1
|
The Moderating Role of Social Support on the Relationship Between Anxiety, Stigma, and Intention to Use Illicit Drugs Among HIV-Positive Men Who Have Sex with Men. AIDS Behav 2020; 24:55-64. [PMID: 31754966 DOI: 10.1007/s10461-019-02719-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The present study examined the association between anxiety, stigma, social support and intention to use illicit drugs, and the moderating role of social support on the association between anxiety/stigma and intention to use illicit drugs among 450 Chinese HIV-positive MSM. Findings show that controlling for significant background variables, self-stigma and anxiety were positively associated with intention to use illicit drugs, while social support was negatively associated with intention to use illicit drugs. A significant moderation effect of social support was also observed, that the negative association between self-stigma/anxiety and intention to use illicit drugs was only significant among participants with lower levels of social support. Findings highlight the importance of reducing self-stigma and anxiety, and promoting social support in drug use prevention for HIV-positive MSM.
Collapse
|
2
|
Elliott JC, Brincks AM, Feaster DJ, Hasin DS, Del Rio C, Lucas GM, Rodriguez AE, Nijhawan AE, Metsch LR. Psychosocial Factors Associated with Problem Drinking Among Substance Users with Poorly Controlled HIV Infection. Alcohol Alcohol 2018; 53:603-610. [PMID: 29596589 DOI: 10.1093/alcalc/agy021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Accepted: 03/05/2018] [Indexed: 02/05/2023] Open
Abstract
Aims We aimed to identify psychosocial factors related to problem drinking among patients with poorly controlled human immunodeficiency virus (HIV) infection. Short Summary We aimed to identify psychosocial factors related to problem drinking among those with poorly controlled HIV infection. Increased levels of interpersonal conflict were associated with greater severity of alcohol problems. Poorer mental health, medical mistrust and less satisfaction with one's physician related to excessive drinking. Methods This secondary analysis used baseline data from a large multisite randomized controlled trial of substance users whose HIV infection was currently poorly controlled, from 11 urban hospitals across the USA. Participants were HIV-infected adult inpatients (n = 801; 67% male, 75% African American) with substance use histories. Participants self-reported on their drinking, perceived health, mental health, social relationships and patient-provider relationship. Structural equation models examined psychosocial factors associated with problem drinking, controlling for demographic covariates. Results Increased levels of interpersonal conflict were associated with greater severity of alcohol problems. Poorer mental health, medical mistrust and less satisfaction with one's physician were associated with excessive drinking. Conclusions Several psychosocial factors, including interpersonal conflict, poor mental health (i.e. anxiety, depression and somatization), medical mistrust and less satisfaction with one's provider, were associated with problem drinking among HIV-infected substance users with poorly controlled HIV infection. The co-occurrence of these concerns highlights the need for comprehensive services (including attention to problem drinking, social services, mental health and quality medical care) in this at-risk group.
Collapse
Affiliation(s)
- Jennifer C Elliott
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA.,New York State Psychiatric Institute, New York, NY, USA
| | - Ahnalee M Brincks
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL, USA.,Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA
| | - Daniel J Feaster
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Deborah S Hasin
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA.,New York State Psychiatric Institute, New York, NY, USA.,Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Carlos Del Rio
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA.,Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Gregory M Lucas
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Allan E Rodriguez
- Division of Infectious Diseases, Department of Medicine, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Ank E Nijhawan
- Division of Infectious Diseases, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Lisa R Metsch
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| |
Collapse
|
3
|
Shacham E, Önen NF, Donovan MF, Rosenburg N, Overton ET. Psychiatric Diagnoses among an HIV-Infected Outpatient Clinic Population. J Int Assoc Provid AIDS Care 2014; 15:126-30. [PMID: 25348798 DOI: 10.1177/2325957414553846] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
As individuals with HIV infection are living longer, the management of psychiatric disorders has increasingly been incorporated into comprehensive care. Individuals were recruited from an outpatient HIV clinic to assess the prevalence and related associations of current psychiatric disorders and biomarkers. Of the 201 participants who completed the interviews, the median age was 43.5 years, and the majority was male and African American. Most were receiving HIV therapy and 78% of those had achieved virologic suppression. Prevalent psychiatric diagnoses included major depressive disorder, generalized anxiety, and agoraphobia. Alcohol and cocaine/crack abuse and dependence were common substance use disorders. Current receipt of HIV therapy was less common among those diagnosed with generalized anxiety disorder. Agoraphobia was the only disorder associated with unsuppressed viral load. Psychiatric and substance use disorders are highly prevalent among an urban HIV clinic population, although we identified few associations between psychiatric diagnoses and HIV diseases status.
Collapse
Affiliation(s)
- Enbal Shacham
- Department of Behavioral Sciences and Health Education, College for Public Health and Social Justice, Saint Louis University, St Louis, MO, USA
| | - Nur F Önen
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St Louis, MO, USA
| | | | - Neal Rosenburg
- Nevada State College, School of Nursing, Henderson, NV, USA
| | - E Turner Overton
- Division of Infectious Diseases, Department of Medicine, University of Alabama School of Medicine, Birmingham, AL, USA
| |
Collapse
|
4
|
Zisook S, Iglewicz A, Avanzino J, Maglione J, Glorioso D, Zetumer S, Seay K, Vahia I, Young I, Lebowitz B, Pies R, Reynolds C, Simon N, Shear MK. Bereavement: course, consequences, and care. Curr Psychiatry Rep 2014; 16:482. [PMID: 25135781 DOI: 10.1007/s11920-014-0482-8] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This paper discusses each of several potential consequences of bereavement. First, we describe ordinary grief, followed by a discussion of grief gone awry, or complicated grief (CG). Then, we cover other potential adverse outcomes of bereavement, each of which may contribute to, but are not identical with, CG: general medical comorbidity, mood disorders, post-traumatic stress disorder, anxiety, and substance use.
Collapse
Affiliation(s)
- Sidney Zisook
- Department of Psychiatry, University of California, 3350 La Jolla Village Dr, San Diego, CA, 92161-116A, USA,
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
5
|
Psychosocial and demographic correlates of drug use in a sample of HIV-positive adults ages 50 and older. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2014; 14:618-27. [PMID: 23408281 DOI: 10.1007/s11121-012-0338-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The prevalence of HIV among adults 50 and older in the USA is increasing as a result of improvements in treatment and detection of HIV infection. Substance use by this population has implications for physical and mental health outcomes. We examined patterns of demographics, mental health, and recent substance use in a diverse sample of heterosexual, bisexual, and gay adults 50 and older living with HIV/AIDS (PLWHA) in New York City. The most commonly used substances were cigarettes or alcohol; however, the majority of the sample did not report recent use of marijuana, poppers, or hard drugs (crystal methamphetamine, cocaine, crack, heroin, ecstasy, GHB, ketamine, and LSD or PCP). Statistically significant associations between substance use and psychological states (well-being and loneliness) were generally weak, and depression scores were not significantly related to use; instead, drug use was associated with gender/sexual orientation. The study observations support addressing substance use specific to subpopulations within PLWHA.
Collapse
|
6
|
Abstract
Clinical management of HIV must account for the "triple diagnosis" of HIV, psychiatric diagnosis, and substance use disorders and requires integrated treatment services that focus beyond just mitigation of substance use and psychiatric and medical symptoms but also address other health behaviors. Because clinical management of HIV/AIDS has shifted significantly with the advent of highly active antiretroviral therapies (HAART) in the mid 1990s, a literature review focusing on literature published since 2000, and using relevant key words was conducted using a wide range of literature search databases. This literature review was complemented by studies to expand on specific treatment modalities for which there was a dearth of literature addressing HIV infected cohorts and to provide discussion of issues around substance abuse treatment as an HIV prevention tool. Existing models of substance abuse treatment including cognitive behavioral therapy and motivational interviewing have proven to be useful for enhancing adherence and reducing substance use in outpatient populations, while methadone maintenance and directly observed treatment have been useful with specific subgroups of users. Contextualization of services heightens the likelihood of successful outcomes and relapse prevention.
Collapse
|
7
|
Hansen NB, Vaughan EL, Cavanaugh CE, Connell CM, Sikkema KJ. Health-related quality of life in bereaved HIV-positive adults: relationships between HIV symptoms, grief, social support, and Axis II indication. Health Psychol 2009; 28:249-57. [PMID: 19290717 DOI: 10.1037/a0013168] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE This study evaluated a model of the impact of borderline and antisocial personality disorder indications on HIV symptoms and health-related quality of life (HRQoL) in AIDS-bereaved adults, accounting for grief severity, social support, and years since HIV diagnosis. DESIGN Structural equation modeling was used to test the proposed model in a sample of 268 HIV-seropositive adults enrolled in an intervention for coping with AIDS-related bereavement. MAIN OUTCOME MEASURES Functional assessment of HIV infection, HIV symptoms. RESULTS The proposed model demonstrated excellent fit with study data and all hypothesized paths were supported. Personality disorder indication was directly related to HIV symptoms and HRQoL and indirectly related through both social support and grief severity. Social support was negatively related to HIV symptoms and positively related to HRQoL, while grief severity was positively related to HIV symptoms and negatively related to HRQoL. Finally, HIV symptoms had a direct negative relationship with HRQoL. CONCLUSION Personality disorders have a direct negative effect on HIV symptoms and HRQoL and indirect effects through grief severity and social support.
Collapse
Affiliation(s)
- Nathan B Hansen
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06511, USA.
| | | | | | | | | |
Collapse
|