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Rtbey G, Mihertabe M, Andualem F, Melkam M, Takelle GM, Tinsae T, Fentahun S. Anxiety and associated factors among medical and surgical patients in Ethiopia: A systematic review and meta-analysis. PLoS One 2024; 19:e0306413. [PMID: 39046996 PMCID: PMC11268606 DOI: 10.1371/journal.pone.0306413] [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: 12/07/2023] [Accepted: 06/12/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND Individuals diagnosed with chronic medical conditions and patients appointed to undergo surgery face various degrees of anxiety as a result of doubts related to the outcome of surgery, and the psycho-socioeconomic costs of the medical illness. This can affect the treatment process and even the outcome of patients with medical and surgical cases. Though different studies were conducted on anxiety and associated factors among medical and surgical patients in Ethiopia, the findings were found to be inconsistent and had a wide discrepancy. So, this systematic review and meta-analysis estimated the pooled effect size of anxiety among this population and guides to plan appropriate intervention at a national level. METHODS Studies conducted on anxiety and associated factors among medical and surgical patients in Ethiopia were included. Data was extracted using Microsoft Excel and analyzed using STATA version 11. The random-effects model was used to estimate the pooled effect size of anxiety and its determinants with 95% confidence intervals. Funnel plots and Egger's regression tests were employed to check publication bias. Sub-group and sensitivity analyses were also conducted. RESULTS The pooled prevalence of anxiety among medical and surgical patients in Ethiopia was found to be 48.82% with a 95% CI (42.66, 54.99). Being female[OR = 2.84(2.02, 4.01)], fear of death [OR = 2.93(1.57, 5.50)], and history of surgery[OR = 0.42(0.27, 0.065)], among surgical patients and being female[OR = 2.35(1.94, 2.850], having poor social support[OR = 2.22(1.62, 3.05)], perceived stigma[OR = 4.25(1.97, 9.18)] and family history of mental illness[OR = 1.86(1.21, 2.86)] among medical patients were significantly associated with anxiety in this systematic review and meta-analysis. CONCLUSION AND RECOMMENDATION The pooled prevalence of anxiety among medical and surgical patients in Ethiopia was found to be high. Therefore, it would be good for professionals to screen patients for anxiety besides managing their medical or surgical cases to detect them early and address them.
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Affiliation(s)
- Gidey Rtbey
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Milen Mihertabe
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Fantahun Andualem
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mamaru Melkam
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Girmaw Medfu Takelle
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Techilo Tinsae
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Setegn Fentahun
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Bu N, Li Z, Jiang J, Chen X, Li Z, Xiao Y, Wang X, Zhao T. Self-stigmatization of high-school students seeking professional psychological help: the chain-mediating effect of perceived social support and optimism. Front Psychiatry 2023; 14:1289511. [PMID: 38025482 PMCID: PMC10679472 DOI: 10.3389/fpsyt.2023.1289511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 10/31/2023] [Indexed: 12/01/2023] Open
Abstract
Background Research has shown that stigmatization of professional psychological help-seeking is an important factor influencing attitudes toward seeking professional psychological help (ATSPPH). However, how perceived social support (PSS) and optimism have a mediating role is not clear. Objective Examine the associations between ATSPPH, self-stigmatization of seeking help, PSS, and optimism in a cohort of Chinese high-school students (HSSs). Methods An offline survey was conducted in three high schools in Chongqing (China) from 20 February to 20 May 2023. Participants were HSSs recruited through their teachers. A total of 2,159 HSSs completed a survey on demographic information as well as the Self-Stigmatization of Seeking Help (SSOSH) score, ATSPPH, Perceived Social Support Scale (PASS), and Life Orientation Test (LOT). Mediation analyses were conducted using the "Process" macro in SPSS 26.0 to estimate the direct and indirect effects of self-stigmatization of seeking psychological help on ATSPPH. Results Self-stigmatization of seeking psychological help was significantly and negatively related to ATSPPH among HSSs. Self-stigmatization of psychological help-seeking influenced ATSPPH through three pathways: (a) separate mediating effect of PSS (effect = -0.029); (b) separate mediating effect of optimism (effect = -0.069); (c) chain-mediating effect of PSS and optimism (effect = -0.017). These data suggested that self-stigmatization of psychological help-seeking could influence ATSPPH directly and indirectly through PSS and optimism. Conclusion PSS and optimism mediated the relationship between self-stigmatization of seeking help and ATSPPH. Improving the ability of HSSs to perceive social support and cultivating optimism could help improve the self-stigmatization of help-seeking and promote a positive attitude toward professional help-seeking.
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Affiliation(s)
- Nanyin Bu
- Key Laboratory of Applied Psychology, Chongqing Normal University, Chongqing, China
| | - Zuoshan Li
- Key Laboratory of Applied Psychology, Chongqing Normal University, Chongqing, China
- School of Teacher Education, Chongqing Normal University, Chongqing, China
| | - Jiarui Jiang
- Key Laboratory of Applied Psychology, Chongqing Normal University, Chongqing, China
| | - Xin Chen
- Key Laboratory of Applied Psychology, Chongqing Normal University, Chongqing, China
| | - Ziying Li
- Key Laboratory of Applied Psychology, Chongqing Normal University, Chongqing, China
| | - Yujuan Xiao
- Key Laboratory of Applied Psychology, Chongqing Normal University, Chongqing, China
| | - Xueyan Wang
- Key Laboratory of Applied Psychology, Chongqing Normal University, Chongqing, China
| | - Tianyi Zhao
- Key Laboratory of Applied Psychology, Chongqing Normal University, Chongqing, China
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Chen X, Chen Y, Zhou L, Tong J. The role of self-esteem as moderator of the relationship between experienced stigma and anxiety and depression among tuberculosis patients. Sci Rep 2023; 13:6889. [PMID: 37105982 PMCID: PMC10134698 DOI: 10.1038/s41598-023-34129-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 04/25/2023] [Indexed: 04/29/2023] Open
Abstract
Anxiety and depression are very common in tuberculosis (TB) patients and can adversely affect TB treatment adherence, ultimately leading to higher morbidity, mortality and drug resistance. Therefore, the aim of this study was to identify the association among experienced stigma, self-esteem and anxiety and depression, and to further explore whether self-esteem could be a moderator in the association between experienced stigma and anxiety and depression in TB patients. A total of 473 TB patients from Dalian, Liaoning Province, Northeast China participated in a cross-sectional survey. A structured questionnaire was developed to collect data. Hierarchical multiple regression was used to analyze the association among experienced stigma, self-esteem and experienced stigma × self-esteem interaction with anxiety and depression. Simple slope analysis was applied to visualize the interaction. Experienced stigma was positively associated with anxiety (B = 0.307, P < 0.01) and depression (B = 0.277, P < 0.01), and self-esteem was negatively associated with anxiety (B = - 0.215, P < 0.01) and depression (B = - 0.351, P < 0.01) in TB patients. The association between experienced stigma and anxiety was different in the low (1 standard deviation (SD) below the mean, B = 0.376, standard error (SE) = 0.056, P < 0.01) and high (1 SD above the mean, B = 0.228, SE = 0.060, P < 0.01) groups of self-esteem. Additionally, the association between experienced stigma and depression was also different in the low (1 SD below the mean, B = 0.363, SE = 0.053, P < 0.01) and high (1 SD above the mean, B = 0.179, SE = 0.056, P < 0.01) groups of self-esteem. Self-esteem could moderate the association between experienced stigma and anxiety and depression. In addition to reducing experienced stigma, enhancing self-esteem as a way to reduce the impact of experienced stigma on anxiety and depression can also help improve the mental health of TB patients.
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Affiliation(s)
- Xu Chen
- Lianyungang Maternal and Child Health Hospital, NO. 669 Qindongmen Street, Haizhou District, Lianyungang, 222000, Jiangsu, People's Republic of China
| | - Yunting Chen
- School of Public Health, Dalian Medical University, 9 Western Section, Lvshun South Street, Lvshunkou District, Dalian, 116044, Liaoning, People's Republic of China
| | - Ling Zhou
- School of Public Health, Dalian Medical University, 9 Western Section, Lvshun South Street, Lvshunkou District, Dalian, 116044, Liaoning, People's Republic of China.
| | - Jiao Tong
- Lianyungang Maternal and Child Health Hospital, NO. 669 Qindongmen Street, Haizhou District, Lianyungang, 222000, Jiangsu, People's Republic of China.
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Yassin Z, Erasmus C, Frantz J. A model to understand HIV-related stigma and the psychosocial well-being of children orphaned by AIDS: a theory generative approach. SAHARA J 2021; 18:131-148. [PMID: 34654354 PMCID: PMC8525949 DOI: 10.1080/17290376.2021.1989023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
HIV-related stigma has negatively impacted the psychosocial well-being of children who have been orphaned by AIDS-related causes. Response to reducing stigma and ensuring child well-being is hindered by the limited understanding of HIV-related stigma and how it affects the psychosocial well-being of children. Due to the call for a comprehensive understanding of HIV-related stigma, this study aimed to develop a model to understand the manner in which HIV-related stigma affects the psychosocial well-being of children orphaned by AIDS. The study implemented a mixed method, exploratory, sequential design within a theory generative approach that included concept development, statement development, model description, and model evaluation. The developed model indicated that HIV-related stigma is embedded in social interaction and mediated by children orphaned by AIDS response to stigma. HIV-related stigma and maladaptive coping strategies collectively affect several domains of child psychosocial well-being and elevate psychosocial distress. This is the first model to provide a child-centred understanding of HIV-related stigma and its consequences for psychosocial well-being. The model may be used to guide future research and inform the development of appropriate interventions.
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Affiliation(s)
- Z. Yassin
- Child and Family Studies, Department of Social Work, University of the Western Cape, Cape Town, South Africa
| | - C. Erasmus
- Child and Family Studies, Department of Social Work, University of the Western Cape, Cape Town, South Africa
| | - J. Frantz
- Department of Research and Innovation, University of the Western Cape, Cape Town, South Africa
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Interdependence and reflected failure: Cultural differences in stigma by association. JOURNAL OF EXPERIMENTAL SOCIAL PSYCHOLOGY 2021. [DOI: 10.1016/j.jesp.2021.104130] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Dias CC, Ayala V, Aliduux FA, Basith SA, Sejdiu A, Nakaska MM, Akter S, Mathialagan K, Majumder P. Psychiatric Comorbidities in Pediatric Inpatients With Human Immunodeficiency Virus Infection and Impact on Hospital Course: Inputs From a Case-Control Inpatient Study. Cureus 2021; 13:e15686. [PMID: 34277275 PMCID: PMC8281798 DOI: 10.7759/cureus.15686] [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] [Accepted: 06/16/2021] [Indexed: 11/05/2022] Open
Abstract
Objectives In this study, we aimed to delineate psychiatric comorbidities in pediatric inpatients with versus without human immunodeficiency virus (HIV) infection and to measure its impact on the length of stay (LOS) and cost of treatment during hospitalization. Methodology We conducted a case-control study using the Nationwide Inpatient Sample and included 4,920 pediatric inpatients between the ages of six and 18 years who were sub-grouped by a comorbid diagnosis of HIV (N = 2,595) and non-HIV (N = 2,325) and matched for demographics (age, sex, and race) by propensity case-control matching. Logistic regression analyses were used to evaluate the adjusted odds ratio (aOR) of association for psychiatric comorbidities (depression, anxiety, post-traumatic stress disorder, psychosis, and drug abuse) in the HIV-positive compared with the HIV-negative (as reference category) pediatric inpatients. We measured the differences in the LOS and cost using the independent sample t-test. Results We found that the most prevalent psychiatric comorbidities in the HIV-positive group were anxiety (6.9%), drug abuse (6.6%), psychosis (6.4%), and depression (6.2%). The HIV-positive group had a significantly higher likelihood of comorbid psychosis (aOR: 1.82; 95% confidence interval [CI]: 1.38-2.40) and depression (aOR: 1.79; 95% CI: 1.36-2.36). The mean LOS per hospitalization episode was longer for the HIV-positive group (11.1 days vs. 6.0 days; P < 0.001) compared to the HIV-negative pediatric inpatients. Conclusions We found an increased risk of depression by 79% and psychosis by 82% in the HIV-positive pediatric population. These inpatients also had an extended hospitalization stay (by five days), adding to the healthcare economic burden.
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Affiliation(s)
- Caroline C Dias
- Psychiatry, Yenepoya Medical College and Hospital, Mangalore, IND
| | - Victoria Ayala
- Psychiatry, Ross University School of Medicine, Bridgetown, BRB
| | | | - Sayeda A Basith
- Psychiatry and Behavioral Sciences, Medical University of the Americas, Charlestown, KNA
| | - Albulena Sejdiu
- Psychiatry, Saints Cyril and Methodius University, Skopje, MKD
| | - Miles M Nakaska
- Family Medicine, American University of the Caribbean, Calgary, CAN
| | - Sabiha Akter
- Psychiatry, Bergen New Bridge Medical Center, Paramus, USA
| | | | - Pradipta Majumder
- Psychiatry, Drexel University College of Medicine, Philadelphia, USA.,Psychiatry, WellSpan Health, York, USA
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Li Y, Duan W, Chen Z. Latent profiles of the comorbidity of the symptoms for posttraumatic stress disorder and generalized anxiety disorder among children and adolescents who are susceptible to COVID-19. CHILDREN AND YOUTH SERVICES REVIEW 2020; 116:105235. [PMID: 32834272 PMCID: PMC7342099 DOI: 10.1016/j.childyouth.2020.105235] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 07/03/2020] [Accepted: 07/03/2020] [Indexed: 05/16/2023]
Abstract
The present study aims to examine the comorbidity patterns of the symptoms (intrusion and avoidance) for posttraumatic stress disorder (PTSD) and generalized anxiety disorder (GAD) and the role of perceived threat and courtesy stigma in distinguishing specific patterns of the symptoms for PTSD and GAD among children and adolescents who are susceptible to coronavirus disease 2019 (COVID-19) in Hubei, China. A total of 1172 (683 female and 489 male) children and adolescents aged 8-18 years were involved in completing the measurements of PTSD, GAD, perceived threat of COVID-19, and COVID-19-related courtesy stigma. The Latent Profile Analysis identified the three profiles of the symptoms for PTSD and GAD which were labeled as Moderate PTSD, Mild Comorbidity, and Severe Comorbidity. The scores of the symptoms for PTSD, GAD, perceived threat, and stigma were different among the three profiles. The risk factors (i.e., perceived threat and stigma) that are related to comorbidity patterns were examined through a three-step method. The possibility of entry into the Severe Comorbidity Profile increased with increasing perceived threat and stigma. The mental health care interventions for children and adolescents who are susceptible to COVID-19 can be developed to reduce perceived threat and stigma.
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Affiliation(s)
- Yumei Li
- Department of Social & Behavioural Sciences, City University of Hong Kong, China
| | - Wenjie Duan
- Social and Public Administration School, East China University of Science and Technology, China
| | - Zheng Chen
- Institute of Education, Wuhan University, China
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8
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Mo PKH, Xin M, Lau JTF. Testing the vulnerability and scar model of the relationship between self-concept, social support and anxiety symptoms among children of HIV-infected parents in China: A 3-year longitudinal study. J Affect Disord 2019; 259:441-450. [PMID: 31611002 DOI: 10.1016/j.jad.2019.08.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Revised: 06/18/2019] [Accepted: 08/17/2019] [Indexed: 11/20/2022]
Abstract
BACKGROUND Mental illness is a great concern among children of HIV-infected parents (COHIP), who are at their crucial stage of psychosocial development. It has been shown that self-concept (SC) and social support (SS) are important correlates of anxiety symptoms (AS), however, nature of the causality remained unclear. METHODS A 3-year longitudinal study was conducted in rural Central China, where many people were infected with HIV through unhygienic blood donation. A total of 195 COHIP (mean age: 12.6 years, 49.2% male) completed the baseline assessment and were followed for three years. Cross-lagged structural equation modeling analyses were used to test competing theoretical models: vulnerability model (low SC/SS contributes to AS), scar model (AS erodes SC/SS) and reciprocity model (low SC/SS and AS predict each other). RESULTS At each wave, 104 (53.3%) and 67 (41.6%) participants presented with anxiety disorders respectively. Nested-model comparison supported the superiority of scar models wherein AS significantly predicted subsequent low SC (β=-0.24, p=0.013) and SS (β=-0.31, p= 0.033), controlling for synchronous and autoregressive effects of all measures. The most parsimonious multivariate model that included significant relations was finally identified with a good model fit. LIMITATIONS Findings might be subject to reporting bias; and could not inform the temporal relationship between SC and SS. CONCLUSION Prevalence of anxiety was high among Chinese COHIP. The present study provides empirical evidence for scarring effects of AS; thus, highlighted the importance of identifying and treating COHIP's anxiety to mitigate long-term negative impacts on their psychosocial development.
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Affiliation(s)
- Phoenix K H Mo
- School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; The Chinese University of Hong Kong Shenzhen Research Institute, Shenzhen, China
| | - Meiqi Xin
- School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; The Chinese University of Hong Kong Shenzhen Research Institute, Shenzhen, China
| | - Joseph T F Lau
- School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; The Chinese University of Hong Kong Shenzhen Research Institute, Shenzhen, China.
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Domlyn AM, Jiang Y, Harrison S, Qiao S, Li X. Stigma and psychosocial wellbeing among children affected by parental HIV in China. AIDS Care 2019; 32:500-507. [PMID: 31690083 DOI: 10.1080/09540121.2019.1687834] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Parental HIV infection presents unique psychosocial challenges for families. Affected children are vulnerable to stigma-related distress from a parent's HIV status and are more likely to experience symptoms of depression and low self-esteem than unaffected peers. This study examined whether HIV-related stigma predicted poorer mental health among children affected by parental HIV and whether psychosocial assets mediated this relationship. METHODS A sample of 790 children (ages 6-17) affected by parental HIV in Henan, China reported on HIV-related stigma, social support, emotional regulation, future outlook, and mental health symptoms. Structural equation modeling was used to examine the direct and indirect effects of stigma on mental health. RESULTS Results indicated that stigma was associated with psychosocial resources, which in turn were associated with mental health symptoms. The indirect pathways from stigma to mental health symptoms through psychosocial resources were consistent across age and gender. CONCLUSION The experience of HIV-related stigma was associated with poorer overall mental health among children affected by parental HIV in China. Children's psychosocial resources, including social support, emotional regulation, and future outlook, mediated the relationship between HIV-related stigma and mental health symptoms. Future interventions may wish to target these modifiable aspects of wellbeing to improve social and behavioral outcomes in this vulnerable population.
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Affiliation(s)
- Ariel M Domlyn
- Department of Psychology, University of South Carolina, Columbia, SC, USA.,South Carolina SmartState Center for Healthcare Quality, Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Yanping Jiang
- South Carolina SmartState Center for Healthcare Quality, Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Sayward Harrison
- South Carolina SmartState Center for Healthcare Quality, Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Shan Qiao
- South Carolina SmartState Center for Healthcare Quality, Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Xiaoming Li
- South Carolina SmartState Center for Healthcare Quality, Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
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10
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Jiang M, Yang J, Song Y, Zheng J, Li X, Yang G, Ma Y, Xu P, Zhang Z, Pan X, Wang Y. Social support, stigma, and the mediating roles of depression on self-reported medication adherence of HAART recipients in China. AIDS Care 2019; 31:942-950. [PMID: 30829055 DOI: 10.1080/09540121.2019.1587360] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Discrimination of people living with HIV/AIDS (PLWHA) is a persistent issue in China, which affects their psychological health. However, the association between psychological factors and adherence to highly active antiretroviral therapy (HAART) has not been systematically investigated before. Therefore, this study examined the impact of social support, depression, and medication-taking self-efficacy on ART adherence among PLWHA based on Cha et al.'s model, and included "stigma" to the original model to explain the psychological mechanism. Of the 504 participants receiving HAART, 37.8% had mild-to-severe depression. According to structural equation modeling, social support was directly associated with depression, stigma, and adherence; depression partially mediated the positive relationship between social support and adherence self-efficacy and the negative association between stigma and self-efficacy. The modified and extended Cha et al.'s model had a satisfactory fit. Interventions to improve mental health through mental health services, social support, and enhancement of adherence self-efficacy beliefs are required.
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Affiliation(s)
- Man Jiang
- a School of Public Health/ Key Lab of Health Technology Assessment, National Health and Family Planning Commission of the People's Republic of China , Fudan University , Shanghai , People's Republic of China
| | - Jiezhe Yang
- b Department of AIDS/STDs Control and Prevention , Zhejiang CDC , Hangzhou , People's Republic of China
| | - Yang Song
- a School of Public Health/ Key Lab of Health Technology Assessment, National Health and Family Planning Commission of the People's Republic of China , Fudan University , Shanghai , People's Republic of China
| | - Jinlei Zheng
- b Department of AIDS/STDs Control and Prevention , Zhejiang CDC , Hangzhou , People's Republic of China
| | - Xinghui Li
- a School of Public Health/ Key Lab of Health Technology Assessment, National Health and Family Planning Commission of the People's Republic of China , Fudan University , Shanghai , People's Republic of China
| | - Guang Yang
- c Department of Medical Affairs , Eye & Ent Hospital of Fudan University , Shanghai , People's Republic of China
| | - Ye Ma
- d National Center for AIDS/STD Control and Prevention , China CDC , Beijing , People's Republic of China
| | - Peng Xu
- d National Center for AIDS/STD Control and Prevention , China CDC , Beijing , People's Republic of China
| | - Ziqi Zhang
- a School of Public Health/ Key Lab of Health Technology Assessment, National Health and Family Planning Commission of the People's Republic of China , Fudan University , Shanghai , People's Republic of China
| | - Xiaohong Pan
- b Department of AIDS/STDs Control and Prevention , Zhejiang CDC , Hangzhou , People's Republic of China
| | - Ying Wang
- a School of Public Health/ Key Lab of Health Technology Assessment, National Health and Family Planning Commission of the People's Republic of China , Fudan University , Shanghai , People's Republic of China
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11
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Mason S, Sultzman VO. Stigma as experienced by children of HIV-positive parents: a narrative review. AIDS Care 2019; 31:1049-1060. [PMID: 30704274 DOI: 10.1080/09540121.2019.1573968] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
This narrative review examines the effects on children of stigma by association with an HIV-positive parent. It expands on previous reviews by including all HIV-affected children, whether orphaned or living with a parent with HIV, and considers the broad effects of stigma-by-association (SBA), including but not limited to the psychological impact. Studies met the following criteria - sample included children, ages 6-19 years old, who were not HIV-positive but were currently living with or had lived with a parent who was HIV-positive (i.e., AIDS orphans). Study findings included children's perspectives on stigma and were available in English. Studies for inclusion were identified by searches in Psychinfo, Proquest, and PubMed from 1996 through 2016. This review substantiates that children across countries and cultures experience HIV SBA. SBA is associated with psychological or emotional problems, disrupted peer and adult relationships, and poor school outcomes for children. Orphans were more likely than children living with positive parents to experience negative outcomes, which can have a long-term impact. Felt stigma was as prevalent as enacted stigma and may become the focus of intervention as HIV disease increasingly becomes a concealable disease. The review findings also point to the complexity of relationships between SBA and variables such as poverty and mental health and the bi-directional relationship between SBA and depression. We adapt a stigma framework developed for people living with HIV (PLWHIV) to structure the results of this review. With these findings, we can develop interventions that support stigma reduction with children and their parents, responding to the wide range of stigma consequences and customized to the children's family and cultural context.
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Affiliation(s)
- Sally Mason
- a Institute for Juvenile Research, University of Illinois at Chicago , Chicago , IL , USA
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12
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Chen WT, Shiu C, Yang JP, Li CSR, Wang K, Zhang L, Zhang J, Bao M, Aung MN, Chen LC, Zhao H, Lu H. Substance use, anxiety, and self-management efficacy in HIV-positive individuals: A mediation analysis. JOURNAL OF SUBSTANCE USE 2018; 23:408-414. [PMID: 30906222 DOI: 10.1080/14659891.2018.1436603] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Context In China, the social stigma of both substance use and HIV remains major barriers. HIV+ individuals have been demonstrated to have higher psychosocial distress in the literature. To ensure quality of life among HIV+ Chinese individuals, self-efficacy in HIV-related management including substance use and anxiety is the key to suppress viral load and maintain healthy lives. Objectives We examine the mediation relationship among substance use, anxiety, and self-management efficacy. Method A cross-sectional study design was used. 137 HIV+ individuals were recruited from two premier Chinese hospitals: Beijing's Ditan Hospital and Shanghai's Public Health Clinic Center (SPHCC). Results HIV+ substance users had significantly lower HIV-management efficacy and higher anxiety scores. About a third of the relations between substance use and anxiety was mediated by HIV-management self-efficacy. Those who used substances in the previous week had higher anxiety levels suggesting the presence of a recent effect. Their higher levels of anxiety could be largely explained by their lower HIV-management efficacy. Conclusion It is useful for healthcare providers to assess substance use behaviors in HIV+ individuals as well as provide support in managing anxiety in this population. Meanwhile, enhancing self-management efficacy to ensure healthy lifestyles may support achieving optimal lives with HIV.
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Affiliation(s)
- Wei-Ti Chen
- School of Nursing, University of California Los Angeles, Los Angeles, CA
| | - Chengshi Shiu
- School of Nursing, University of California Los Angeles, Los Angeles, CA
| | - Joyce P Yang
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA
| | - Chiang-Shan Ray Li
- Psychiatry and of Neuroscience, School of Medicine, Yale University, New Haven, CT
| | - Kerong Wang
- Ditan Hospital, Capital Medical University, Beijing, China
| | - Lin Zhang
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Jing Zhang
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Meijuan Bao
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | | | - Li-Chen Chen
- National Cheng Kung University, School of Nursing, Tainan, Taiwan
| | - Hongxin Zhao
- Ditan Hospital, Capital Medical University, Beijing, China
| | - Hongzhou Lu
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
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