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Wu Q, Tan J, Chen S, Wang J, Liao X, Jiang L. Incidence and influencing factors related to social isolation among HIV/AIDS patients: Protocol for a systematic review and meta-analysis. PLoS One 2024; 19:e0307656. [PMID: 39052562 PMCID: PMC11271913 DOI: 10.1371/journal.pone.0307656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Accepted: 07/09/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND People living with HIV (PLWH) are susceptible to social isolation as a result of stigma and discrimination, which not only diminishes adherence to antiretroviral therapy but also heightens the risks of hospital readmission, depression, and mortality. However, there is currently no systematic review addressing the occurrence and impact of social isolation in individuals with HIV. Therefore, this study undertook a comprehensive systematic review and meta-analysis of existing literature to examine the prevalence and influencing factors associated with social isolation among PLWH. METHODS AND ANALYSIS PubMed, EMBASE, CINAHL, Cochrane Library, Web of Science, Google Scholar, China Science and Technology Journal Database, The China National Knowledge Infrastructure, WanFang Data and Chinese Biomedicine Literature Database will be searched from the establishment of the database to the latest search date. Literature screening, data extraction and literature quality assessment will be done independently by two researchers and results will be cross-referenced. Data analysis will be performed using stata15.1 software. Risk of publication bias will be assessed using Begg's and Egger's methods. Heterogeneity between studies will then be assessed using the I2 index and its 95% CI and Q statistics. Sources of heterogeneity will be accounted for by subgroup and sensitivity analyses. RESULTS The results may reveal the prevalence of social isolation among PLWH and provide data support for understanding its etiology and prevention. CONCLUSION By systematically reviewing the existing literature on social isolation among PLWH, this study aims to provide a comprehensive understanding of the prevalence of social isolation within this population, elucidate the detrimental effects it poses for people affected by HIV, and effectively inform targeted interventions for high-risk groups. Furthermore, these findings offer valuable insights to support evidence-based decision-making in public health policy. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration number: CRD42024499044.
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Affiliation(s)
- Qiao Wu
- Department of Nursing, Chongqing Public Health Medical Center, Chongqing, China
| | - Jiarong Tan
- Department of Nursing, Chongqing Public Health Medical Center, Chongqing, China
| | - Shu Chen
- Department of Nursing, Chongqing Public Health Medical Center, Chongqing, China
| | - Jiayi Wang
- Department of Nursing, Chongqing Public Health Medical Center, Chongqing, China
| | - Xiaogang Liao
- Department of Nursing, Chongqing Public Health Medical Center, Chongqing, China
| | - Lingling Jiang
- Department of Nursing, Chongqing Public Health Medical Center, Chongqing, China
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Harsono D, Deng Y, Chung S, Barakat LA, Friedland G, Villanueva M, Yager JE, Justen M, Edelman EJ. Prevalence and Correlates of Physical Inactivity Among Individuals with HIV During the First COVID-19 Wave: A Cross-sectional Survey. AIDS Behav 2024; 28:1531-1545. [PMID: 37824037 PMCID: PMC11349050 DOI: 10.1007/s10461-023-04170-5] [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] [Accepted: 09/08/2023] [Indexed: 10/13/2023]
Abstract
Physical activity is associated with improved health outcomes among people with HIV (PWH). In the recent pandemic context, policies designed to mitigate COVID-19 transmission may result in an increase in sedentary lifestyle and decreased physical activity. In this study, we aimed to characterize self-reported physical activity and factors associated with physical inactivity during the first wave of the COVID-19 pandemic among a sample of PWH engaged in care. We also described whether psychological coping strategies measured by the Brief COPE differed based on physical activity levels. Among 260 surveyed PWH in two HIV clinics in the US Northeast, 28.5% (n = 74) met the criteria for being physically active according to the Centers for Disease Control and Prevention (CDC)'s physical activity guidelines. Receiving care in New Haven, CT, presence of a detectable HIV viral load, every day tobacco use, and unhealthy alcohol use were associated with physical inactivity. Problem-focused coping, emotion-focused coping, and avoidance-focused coping strategies were found to be protective against physical inactivity. In adjusted analysis, only problem-focused coping continued to be significantly associated with lower odds of reporting physical inactivity. Efforts are urgently needed to promote physical activity among PWH, including among those without problem-focused coping strategies.
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Affiliation(s)
- Dini Harsono
- Center for Interdisciplinary Research on AIDS, Yale School of Public Health, 135 College St, Suite 200, New Haven, CT, 06510, USA.
| | - Yanhong Deng
- Yale Center for Analytical Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Sangyun Chung
- Yale Center for Analytical Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Lydia A Barakat
- AIDS Care Program, Section of Infectious Disease, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Gerald Friedland
- Center for Interdisciplinary Research on AIDS, Yale School of Public Health, 135 College St, Suite 200, New Haven, CT, 06510, USA
- AIDS Care Program, Section of Infectious Disease, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
| | - Merceditas Villanueva
- Center for Interdisciplinary Research on AIDS, Yale School of Public Health, 135 College St, Suite 200, New Haven, CT, 06510, USA
- AIDS Care Program, Section of Infectious Disease, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Jessica E Yager
- Center for Interdisciplinary Research on AIDS, Yale School of Public Health, 135 College St, Suite 200, New Haven, CT, 06510, USA
- SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | | | - E Jennifer Edelman
- Center for Interdisciplinary Research on AIDS, Yale School of Public Health, 135 College St, Suite 200, New Haven, CT, 06510, USA
- Section of General Internal Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
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3
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Kim AW. Psychosocial stress, adult suicidal ideation, and the mediating effect of poor sleep quality during the COVID-19 pandemic in South Africa. Am J Hum Biol 2024; 36:e24038. [PMID: 38174783 DOI: 10.1002/ajhb.24038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 11/28/2023] [Accepted: 12/20/2023] [Indexed: 01/05/2024] Open
Abstract
OBJECTIVES South Africa instituted one of the world's strictest lockdowns during the COVID-19 pandemic, which generated heightened conditions of psychosocial stress and posed widespread mental health risks. Despite the elevated burdens of suicidal behaviors and risk of psychiatric disease in the country, few studies have examined the impacts of psychosocial stress from the pandemic on suicidal ideation in South Africa. This study examined the association between psychosocial stress experienced under the COVID-19 pandemic and adult suicidal ideation, as well as degree to which sleep quality and duration mediated this relationship. METHODS An online survey assessed experiences of COVID-19 psychosocial stress, sleep quality and duration, and suicidal ideation in a sample of 189 South African adults during the second and third waves of the COVID-19 pandemic. A causal inference framework for mediation analysis was used to assess the degree to which sleep quality and duration explained the association between COVID-19 psychosocial stress and suicidal ideation. RESULTS Suicidal ideation was reported in 21% of adults. Adults described having moderate sleep quality and an average of 6.9 hours of sleep per night. COVID-19 psychosocial stress significantly predicted adult suicidal ideation in fully adjusted models. Sleep quality, but not sleep duration, significantly mediated the association between COVID-19 psychosocial stress and suicidal ideation, accounting for 25.9% of the total effect. CONCLUSIONS Poor sleep quality may play an important role in exacerbating the alarming stress-induced mental health effects of the COVID-19 pandemic. Further research is necessary to understand the underlying sleep dynamics and associated psychological and neurobiological processes that perpetuate adult suicidal ideation.
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Affiliation(s)
- Andrew Wooyoung Kim
- Department of Anthropology, University of California, Berkeley, California, USA
- SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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4
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Dadi TL, Wiemers AMC, Tegene Y, Medhin G, Spigt M. Experiences of people living with HIV in low- and middle-income countries and their perspectives in self-management: a meta-synthesis. AIDS Res Ther 2024; 21:7. [PMID: 38297363 PMCID: PMC10829476 DOI: 10.1186/s12981-024-00595-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 01/17/2024] [Indexed: 02/02/2024] Open
Abstract
INTRODUCTION Availability of anti-retroviral treatment has changed HIV in to a manageable chronic disease, making effective self-management essential. However, only a few studies in low- and middle-income countries (LMICs) reported experiences of people living with HIV (PLWH) on self-management. METHODS This meta-synthesis of qualitative studies investigated perspectives of PLWH in LMICs on self-management. Various databases, including PubMed, EMBASE, EBSCO, and CINHAL, were searched through June 2022. Relevant additional articles were also included using cross-referencing of the identified papers. We used a thematic synthesis guided by the "Model of the Individual and Family Self-Management Theory" (IFSMT). RESULT PLWH in LIMICs experience a variety of challenges that restrict their options for effective self-management and compromises their quality of life. The main ones include: misconceptions about the disease, poor self-efficacy and self-management skills, negative social perceptions, and a non-patient-centered model of care that reduces the role of patients. The experiences that influenced the ability to practice self-management are summarized in context (the condition itself, physical and environmental factors, individual and family factors) and process factors (knowledge and beliefs, relationship with the health care worker, self-regulation skills and abilities, and social facilitation). Context and process greatly impacted quality of life through the self-management practices of the patients. CONCLUSION AND RECOMMENDATION PLWH encounter multiple challenges, are not empowered enough to manage their own chronic condition, and their needs beyond medical care are not addressed by service providers. Self-management practice of these patients is poor, and service providers do not follow service delivery approaches that empower patients to be at the center of their own care and to achieve an effective and sustainable outcome from treatment. These findings call for a comprehensive well thought self-management interventions.
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Affiliation(s)
- Tegene Legese Dadi
- School of Public Health, College of Medicine & Health Science, Hawassa University, Hawassa, Ethiopia.
- Faculty of Health, Medicine and Life Sciences, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands.
| | - Anja M C Wiemers
- Faculty of Health, Medicine and Life Sciences, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
| | - Yadessa Tegene
- School of Public Health, College of Medicine & Health Science, Hawassa University, Hawassa, Ethiopia
- Faculty of Health, Medicine and Life Sciences, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
| | - Girmay Medhin
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
- MERQ Consultancy PLC, Addis Ababa, Ethiopia
| | - Mark Spigt
- Faculty of Health, Medicine and Life Sciences, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
- General Practice Research Unit, Department of Community Medicine, UiT the Arctic University of Norway, Tromsö, Norway
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Savage V, Gomez H, Perez M, Donastorg Y, Kerrigan D, Barrington C. Trajectories of HIV management among virally suppressed and unsuppressed female sex workers in the Dominican Republic: A comparative qualitative analysis. Int J Qual Stud Health Well-being 2023; 18:2164947. [PMID: 36681941 PMCID: PMC9869989 DOI: 10.1080/17482631.2023.2164947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
PURPOSE Despite suboptimal HIV outcomes among female sex workers (FSW), limited research has been conducted on factors that impact viral suppression among this population. Examining narratives of HIV management, we examined how experiences of diagnosis, treatment initiation, and ongoing care behaviours shaped viral suppression outcomes over time. METHODS We conducted 20 in-depth interviews with FSW in Santo Domingo, Dominican Republic. Using narrative and thematic qualitative approaches, we developed analytic summaries and matrices to compare trajectories of managing HIV between suppressed and unsuppressed participants. RESULTS Regardless of suppression status, participants described similar narratives of overcoming initial challenges to HIV management through personal resilience and social support. Unsuppressed participants identified more delays in initiating antiretroviral therapy and more lapses in adherence due to less active acceptance of their HIV status and more persistent experiences of economic hardship and HIV stigma. CONCLUSIONS We found that individual, interpersonal and structural factors, including stigma and economic precarity, differentiated trajectories towards viral suppression among FSW indicating the importance of multilevel interventions. Improved access to mental health services and social support could promote greater early acceptance of HIV status and progress towards viral suppression among FSW.
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Affiliation(s)
- Virginia Savage
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- CONTACT Virginia Savage Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, 35 Dauer Drive, CB #7440, Chapel Hill, NC27599, USA
| | - Hoisex Gomez
- HIV Vaccine Trials Research Unit, Instituto Dermatologico y Cirugia de la Piel, Santo Domingo, Dominican Republic
| | - Martha Perez
- HIV Vaccine Trials Research Unit, Instituto Dermatologico y Cirugia de la Piel, Santo Domingo, Dominican Republic
| | - Yeycy Donastorg
- HIV Vaccine Trials Research Unit, Instituto Dermatologico y Cirugia de la Piel, Santo Domingo, Dominican Republic
| | - Deanna Kerrigan
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, District of Columbia, USA
| | - Clare Barrington
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Malama K, Logie CH, Sokolovic N, Skeritt L, O'Brien N, Cardinal C, Gagnier B, Loutfy M, Kaida A, de Pokomandy A. Pathways From HIV-Related Stigma, Racial Discrimination, and Gender Discrimination to HIV Treatment Outcomes Among Women Living With HIV in Canada: Longitudinal Cohort Findings. J Acquir Immune Defic Syndr 2023; 94:116-123. [PMID: 37368938 DOI: 10.1097/qai.0000000000003241] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 04/21/2023] [Indexed: 06/29/2023]
Abstract
BACKGROUND HIV-related stigma, gender discrimination, and racial discrimination harm mental health and hamper HIV treatment access for women living with HIV. Maladaptive coping strategies, such as substance use, can further worsen HIV treatment outcomes, whereas resilience can improve HIV outcomes. We examined resilience and depression as mediators of the relationship between multiple stigmas and HIV treatment outcomes among women living with HIV. SETTING Ontario, British Columbia, and Quebec, Canada. METHODS We conducted a longitudinal study with 3 waves at 18-month intervals. We used structural equation modeling to test the associations of multiple stigmas (HIV-related stigma, racial discrimination, and gender discrimination) or an intersectional construct of all 3 stigmas at wave 1 on self-reported HIV treatment cascade outcomes (≥95% antiretroviral treatment [ART] adherence, undetectable viral load) at wave 3. We tested depression and resilience at wave 2 as potential mediators and adjusted for sociodemographic factors. RESULTS There were 1422 participants at wave 1, half of whom were Black (29%) or Indigenous (20%). Most participants reported high ART adherence (74%) and viral suppression (93%). Racial discrimination was directly associated with having a detectable viral load, while intersectional stigma was directly associated with lower ART adherence. Resilience mediated associations between individual and intersectional stigmas and HIV treatment cascade outcomes, but depression did not. Racial discrimination was associated with increased resilience, while intersectional and other individual stigmas were associated with reduced resilience. CONCLUSION Race, gender and HIV-related stigma reduction interventions are required to address intersectional stigma among women living with HIV. Including resilience-building activities in these interventions may improve HIV treatment outcomes.
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Affiliation(s)
- Kalonde Malama
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | - Carmen H Logie
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | - Nina Sokolovic
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | - Lashanda Skeritt
- Centre for Outcomes Research and Evaluation, McGill University, Montréal, Canada
| | - Nadia O'Brien
- Department of Family Medicine, McGill University, Montréal, Canada
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7
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Mwangala PN, Wagner RG, Newton CR, Abubakar A. Strategies for improving mental health and wellbeing used by adults ageing with HIV from the Kenyan coast: a qualitative exploration. Wellcome Open Res 2023; 7:221. [PMID: 37415804 PMCID: PMC10320323 DOI: 10.12688/wellcomeopenres.18212.2] [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: 06/20/2023] [Indexed: 07/08/2023] Open
Abstract
Background: Physical and mental health problems are common among older adults living with HIV (OALWH). Adaptive coping strategies play a vital role in improving these adults' mental health and well-being despite the deleterious effects of HIV and ageing. However, in sub-Saharan Africa, limited evidence exists on the commonly utilized coping strategies in this population. We explore the coping strategies used by Kenyan OALWH to improve their mental health and wellbeing. Methods: Semi-structured in-depth interviews were conducted between October and December 2019 with 56 participants: 34 OALWH (53% female), 11 healthcare providers (63% female) and 11 primary caregivers (73% female) in Kilifi County. All interviews were audio-recorded and transcribed verbatim. We used the framework approach to synthesize the qualitative data. Results: Five major themes emerged from the analysis of participants' narratives, including self-care practices, religion and spirituality, relational living (social connectedness), generativity, identity, and mastery. Our study further revealed maladaptive coping strategies, including reliance on over-the-counter medications, self-isolation, waiting to see if symptoms would subside despite doing nothing, and HIV treatment interruptions during prolonged periods of prayer and fasting. Conclusions: Our findings provide an initial understanding of the coping strategies used by OALWH to confront HIV and ageing challenges in a low-literacy, low socio-economic Kenyan setting. Our results suggest that interventions designed to enhance personal capacity, social support, positive religiosity and spirituality, and intergenerational connections may be beneficial in improving the mental health and well-being of OALWH.
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Affiliation(s)
- Patrick N. Mwangala
- Centre for Geographic Medicine Research Coast, Kenya Medical Research Institute (KEMRI), Kilifi, P O Box 230-80108, Kenya
- School of Public Health, University of the Witwatersrand, Johannesburg, 27 St Andrews Road, Parktown 2193, South Africa
- Institute for Human Development, Aga Khan University, Nairobi, P.O. BOX 30270-00100, Kenya
| | - Ryan G. Wagner
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), University of the Witwatersrand, Faculty of Health Sciences, Johannesburg, South Africa
| | - Charles R. Newton
- Centre for Geographic Medicine Research Coast, Kenya Medical Research Institute (KEMRI), Kilifi, P O Box 230-80108, Kenya
- Institute for Human Development, Aga Khan University, Nairobi, P.O. BOX 30270-00100, Kenya
- Department of Psychiatry, University of Oxford, Warneford Hospital, Warneford Ln, Oxford, OX3 7JX, UK
- Department of Public Health, Pwani University, Kilifi, P.O. BOX 195-80108, Kenya
| | - Amina Abubakar
- Centre for Geographic Medicine Research Coast, Kenya Medical Research Institute (KEMRI), Kilifi, P O Box 230-80108, Kenya
- Institute for Human Development, Aga Khan University, Nairobi, P.O. BOX 30270-00100, Kenya
- Department of Psychiatry, University of Oxford, Warneford Hospital, Warneford Ln, Oxford, OX3 7JX, UK
- Department of Public Health, Pwani University, Kilifi, P.O. BOX 195-80108, Kenya
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8
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Fauk NK, Gesesew HA, Mwanri L, Hawke K, Merry MS, Asa GA, Ward PR. Understanding coping strategies of mothers living with HIV who care for children living with HIV: a qualitative study in Indonesia. BMC Womens Health 2023; 23:172. [PMID: 37041572 PMCID: PMC10091524 DOI: 10.1186/s12905-023-02299-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 03/22/2023] [Indexed: 04/13/2023] Open
Abstract
HIV infection and its sequelae continue to be a significant challenge among women and their families in developing countries despite the progress that has been made in the prevention and treatment of HIV. This paper describes the strategies employed by mothers with HIV to cope with the various challenges experienced following their own and their children's HIV diagnosis. This paper uses previously unpublished data collected for a study that sought to explore the mental health challenges and coping strategies of mothers living with HIV (MLHIV) (n = 23) who have children living with HIV (CLHIV). Data collection was conducted using in-depth interviews, and participants were recruited using the snowball sampling technique. The concept of meaning-making was used to guide the conceptualisation, analysis, and discussion of the findings. Our analysis showed that meaning-making such as the awareness of how important mothers were to their children/CLHIV and families and religious meaning were used by participants to cope with HIV-related and mental health challenges they faced. The meaning of mother-child relationship which was supported and maintained through the provision of time, attention and fulfillment of CLHIV's needs were also coping strategies employed by these women. Additional coping strategies used were to link their CLHIV to groups and activities of CLHIV. The connections made through these links enabled their children to know other CLHIV, build relationships, and share experiences. These findings are useful evidence that can inform policies and practices and indicate the need for the development of intervention programs that address the needs of MLHIV and their families to cope with HIV-related challenges of their children. Future large-scale studies involving MLHIV who have CLHIV are recommended to have a comprehensive understanding of strategies they employ to cope with HIV-related challenging circumstances and mental health issues that they continue to face.
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Affiliation(s)
- Nelsensius Klau Fauk
- Research Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, Adelaide, South Australia, Australia
- Institute of Resource Governance and Social Change, Kupang, Indonesia
| | - Hailay Abrha Gesesew
- Research Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, Adelaide, South Australia, Australia.
- College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia.
| | - Lillian Mwanri
- Research Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, Adelaide, South Australia, Australia
| | - Karen Hawke
- Women and Kids theme, Aboriginal Health, South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Maria Silvia Merry
- Medicine Faculty, Duta Wacana Christian University, Yogyakarta, Indonesia
| | - Gregorius Abanit Asa
- Research Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, Adelaide, South Australia, Australia
| | - Paul Russell Ward
- Research Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, Adelaide, South Australia, Australia
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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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10
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Ma H, Bu M, Zhai H, Li B, Xiong L. New Insight into HIV-Related Psychological Distress: A Concept Analysis. Clin Nurs Res 2023; 32:60-72. [PMID: 35259946 DOI: 10.1177/10547738221081002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Psychological distress is a frequently reported outcome measure in HIV research. However, because of its poor conceptualization, many studies only partially capture it because they focus solely on depression or anxiety based on symptoms. This study undertook a concept analysis of HIV-related psychological distress (HRPD) using Walker and Avant's method. The findings include HRPD's (a) attributes, including changes to emotional status, symptom burden, HIV disclosure distress and HIV-related stigma; (b) antecedents, including HIV-related stressors, cognitive appraisal of stressors and difficulty coping with the disease or treatment; and (c) consequences, including poor health outcomes and posttraumatic growth. Lazarus and Folkman's theory and the conservation of resources theory were adapted to further understand HRPD. This article provides insight into HRPD and increases the awareness of how to screen and assess HRPD at an early stage. The findings indicate the need to develop specific and rigorous measures and to provide appropriate interventions.
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Affiliation(s)
- Haiqi Ma
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Mengru Bu
- Integrated Hospital of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
| | - Huimin Zhai
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Bing Li
- Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Ling Xiong
- Nanfang Hospital, Southern Medical University, Guangzhou, China
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11
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Waldron EM, Miller ES, Wee V, Statton A, Moskowitz JT, Burnett‐Zeigler I. Stress, coping and the acceptability of mindfulness skills among pregnant and parenting women living with HIV in the United States: A focus group study. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e6255-e6266. [PMID: 36214377 PMCID: PMC10092748 DOI: 10.1111/hsc.14063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 08/25/2022] [Accepted: 09/12/2022] [Indexed: 06/16/2023]
Abstract
Pregnant and parenting women living with HIV (WLWH) face high levels of psychological stress and mental illness but lack tailored and acceptable psychosocial treatments. The research team sought to inform the adaptation of a mindfulness intervention for pregnant and parenting WLWH through focus groups exploring psychosocial treatment needs and mindfulness intervention preferences. The research team conducted focus groups with pregnant and parenting WLWH (n = 16) and case managers (n = 6) recruited from a community-based enhanced case management program. The research team utilised an iterative inductive approach to coding of the transcripts from these focus groups. Five themes emerged: stressors, signs of stress, coping, lack of access and acceptability of care, and motivation and trust in care engagement. These focus groups revealed a desire for a group intervention that could decrease isolation while protecting against involuntary disclosure of HIV status. Participants expressed openness to mindfulness skills for coping with stress. The focus group participants' preference for a non-stigmatising group intervention supports the potential of a mindfulness-based group intervention to reduce stress and improve the mental health of pregnant and parenting women living with HIV.
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Affiliation(s)
- Elizabeth M. Waldron
- Department of Psychiatry and Behavioral SciencesNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
- Present address:
Department of PsychiatryMassachusetts General HospitalBostonMassachusettsUSA
| | - Emily S. Miller
- Department of Psychiatry and Behavioral SciencesNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
- Department of Obstetrics and Gynecology, Division of Maternal Fetal MedicineNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Victoria Wee
- Department of Psychiatry and Behavioral SciencesNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | | | - Judith T. Moskowitz
- Department of Medical Social SciencesNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Inger Burnett‐Zeigler
- Department of Psychiatry and Behavioral SciencesNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
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12
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McIntosh RC, Lobo JD, Reed M, Britton JC. Anterior Insula Activation During Cardiac Interoception Relates to Depressive Symptom Severity in HIV-Positive and HIV-Negative Postmenopausal Women. Psychosom Med 2022; 84:863-873. [PMID: 36162077 PMCID: PMC9553270 DOI: 10.1097/psy.0000000000001136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 06/22/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVE This study aimed to determine whether subclinical symptoms of depression in postmenopausal women are associated with blood oxygen level-dependent (BOLD) activity within the anterior insula during cardiac interoceptive awareness and whether this association differs for persons living with the human immunodeficiency virus (PWH). METHOD Twenty-three postmenopausal (mean [standard deviation] age = 56.5 [4.8] years) and 27 HIV-negative women (mean [standard deviation] age = 56.4 [8.0]) underwent functional magnetic resonance imaging while performing a heartbeat detection task. BOLD activation within the bilateral anterior insula based on the contrast of a heartbeat detection condition with and without a distracting tone was entered along with age, HIV status, and psychological stress into two multivariate regression models with self-reported depressive symptom severity as the outcome. RESULTS Depressive symptoms did not vary by HIV status, nor was there a main effect or interaction for PWH on insula BOLD activation. Depressive symptoms were positively associated with psychological stress for the left ( β = 0.310, t (49) = 2.352, p = .023) and right brain models ( β = 0.296, t (49) = 2.265, p = .028) as well as the magnitude of BOLD activation in the left insula ( β = 0.290, t (49) = 2.218, p = .032) and right insula ( β = 0.318, t (49) = 2.453, p = .018), respectively. Exploratory analyses revealed that greater magnitude of BOLD activation attributed to exteroceptive noise (tone) was also correlated with self-reported distrust and preoccupation with interoceptive sensations. CONCLUSIONS Results support an active interference model for interoceptive awareness wherein greater BOLD signal in the anterior insula in the presence of distracting exteroceptive stimuli may reflect greater prediction error, a feature of depression.
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Mwangala PN, Wagner RG, Newton CR, Abubakar A. Strategies for improving mental health and wellbeing used by adults ageing with HIV: a qualitative exploration. Wellcome Open Res 2022. [DOI: 10.12688/wellcomeopenres.18212.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Physical and mental health problems are common among older adults living with HIV (OALWH). Adaptive coping strategies play a vital role in improving these adults' mental health and well-being despite the deleterious effects of HIV and ageing. However, in sub-Saharan Africa, limited evidence exists on the commonly utilized coping strategies in this population. We explore the coping strategies used by Kenyan OALWH to improve their mental health and wellbeing. Methods: Semi-structured in-depth interviews were conducted between October and December 2019 with 56 participants: 34 OALWH (53% female), 11 healthcare providers (63% female) and 11 primary caregivers (73% female) in Kilifi County. All interviews were audio-recorded and transcribed verbatim. We used the framework approach to synthesize the qualitative data. Results: Five major themes emerged from the analysis of participants’ narratives, including self-care practices, religion and spirituality, relational living (social connectedness), generativity, identity, and mastery. Our study further revealed maladaptive coping strategies, including reliance on over-the-counter medications, self-isolation, waiting to see if symptoms would subside despite doing nothing, and HIV treatment interruptions during prolonged periods of prayer and fasting. Conclusions: Our findings provide an initial understanding of the coping strategies used by OALWH to confront HIV and ageing challenges in a low-literacy, low socio-economic Kenyan setting. Our results suggest that interventions designed to enhance personal capacity, social support, positive religiosity and spirituality, and intergenerational connections may be beneficial in improving the mental health and well-being of OALWH.
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14
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Wang Q, Fong VWI, Qin Q, Yao H, Zheng J, Wang X, Wang A, Gao Q, Mo PKH. Trends in the psychosocial and mental health of HIV-positive women in China from 2015 to 2020: Results from two cross-sectional surveys. Health Expect 2022; 25:1555-1562. [PMID: 35726358 PMCID: PMC9327813 DOI: 10.1111/hex.13498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 03/28/2022] [Accepted: 03/30/2022] [Indexed: 11/05/2022] Open
Abstract
Background The human immunodeficiency virus (HIV) continues to be one of the major public health challenges in the world. Despite the advancement in medication and changes in views towards HIV in Chinese society, little is known about the changes in the psychosocial and mental health of HIV‐positive women in recent years. Objectives The present study examined the change in depression, anxiety, stigma, relationship with the child, intimacy with a partner, and social support from family, friends, and health professionals, for HIV‐positive women in China from 2015 to 2020. Methods Two cross‐sectional surveys were conducted in 2015 and 2020, and 429 and 382 HIV‐positive women were recruited from the Women's Health Department in Yunnan and Guangxi, China between November 2015 to May 2016, and November 2019 to January 2020, respectively. Results After controlling for significant sociodemographic variables, participants recruited in 2019–2020 had significantly lower levels of depression and anxiety and higher scores on emotional and tangible support from friends. On the other hand, they had lower scores in intimacy with partners and emotional and tangible support from family. No significant changes were found in stigma, relationship with the child, and support from health professionals. Conclusion Results provide important information on the changes in psychosocial and mental health, which offer insights into the design of interventions to promote psychosocial and mental health among HIV‐positive women in China. Patient or Public Contribution HIV‐positive women contributed to the data of this study. Health care professionals were involved in the discussion of the methods and results.
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Affiliation(s)
- Qian Wang
- Antenatal Health Care Department, National Center for Women and Children's Health, China CDC, Beijing, China
| | - Vivian W I Fong
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - Qinghua Qin
- Antenatal Health Care Department, Maternal and Child Health Hospital of Guangxi, Zhuang Autonomous Region, Nanning, China
| | - Hui Yao
- Antenatal Health Care Department, Maternal and Child Health Hospital of Guangxi, Zhuang Autonomous Region, Nanning, China
| | - Jiarui Zheng
- Antenatal Health Care Department, Yunnan Maternal and Child Health Care Hospital, Kunming, China
| | - Xiaoyan Wang
- Antenatal Health Care Department, National Center for Women and Children's Health, China CDC, Beijing, China
| | - Ailing Wang
- Antenatal Health Care Department, National Center for Women and Children's Health, China CDC, Beijing, China
| | - Qun Gao
- Antenatal Health Care Department, National Center for Women and Children's Health, China CDC, Beijing, China
| | - Phoenix K H Mo
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Sha Tin, Hong Kong.,The Chinese University of Hong Kong Shenzhen Research Institute, Shenzhen, China
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15
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Fazeli PL, Hopkins CN, Wells A, Lambert CC, Turan B, Kempf MC, Vance DE. Examining the Acceptability of a Resilience Building Intervention Among Adults Aging With HIV. J Assoc Nurses AIDS Care 2022; 33:155-167. [PMID: 33427766 PMCID: PMC8257766 DOI: 10.1097/jnc.0000000000000229] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
ABSTRACT Few interventions have targeted resilience resources in people living with HIV (PLWH). We tested the acceptability of an existing resilience intervention in middle-age and older PLWH. Fourteen PLWH attended one 3-hr group session, which included videos, quizzes, and written activities. Participants provided quantitative and qualitative feedback. The mean acceptability rating was 8.71 (1.27) on a 10-point scale. A majority of participants reported that the intervention was an appropriate length; that it improved their resilience, mood, and ability to manage HIV; and that they would likely continue using the tools. Average content retention accuracy was 75% (12.66). Qualitative feedback suggested addressing HIV-specific stressors, including disclosure concerns, stigma, health concerns, and treatment adherence. The resilience intervention was deemed highly acceptable among older PLWH. Uptake may increase by addressing HIV-specific stressors and improving comprehensibility. Future research should further refine and test the efficacy of a modified version of the intervention.
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Affiliation(s)
- Pariya L Fazeli
- Pariya L. Fazeli, PhD, is an Associate Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Cierra N. Hopkins, BS, is a Program Manager, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Andrea Wells, MSN, is a Doctoral Student, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Crystal Chapman Lambert, PhD, is an Assistant Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Bulent Turan, PhD, is an Associate Professor, Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Mirjam-Colette Kempf, PhD, MPH, is a Professor, School of Nursing, Departments of Epidemiology and Health Behavior, and School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- David E. Vance, PhD, is a Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Cierra N Hopkins
- Pariya L. Fazeli, PhD, is an Associate Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Cierra N. Hopkins, BS, is a Program Manager, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Andrea Wells, MSN, is a Doctoral Student, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Crystal Chapman Lambert, PhD, is an Assistant Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Bulent Turan, PhD, is an Associate Professor, Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Mirjam-Colette Kempf, PhD, MPH, is a Professor, School of Nursing, Departments of Epidemiology and Health Behavior, and School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- David E. Vance, PhD, is a Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Andrea Wells
- Pariya L. Fazeli, PhD, is an Associate Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Cierra N. Hopkins, BS, is a Program Manager, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Andrea Wells, MSN, is a Doctoral Student, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Crystal Chapman Lambert, PhD, is an Assistant Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Bulent Turan, PhD, is an Associate Professor, Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Mirjam-Colette Kempf, PhD, MPH, is a Professor, School of Nursing, Departments of Epidemiology and Health Behavior, and School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- David E. Vance, PhD, is a Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Crystal Chapman Lambert
- Pariya L. Fazeli, PhD, is an Associate Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Cierra N. Hopkins, BS, is a Program Manager, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Andrea Wells, MSN, is a Doctoral Student, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Crystal Chapman Lambert, PhD, is an Assistant Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Bulent Turan, PhD, is an Associate Professor, Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Mirjam-Colette Kempf, PhD, MPH, is a Professor, School of Nursing, Departments of Epidemiology and Health Behavior, and School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- David E. Vance, PhD, is a Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Bulent Turan
- Pariya L. Fazeli, PhD, is an Associate Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Cierra N. Hopkins, BS, is a Program Manager, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Andrea Wells, MSN, is a Doctoral Student, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Crystal Chapman Lambert, PhD, is an Assistant Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Bulent Turan, PhD, is an Associate Professor, Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Mirjam-Colette Kempf, PhD, MPH, is a Professor, School of Nursing, Departments of Epidemiology and Health Behavior, and School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- David E. Vance, PhD, is a Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Mirjam-Colette Kempf
- Pariya L. Fazeli, PhD, is an Associate Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Cierra N. Hopkins, BS, is a Program Manager, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Andrea Wells, MSN, is a Doctoral Student, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Crystal Chapman Lambert, PhD, is an Assistant Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Bulent Turan, PhD, is an Associate Professor, Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Mirjam-Colette Kempf, PhD, MPH, is a Professor, School of Nursing, Departments of Epidemiology and Health Behavior, and School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- David E. Vance, PhD, is a Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - David E Vance
- Pariya L. Fazeli, PhD, is an Associate Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Cierra N. Hopkins, BS, is a Program Manager, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Andrea Wells, MSN, is a Doctoral Student, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Crystal Chapman Lambert, PhD, is an Assistant Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Bulent Turan, PhD, is an Associate Professor, Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Mirjam-Colette Kempf, PhD, MPH, is a Professor, School of Nursing, Departments of Epidemiology and Health Behavior, and School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- David E. Vance, PhD, is a Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
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16
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Levy ME, Waters A, Sen S, Castel AD, Plankey M, Molock S, Asch F, Goparaju L, Kassaye S. Psychosocial stress and neuroendocrine biomarker concentrations among women living with or without HIV. PLoS One 2021; 16:e0261746. [PMID: 34941922 PMCID: PMC8699620 DOI: 10.1371/journal.pone.0261746] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 12/09/2021] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE Women living with HIV (WLWH) experience psychosocial stress related to social-structural vulnerabilities. To investigate neuroendocrine pathways linking stress and increased cardiovascular disease risk among WLWH, we evaluated associations between psychosocial stress (i.e., perceived stress, posttraumatic stress, and experiences of race- and gender-based harassment) and a composite neuroendocrine biomarker index among WLWH and women without HIV. METHODS In 2019-2020, Women's Interagency HIV Study participants in Washington, DC completed a questionnaire and provided blood and 12-hour overnight urine samples for testing of serum dehydroepiandrosterone sulfate (DHEA-S) and urinary free cortisol, epinephrine, and norepinephrine. Psychosocial stress was measured using the Perceived Stress Scale, PTSD Checklist-Civilian Version, and Racialized Sexual Harassment Scale. Latent profile analysis was used to classify participants into low (38%), moderate (44%), and high (18%) stress groups. Composite biomarker index scores between 0-4 were assigned based on participants' number of neuroendocrine biomarkers in high-risk quartiles (≥75th percentile for cortisol, epinephrine, and norepinephrine and ≤25th percentile for DHEA-S). We evaluated associations between latent profile and composite biomarker index values using multivariable linear regression, adjusting for socio-demographic, behavioral, metabolic, and HIV-related factors. RESULTS Among 90 women, 62% were WLWH, 53% were non-Hispanic Black, and median age was 55 years. In full multivariable models, there was no statistically significant association between psychosocial stress and composite biomarker index values among all women independent of HIV status. High (vs. low) psychosocial stress was positively associated with higher mean composite biomarker index values among all monoracial Black women (adjusted β = 1.32; 95% CI: 0.20-2.43), Black WLWH (adjusted β = 1.93; 95% CI: 0.02-3.83) and Black HIV-negative women (adjusted β = 2.54; 95% CI: 0.41-4.67). CONCLUSIONS Despite a null association in the overall sample, greater psychosocial stress was positively associated with higher neuroendocrine biomarker concentrations among Black women, highlighting a plausible mechanism by which psychosocial stress could contribute to cardiovascular disease risk.
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Affiliation(s)
- Matthew E. Levy
- Department of Epidemiology, Milken Institute School of Public Health at the George Washington University, Washington, DC, United States of America
- Westat, Rockville, Maryland, United States of America
- * E-mail:
| | - Ansley Waters
- Department of Epidemiology, Milken Institute School of Public Health at the George Washington University, Washington, DC, United States of America
- Division of Clinical Epidemiology, Office of Epidemiology, Virginia Department of Health, Richmond, Virginia, United States of America
| | - Sabyasachi Sen
- Division of Endocrinology, George Washington University School of Medicine and Health Sciences, Washington, DC, United States of America
| | - Amanda D. Castel
- Department of Epidemiology, Milken Institute School of Public Health at the George Washington University, Washington, DC, United States of America
| | - Michael Plankey
- Department of Medicine, Georgetown University Medical Center, Washington, DC, United States of America
| | - Sherry Molock
- Department of Psychology, The George Washington University, Washington, DC, United States of America
| | - Federico Asch
- Cardiovascular Core Laboratories and Cardiac Imaging Research, MedStar Health Research Institute, MedStar Heart and Vascular Institute, Washington, DC, United States of America
| | - Lakshmi Goparaju
- Department of Medicine, Georgetown University Medical Center, Washington, DC, United States of America
| | - Seble Kassaye
- Department of Medicine, Georgetown University Medical Center, Washington, DC, United States of America
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17
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Um MY, Maleku A, Rios-Richardson R, Rice E. A multidimensional examination of psychological distress among Latina mothers with and without HIV. SOCIAL WORK IN PUBLIC HEALTH 2021; 36:806-819. [PMID: 34556011 PMCID: PMC8608717 DOI: 10.1080/19371918.2021.1958117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The Latino population is disproportionally affected by HIV in the United States. Latina women, in particular, have significantly higher rates of HIV diagnosis than their White counterparts. Latinas with HIV who are primary family caregivers face multidimensional challenges from caregiving demands to stressors related to chronic illness, acculturation, family functioning, and socioeconomic disparities, which may contribute to higher psychological distress than Latina mothers without HIV. However, to date, scant research has focused on the mental health needs of Latina mothers living with HIV (MLHs) and how these needs are similar or different to Latina mothers without HIV. Thus, using a multidimensional approach we: (a) examined the associations between HIV status, acculturation, family functioning, socioeconomic status, and psychological distress among Latina mothers and (b) identified how these associations differed between Latina mothers with and without HIV. Cross-sectional, self-reported data were obtained via face-to-face interviews from 221 Latina MLHs and 116 Latina neighborhood control mothers (NCMs) living without HIV in Los Angeles, California. Results from multivariate ordinary least square regressions showed that higher acculturation was associated with psychological distress among MLHs, whereas higher levels of family conflict and education were associated with psychological distress among NCMs. Findings highlight the differential mental health needs of Latina mothers based on HIV status. Our study findings provide social work implications for culturally responsive interventions that can address multidimensional stressors experienced by marginalized Latinas MLHs.
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Affiliation(s)
- Mee Young Um
- Arizona State University, Watts College of Public Service and Community Solutions, School of Social Work, 411 N. Central Ave, Phoenix, AZ 85004
| | - Arati Maleku
- The Ohio State University, College of Social Work, 1947 N. College Road Columbus, OH 43210
| | - Rachel Rios-Richardson
- Arizona State University, Watts College of Public Service and Community Solutions, School of Social Work, 411 N. Central Ave, Phoenix, AZ 85004
| | - Eric Rice
- University of Southern California, Suzanne Dworak-Peck School of Social Work, 1149 S. Hill Street, Los Angeles, CA 90015
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18
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Brody LR, Firpo-Perretti Y, Bruck-Segal D, Dale SK, Ruffing EG, Cassiello-Robbins C, Weber KM, Cohen MH. Positive Psychological Factors and Life Themes in Relation to Health Outcomes in Women Living with HIV. Int J Behav Med 2021; 29:469-479. [PMID: 34713412 PMCID: PMC9046468 DOI: 10.1007/s12529-021-10032-y] [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] [Accepted: 09/25/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND This mixed methods study identified positive psychological factors and life themes expressed in autobiographical narratives of predominantly Black women living with HIV (WLWH) and investigated these in relation to depressive symptoms, antiretroviral therapy (ART) adherence (≥ 95% of time), and undetectable HIV viral load (VL) (< 80 copies/ml). METHOD Ninety-eight WLWH from the Women's Interagency HIV Study Chicago site (M age = 45.3; 91% Black) narrated three autobiographical life turning points, reliably coded for positive factors and life themes. ART adherence, VL and depressive symptoms, assessed with Center for Epidemiologic Studies Depression Scale total score (TOT) including its four factors (negative affect (NA), positive affect (PA), somatic symptoms (SS), and interpersonal problems (IP)), were collected over two time points: concurrently with narratives and 6 months later. Composite scores across the two time points were used in all analyses. RESULTS Ten positive psychological factors (gratitude, insight, compassion, meaning-making, acceptance, mindfulness, generativity, optimism, self-reliance, and benevolent God beliefs) and three positive life themes (health improvements, positive relationships, and accomplishments) were identified in narratives. Higher accomplishments, overall positive factors, insight, mindfulness, self-reliance, optimism, meaning-making, and acceptance related to lower depressive symptoms (TOT, NA, SS, or IP). Positive factors and life themes did not significantly relate to PA. Higher compassion related to higher ART adherence. Higher accomplishments related to undetectable VL independent of ART adherence. CONCLUSION Findings that positive psychological factors and life accomplishments may relate to better health, especially to lower depression, potentially contribute to developing positive psychology interventions for Black WLWH.
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Affiliation(s)
- Leslie R Brody
- Department of Psychological and Brain Sciences, Boston University, Boston, USA.
| | | | - Dana Bruck-Segal
- Department of Psychological and Brain Sciences, Boston University, Boston, USA
| | | | - Elizabeth G Ruffing
- Department of Psychological and Brain Sciences, Boston University, Boston, USA
| | | | - Kathleen M Weber
- Hektoen Institute of Medicine, Cook County Health and Hospitals System, Chicago, USA
| | - Mardge H Cohen
- Departments of Medicine, Stroger Hospital, Cook County Health and Hospitals System and Rush Medical School, Chicago, USA
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19
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Waldron EM, Burnett-Zeigler I, Wee V, Ng YW, Koenig LJ, Pederson AB, Tomaszewski E, Miller ES. Mental Health in Women Living With HIV: The Unique and Unmet Needs. J Int Assoc Provid AIDS Care 2021; 20:2325958220985665. [PMID: 33472517 PMCID: PMC7829520 DOI: 10.1177/2325958220985665] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Women living with HIV (WLWH) experience depression, anxiety, and posttraumatic
stress symptoms at higher rates than their male counterparts and more often than
HIV-unaffected women. These mental health issues affect not only the well-being
and quality of life of WLWH, but have implications for HIV management and
transmission prevention. Despite these ramifications, WLWH are under-treated for
mental health concerns and they are underrepresented in the mental health
treatment literature. In this review, we illustrate the unique mental health
issues faced by WLWH such as a high prevalence of physical and sexual abuse
histories, caregiving stress, and elevated internalized stigma as well as myriad
barriers to care. We examine the feasibility and outcomes of mental health
interventions that have been tested in WLWH including cognitive behavioral
therapy, mindfulness-based interventions, and supportive counseling. Future
research is required to address individual and systemic barriers to mental
health care for WLWH.
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Affiliation(s)
- Elizabeth M Waldron
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, 12244Northwestern University, Chicago, IL, USA
| | - Inger Burnett-Zeigler
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, 12244Northwestern University, Chicago, IL, USA
| | - Victoria Wee
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, 12244Northwestern University, Chicago, IL, USA
| | - Yiukee Warren Ng
- Department of Psychiatry, Columbia University Irving Medical Center, New York-Presbyterian Hospital, New York, NY, USA
| | - Linda J Koenig
- Division of HIV/AIDS Prevention, 1242Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Aderonke Bamgbose Pederson
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, 12244Northwestern University, Chicago, IL, USA
| | - Evelyn Tomaszewski
- Department of Social Work, College of Health and Human Services, 49340George Mason University, Fairfax, VA, USA
| | - Emily S Miller
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, 12244Northwestern University, Chicago, IL, USA.,Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Feinberg School of Medicine, 12244Northwestern University, Chicago, IL, USA
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20
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Chen X, Liu S, Zeng C, Li X, Qiao S, Lv R, Shen Z. Propensity score matching evaluation of psychological stress and hair cortisol among people living with HIV in China. Sci Rep 2021; 11:11426. [PMID: 34075127 PMCID: PMC8169931 DOI: 10.1038/s41598-021-90922-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 05/18/2021] [Indexed: 11/30/2022] Open
Abstract
To compare the psychological stress level and hair cortisol level of people living with HIV (PLWH) with those without HIV in China, a total of 220 participants were initially enrolled in the study, including 200 PLWH and 20 people living without HIV. Psychological stress level, including quality of life, anxiety, perceived stress and psychological resilience, was self-reported in both groups with related scales. The cortisol in hair was extracted and assessed by LC-APCI-MS/MS method. Propensity score matching analysis was performed to balance the baseline covariates of the two groups, whereas the difference in psychological stress level and hair cortisol level between the two groups was compared. Furthermore, the associations between psychological stress level and cortisol level were examined. Two comparison groups were matched by 1:3 propensity score matching, which yielding 20 people living without HIV and 60 PLWH. Ultimately, in regarding to the psychological stress, the levels of the anxiety (34 vs. 26, p < 0.001), perceived stress (38.5 vs. 33, p = 0.001) and psychological resilience (31 vs. 26, p = 0.004) were higher among PLWH than those living without HIV, but the people without HIV showed higher quality of life (109 vs.116, p < 0. 001). The hair cortisol level (34.66 vs. 21.61, p = 0.002) in PLWH was higher than those living without HIV. However, there were no significant associations between psychological stress level and cortisol level (p > 0.05). The PLWH showed higher level of psychological stress and cortisol than those without HIV. No relationship was seen between psychological stress level and cortisol level in PLWH.
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Affiliation(s)
- Xu Chen
- Department of Respiratory and Critical Care Medicine, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, Guilin, Guangxi, China
| | - Shuaifeng Liu
- Guangxi Center for Disease Prevention and Control, Nanning, Guangxi, China
| | - Chengbo Zeng
- Department of Health Promotion Education and Behavior, School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Xiaoming Li
- Department of Health Promotion Education and Behavior, School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Shan Qiao
- Department of Health Promotion Education and Behavior, School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Riying Lv
- Department of Infectious Diseases, Guigang City People's Hospital, Guigang, Guangxi, China.
| | - Zhiyong Shen
- Guangxi Center for Disease Prevention and Control, Nanning, Guangxi, China.
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21
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Paleari FG, Pivetti M, Galati D, Fincham FD. Hedonic and eudaimonic well-being during the COVID-19 lockdown in Italy: The role of stigma and appraisals. Br J Health Psychol 2021; 26:657-678. [PMID: 33460503 PMCID: PMC8013861 DOI: 10.1111/bjhp.12508] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVES This study examines perceived and anticipated stigma towards infected people, threat and impact appraisals of the COVID-19 pandemic as well as distressing personal experiences related to the virus in order to determine the extent to which they directly and indirectly predict hedonic and eudaimonic well-being. Investigated experiences included exposure to COVID-19-related news, having being in close proximity to people with a COVID-19 diagnosis or with COVID-19-like symptoms, having being sick or having suffered COVID-19-like symptoms, having tested negative for COVID-19. METHODS Adults from northern Italy (n = 326; M age = 29.86) provided cross-sectional data through an online survey during the nationwide lockdown period. Structural equation modelling analyses were conducted. RESULTS Perceived and anticipated stigma, exposure to COVID-19 news, perceived threat and impact on material resources access were negatively and indirectly related to both hedonic and eudaimonic well-being via perceived COVID-19 psychological impact which served as a mediator. Perceived stigma was also directly and negatively related to hedonic and eudaimonic well-being, whereas having tested negative for COVID diagnosis was positively and directly associated with eudaimonic well-being. CONCLUSIONS COVID-19-related stigma and appraisals can impair positive feelings about life as well as the pursuit of self-realization and the search for meaning in life. The findings highlight the importance of developing psychological preventive and rehabilitative interventions to help people cope with these risk factors.
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Affiliation(s)
| | - Monica Pivetti
- Department of Human and Social SciencesUniversity of BergamoItaly
| | - Desirèe Galati
- Department of Human and Social SciencesUniversity of BergamoItaly
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22
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Added socioeconomic burden of non-communicable disease on HIV/AIDS affected households in the Asia Pacific region: A systematic review. LANCET REGIONAL HEALTH-WESTERN PACIFIC 2021; 9:100111. [PMID: 34327436 PMCID: PMC8315338 DOI: 10.1016/j.lanwpc.2021.100111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 01/22/2021] [Accepted: 02/03/2021] [Indexed: 01/11/2023]
Abstract
Background HIV/AIDS causes significant socioeconomic burden to affected households and individuals, which is exacerbated by non-communicable diseases (NCDs). The Asia Pacific Region (APR) comprises about 60% of the global population and has been significantly affected by HIV/AIDS with 5.8 million after Sub-Saharan Africa in 2019. We investigated socioeconomic impacts of HIV/AIDS alone and the added burden of NCDs on HIV-affected households (HIV-HHs) and individuals in the APR. Method We searched multiple databases for studies published in English over 30 years on socioeconomic impact of HIV/AIDS alone and HIV/AIDS with NCDs on affected households or individuals in APR. Findings were synthesised across six domains: employment, health-related expenditure, non-health expenditure, strategies for coping with household liabilities, food security, and social protection. Findings HIV-HHs had a significantly higher socioeconomic burden compared to Non-HIV households. Total household expenditure was lower in HIV-HHs but with higher expenditure on health services. HIV-HHs experienced more absenteeism, lower wages, higher unemployment, and higher food insecurity. There is a paucity of evidence on the added burden of NCDs on HIV-HHs with only a single study from Myanmar. Interpretation Understanding the socioeconomic impact of HIV/AIDS with and without NCD is important. The evidence indicates that HIV-HHs in APR suffer from a significantly higher socioeconomic burden than Non-HIV-HHs. However, evidence on the additional burden of NCDs remains scarce and more studies are needed to understand the joint socioeconomic impact of HIV/AIDS and NCDs on affected households. Funding Deakin University School of Health and Social Development grant and Career Continuity grant.
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23
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Assessing anxiety, depression and insomnia symptoms among Ebola survivors in Africa: A meta-analysis. PLoS One 2021; 16:e0246515. [PMID: 33544772 PMCID: PMC7864444 DOI: 10.1371/journal.pone.0246515] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 01/20/2021] [Indexed: 11/19/2022] Open
Abstract
Background During health disaster events such as the current devastating havoc being inflicted on countries globally by the SARS-CoV-19 pandemic, mental health problems among survivors and frontline workers are likely concerns. However, during such health disaster events, stakeholders tend to give more precedence to the socio-economic and biomedical health consequences at the expense of mental health. Meanwhile, studies show that regardless of the kind of disaster/antecedent, all traumatic events trigger similar post-traumatic stress symptoms among survivors, families, and frontline workers. Thus, our study investigated the prevalence of anxiety, depression and insomnia symptoms among survivors of the 2014–2016 Ebola virus disease that plagued the West African sub-region. Methods We systematically retrieved peer-reviewed articles published between 1970 and 2019 from seven electronic databases, including Google Scholar, MEDLINE, PsychInfo, PubMed, Scopus, Springer Link, Web of Science on Ebola and post-traumatic stress disorder symptoms. A comprehensive hand search complemented this literature search. Of the 87 articles retrieved, only 13 met the inclusion criteria for this meta-analysis. Results After heterogeneity, influence, and publication bias analysis, our meta-analysis pooled proportion effects estimates showed a moderate to a high prevalence of anxiety (14%; 99% CI: 0.05–0.30), depression (15%; 99% CI: 0.11–0.21), and insomnia (22%; 99% CI: 0.13–0.36). Effect estimates ranging from (0.13; 99% CI: 0.05, 0.28) through to (0.11; 99% CI: 0.05–0.22), (0.15; 99% CI: 0.09–0.25) through to (0.13; 99% CI: 0.08–0.21) and (0.23; 99% CI: 0.11–0.41) to (0.23; 99% CI: 0.11–0.41) were respectively reported for anxiety, depression and insomnia symptoms. These findings suggest a significant amount of EVD survivors are struggling with anxiety, depression and insomnia symptoms. Conclusion Our study provided the first-ever meta-analysis evidence of anxiety, depression, and insomnia symptoms among EVD survivors, and suggest that the predominant biomedical health response to regional and global health disasters should be complemented with trauma-related mental health services.
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24
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Qiao S, Ingram L, Li X, Weissman SB. Perceptions of functional wellness in women living with HIV in South Carolina, United States: Voices from both patients and providers. AIDS Care 2021; 33:201-205. [PMID: 32266829 PMCID: PMC7541540 DOI: 10.1080/09540121.2020.1748865] [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: 06/15/2019] [Accepted: 03/18/2020] [Indexed: 10/24/2022]
Abstract
Functional wellness refers to optimal functioning across multiple domains of health and wellbeing (e.g., physical, psychological, social, spiritual), and posits that wellness goes beyond traditional physical/biological health outcomes to include behavioral and social dimensions of health. Its application could contribute to developing integrated care and improving self-management for HIV patients including women living with HIV (WLH). In order to explore the perceptions of functional wellness from the perspectives of both healthcare providers (HCPs) and WLH, we conducted in-depth interviews among a purposive sample of 20 WLH and 10 HCPs in South Carolina. Most of the WLH were African American, older, living in urban setting and diagnosed over five years ago. The HCPs were dominantly female and represented different types of healthcare providers. Qualitative analysis was guided by the ground theory and conducted using the software NVivo 11. The WLH and HCPs had some common perceptions on wellness. To achieve functional wellness, WLH should be living and functioning in their daily life, be able to take care of themselves and develop resilience, be engaged in social activities, and prevent themselves from comorbidities (e.g., chronic disease, mental health issues) by receiving holistic service in response to the needs of womanhood.
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Affiliation(s)
- Shan Qiao
- Dept. of Health Promotion Education & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, S.C. 29208 USA
| | - LaDrea Ingram
- Dept. of Health Promotion Education & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, S.C. 29208 USA
| | - Xiaoming Li
- Dept. of Health Promotion Education & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, S.C. 29208 USA
| | - Sharon Beth Weissman
- Dept. of Internal Medicine, School of Medicine, University of South Carolina, 1 Medical Park Dr, Columbia, SC 29203 USA
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25
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Marziali ME, McLinden T, Card KG, Closson K, Wang L, Trigg J, Salters K, Lima VD, Parashar S, Hogg RS. Social Isolation and Mortality Among People Living with HIV in British Columbia, Canada. AIDS Behav 2021; 25:377-388. [PMID: 32797358 PMCID: PMC7427496 DOI: 10.1007/s10461-020-03000-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Social isolation, a risk factor for poor health within the general population, may be exacerbated by unique challenges faced by people living with HIV (PLHIV). This analysis examines the association between social isolation and all-cause mortality among a cohort of PLHIV experiencing multiple social vulnerabilities. The analytical sample included 936 PLHIV ≥ 19 years, living in British Columbia, Canada, and enrolled in the Longitudinal Investigation into Supportive and Ancillary Health Services (LISA) Study (2007–2010). Participants were classified as Socially Connected (SC), Minimally Isolated (MI) or Socially Isolated (SI) via latent class analysis. Cross-sectional survey data was linked to longitudinal clinical data from a provincial HIV treatment database. Mortality was assessed longitudinally up to and including December 31st, 2017. Through multivariable logistic regression, an association between SI and all-cause mortality was found (adjusted OR: 1.48; 95% CI 1.08, 2.01). These findings emphasize the need to mitigate effects of social isolation among PLHIV.
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Affiliation(s)
- Megan E Marziali
- Epidemiology and Population Health Program, BC Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
- Mailman School of Public Health, Columbia University, New York City, NY, USA
| | - Taylor McLinden
- Epidemiology and Population Health Program, BC Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
| | - Kiffer G Card
- Faculty of Human and Social Development, School of Public Health and Social Policy, University of Victoria, Victoria, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - Kalysha Closson
- Faculty of Medicine, School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Lu Wang
- Epidemiology and Population Health Program, BC Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
| | - Jason Trigg
- Epidemiology and Population Health Program, BC Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
| | - Kate Salters
- Epidemiology and Population Health Program, BC Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - Viviane D Lima
- Epidemiology and Population Health Program, BC Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
- Division of Infectious Diseases, Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Surita Parashar
- Epidemiology and Population Health Program, BC Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - Robert S Hogg
- Epidemiology and Population Health Program, BC Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada.
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada.
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26
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Putera AM, Irwanto, Maramis MM. Quality-of-Life (QoL) of Indonesian Children Living with HIV: The Role of Caregiver Stigma, Burden of Care, and Coping. HIV AIDS-RESEARCH AND PALLIATIVE CARE 2020; 12:573-581. [PMID: 33116919 PMCID: PMC7569035 DOI: 10.2147/hiv.s269629] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 09/03/2020] [Indexed: 12/27/2022]
Abstract
Background Treatment of children with HIV infection has increased rapidly by increasing the life span of HIV patients from baby to adult. Improving the quality-of-life (QoL) in children living with HIV is a priority of HIV management in children and caregivers of children living with HIV have important roles. Caregiver stigma, caregiver burden, and caregiver coping affect caregivers in treating children living with HIV. Objective Analyzing the association of caregiver stigma, caregiver burden, and caregiver coping on QoL of Indonesian children living with HIV. Methods Participants in this study were caregivers of Indonesian children living with HIV. Participants were measured for caregiver stigma, caregiver burden, caregiver coping, and QoL of Indonesian children living with HIV. The instrument used in measuring caregiver stigma was people living with HIV/AIDS and caregiver questionnaire, caregiver burden used Zarit Burden questionnaire, caregiver coping used F-COPES questionnaire, and QoL used PedsQL for children aged 2-18 years old. Measurement data were analyzed using logistic regression and independent t tests with P<0.05. Results Indonesian children living with HIV in this study had an average age of 7.7±3.68 years and average participant age of 40.2±11.26 years. All participants stated that Indonesian children living with HIV tend to keep their health status confidential. Most QoL of Indonesian children living with HIV was good (71.7%), caregiver stigma value was 21.7±2.06, and caregiver burden level was moderate, of 50.9%. However, there was no significant association between caregiver stigma (β=0.064; P=0.548) and burden level (β=0.058; P=0.593) on QoL. On the other hand, caregiver coping value was 77.2±7.30, and there was a significant association of caregiver coping on QoL (β=-0.196; P=0.049). Conclusion There is an association of caregiver coping on QoL of Indonesian children living with HIV, in which the higher the caregiver coping, the lower the QoL. Meanwhile, there is no significant association of caregiver stigma and burden on QoL of Indonesian children living with HIV.
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Affiliation(s)
- Azwin Mengindra Putera
- Department of Child Health, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Irwanto
- Department of Child Health, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Margarita Maria Maramis
- Department of Psychiatry, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
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Abbamonte JM, Sawhney M, Alcaide ML, Weiss SM, Kumar M, Asfar T, Jones DL. The association of HIV and cocaine use to cigarette smoking in the context of depression and perceived stress. AIDS Care 2020; 32:1229-1237. [PMID: 32539456 PMCID: PMC7529880 DOI: 10.1080/09540121.2020.1778627] [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: 01/14/2020] [Accepted: 06/02/2020] [Indexed: 10/24/2022]
Abstract
Mental well-being can contribute to cigarette smoking and negatively impact disease progression among people living with HIV (PLWH). This study examined potential associations between cocaine use (COC), depression, and HIV status in predicting cigarette smoking; hypothesizing that depression would be highest in cocaine users and predict cigarette smoking. An exploratory analysis including stress was also examined as a potential predictor of cigarette use. More than half of the sample (65%) endorsed smoking at some point in the past, and 52% endorsed being current smokers at the time of the study. Smokers were most likely to be cocaine users (87.1%), cocaine using PLWH (74.3%), or PLWH (36.6%). Neither HIV status (χ2(1) = 1.5, p = .221), perceived stress (χ2(1) = 0.75 p = .386), nor depressive symptomatology (χ2(1) = 1.2, p = .274) were related to smoking. Non-cocaine users were approximately 95.4% less likely to smoke than cocaine users, controlling for all other variables. Overall, cocaine use was the greatest predictor of cigarette smoking and quantity of cigarettes smoked. Perceived stress and depression were not associated with cigarette smoking in the sample. Future interventions targeting cigarette use should include a cocaine-related component to encourage smoking cessation among this high-risk group.
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Affiliation(s)
- J M Abbamonte
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - M Sawhney
- Liffrig Family School of Education & Behavioral Sciences, University of Mary, Bismarck, ND, USA
| | - M L Alcaide
- Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | - S M Weiss
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - M Kumar
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - T Asfar
- Department of Public Health, University of Miami Miller School of Medicine, Miami, FL, USA
| | - D L Jones
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
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28
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Marziali ME, Card KG, McLinden T, Wang L, Trigg J, Hogg RS. Physical Distancing in COVID-19 May Exacerbate Experiences of Social Isolation among People Living with HIV. AIDS Behav 2020; 24:2250-2252. [PMID: 32328849 PMCID: PMC7178096 DOI: 10.1007/s10461-020-02872-8] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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29
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Kunzler AM, Helmreich I, König J, Chmitorz A, Wessa M, Binder H, Lieb K. Psychological interventions to foster resilience in healthcare students. Cochrane Database Syst Rev 2020; 7:CD013684. [PMID: 32691879 PMCID: PMC7388680 DOI: 10.1002/14651858.cd013684] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Resilience can be defined as maintaining or regaining mental health during or after significant adversities such as a potentially traumatising event, challenging life circumstances, a critical life transition or physical illness. Healthcare students, such as medical, nursing, psychology and social work students, are exposed to various study- and work-related stressors, the latter particularly during later phases of health professional education. They are at increased risk of developing symptoms of burnout or mental disorders. This population may benefit from resilience-promoting training programmes. OBJECTIVES To assess the effects of interventions to foster resilience in healthcare students, that is, students in training for health professions delivering direct medical care (e.g. medical, nursing, midwifery or paramedic students), and those in training for allied health professions, as distinct from medical care (e.g. psychology, physical therapy or social work students). SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, 11 other databases and three trial registries from 1990 to June 2019. We checked reference lists and contacted researchers in the field. We updated this search in four key databases in June 2020, but we have not yet incorporated these results. SELECTION CRITERIA Randomised controlled trials (RCTs) comparing any form of psychological intervention to foster resilience, hardiness or post-traumatic growth versus no intervention, waiting list, usual care, and active or attention control, in adults (18 years and older), who are healthcare students. Primary outcomes were resilience, anxiety, depression, stress or stress perception, and well-being or quality of life. Secondary outcomes were resilience factors. DATA COLLECTION AND ANALYSIS Two review authors independently selected studies, extracted data, assessed risks of bias, and rated the certainty of the evidence using the GRADE approach (at post-test only). MAIN RESULTS We included 30 RCTs, of which 24 were set in high-income countries and six in (upper- to lower-) middle-income countries. Twenty-two studies focused solely on healthcare students (1315 participants; number randomised not specified for two studies), including both students in health professions delivering direct medical care and those in allied health professions, such as psychology and physical therapy. Half of the studies were conducted in a university or school setting, including nursing/midwifery students or medical students. Eight studies investigated mixed samples (1365 participants), with healthcare students and participants outside of a health professional study field. Participants mainly included women (63.3% to 67.3% in mixed samples) from young adulthood (mean age range, if reported: 19.5 to 26.83 years; 19.35 to 38.14 years in mixed samples). Seventeen of the studies investigated group interventions of high training intensity (11 studies; > 12 hours/sessions), that were delivered face-to-face (17 studies). Of the included studies, eight compared a resilience training based on mindfulness versus unspecific comparators (e.g. wait-list). The studies were funded by different sources (e.g. universities, foundations), or a combination of various sources (four studies). Seven studies did not specify a potential funder, and three studies received no funding support. Risk of bias was high or unclear, with main flaws in performance, detection, attrition and reporting bias domains. At post-intervention, very-low certainty evidence indicated that, compared to controls, healthcare students receiving resilience training may report higher levels of resilience (standardised mean difference (SMD) 0.43, 95% confidence interval (CI) 0.07 to 0.78; 9 studies, 561 participants), lower levels of anxiety (SMD -0.45, 95% CI -0.84 to -0.06; 7 studies, 362 participants), and lower levels of stress or stress perception (SMD -0.28, 95% CI -0.48 to -0.09; 7 studies, 420 participants). Effect sizes varied between small and moderate. There was little or no evidence of any effect of resilience training on depression (SMD -0.20, 95% CI -0.52 to 0.11; 6 studies, 332 participants; very-low certainty evidence) or well-being or quality of life (SMD 0.15, 95% CI -0.14 to 0.43; 4 studies, 251 participants; very-low certainty evidence). Adverse effects were measured in four studies, but data were only reported for three of them. None of the three studies reported any adverse events occurring during the study (very-low certainty of evidence). AUTHORS' CONCLUSIONS For healthcare students, there is very-low certainty evidence for the effect of resilience training on resilience, anxiety, and stress or stress perception at post-intervention. The heterogeneous interventions, the paucity of short-, medium- or long-term data, and the geographical distribution restricted to high-income countries limit the generalisability of results. Conclusions should therefore be drawn cautiously. Since the findings suggest positive effects of resilience training for healthcare students with very-low certainty evidence, high-quality replications and improved study designs (e.g. a consensus on the definition of resilience, the assessment of individual stressor exposure, more attention controls, and longer follow-up periods) are clearly needed.
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Affiliation(s)
| | | | - Jochem König
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Andrea Chmitorz
- Faculty of Social Work, Health Care and Nursing, Esslingen University of Applied Sciences, Esslingen, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Michèle Wessa
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Department of Clinical Psychology and Neuropsychology, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Harald Binder
- Institute for Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Klaus Lieb
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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30
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Kunzler AM, Helmreich I, Chmitorz A, König J, Binder H, Wessa M, Lieb K. Psychological interventions to foster resilience in healthcare professionals. Cochrane Database Syst Rev 2020; 7:CD012527. [PMID: 32627860 PMCID: PMC8121081 DOI: 10.1002/14651858.cd012527.pub2] [Citation(s) in RCA: 101] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Resilience can be defined as the maintenance or quick recovery of mental health during or after periods of stressor exposure, which may result from a potentially traumatising event, challenging life circumstances, a critical life transition phase, or physical illness. Healthcare professionals, such as nurses, physicians, psychologists and social workers, are exposed to various work-related stressors (e.g. patient care, time pressure, administration) and are at increased risk of developing mental disorders. This population may benefit from resilience-promoting training programmes. OBJECTIVES To assess the effects of interventions to foster resilience in healthcare professionals, that is, healthcare staff delivering direct medical care (e.g. nurses, physicians, hospital personnel) and allied healthcare staff (e.g. social workers, psychologists). SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, 11 other databases and three trial registries from 1990 to June 2019. We checked reference lists and contacted researchers in the field. We updated this search in four key databases in June 2020, but we have not yet incorporated these results. SELECTION CRITERIA Randomised controlled trials (RCTs) in adults aged 18 years and older who are employed as healthcare professionals, comparing any form of psychological intervention to foster resilience, hardiness or post-traumatic growth versus no intervention, wait-list, usual care, active or attention control. Primary outcomes were resilience, anxiety, depression, stress or stress perception and well-being or quality of life. Secondary outcomes were resilience factors. DATA COLLECTION AND ANALYSIS Two review authors independently selected studies, extracted data, assessed risks of bias, and rated the certainty of the evidence using the GRADE approach (at post-test only). MAIN RESULTS We included 44 RCTs (high-income countries: 36). Thirty-nine studies solely focused on healthcare professionals (6892 participants), including both healthcare staff delivering direct medical care and allied healthcare staff. Four studies investigated mixed samples (1000 participants) with healthcare professionals and participants working outside of the healthcare sector, and one study evaluated training for emergency personnel in general population volunteers (82 participants). The included studies were mainly conducted in a hospital setting and included physicians, nurses and different hospital personnel (37/44 studies). Participants mainly included women (68%) from young to middle adulthood (mean age range: 27 to 52.4 years). Most studies investigated group interventions (30 studies) of high training intensity (18 studies; > 12 hours/sessions), that were delivered face-to-face (29 studies). Of the included studies, 19 compared a resilience training based on combined theoretical foundation (e.g. mindfulness and cognitive-behavioural therapy) versus unspecific comparators (e.g. wait-list). The studies were funded by different sources (e.g. hospitals, universities), or a combination of different sources. Fifteen studies did not specify the source of their funding, and one study received no funding support. Risk of bias was high or unclear for most studies in performance, detection, and attrition bias domains. At post-intervention, very-low certainty evidence indicated that, compared to controls, healthcare professionals receiving resilience training may report higher levels of resilience (standardised mean difference (SMD) 0.45, 95% confidence interval (CI) 0.25 to 0.65; 12 studies, 690 participants), lower levels of depression (SMD -0.29, 95% CI -0.50 to -0.09; 14 studies, 788 participants), and lower levels of stress or stress perception (SMD -0.61, 95% CI -1.07 to -0.15; 17 studies, 997 participants). There was little or no evidence of any effect of resilience training on anxiety (SMD -0.06, 95% CI -0.35 to 0.23; 5 studies, 231 participants; very-low certainty evidence) or well-being or quality of life (SMD 0.14, 95% CI -0.01 to 0.30; 13 studies, 1494 participants; very-low certainty evidence). Effect sizes were small except for resilience and stress reduction (moderate). Data on adverse effects were available for three studies, with none reporting any adverse effects occurring during the study (very-low certainty evidence). AUTHORS' CONCLUSIONS For healthcare professionals, there is very-low certainty evidence that, compared to control, resilience training may result in higher levels of resilience, lower levels of depression, stress or stress perception, and higher levels of certain resilience factors at post-intervention. The paucity of medium- or long-term data, heterogeneous interventions and restricted geographical distribution limit the generalisability of our results. Conclusions should therefore be drawn cautiously. The findings suggest positive effects of resilience training for healthcare professionals, but the evidence is very uncertain. There is a clear need for high-quality replications and improved study designs.
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Affiliation(s)
| | | | - Andrea Chmitorz
- Faculty of Social Work, Health Care and Nursing, Esslingen University of Applied Sciences, Esslingen, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Jochem König
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Harald Binder
- Institute for Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Michèle Wessa
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Department of Clinical Psychology and Neuropsychology, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Klaus Lieb
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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31
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Payán DD, Derose KP, Fulcar MA, Farías H, Palar K. "It Was as Though My Spirit Left, Like They Killed Me": The Disruptive Impact of an HIV-Positive Diagnosis among Women in the Dominican Republic. J Int Assoc Provid AIDS Care 2020; 18:2325958219849042. [PMID: 31109213 PMCID: PMC6748475 DOI: 10.1177/2325958219849042] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
An HIV diagnosis may be associated with severe emotional and psychological distress,
which can contribute to delays in care or poor self-management. Few studies have explored
the emotional, psychological, and psychosocial impacts of an HIV diagnosis on women in
low-resource settings. We conducted in-depth interviews with 30 women living with HIV in
the Dominican Republic. Interviews were audio-recorded, transcribed, and analyzed using
the biographical disruption framework. Three disruption phases emerged (impacts of a
diagnosis, postdiagnosis turning points, and integration). Nearly all respondents
described the news as deeply distressful and feelings of depression and loss of self-worth
were common. Several reported struggling with the decision to disclose—worrying about
stigma. Postdiagnosis turning points consisted of a focus on survival and motherhood;
social support (family members, friends, HIV community) promoted integration. The findings
suggest a need for psychological resources and social support interventions to mitigate
the negative impacts of an HIV diagnosis.
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Affiliation(s)
- Denise Diaz Payán
- 1 Department of Public Health, School of Social Sciences, Humanities, and Arts, University of California, Merced, CA, USA.,2 RAND Corporation, Santa Monica, CA, USA
| | | | - María Altagracia Fulcar
- 3 United Nations World Food Programme, Dominican Republic Country Office, Santo Domingo, Dominican Republic
| | - Hugo Farías
- 4 United Nations World Food Programme, Regional Office for Latin America and the Caribbean, Panamá, Dominican Republic
| | - Kartika Palar
- 5 School of Medicine, University of California, San Francisco, San Francisco, CA, USA
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32
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Halpin SN, Ge L, Mehta CC, Gustafson D, Robertson KR, Rubin LH, Sharma A, Vance D, Valcour V, Waldrop-Valverde D, Ofotokun I. Psychosocial Resources and Emotions in Women Living With HIV Who Have Cognitive Impairment: Applying the Socio-Emotional Adaptation Theory. Res Theory Nurs Pract 2020; 34:49-64. [PMID: 31937636 PMCID: PMC8062986 DOI: 10.1891/1541-6577.34.1.49] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Decreased cognitive function is related to undesirable psychological outcomes such as greater emotional distress and lower quality of life, particularly among women living with HIV who experience cognitive impairment (WLWH-CI). Yet, few studies have examined the psychosocial resources that may attenuate these negative emotional outcomes. The current study sought to identify the interrelated contributions of social relationships and psychological resources in 399 WLWH-CI by applying Socio-Emotional Adaptation (SEA) theory using data from the Women's Interagency HIV Study (WIHS). Cognitive impairment (CI) was defined as impairment on two or more cognitive domains. Logistic regression models were used to estimate the odds of experiencing specific emotions due to a combination of four psychosocial resources. Emotions (i.e., depression, apathy, fear, anger, and acceptance) were related to a combination of binary (positive/negative) psychosocial resources including relationship with an informal support partner, relationship with a formal caregiver, coping, and perceived control. Understanding the conditions that may influence emotions in WLWH-CI is important for identifying and appropriately addressing the needs of this population. As CI increases, these individuals experience increasing challenges with articulating their care needs and having their needs met. As such, it becomes increasingly important to identify possible triggers for emotional responses to best address these underlying challenges.
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Affiliation(s)
| | - Lin Ge
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, GA
| | - Christina C Mehta
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, GA
| | | | - Kevin R Robertson
- AIDS Neurological Center, Department of Neurology.,School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Leah H Rubin
- Departments of Neurology and Epidemiology, Johns Hopkins University, Baltimore, MD
| | - Anjali Sharma
- Albert Einstein College of Medicine, Yeshiva University, New York, NY
| | - David Vance
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL
| | - Victor Valcour
- Global Brain Health Institute, San Franscisco, CA.,Department of Neurology, University of California San Fransisco, San Fransisco, CA
| | | | - Igho Ofotokun
- Emory University School of Medicine, Division of Infectious Disease, Atlanta, GA
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33
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Examining the Associations Between Immigration Status and Perceived Stress Among HIV-Infected and Uninfected Women. J Community Health 2019; 43:1172-1181. [PMID: 29926272 DOI: 10.1007/s10900-018-0537-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Stress is associated with poor mental and physical health outcomes. In the United States (U.S.), little is known about perceived stress and associated factors among HIV-infected and immigrant women. Here, we examine these associations within a sample of 305 HIV-infected and uninfected, U.S.-born and non-U.S.-born women who were part of the Women's Interagency HIV Study (WIHS) at three sites (New York, Chicago, and Los Angeles). Perceived stress was measured using the 10-item Perceived Stress Scale (PSS-10); HIV infection was serologically confirmed, and nativity status was self-reported. Bivariate and multivariable logistic regression were used to identify associations with perceived stress. The majority of participants were U.S.-born (232, 76.1%) and were HIV-infected (212, 68.5%). Mutlivariable analyses found the odds of perceived stress to be lower for those employed [adjusted odds ratio (AOR) = 0.31, 95% confidence interval (CI) = (0.15-0.63)], with high levels of social support (AOR = 0.45, 95% CI 0.26-0.79), and HIV-infected (AOR = 0.44, 95% CI 0.24-0.79). Perceived stress was positively associated with living in unstable housing (AOR = 2.54, 95% CI 1.17-5.51). Here, immigration status was not associated with perceived stress. We identified stress to be higher among women who were unemployed, unstably housed, or who had low social support. Community-based programs should tailor interventions to include stress reduction strategies for participants with identified risk factors to improve mental and physical health outcomes.
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34
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Finkelstein-Fox L, Park CL, Kalichman SC. Health benefits of positive reappraisal coping among people living with HIV/AIDS: A systematic review. Health Psychol Rev 2019; 14:394-426. [PMID: 31284849 DOI: 10.1080/17437199.2019.1641424] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
People living with HIV/AIDS (PLWHA) often face significant stress, ranging from perceiving identity changes to encountering barriers to daily health behavior engagement. To manage these experiences, many people use positive reappraisal coping (including benefit finding and perceiving growth). Effective coping is highly important for PLWHA; stress reduction has salutary effects on multiple indicators of health. The present systematic review, conducted in PubMed, PsycINFO, and CINAHL, synthesises findings from 33 studies of PLWHA, addressing effects of positive reappraisal on health-related outcomes for adults living with HIV as a chronic illness. Studies were evaluated based on methodological considerations, measurement of key variables, and implications for specific aspects of health. Results suggest that positive reappraisal is often beneficial when dealing with the implications of a potentially traumatic HIV diagnosis on one's identity, although effects may be contextually bound. Implications of these findings are reviewed, emphasizing the importance of positive reappraisal for enhancing health promotion and self-management of HIV. Although the present review is limited by inclusion of multiple disparate outcomes and exclusion of non-English-language articles, these findings inform a comprehensive model of direct and indirect effects of positive reappraisal on emotional, functional, physiological, and behavioural aspects of health useful for guiding future research.
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Affiliation(s)
| | - Crystal L Park
- Department of Psychological Sciences, University of Connecticut, Storrs, CT
| | - Seth C Kalichman
- Department of Psychological Sciences, University of Connecticut, Storrs, CT
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35
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Hill M, Huff A, Chumbler N. "I'm Gonna Get Busy Living": Examining the Trajectories of Affect, Behavioral Health, and Psychological Resilience Among Persons Living With HIV in a Southeastern U.S. Health District. Glob Qual Nurs Res 2019; 6:2333393619834937. [PMID: 31069249 PMCID: PMC6492360 DOI: 10.1177/2333393619834937] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 02/02/2019] [Accepted: 02/04/2019] [Indexed: 11/16/2022] Open
Abstract
Internal psychological states and coping processes are significant determinants
of resilience. The primary aim of this qualitative work is to provide further
insight into how core affect influences the adaptability of persons living with
HIV (PLWH) after diagnosis. In-depth interviews were conducted with a diverse
group of PLWH in a health district located in the Southeastern United States. A
deductive-inductive approach was taken while coding and analyzing,
N = 18 participant narratives concerning the psychological
and coping processes surrounding diagnosis and engagement in care. Active
behavioral and cognitive coping after diagnosis was exhibited by PLWH expressing
salient attributes of positive affect, whereas the salience of negative affect
among PLWH was associated with avoidant coping and heightened distress. Our
findings illuminate the beneficial role of positive affect and active coping on
the health and well-being of PLWH. The study implications extend to the
development and enhancement of programs designed to fortify psychological
resilience.
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Affiliation(s)
| | - Amber Huff
- University of Sussex, Brighton, United Kingdom
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36
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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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37
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Brown MJ, Serovich JM, Laschober TC, Kimberly JA, Lescano CM. Ways of coping and HIV disclosure among people living with HIV: mediation of decision self-efficacy and moderation by sex. AIDS Care 2019; 31:1001-1010. [PMID: 30974958 DOI: 10.1080/09540121.2019.1605045] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Individuals living with HIV/AIDS face several stressors and use varying strategies to cope. Disclosure (or nondisclosure) of HIV serostatus is an important consideration among individuals living with HIV. However, studies examining the association between coping and HIV disclosure are lacking, and more research examining potential mediators and moderators is needed. The transactional model of stress and coping and the theory of planned behavior may help in understanding the mediating relationship between coping, decision self-efficacy, and HIV disclosure. Therefore, the aims of this study were to examine the association between coping and HIV disclosure to sexual partners, assess the mediating role of decision self-efficacy, and examine moderation by sex. Baseline data from 262 individuals living with HIV who participated in a disclosure intervention were used for analysis. Descriptive statistics were used to assess sociodemographic characteristics. Principal component analysis was used to operationalize coping. Path analysis was then used to determine the mediating role of decision self-efficacy in the association between overall, adaptive, distancing, and attack/escape avoidance coping and HIV disclosure to sexual partners. After adjusting for age and time since diagnosis, direct associations between coping and decision self-efficacy, and decision self-efficacy and disclosure behavior varied by sex. Among the overall study population, decision self-efficacy mediated the associations between adaptive coping (β = 0.064, p = 0.003), attack/escape avoidance coping (β = -0.052, p = 0.009) and disclosure behavior. Disclosure intervention programs geared towards populations living with HIV should include decision self-efficacy and adaptive coping, and attenuate attack/escape avoidance coping.
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Affiliation(s)
- Monique J Brown
- a Department of Epidemiology and Biostatistics, Arnold School of Public Health , University of South Carolina , Columbia , SC , USA.,b South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health , University of South Carolina , Columbia , SC , USA
| | - Julianne M Serovich
- c College of Behavioral and Community Sciences , University of South Florida , Tampa , FL , USA
| | - Tanja C Laschober
- c College of Behavioral and Community Sciences , University of South Florida , Tampa , FL , USA
| | - Judy A Kimberly
- d Division of Biology and Medicine , Brown University , Providence , RI , USA
| | - Celia M Lescano
- e Department of Mental Health Law and Policy, College of Behavioral and Community Sciences , University of South Florida , Tampa , FL , USA
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38
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James PB, Wardle J, Steel A, Adams J. Post-Ebola psychosocial experiences and coping mechanisms among Ebola survivors: a systematic review. Trop Med Int Health 2019; 24:671-691. [PMID: 30843627 DOI: 10.1111/tmi.13226] [Citation(s) in RCA: 90] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVE A myriad of physical and psychosocial sequelae have been reported among Ebola survivors from previous Ebola virus disease (EVD) outbreaks, including the most recent in West Africa. This review examines the various forms of psychological distress experienced by EVD survivors, family and community reactions to EVD survivors and EVD survivors' coping mechanisms. METHODS We conducted a literature search of original articles employing Medline (Ovid), PubMed, Web of Science, Scopus, CINAHL, EBSCO host academic search complete, PsycINFO (EBSCO) and Embase databases. RESULTS Our search identified 1890 articles of which 24 met our inclusion criteria. Various forms of psychological distress were prevalent among EVD survivors including depression, anxiety, anger, grief, guilt, flashbacks, sadness, worthlessness, substance addiction, suicidal tendencies and self-stigmatisation. Family and community responses to EVD survivors ranged from acceptance to rejection, isolation, stigmatisation and discrimination. EVD survivors' coping strategies included engagement with religious faith, EVD survivors associations and involvement in EVD prevention and control interventions. CONCLUSION Psychological distress, including that resulting from family and community stigma and discrimination, appears common among EVD survivors. Community-based mental health and psychosocial interventions integrated within a broader package of care for EVD survivors that also recognises the physical health challenges are required. Well-designed longitudinal studies can provide clear insights on the nature and trajectory of the psychosocial issues currently experienced by EVD survivors.
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Affiliation(s)
- P B James
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia.,Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - J Wardle
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - A Steel
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - J Adams
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
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39
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Molina Y, Ulrich A, Greer AC, Primbas A, Wandell G, Sanchez H, Bain C, Konda KA, Clark JL, De la Grecca R, Villarán MV, Pasalar S, Lama JR, Duerr AC. Impact of pre-diagnosis awareness of HIV-related stigma and dispositional coping on linkage to HIV care among newly diagnosed HIV+ Peruvian patients. AIDS Care 2019; 31:848-856. [PMID: 30616376 DOI: 10.1080/09540121.2018.1563282] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
A substantial body of literature has characterized how psychosocial factors, including HIV-related stigma and coping, are associated with HIV testing and HIV care utilization post-diagnosis. Less is known about if certain psychosocial characteristics pre-diagnosis may also predict linkage to care among individuals who receive an HIV-positive diagnosis. We examined if pre-diagnosis awareness/perception about HIV-related stigma and dispositional coping styles predicted linkage to HIV care within three months post-diagnosis with a secondary analysis of 604 patients from a randomized controlled trial (Sabes Study). Awareness/perception about HIV-related stigma, dispositional maladaptive and adaptive coping were measured before patients underwent an HIV test. Linkage to care was measured as receipt of care within three months of receiving the diagnosis. After adjusting for covariates, individuals who reported greater dispositional maladaptive coping pre-diagnosis had lower odds of linking to care, OR = 0.82, 95%CI [0.67, 1.00], p = .05. There was also a non-significant inverse association between dispositional adaptive coping pre-diagnosis and linkage to care. These preliminary data suggest the need for further longitudinal research and highlight the potential utility of pre-diagnosis psychosocial assessment and tailored counseling when providing positive HIV diagnosis results.
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Affiliation(s)
- Yamilé Molina
- a Community Health Sciences, Center for Research on Women and Gender , University of Illinois at Chicago , Chicago , IL , USA.,b Cancer Center, Center for Research on Women and Gender , University of Illinois at Chicago , Chicago , IL , USA
| | - Angela Ulrich
- c Vaccine and Infectious Disease & Public Health Science Divisions , Fred Hutchinson Cancer Research Center , Seattle , WA , USA.,d Division of Epidemiology and Community Health , University of Minnesota , Minneapolis , MN , USA
| | | | - Angela Primbas
- e University of Washington , Seattle , WA , USA.,f Department of Medicine , Stanford University , Stanford , WA , USA
| | | | | | - Carolyn Bain
- c Vaccine and Infectious Disease & Public Health Science Divisions , Fred Hutchinson Cancer Research Center , Seattle , WA , USA.,h PATH , Seattle , WA , USA
| | - Kelika A Konda
- i Department of Epidemiology, School of Public Health , University of California Los Angeles , Lima , Peru
| | - Jesse L Clark
- j Department of Medicine, Division of Infectious Diseases , University of California Los Angeles , Los Angeles , CA , USA
| | - Robert De la Grecca
- k Asociación Civil Impacta Salud y Educación , Lima , Peru.,l HIV Vaccine Trials Network (HVTN), Fred Hutchinson Cancer Research Center , Seattle , WA , USA
| | | | - Siavash Pasalar
- c Vaccine and Infectious Disease & Public Health Science Divisions , Fred Hutchinson Cancer Research Center , Seattle , WA , USA
| | - Javier R Lama
- k Asociación Civil Impacta Salud y Educación , Lima , Peru
| | - Ann C Duerr
- c Vaccine and Infectious Disease & Public Health Science Divisions , Fred Hutchinson Cancer Research Center , Seattle , WA , USA
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40
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Wang YY, Dong M, Zhang Q, Xu DD, Zhao J, Ng CH, Ungvari GS, Jia FJ, Xiang YT. Suicidality and clinical correlates in Chinese men who have sex with men (MSM) with HIV infection. PSYCHOL HEALTH MED 2018; 24:137-143. [PMID: 30175922 DOI: 10.1080/13548506.2018.1515495] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Little is known about suicidality in Chinese men who has sex with men (MSM) infected with human immunodeficiency virus (HIV). This study investigated suicidality and its clinical correlates in Chinese MSM with HIV infection. Suicidality, demographic and clinical characteristics were assessed in 410 MSM with HIV infection consecutively recruited from a public HIV clinic in China. The prevalence of suicidality was 10.7% in Chinese HIV-infected MSM. Compared with those without suicidality, MSM with suicidality were more likely to be younger, unmarried and unemployed, and have more frequent insomnia, lower CD4 lymphocyte counts, and higher GAD-7 and CSE-D total scores. Multiple logistic regression analyses revealed that suicidality was independently associated with unemployment (p = 0.03, OR = 0.3, 95% CI = 0.1-0.9), age (p < 0.01, OR = 0.9, 95% CI = 0.8-0.9), CD4 lymphocyte counts (p = 0.02, OR = 0.9, 95% CI = 0.9-1.0), and the GAD-7 total score (p < 0.001, OR = 1.3, 95% CI = 1.1-1.5). Suicidality is common in Chinese MSM with HIV infection. There is an urgent need to develop comprehensive suicide prevention program and mental health services for this population.
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Affiliation(s)
- Yuan-Yuan Wang
- a Faculty of Health Sciences, Unit of Psychiatry , University of Macau , Macao SAR , China
| | - Min Dong
- a Faculty of Health Sciences, Unit of Psychiatry , University of Macau , Macao SAR , China
| | - Qinge Zhang
- b The National Clinical Research Center for Mental Disorders, China &Center of Depression , Beijing Institute for Brain Disorders & Mood Disorders Center, Beijing Anding Hospital, Capital Medical University , Beijing , China
| | - Dan-Dan Xu
- a Faculty of Health Sciences, Unit of Psychiatry , University of Macau , Macao SAR , China
| | - Jin Zhao
- c Shenzhen Center for Disease Control and Prevention , Guangdong City , Guangdong province , China
| | - Chee H Ng
- d Department of Psychiatry , University of Melbourne , Melbourne , Victoria , Australia
| | | | - Fu-Jun Jia
- f Guangdong Mental Health Center , Guangdong General Hospital & Guangdong Academy of Medical Sciences , Guangdong City , Guangdong Province , China
| | - Yu-Tao Xiang
- a Faculty of Health Sciences, Unit of Psychiatry , University of Macau , Macao SAR , China
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41
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Seffren V, Familiar I, Murray SM, Augustinavicius J, Boivin MJ, Nakasujja N, Opoka R, Bass J. Association between coping strategies, social support, and depression and anxiety symptoms among rural Ugandan women living with HIV/AIDS. AIDS Care 2018; 30:888-895. [PMID: 29471677 PMCID: PMC9850497 DOI: 10.1080/09540121.2018.1441969] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Poor mental health detrimentally affects quality of life among women living with HIV/AIDS. An improved understanding of how coping and social support relate to depression and anxiety in this population can facilitate the design and implementation of appropriate mental health treatment and support services. Secondary analysis was conducted on baseline data from 288 HIV-positive women enrolled in a parenting intervention in Uganda. Depression and anxiety symptoms, social support, and coping were assessed with the Hopkins Symptom Checklist and adapted versions of the Multidimensional Scale for Perceived Social Support and Ways of Coping Questionnaire. General linear regression models were used to estimate associations between coping and mental health. Based on report of elevated symptoms, approximately 10% of women were categorized as having clinically-relevant depression or anxiety. Emotion-focused (EF: p < .001) and problem-focused (PF: p = .01) coping were associated with more depressive symptoms while greater family support (EF: p = .002; PF: p = .003) was associated with fewer depression symptoms. More anxiety symptoms were associated with reporting both coping strategies (EF: p < .001; PF: p = .02) and higher community support (EF&PF: p = .01). The cross-sectional nature of the study limits our ability to rule out the role of reverse causation in the significant relationship between coping and mental health. Findings do suggest that high family support can be protective against depression and anxiety symptoms among women living with HIV.
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Affiliation(s)
- Victoria Seffren
- a Department of Health Behavior and Health Education , University of Michigan School of Public Health , Ann Arbor , MI , USA
| | - Itziar Familiar
- b Department of Psychiatry , Michigan State University , East Lansing , MI , USA
| | - Sarah M Murray
- c Department of Mental Health , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA
| | - Jura Augustinavicius
- c Department of Mental Health , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA
| | - Michael J Boivin
- b Department of Psychiatry , Michigan State University , East Lansing , MI , USA
- f Departments of Psychiatry and Neurology & Ophthalmology , Michigan State University , East Lansing , MI , USA
- g Department of Psychiatry , University of Michigan , Ann Arbor , MI , USA
| | | | - Robert Opoka
- e Department of Pediatrics and Child Health , Makerere University , Kampala , Uganda
| | - Judith Bass
- c Department of Mental Health , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA
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42
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Wang YY, Zhao J, Zhang Q, Zhang Y, Bai B, Ng CH, Ungvari GS, Jia FJ, Xiang YT. Prevalence of depressive syndrome and their association with demographic and clinical characteristics in Chinese HIV patients. AIDS Care 2018; 30:1388-1392. [PMID: 29690783 DOI: 10.1080/09540121.2018.1465172] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
To investigate the prevalence of depressive syndrome and their association with demographic and clinical characteristics in Chinese patients infected with the human immunodeficiency virus (HIV). A total of 416 patients with HIV infection were consecutively screened and enrolled in the study. Depressive syndrome was assessed with the Center for Epidemiologic Studies-Depression Scale (CES-D). The proportion of depressive syndrome was 36.3%. Patients with depressive syndrome were younger, and were more likely to have severe anxiety symptoms, religious beliefs and psychological treatment. Multiple logistic regression analyses revealed that religious beliefs (p = 0.001, OR = 3.9, 95% CI = 1.7-8.6) and more severe anxiety symptoms (p = 0.001, OR = 1.6, 95% CI = 1.4-1.7) were independently associated with depressive syndrome. Regular screening for depressive syndrome and appropriate biopsychosocial interventions are urgently needed for this population.
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Affiliation(s)
- Yuan-Yuan Wang
- a Unit of Psychiatry, Faculty of Health Sciences , University of Macau , Taipa , People's Republic of China
| | - Jin Zhao
- b Shenzhen Center for Disease Control and Prevention , Shenzhen , People's Republic of China
| | - Qinge Zhang
- c The National Clinical Research Center for Mental Disorders, China &Center of Depression, Beijing Institute for Brain Disorders & Mood Disorders Center , Beijing Anding Hospital, Capital Medical University , Beijing , People's Republic of China
| | - Yan Zhang
- b Shenzhen Center for Disease Control and Prevention , Shenzhen , People's Republic of China
| | - Baolian Bai
- b Shenzhen Center for Disease Control and Prevention , Shenzhen , People's Republic of China
| | - Chee H Ng
- d Department of Psychiatry , University of Melbourne , Melbourne , Australia
| | - Gabor S Ungvari
- e School of Psychiatry and Clinical Neurosciences , University of Notre Dame Australia / Graylands Hospital , Perth , Australia
| | - Fu-Jun Jia
- f Guangdong Mental Health Center, Guangdong General Hospital & Guangdong Academy of Medical Sciences , Guangzhou , People's Republic of China
| | - Yu-Tao Xiang
- a Unit of Psychiatry, Faculty of Health Sciences , University of Macau , Taipa , People's Republic of China
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43
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Silva RTS, Silva RARD, Rodrigues IDCV, Souza Neto VLD, Silva BCOD, Souza FMDLC. Coping strategies of people living with AIDS in face of the disease. Rev Lat Am Enfermagem 2018. [PMID: 29538581 PMCID: PMC5863275 DOI: 10.1590/1518-8345.2284.2985] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Objective: to identify the coping strategies of people living with aids to face the disease
and analyze them according to sociodemographic, clinical and lifestyle variables.
Method: this is a cross-sectional quantitative study. The sample consisted of 331 people
living with aids treated at an outpatient clinic at a referral hospital for
treatment of aids. The Coping Strategies Inventory was used to collect the data.
Results: emotion-focused coping modes were more frequently mentioned. The mean scores of
women, workers, religious people, and people who never withdrew from the treatment
were higher for all factors. Patients who had a partner, who lived with family
members and who received treatment support, had higher mean scores in coping,
withdrawal and social support factors. As for leisure and the practice of physical
exercises, the emotion-focused modes also predominated. A correlation was
identified between treatment time, schooling, family income and the factors of the
Coping Strategies Inventory of. Conclusion: the study showed that the most frequent coping modes were those focused on
emotion.
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Affiliation(s)
- Rafael Tavares Silveira Silva
- MSc, Coordinator of the undergraduate course in nursing, Faculdade Evolução Alto Oeste Potiguar, Pau dos Ferros, RN, Brazil
| | | | - Iellen Dantas Campos Verdes Rodrigues
- PhD, RN, Serviço de Atendimento Móvel de Urgência, Prefeitura Municipal de Timon, Timon, MA, Brazil. Adjunct Professor, Departamento de Enfermagem, Universidade Federal de Sergipe, Lagarto, SE, Brazil
| | | | | | - Francisca Marta de Lima Costa Souza
- Doctoral Student, Programa de Pós-Graduação em Enfermagem, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil. RN, Maternidade Professor Leide Morais, Natal, RN, Brazil. Professor, Departamento de Enfermagem, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil
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Sikkema KJ, Mulawa MI, Robertson C, Watt MH, Ciya N, Stein DJ, Cherenack EM, Choi KW, Kombora M, Joska JA. Improving AIDS Care After Trauma (ImpACT): Pilot Outcomes of a Coping intervention Among HIV-Infected Women with Sexual Trauma in South Africa. AIDS Behav 2018; 22:1039-1052. [PMID: 29270789 PMCID: PMC5828984 DOI: 10.1007/s10461-017-2013-1] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Improving AIDS Care after Trauma (ImpACT), a coping intervention for HIV-infected women with sexual abuse histories, was evaluated for feasibility and potential efficacy in a public clinic in Cape Town, South Africa. Sixty-four participants were enrolled prior to starting antiretroviral therapy (ART). After completing baseline assessments, participants were randomly assigned to standard of care (SoC: three adherence counseling sessions) or ImpACT (SoC plus four individual and three group sessions). Participants completed assessments at 3 months (after individual sessions) and 6 months post-baseline. In exploratory analysis of primary outcomes, ImpACT participants, compared to SoC, reported greater reductions in avoidance and arousal symptoms of PTSD and greater increases in ART adherence motivation at 3 months. Clinically significant decreases in overall PTSD symptoms were also demonstrated at 3 months. These effects continued as trends at the 6-month assessment, in addition to increases in social/spiritual coping. In analysis of secondary outcomes, high levels of non-adherence to ART and poor care engagement were evident at 6 months, with no differences between study arms. A trauma-focused, culturally-adapted individual intervention delivered by a non-specialist in the HIV care setting is feasible and acceptable. Preliminary findings suggest ImpACT has potential to reduce PTSD symptoms and increase ART adherence motivation, but a more intensive intervention may be needed to improve and maintain care engagement among this population. TRIAL REGISTRATION ClinicalTrials.gov NCT02223390.
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Affiliation(s)
- Kathleen J Sikkema
- Duke Global Health Institute, Duke University, Durham, NC, USA.
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA.
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
- Department of Psychology and Neuroscience, Duke University, 417 Chapel Drive, Box 90086, Durham, NC, 27708-0086, USA.
| | - Marta I Mulawa
- Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Corne Robertson
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Melissa H Watt
- Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Nonceba Ciya
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Dan J Stein
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Emily M Cherenack
- Duke Global Health Institute, Duke University, Durham, NC, USA
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | - Karmel W Choi
- Duke Global Health Institute, Duke University, Durham, NC, USA
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | - Matapelo Kombora
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - John A Joska
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
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45
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Pinho CM, Dâmaso BFR, Gomes ET, Trajano MDFC, Andrade MS, Valença MP. Religious and spiritual coping in people living with HIV/Aids. Rev Bras Enferm 2017; 70:392-399. [PMID: 28403299 DOI: 10.1590/0034-7167-2015-0170] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 08/26/2016] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE evaluate the religiosity and the religious/spiritual coping of people living with HIV/Aids. METHOD descriptive, cross-sectional study with quantitative approach, conducted in a reference HIV/Aids outpatient clinic in a university hospital of Recife-PE, Brazil, from June to November 2015. At total of 52 people living with HIV/Aids (PLWHA) participated in the research, which employed own questionnaire, the Duke University Religion Index (DUREL), and the Religious/Spiritual Coping Scale (RCOPE). RESULTS the sample presented high indices of organizational religiosity (4.23±1.66), non-organizational religiosity (4.63±1.50), and intrinsic religiosity (13.13±2.84). Positive RCOPE was used in high mean scores (3.66±0.88), and negative RCOPE had low use (2.12 ± 0.74). In total, use of RCOPE was high (3.77±0.74), having predominated the positive RCOPE (NegRCOPE/PosRCOPE ratio=0.65±0.46). CONCLUSION it is evident the importance of encouraging religious activity and RCOPE strategies, seen in the past as inappropriate interventions in clinical practice.
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Affiliation(s)
- Clarissa Mourão Pinho
- Associate Program in Postgraduate Program Nursing, Faculty of Nursing Nossa Senhora das Graças, Universidade de Pernambuco, Recife, Pernambuco, Brazil
| | - Bruno Felipe Remigio Dâmaso
- Residency Program in Nursing, University Hospital Oswaldo Cruz, Universidade de Pernambuco, Recife, Pernambuco, Brazil
| | - Eduardo Tavares Gomes
- Associate Program in Postgraduate Program Nursing, Faculty of Nursing Nossa Senhora das Graças, Universidade de Pernambuco, Recife, Pernambuco, Brazil
| | | | - Maria Sandra Andrade
- Associate Program in Postgraduate Program Nursing, Faculty of Nursing Nossa Senhora das Graças, Universidade de Pernambuco, Recife, Pernambuco, Brazil
| | - Marília Perrelli Valença
- Associate Program in Postgraduate Program Nursing, Faculty of Nursing Nossa Senhora das Graças, Universidade de Pernambuco, Recife, Pernambuco, Brazil
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McIntosh RC, Ironson G, Antoni M, Lai B, Kumar M, Fletcher MA, Schneiderman N. Psychological Distress Mediates the Effect of Alexithymia on 2-Year Change in HIV Viral Load. Int J Behav Med 2017; 24:294-304. [PMID: 27882489 DOI: 10.1007/s12529-016-9602-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE Individuals with trait alexithymia (AL) display poor cognitive assimilation of thoughts, feelings, and emotions. This may result in the persistence of stress, anxiety, and depressive disorders. The cumulative effect of this psychological distress is also linked clinical markers of human immunodeficiency virus (HIV) disease progression. This study examines the indirect effect of AL on HIV viral load as a function of baseline levels and change in psychological distress. METHODS N = 123 HIV positive adults aged 37.9 ± 9.2 years provided blood samples for HIV-1 viral RNA and CD4 T lymphocytes along with self-reported stress, anxiety, and depression every 6 months for 2 years. A second-order conditional latent growth model was used to represent baseline and 2-year change in cumulative levels of psychological distress and to test the indirect effect of baseline levels of trait AL on change in HIV-1 viral load through this latent measure. RESULTS AL was associated with baseline and latent change in psychological distress. Furthermore, baseline psychological distress predicted 2-year change in HIV-1 viral RNA after controlling for viral load at baseline. Altogether, trait AL had a significant indirect effect on change in viral load (β = 0.16, p = 0.03) as a function of baseline levels of distress. CONCLUSION Identification and communication of thoughts, feelings, and emotions are important for long-term psychological adaptation in HIV. Greater psychological distress, in turn, allows for persistence of peripheral viral replication.
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Affiliation(s)
- Roger C McIntosh
- Department of Health Psychology, University of Miami, Miami, FL, 33124, USA.
| | - Gail Ironson
- Department of Health Psychology, University of Miami, Miami, FL, 33124, USA
| | - Michael Antoni
- Department of Health Psychology, University of Miami, Miami, FL, 33124, USA
| | - Betty Lai
- School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Mahendra Kumar
- Departments of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Mary Ann Fletcher
- Department of Clinical Immunology, Institute of Neuro Immune Medicine, Nova Southeastern University, Davie, FL, USA
| | - Neil Schneiderman
- Department of Health Psychology, University of Miami, Miami, FL, 33124, USA
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47
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Pinho CM, Gomes ET, Trajano MDFC, Cavalcanti ATDAE, Andrade MS, Valença MP. Impaired religiosity and spiritual distress in people living with HIV/AIDS. ACTA ACUST UNITED AC 2017; 38:e67712. [PMID: 28723987 DOI: 10.1590/1983-1447.2017.02.67712] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 01/17/2017] [Indexed: 11/22/2022]
Abstract
Objective To verify the inference of Nursing Diagnoses, Impaired religiosity and Spiritual distress in people living with HIV/AIDS. Methods This is a cross-sectional study with a quantitative approach, performed in a specialized Service CenteR of Recife, Pernambuco, from June to November 2015. The results related to 52 people living with HIV/AIDS and that were interviewed were analyzed by three nurse judges. Results Spiritual distress was estimated at 73.1% (38), Impaired religiosity at 36.5% (19), with an average number of defining characteristics of 3.88 ± 2.05 and 2.55±0.69. The main defining characteristic for Impaired religiosity was: "reports a need to reconnect with previous beliefs" (92.3%); and for Spiritual distress, it was: "Expresses a lack of purpose in life/expresses lack of meaning in life" (86.5%). Conclusions The results point to the need to consider the religious-spiritual dimension in care protocols and research in nursing.
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Affiliation(s)
- Clarissa Mourão Pinho
- Universidade de Pernambuco (UPE), Faculdade de Enfermagem Nossa Senhora das Graças, Programa Associado de Pós-Graduação em Enfermagem. Recife, Pernambuco, Brasil
| | - Eduardo Tavares Gomes
- Universidade de Pernambuco (UPE), Faculdade de Enfermagem Nossa Senhora das Graças, Programa Associado de Pós-Graduação em Enfermagem. Recife, Pernambuco, Brasil
| | - Maria de Fátima Cordeiro Trajano
- Universidade Federal de Pernambuco (UFPE), Programa de Pós-Graduação em Saúde da Criança e do Adolescente. Recife, Pernambuco, Brasil
| | | | - Maria Sandra Andrade
- Universidade de Pernambuco (UPE), Faculdade de Enfermagem Nossa Senhora das Graças, Programa Associado de Pós-Graduação em Enfermagem. Recife, Pernambuco, Brasil
| | - Marília Perrelli Valença
- Universidade de Pernambuco (UPE), Programa de Pós-Graduação em Ciências da Saúde. Recife, Pernambuco, Brasil
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Rzeszutek M, Gruszczyńska E, Firląg-Burkacka E. Coping profiles and subjective well-being among people living with HIV: less intensive coping corresponds with better well-being. Qual Life Res 2017; 26:2805-2814. [PMID: 28584892 PMCID: PMC5597686 DOI: 10.1007/s11136-017-1612-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2017] [Indexed: 01/07/2023]
Abstract
Purpose The aim of this study was to investigate the relationship between coping strategies and subjective well-being (SWB) among people living with HIV (PLWH) using the latent profile analysis (LPA) with control for socio-medical covariates. Methods The sample comprised five hundred and thirty people (N = 530) with a confirmed diagnosis of HIV+. The study was cross-sectional with SWB operationalized by satisfaction with life (Satisfaction with Life Scale) and positive and negative affect (PANAS-X). Coping with stress was measured by the Brief COPE Inventory, enriched by several items that assessed rumination and enhancement of positive emotional states. Additionally, the relevant socio-medical variables were collected. Results The one-step model of LPA revealed the following: (1) a solution with five different coping profiles suited the data best; (2) socio-medical covariates, except for education, were not related to the profiles’ membership. Further analysis with SWB as a distal outcome showed that higher intensity coping profiles have significantly worse SWB when compared with lower intensity coping profiles. However, the lowest SWB was noted for mixed intensity coping profile (high adaptive/low maladaptive). Conclusions The person-centered approach adopted in this study informs about the heterogeneity of disease-related coping among PLWH and its possible reactive character, as the highest SWB was observed among participants with the lowest intensity of coping.
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Affiliation(s)
- Marcin Rzeszutek
- Faculty of Psychology, University of Warsaw, Stawki 5/7, 00-183, Warsaw, Poland.
| | - Ewa Gruszczyńska
- Health Psychology Department, University of Social Sciences and Humanities, Chodakowska 19/31, 03-815, Warsaw, Poland
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Rotheram-Borus MJ, Tomlinson M, Scheffler A, Harris DM, Nelson S. Adjustment of a Population of South African Children of Mothers Living With/and Without HIV Through Three Years Post-Birth. AIDS Behav 2017; 21:1601-1610. [PMID: 27260178 PMCID: PMC5136343 DOI: 10.1007/s10461-016-1436-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Mothers living with HIV (MLH) and their children are typically studied to ensure that perinatal HIV transmission is blocked. Yet, HIV impacts MLH and their children lifelong. We examine child outcomes from pregnancy to 3 years post-birth among a peri-urban population of pregnant MLH and mothers without HIV (MWOH). Almost all pregnant women in 12 neighborhoods (98 %; N = 584) in Cape Town, South Africa were recruited and repeatedly assessed within 2 weeks of birth (92 %), at 6 months (88 %), 18 months (84 %), and 3 years post-birth (86 %). There were 186 MLH and 398 MWOH. Controlling for neighborhood and repeated measures, child and maternal outcomes were contrasted over time using longitudinal random effects regression analyses. For measures collected only at 3 years, outcomes were analyzed using multiple regressions. Compared to MWOH, MLH had less income, more informal housing and food insecurity, used alcohol more often during pregnancy, and were more depressed during pregnancy and over time. Only 4.8 % of MLH's children were seropositive; seropositive children were excluded from additional analyses. Children of MLH tended to have significantly lower weights (p < .10) over time (i.e., lower weight-for-age Z-scores) and were also hospitalized significantly more often than children of MWOH (p < .01). Children of MLH and MWOH died at similar rates (8.5 %) and were similar in social and behavioral adjustment, vocabulary, and executive functioning at 3 years post-birth. Despite living in households with fewer resources and having more depressed mothers, only the physical health of children of MLH is compromised, compared to children of MWOH. In township neighborhoods with extreme poverty, social, behavioral, language, and cognitive functioning appear similar over the first three years of life between children of MLH and MWOH.
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Affiliation(s)
- Mary Jane Rotheram-Borus
- Department of Psychiatry & Biobehavioral Sciences, Semel Institute, University of California at Los Angeles, 10920 Wilshire Blvd., Suite 350, Los Angeles, CA, 90024, USA.
| | - Mark Tomlinson
- Department of Psychology, Stellenbosch University, Private Bag X1, Matieland, 7602, South Africa
| | - Aaron Scheffler
- Department of Psychiatry & Biobehavioral Sciences, Semel Institute, University of California at Los Angeles, 10920 Wilshire Blvd., Suite 350, Los Angeles, CA, 90024, USA
| | - Danielle M Harris
- Department of Psychiatry & Biobehavioral Sciences, Semel Institute, University of California at Los Angeles, 10920 Wilshire Blvd., Suite 350, Los Angeles, CA, 90024, USA
| | - Sandahl Nelson
- Department of Psychiatry & Biobehavioral Sciences, Semel Institute, University of California at Los Angeles, 10920 Wilshire Blvd., Suite 350, Los Angeles, CA, 90024, USA
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50
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Ashaba S, Kaida A, Burns BF, O'Neil K, Dunkley E, Psaros C, Kastner J, Tsai AC, Bangsberg DR, Matthews LT. Understanding coping strategies during pregnancy and the postpartum period: a qualitative study of women living with HIV in rural Uganda. BMC Pregnancy Childbirth 2017; 17:138. [PMID: 28482821 PMCID: PMC5423027 DOI: 10.1186/s12884-017-1321-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Accepted: 05/03/2017] [Indexed: 01/03/2023] Open
Abstract
Background In sub-Saharan Africa, 58% of adults living with HIV are women. In Uganda, HIV prevalence is 8.3% for women compared to 6.1% for men. Access to antiretroviral therapy (ART) and prevention of mother to child transmission (PMTCT) programs have enabled women living with HIV (WLWH) to have children with minimal risk of perinatal transmission. Nevertheless, pregnant WLWH face many challenges. We explored women’s perceptions of how they cope with the challenges of pregnancy and the postpartum period as HIV-infected women. Methods We conducted semi-structured interviews with postpartum WLWH accessing ART who had a pregnancy within 2 years prior to recruitment between February–August, 2014. Childbearing associated stressors and coping strategies were discussed. We used content analysis to identify major themes and NVivo 10 software facilitated data analysis. Results Twenty women were interviewed with median age 33 (IQR: 28–35) years, CD4 cell count 677 cells/mm3 (IQR: 440–767), number of live births 4 (IQR: 2–6), and number of living children 3 (IQR: 2–4.3). We summarize five identified coping strategies within a socio-ecological framework according to Bronfenbrenner’s Ecological Model. Coping strategies on the individual level included acceptance of self and HIV status, and self-reliance. On the interpersonal level, participants reported coping through support from partners, family, and friends. On the organizational level, participants reported coping through HIV-related healthcare delivery and system supports. At the community level, women reported coping through support from church and spirituality. Conclusions The results highlight coping strategies used by WLWH to manage the myriad challenges faced during pregnancy and the postpartum period. Intervention programs for WLWH must emphasize psychosocial care and incorporate strategies that address psychosocial challenges in the HIV care package in order to optimize well-being. Additionally policies that support networks of WLWH should be put in place and funding support should be provided through existing funding mechanisms in order to respond to the needs and challenges of WLWH. Programmes that support WLWH for economic empowerment and improved livelihoods should be strengthened across all regions in the country. Electronic supplementary material The online version of this article (doi:10.1186/s12884-017-1321-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Scholastic Ashaba
- Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, Uganda.
| | - Angela Kaida
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | | | - Kasey O'Neil
- MGH Global Health, Massachusetts General Hospital, Boston, MA, USA
| | - Emma Dunkley
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - Christina Psaros
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Jasmine Kastner
- Research Institute McGill University Health Centre Montreal, Montreal, Canada
| | - Alexander C Tsai
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - David R Bangsberg
- MGH Global Health, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Lynn T Matthews
- MGH Global Health, Massachusetts General Hospital, Boston, MA, USA.,Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
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