability and willingness to participate, and if their schedule allowed. Training sessions were held once a week for 6 weeks with 30 min of meditation followed by 30 min of aerobic exercise. Before and after 6 weeks of training, participants completed the Behavioral Pattern Separation Task as a measure of discrimination learning, self-report questionnaires of ruminative and trauma-related thoughts, depression, anxiety, and perceived stress, and an assessment of HRV at rest. After training, participants reported fewer ruminative and trauma-related thoughts, fewer depressive and anxiety symptoms, and less perceived stress (p’s < 0.05). The positive impact on ruminative thoughts and depressive symptoms persisted 6 months after training. They also demonstrated enhanced discrimination of similar patterns of information (p < 0.05). HRV did not change after training (p > 0.05). Combining mental and physical training is an effective program for enhancing mental health and aspects of cognition in women living with HIV, although not necessarily through variance in heart rate.
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Affiliation(s)
- Emma M Millon
- Behavioral and Systems Neuroscience, Department of Psychology, Rutgers University, Piscataway, New Jersey, USA.
| | - Paul M Lehrer
- Department of Psychiatry, Rutgers-Robert Wood Johnson Medical School, Piscataway, New Jersey, USA
| | - Tracey J Shors
- Behavioral and Systems Neuroscience, Department of Psychology, Rutgers University, Piscataway, New Jersey, USA.,W.M. Keck Center for Collaborative Neuroscience, Rutgers University, Piscataway, New Jersey, USA
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6
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Millon EM, Shors TJ. How mental health relates to everyday stress, rumination, trauma and interoception in women living with HIV: A factor analytic study. LEARNING AND MOTIVATION 2021. [DOI: 10.1016/j.lmot.2020.101680] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Armistead LP, Marelich WD, Schulte MT, Gilbert M, Murphy DA. HIV and Mother-Child Conflict: Associations with Mother's Mental and Physical Health. CHILD & ADOLESCENT SOCIAL WORK JOURNAL : C & A 2019; 36:621-629. [PMID: 31673198 PMCID: PMC6822983 DOI: 10.1007/s10560-019-00601-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Maternal illness is a stressor that can disrupt family processes and contribute to negative child outcomes, and researchers have considered family variables that mediate or moderate the maternal illness-child outcome relationship. Through reliance on a diverse sample (ethnically and racially, as well as geographically), the current study expands prior literature with a focus on parent-child conflict. Specifically, associations between aspects of HIV positive mothers' illness and mother-child conflict were explored. One goal of the study was to determine if there were direct or indirect associations with aspects of mothers' HIV and mother-child conflict. HIV-positive mothers (N = 136) provided CD4 count and completed measures assessing their perceived level of physical functioning, depressive symptoms, HIV health-related anxiety, and mother-child conflict with their healthy school-age children. Path analysis considered the pattern of relationships across variables. Results showed maternal vitality and depressive symptoms were directly associated with mother-child conflict. CD4 cell count and health-related anxiety operated indirectly through maternal depressive symptoms. Mediation analyses further assessed the influence of maternal CD4 cell count on mother-child conflict behavior; results indicated an indirect effect was mediated by vitality. HIV health-related anxiety and vitality separately showed indirect effects on mother-child conflict, mediated by maternal depressive symptoms. These findings are the first to focus on mother-child conflict among children affected by maternal HIV and highlight the need for screening and intervention to address depressive symptoms among HIV-positive mothers.
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Affiliation(s)
- Lisa P Armistead
- 100 Auburn Avenue, Suite 308, Georgia State University, 404.413.2091, , Telephone: 404.413.2091
| | | | | | | | - Debra A Murphy
- Univ. of California-Los Angeles, , Telephone: 619.955.8433
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Schulte MT, Marelich W, Lanza HI, Goodrum NM, Armistead L, Murphy DA. Alcohol use, mental health, and parenting practices among HIV-positive mothers. JOURNAL OF HIV/AIDS & SOCIAL SERVICES 2019; 18:111-128. [PMID: 32774181 PMCID: PMC7413222 DOI: 10.1080/15381501.2019.1596185] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 02/08/2019] [Accepted: 03/12/2019] [Indexed: 06/11/2023]
Abstract
Mothers living with HIV (MLH) must balance childcare, their illness, and oftentimes other mental health problems/stressors. It is important to understand how a maladaptive coping strategy, (alcohol use) is linked to poorer parenting practices. We assessed the relationship between mental health/coping (anxiety, depression, alcohol use, social support) and parenting/family dimensions (communication, parenting style/stress, family routines/cohesion) among 152 MLH. Mothers reporting more psychiatric symptoms and less social support also reported poorer parenting practices and interactions. Further, MLH who used more alcohol reported less parenting involvement and fewer family interactions. Alcohol use, even at subclinical levels, can negatively impact the parent-child relationship.
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Affiliation(s)
- Marya T. Schulte
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles,
California, USA
| | - William Marelich
- Department of Psychology, California State University, Fullerton, Fullerton, California, USA
| | - H. Isabella Lanza
- Department of Human Development, California State University, Long Beach, Long Beach California, USA
| | - Nada M. Goodrum
- Department of Psychology, Georgia State University, Atlanta, Georgia, USA
| | - Lisa Armistead
- Department of Psychology, Georgia State University, Atlanta, Georgia, USA
| | - Debra A. Murphy
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles,
California, USA
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