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Lo Hog Tian JM, Watson JR, Cioppa L, Murphy M, Boni AR, Parsons JA, Maunder RG, Rourke SB. The Role of Dimensions of Social Support in the Relationship Between Stigma and Mental Health: A Moderation Analysis. AIDS Behav 2024:10.1007/s10461-024-04506-9. [PMID: 39325117 DOI: 10.1007/s10461-024-04506-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2024] [Indexed: 09/27/2024]
Abstract
HIV stigma remains a barrier to good health and understanding how social support may reduce the negative impact of stigma on health may help with designing stigma interventions. This study aims to understand how different types of social support may moderate or change the nature of the relationship between stigma and mental health. We recruited 327 participants to complete the People Living with HIV Stigma Index at baseline (t1) between August 2018 and September 2019 and at follow-up (t2) between February 2021 and October 2021. Separate moderation models were created with different types of social support (emotional/informational, tangible, affectionate, positive social interaction) as moderators, baseline stigma (internalized, enacted, anticipated) as the antecedent, and mental health (t2) as the outcome. Emotional/informational support was a significant moderator for the relationship between enacted (b = -2.12, 95% CI: -3.73, -0.51), internalized (b = -1.72, 95% CI: -3.24, -0.20), and anticipated (b = -2.59, 95% CI: -4.59, -0.60) stigma at t1 and mental health at t2. Tangible support was a significant moderator for internalized stigma (b = -1.54, 95% CI: -2.74, -0.35). Lastly, positive social interaction was a significant moderator for internalized (b = -1.38, 95% CI: -2.71, -0.04) and anticipated stigma (b = -2.14, 95% CI: -3.93, -0.36). In general, the relationship between social support and better mental health was stronger for participants with low stigma. Intervention strategies aimed at both stigma reduction and boosting social supports with different functions may be important for improving the mental health of people living with HIV.
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Affiliation(s)
- Jason M Lo Hog Tian
- MAP Centre for Urban Health Solutions, Unity Health Toronto, Toronto, Canada
- Institute of Medical Science, University of Toronto, Toronto, Canada
| | - James R Watson
- MAP Centre for Urban Health Solutions, Unity Health Toronto, Toronto, Canada
| | - Lynne Cioppa
- MAP Centre for Urban Health Solutions, Unity Health Toronto, Toronto, Canada
| | - Michael Murphy
- MAP Centre for Urban Health Solutions, Unity Health Toronto, Toronto, Canada
| | - Anthony R Boni
- MAP Centre for Urban Health Solutions, Unity Health Toronto, Toronto, Canada
| | - Janet A Parsons
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | | | - Sean B Rourke
- MAP Centre for Urban Health Solutions, Unity Health Toronto, Toronto, Canada.
- Institute of Medical Science, University of Toronto, Toronto, Canada.
- Department of Psychiatry, University of Toronto, Toronto, Canada.
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Machado N, Abreo L, Petkari E, Pinto da Costa M. The relationship of social contacts with prisoners' mental health: a systematic review. Public Health 2024; 234:199-216. [PMID: 39053366 DOI: 10.1016/j.puhe.2024.06.013] [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: 03/11/2024] [Revised: 06/11/2024] [Accepted: 06/11/2024] [Indexed: 07/27/2024]
Abstract
OBJECTIVES Prisoners' common mental disorders (CMDs) and their social contacts are a complex and significant concern. We have systematically investigated the relationship between social contacts (i.e. perceived, and objective social support, and loneliness) and prisoners' mental health. STUDY DESIGN This systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). METHODS A protocol was developed and registered in PROSPERO (CRD42023372942). A search strategy was applied across four databases (namely MEDLINE [via OVID SP], APA PsycINFO, Scopus, and Web of Science). The quality assessment entailed the critical appraisal skills program (CASP) Checklist for cohort studies. The data were presented through a narrative synthesis. RESULTS After screening, 32 studies that fulfilled the inclusion criteria were included in this review. Most were cross-sectional (k = 27), while five had a longitudinal design. The total number of study participants was 10,613. The majority of the studies reported negative correlations between perceived and objective social support and symptoms of common mental disorders (CMDs), specifically, depression, anxiety, and post-traumatic stress disorder (PTSD). The included studies appeared to indicate a correlation between loneliness and PTSD symptoms. CONCLUSIONS The lack of social support was linked to the development or exacerbation of CMDs in prisoners. Initiatives, such as reducing visitation barriers and providing access to technology for remote communication, can assist prisoners in strengthening their support systems and enhancing their opportunities for reintegration into society.
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Affiliation(s)
- N Machado
- Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal
| | - L Abreo
- South London and Maudsley NHS Foundation Trust, London, UK
| | - E Petkari
- Faculty of Health Sciences of the Universidad Internacional de La Rioja, La Rioja, Spain
| | - M Pinto da Costa
- Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal; South London and Maudsley NHS Foundation Trust, London, UK; Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
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Miwa T, Wakabayashi C, Hayashi K, Tanuma J, Ikeda K, Yokomaku Y, Ikushima Y. Investigating the Moderating Effect of HIV Status Disclosure on the Link Between Discrimination Experience and Psychological Distress Among People Living with HIV in Japan Infected Through Sexual Contact. Int J Behav Med 2024:10.1007/s12529-024-10304-3. [PMID: 38942978 DOI: 10.1007/s12529-024-10304-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2024] [Indexed: 06/30/2024]
Abstract
BACKGROUND There is a scarcity of research on the potential impact of disclosing HIV status to friends and family in moderating the adverse effects of discrimination on the mental health of people living with HIV (PLWH). This study assessed the experiences of discrimination and HIV status disclosure among PLWH in Japan, and evaluated their potential associations with psychological distress. METHOD Data were derived from a nationwide cross-sectional survey of PLWH conducted in Japan between 2019 and 2020. The interaction effects of HIV-related discrimination and HIV status disclosure on the psychological distress were examined using logistic and linear regression analyses. RESULTS The median age of the 804 respondents was 46 years old. Most respondents were male and 85.4% (687/804) identified as homosexuals or bisexuals. A total of 12.7% (102/804) of the respondents reported that they had recently experienced discrimination because of their HIV status. Experience of HIV-related discrimination was independently associated with high psychological distress (adjusted OR 2.02; 95% CI, 1.15-3.57), and HIV status disclosure to friends partially weakened the association between discrimination and the level of psychological distress (regression coefficient -3.115; p = 0.004). CONCLUSION While measures that aim to end discrimination remain vital, increasing the opportunities of PLWH to communicate with friends they feel comfortable disclosing their HIV status may also be helpful in protecting their mental health.
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Affiliation(s)
- Takeshi Miwa
- Department of Health Sciences, Saitama Prefectural University, 820 Sannomiya, Koshigaya-shi, Saitama, 343-8540, Japan.
- Positive Living and Community Empowerment Tokyo (PLACE TOKYO), 4-11-5-403 Takadanobaba, Shinjuku-ku, Tokyo, 169-0075, Japan.
| | - Chihiro Wakabayashi
- Department of Health Sciences, Saitama Prefectural University, 820 Sannomiya, Koshigaya-shi, Saitama, 343-8540, Japan
| | - Kanna Hayashi
- Faculty of Health Sciences, Simon Fraser University, Blusson Hall, Room 11300, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada
| | - Junko Tanuma
- Center Hospital of the National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
| | - Kazuko Ikeda
- Center Hospital of the National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
| | - Yoshiyuki Yokomaku
- Department of Infectious Diseases & Immunology, Clinical Research Center, National Hospital Organization Nagoya Medical Center, 4-1-1 Sannomaru, Naka-ku, Nagoya, Aichi, 460-0001, Japan
| | - Yuzuru Ikushima
- Positive Living and Community Empowerment Tokyo (PLACE TOKYO), 4-11-5-403 Takadanobaba, Shinjuku-ku, Tokyo, 169-0075, Japan
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Moore KE, Phillips S, Kromash R, Siebert S, Roberts W, Peltier M, Smith MD, Verplaetse T, Marotta P, Burke C, Allison G, McKee SA. The Causes and Consequences of Stigma among Individuals Involved in the Criminal Legal System: A Systematic Review. STIGMA AND HEALTH 2024; 9:224-235. [PMID: 39381322 PMCID: PMC11456775 DOI: 10.1037/sah0000483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2024]
Abstract
The purpose of this study was to systematically review the types of stigmatized attributes that have been assessed and the causes and consequences of stigma for individuals involved in the criminal legal system. PubMed, GoogleScholar, and PsycInfo databases were searched to identify studies for inclusion through March 2021. Eligible studies were peer-reviewed, quantitative, and assessed stigma from the perspective of the person involved in the criminal legal system. 59 studies were included (total n=21,738), assessing stigma associated with criminal involvement, HIV, substance use, race/ethnicity, help-seeking, and others. Experiencing criminal involvement stigma was linked to poor well-being, but less so for racial/ethnic minorities. Experiencing racial/ethnic stigma was associated with recidivism risk, and substance use stigma was associated with substance use risk. Several stigmas intersected to impact treatment engagement and well-being. In conclusion, individuals involved in the criminal legal system experience many stigmatized statuses that impact their well-being, treatment adherence, community integration, and criminal behavior. Stigma must be addressed among individuals involved in the criminal legal system and the systems they interact with to reduce health inequity and recidivism risk.
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Affiliation(s)
- Kelly E. Moore
- Department of Psychology, East Tennessee State University, 420 Rogers-Stout Hall P.O. Box 70649, Johnson City, TN 37614, U.S
| | - Sarah Phillips
- Department of Psychiatry, Yale School of Medicine, Church St South, Suite 109, New Haven, CT, 06519, U.S
| | - Rachelle Kromash
- Department of Psychology, East Tennessee State University, 420 Rogers-Stout Hall P.O. Box 70649, Johnson City, TN 37614, U.S
| | - Shania Siebert
- Department of Psychology, East Tennessee State University, 420 Rogers-Stout Hall P.O. Box 70649, Johnson City, TN 37614, U.S
| | - Walter Roberts
- Department of Psychiatry, Yale School of Medicine, Church St South, Suite 109, New Haven, CT, 06519, U.S
| | - MacKenzie Peltier
- Department of Psychiatry, Yale School of Medicine, Church St South, Suite 109, New Haven, CT, 06519, U.S
| | - Madison D. Smith
- Department of Psychology, East Tennessee State University, 420 Rogers-Stout Hall P.O. Box 70649, Johnson City, TN 37614, U.S
| | - Terril Verplaetse
- Department of Psychiatry, Yale School of Medicine, Church St South, Suite 109, New Haven, CT, 06519, U.S
| | - Phillip Marotta
- Brown School, Washington University in St. Louis, 1 Brookings Dr, St. Louis, MO 63130
| | - Catherine Burke
- Department of Psychiatry, Yale School of Medicine, Church St South, Suite 109, New Haven, CT, 06519, U.S
| | - Genevieve Allison
- Department of Psychology, East Tennessee State University, 420 Rogers-Stout Hall P.O. Box 70649, Johnson City, TN 37614, U.S
| | - Sherry A. McKee
- Department of Psychiatry, Yale School of Medicine, Church St South, Suite 109, New Haven, CT, 06519, U.S
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Zhang Y, Chai C, Xiong J, Zhang L, Zheng J, Ning Z, Wang Y. The impact of anxiety, depression, and social support on the relationship between HIV-related stigma and mental health-related quality of life among Chinese patients: a cross-sectional, moderate-mediation study. BMC Psychiatry 2023; 23:818. [PMID: 37940853 PMCID: PMC10634100 DOI: 10.1186/s12888-023-05103-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 08/10/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND/OBJECTIVE People living with HIV (PLWH) are prone to mental health problems and evidence indicates that HIV-related stigma can negatively impact mental health-related quality of life. This study explored potential mechanisms between HIV-related stigma and mental health-related quality of life, specifically whether anxiety or depression mediates, and whether social support moderates, the relationship. METHOD A total of 1197 Chinese PLWH participated in the study. The Berger HIV Stigma Scale, the Hospital Anxiety and Depression Scale (HADS), the 12-item Brief Health Survey (SF-12), and the Multidimensional Scale of Perceived Social Support (MSPSS) were employed. RESULTS HIV-related stigma was negatively associated with mental health-related quality of life. Anxiety and depression partially mediated the relationship between HIV-related stigma and mental health-related quality of life; social support played a moderating role. CONCLUSIONS The mental health-related quality of life in PLWH was shown to be indirectly affected by HIV-related stigma through anxiety and depression in China. The negative impact of HIV-related stigma decreased with increased social support.
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Affiliation(s)
- Yushu Zhang
- School of Public Health, Fudan University, Shanghai, China
- NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Chengliang Chai
- Department of AIDS/STDs Control and Prevention, Zhejiang Provincial Center for Diseases Control and Prevention, Zhejiang Province, Hangzhou, China
| | - Jianjing Xiong
- Jing'an District Center for Disease Prevention and Control, Shanghai, China
| | - Lin Zhang
- Center for Disease Control and Prevention, 10, East Section of Taihao Road, Henan Province, Zhoukou, 466000, China
| | - Jinlei Zheng
- Zhejiang Provincial Center for Disease Control and Prevention, Zhejiang Province, Hangzhou, China
| | - Zhen Ning
- Division of Tuberculosis and AIDS Control and Prevent Shanghai Municipal Center for Disease Control and Prevention 1380, Zhongshan Xi Road, Shanghai, 200336, China.
| | - Ying Wang
- NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China.
- Department of Social Medicine, School of Public Health, Fudan University, Shanghai, 200032, China.
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Skowroński B, Talik E. Psychophysical quality of life and its determinants in prisoners: the role of selected psychosocial factors. Int J Prison Health 2023; 19:376-391. [PMID: 36156461 DOI: 10.1108/ijph-10-2021-0102] [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] [Indexed: 11/17/2022]
Abstract
PURPOSE Penal institutions affect their inmates' mental as well as physical health. Prisoners have higher rates of physical health conditions than the public. While it is known that psychosocial factors determine patients' quality of life, little research has focused on factors related to prisoners' psychophysical quality of life (PQoL). The purpose of this study is to analyze the determinants of prisoners' PQoL. DESIGN/METHODOLOGY/APPROACH The sample consisted of 390 prisoners recruited from correctional facilities administered by the Warsaw District Inspectorate of Prisons. This study hypothesized that social support, coherence and self-efficacy would be positive determinants of PQoL and that depression, anxiety and anger would be its negative determinants. The collected data were analyzed by means of structural equation modeling. FINDINGS The positive determinants of PQoL in prisoners are coherence, self-efficacy and social support. The negative determinant of PQoL is trait depression. ORIGINALITY/VALUE This study has revealed a list of factors significant for improving prisoners' PQoL. Factors have also indicated which of the predictors measured are the most significant. The identified set of significant factors should be taken into account in social rehabilitation programs for prisoners as contributing to the preservation of life and health.
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Affiliation(s)
- Bartłomiej Skowroński
- Department of Applied Social Sciences and Resocialization, University of Warsaw, Warsaw, Poland
| | - Elżbieta Talik
- Faculty of Social Sciences, John Paul II Catholic University of Lublin, Lublin, Poland
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Liu C, Yuan GF, Li X, Fung HW, Wong MYC, Zhao J, Feng X. Associations among internalized and perceived stigma, state mindfulness, self-efficacy, and depression symptoms among men who have sex with men in China: A serial mediation model. Arch Psychiatr Nurs 2023; 45:81-88. [PMID: 37544707 DOI: 10.1016/j.apnu.2023.06.001] [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: 11/17/2022] [Revised: 03/23/2023] [Accepted: 06/01/2023] [Indexed: 08/08/2023]
Abstract
Previous research has demonstrated that stigma is strongly related to depressive symptoms among men who have sex with men (MSM). However, data are limited regarding the associations between stigma, state mindfulness, self-efficacy, and depression symptoms. The current study aimed to analyze state mindfulness and self-efficacy as possible mediators between internalized and perceived stigma and depression symptoms. A sample of 2610 Chinese MSM (Mage = 23.99, SD = 6.09, age range: 18-68 years) was recruited from an online survey platform and completed the HIV and Homosexuality Related Stigma Scale, Patient Health Questionnaire-9, the short version of Five Facet Mindfulness Questionnaire, and the Chinese General Self-Efficacy Scale. Results indicated that state mindfulness significantly mediated the linkage between internalized and perceived stigma and depressive symptoms, and self-efficacy significantly mediated the relation between state mindfulness and depression symptoms. Furthermore, internalized and perceived stigma were associated with depression symptoms through a serial mediation of state mindfulness and self-efficacy. This study highlights that state mindfulness and self-efficacy might play important roles in the psychological response of MSM to stigmatization and psychopathology symptoms.
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Affiliation(s)
- Caimeng Liu
- College of Teacher Education, Institute of Education Science, Leshan Normal University, Leshan, China
| | - Guangzhe Frank Yuan
- Department of Health Promotion Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA; South Carolina SmartState Center for Healthcare Quality, University of South Carolina, Columbia, SC, USA.
| | - Xiaoming Li
- Department of Health Promotion Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA; South Carolina SmartState Center for Healthcare Quality, University of South Carolina, Columbia, SC, USA
| | - Hong Wang Fung
- Department of Social Work, Faculty of Social Sciences, The Hong Kong Baptist University, Kowloon Tong, Hong Kong
| | - Ming Yu Claudia Wong
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong
| | - Jingjing Zhao
- Department of Psychology, Beijing Forestry University, Beijing, China
| | - Xueyou Feng
- Center for Mental Health Education and Counseling, Guangzhou College of Commerce, Guangzhou, China
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Walsh JL, John SA, Quinn KG, Hirshfield S, O’Neil A, Petroll AE. Factors associated with quality of life, depressive symptoms, and perceived stress among rural older adults living with HIV in the United States. J Rural Health 2023; 39:488-498. [PMID: 36510755 PMCID: PMC10038895 DOI: 10.1111/jrh.12730] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
PURPOSE Rural older people living with HIV (PLH) in the United States are a population of growing size and significance. A better understanding of factors associated with quality of life (QOL), depressive symptoms, and stress in this population-especially modifiable factors-could inform future interventions. METHODS Online or on paper, we surveyed 446 PLH aged 50+ residing in rural counties across the United States (Mage = 56, 67% male, 67% White, and 23% Black). Associations between social support, HIV stigma, satisfaction with medical care, discrimination in health care settings, and structural barriers and health-related QOL, depressive symptoms, and perceived stress were assessed using multiple linear regressions. FINDINGS Controlling for demographics, greater social support was associated with better QOL, fewer depressive symptoms, and less stress. Greater HIV stigma was associated with more depressive symptoms and stress. Satisfaction with care was associated with better QOL and less stress. Discrimination in medical settings was associated with lower QOL and more depressive symptoms and stress. Finally, experiencing more structural barriers was associated with lower QOL and more depressive symptoms and stress. CONCLUSIONS In addition to engagement in care and viral suppression, QOL and mental health are also critical considerations for rural older PLH. Increasing social support, reducing or providing skills to cope with HIV stigma, improving quality of care, reducing discrimination and stigma in medical settings, and reducing or mitigating the impact of structural barriers present potential targets for interventions aiming to improve the well-being of older rural PLH.
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Affiliation(s)
- Jennifer L. Walsh
- Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, The Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Steven A. John
- Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, The Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Katherine G. Quinn
- Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, The Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Sabina Hirshfield
- STAR Program, Department of Medicine, SUNY Downstate Health Sciences University, New York, New York, USA
| | - Andrew O’Neil
- Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, The Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Andrew E. Petroll
- Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, The Medical College of Wisconsin, Milwaukee, Wisconsin, USA
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Significant Others and Not Family or Friend Support Mediate Between Stigma and Discrimination Among People Living With HIV in Lagos State, Nigeria: A Cross-sectional Study. J Assoc Nurses AIDS Care 2023; 34:96-104. [PMID: 36198119 DOI: 10.1097/jnc.0000000000000366] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
ABSTRACT Approximately 70% of the 37.7 million people living with HIV (PLWH) globally reside in sub-Saharan Africa and 10% of the global HIV burden is in Nigeria. PLWH encounter stigma and discrimination. Limited support from family, friends, and significant others increases stigma and discrimination among PLWH. This study sought to understand how support from family, friends, and significant others mediates stigma and discrimination in the Nigerian context. This descriptive cross-sectional study enrolled 396 PLWH from six health facilities between June and July 2021 in Lagos State, Nigeria. Stigma, discrimination, and social support were assessed. On average, participants were 32 years of age and female. Increased social support was associated with reduced stigma and discrimination. Support from participants' significant others was found to mediate the relationship between stigma and discrimination.
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Wang J, Zou R, Wu N, Fu H, He Y, Crawford P, Kane E, Dai J. Depressive symptoms, social support, and health-related quality of life: A community-based study in Shanghai, China. Compr Psychiatry 2022; 113:152292. [PMID: 34959003 DOI: 10.1016/j.comppsych.2021.152292] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 12/06/2021] [Accepted: 12/17/2021] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Depressive symptoms erode both physical and mental aspects of health-related quality of life (HRQoL). Social support (SS) may improve HRQoL through its direct effects or buffering effects. The association among depressive symptoms, SS, and HRQoL has been studied in specific groups, but research in the general adult population remains limited. This study examined the association among depressive symptoms, SS, and HRQoL, including exploring whether SS (including its three dimensions: subjective SS, objective SS and support utilization) mediated or moderated the relationship between depressive symptoms and HRQoL among community-based adults. METHODS We conducted a cross-sectional survey in six communities in Shanghai, China, and 1642 adult participants with complete information on depressive symptoms and/or SS, and HRQoL were included. Linear regression analysis was used to investigate the association among depressive symptoms, SS, and HRQoL. In addition, we explored the mediating and moderating role of SS in the relationship between depressive symptoms and HRQoL. RESULTS More depressive symptoms were associated with lower physical HRQoL (B = -0.64, p < .001) and lower mental HRQoL (B = -0.83, p < .001). SS (B = 0.07, p = .02), specifically subjective SS (B = 0.09, p = .03), was positively related to mental HRQoL. After adjusting for covariates, we found no evidence for a mediating role of SS in the relationship between depressive symptoms and HRQoL, while SS (subjective SS and objective SS) moderated the association between depressive symptoms and mental HRQoL. LIMITATIONS Due to the low voluntary participation rate of employees, participants represented approximately 50% of the individuals approached, thus limiting the generalizability of our findings. Data collected through self-report scales could lead to information bias. CONCLUSIONS SS does not appear to underlie the relationship between depressive symptoms and HRQoL. However, interventions to increase SS (in particular, subjective SS and objective SS) should be studied to determine whether they may be beneficial in alleviating the adverse impact of depressive symptoms on mental HRQoL.
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Affiliation(s)
- Jie Wang
- Department of Preventive Medicine and Health Education, School of Public Health, Fudan Health Communication Institute, Fudan University, Shanghai, China
| | - Runyu Zou
- Department of Preventive Medicine and Health Education, School of Public Health, Fudan Health Communication Institute, Fudan University, Shanghai, China; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Ning Wu
- Department of Preventive Medicine and Health Education, School of Public Health, Fudan Health Communication Institute, Fudan University, Shanghai, China
| | - Hua Fu
- Department of Preventive Medicine and Health Education, School of Public Health, Fudan Health Communication Institute, Fudan University, Shanghai, China
| | - Yanling He
- Shanghai Mental Health Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Paul Crawford
- Institute of Mental Health, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, United Kingdom
| | - Eddie Kane
- Institute of Mental Health, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, United Kingdom
| | - Junming Dai
- Department of Preventive Medicine and Health Education, School of Public Health, Fudan Health Communication Institute, Fudan University, Shanghai, China.
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Gao T, Mei S, Li M, O'Donnell K, Caron J, Meng X. Impulsivity mediates the relationship between childhood maltreatment and quality of life: Does social support make it different? PERSONALITY AND INDIVIDUAL DIFFERENCES 2022. [DOI: 10.1016/j.paid.2021.111208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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12
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Wanjala SW, Too EK, Luchters S, Abubakar A. Psychometric Properties of the Berger HIV Stigma Scale: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:13074. [PMID: 34948690 PMCID: PMC8701211 DOI: 10.3390/ijerph182413074] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 12/07/2021] [Accepted: 12/08/2021] [Indexed: 11/17/2022]
Abstract
Addressing HIV-related stigma requires the use of psychometrically sound measures. However, despite the Berger HIV stigma scale (HSS) being among the most widely used measures for assessing HIV-related stigma, no study has systematically summarised its psychometric properties. This review investigated the psychometric properties of the HSS. A systematic review of articles published between 2001 and August 2021 was undertaken (CRD42020220305) following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Additionally, we searched the grey literature and screened the reference lists of the included studies. Of the total 1241 studies that were screened, 166 were included in the review, of which 24 were development and/or validation studies. The rest were observational or experimental studies. All the studies except two reported some aspect of the scale's reliability. The reported internal consistency ranged from acceptable to excellent (Cronbach's alpha ≥ 0.70) in 93.2% of the studies. Only eight studies reported test-retest reliability, and the reported reliability was adequate, except for one study. Only 36 studies assessed and established the HSS's validity. The HSS appears to be a reliable and valid measure of HIV-related stigma. However, the validity evidence came from only 36 studies, most of which were conducted in North America and Europe. Consequently, more validation work is necessary for more precise insights.
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Affiliation(s)
- Stanley W. Wanjala
- Department of Public Health and Primary Care, Campus UZ-Ghent, Ghent University, 9000 Ghent, Belgium
- Department of Social Sciences, Pwani University, Kilifi P.O. Box 195-80108, Kenya
| | - Ezra K. Too
- Institute for Human Development, Aga Khan University, Nairobi P.O. Box 30270-00100, Kenya; (E.K.T.); (A.A.)
| | - Stanley Luchters
- Department of Public Health and Primary Care, Campus UZ-Ghent, Ghent University, 9000 Ghent, Belgium
- Institute for Human Development, Aga Khan University, Nairobi P.O. Box 30270-00100, Kenya; (E.K.T.); (A.A.)
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Amina Abubakar
- Institute for Human Development, Aga Khan University, Nairobi P.O. Box 30270-00100, Kenya; (E.K.T.); (A.A.)
- Department of Public Health, Pwani University, Kilifi P.O. Box 195-80108, Kenya
- Department of Psychiatry, University of Oxford, Oxford OX3 7JX, UK
- Neuroassessment Group, KEMRI/Wellcome Trust Research Programme, Centre for Geographic Medicine Research (Coast), Kilifi P.O. Box 230-80108, Kenya
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Kim SH, Lee H, Kim Y. Health-related quality of life after pulmonary tuberculosis in South Korea: analysis from the Korea National Health and Nutrition Examination Survey between 2010 and 2018. Health Qual Life Outcomes 2021; 19:195. [PMID: 34372867 PMCID: PMC8350551 DOI: 10.1186/s12955-021-01833-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 07/31/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although several studies have reported an association between tuberculosis and health-related quality of life, the change in health-related quality of life after pulmonary tuberculosis has been rarely studied. The purpose of this study was to investigate the effect of past history of pulmonary tuberculosis on health-related quality of life using a nationwide, cross-sectional, observational study in Korea. METHODS Among 72,751 people selected using a stratified multi-stage sampling method, 7260 Korean participants were included using propensity score matching. Past history of pulmonary tuberculosis was defined as a previous diagnosis of pulmonary tuberculosis excluding patients with active pulmonary tuberculosis. The primary outcome, health-related quality of life, was assessed by EQ-5D disutility. RESULTS Before matching, the mean EQ-5D of individuals with pulmonary tuberculosis history was lower (0.066 vs. 0.056, p: 0.009). However, the difference was nullified after matching (0.066 vs. 0.062, p = 0.354). In multivariable Poisson regression analysis, EQ-5D disutility score was not associated with past pulmonary tuberculosis history. In subgroup analysis, past pulmonary tuberculosis history increased odds of low health-related quality of life in young (odds ratio [OR] 1.57, 95% confidence interval [CI] 1.17-2.11, p = 0.003), unmarried (OR 1.98, 95% CI 1.05-3.73, p = 0.036), or separated patients (OR 1.30, 95% CI 1.02-1.66, p = 0.032). Age and marital status were modulating factors on the effect of past pulmonary tuberculosis history on health-related quality of life. CONCLUSIONS There was no difference in health-related quality of life between individuals with and without past pulmonary tuberculosis history. Young and unmarried groups had increased odds for low health-related quality of life after pulmonary tuberculosis due to modulating effects of age and marital status.
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Affiliation(s)
- Sang Hyuk Kim
- Division of Pulmonology and Critical Care Medicine, Samsung Medical Center, Department of Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hyun Lee
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, College of Medicine, Hanyang University, Seoul, Korea
| | - Youlim Kim
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Chuncheon Sacred Heart Hospital, 77, Sakju-ro, Chuncheon-si, Gangwon-do, 200-704, Republic of Korea.
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Cernasev A, Kodidela S, Veve MP, Cory T, Jasmin H, Kumar S. A Narrative Systematic Literature Review: A Focus on Qualitative Studies on HIV and Medication-Assisted Therapy in the United States. PHARMACY 2021; 9:67. [PMID: 33806974 PMCID: PMC8005949 DOI: 10.3390/pharmacy9010067] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 02/21/2021] [Accepted: 03/19/2021] [Indexed: 01/09/2023] Open
Abstract
Over the last two decades, the United States (U.S.) has experienced an opioid crisis that has had a significant negative societal and economic impact. Due to the high utilization of opioids in Persons Living with HIV and AIDS (PLWHA), there is a need for a qualitative literature review that presents opioid-use related problems in this population. This study aims to present and identify a thematic overview of the qualitative manuscripts on PLWHA who take opioid medications in the U.S., with a focus on perceptions surrounding medication assisted therapy. The systematic literature search was performed in December 2019. Four databases were searched: PubMed/MEDLINE, Scopus, Web of Science, and Cumulative Index to Nursing & Allied Health Literature (CINAHL). A total of 5348 results were exported from databases into EndNote x9, and duplicates were removed for a total of 3039 unique abstracts to screen. The records were imported into Rayyan, an online platform designed to expedite the screening process. Three authors screened titles and abstracts and determined 19 articles that would be screened in full text. On 9 April 2020, it was determined that eight articles would be included for review. The analysis of the eight manuscripts that fit the inclusion and exclusion criteria revealed barriers and facilitators to medication assisted therapy (MAT) in PLWHA. This review communicates or describes the story of PLWHA who might have delayed access to HIV healthcare providers and the commencement of antiretroviral therapy. In the literature, several studies have focused on the role of physicians in prescribing and addressing the medication regimens but none of the studies examined the role of pharmacists in access to care in this population. Therefore, further research is needed for a better understanding of the social aspects of taking opioid medications in PLWHA and the role of pharmacists within the continuum of care.
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Affiliation(s)
- Alina Cernasev
- Department of Clinical Pharmacy and Translational Science, University of Tennessee Health Sciences Center, Nashville, TN 37211, USA
| | - Sunitha Kodidela
- Department of Pharmaceutical Sciences, University of Tennessee Health Science Center, Memphis, TN 38163, USA; (S.K.); (S.K.)
| | - Michael P. Veve
- Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, 259 Mack Avenue, Detroit, MI 48201, USA;
| | - Theodore Cory
- Department of Clinical Pharmacy and Translational Science, University of Tennessee Health Science Center, Memphis, TN 38163, USA;
| | - Hilary Jasmin
- Health Sciences Library, University of Tennessee Health Science Center, Memphis, TN 38163, USA;
| | - Santosh Kumar
- Department of Pharmaceutical Sciences, University of Tennessee Health Science Center, Memphis, TN 38163, USA; (S.K.); (S.K.)
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15
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Cody SL. Influence of Spirituality, HIV Stigma and Education on HIV Knowledge in Rural African American Congregants in the Deep South: Additional Findings from Project FAITHH. JOURNAL OF HEALTHCARE, SCIENCE AND THE HUMANITIES 2021; 11:259-274. [PMID: 36818217 PMCID: PMC9930515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
HIV incidence has shifted racially and geographically in the United States and now represents higher proportions of African Americans living in the Rural South. Lower levels of HIV knowledge may be the culprit behind the increasing HIV rates observed in the Rural South. The purpose of this study was to investigate the individual and joint correlates of HIV knowledge in a sample of rural African Americans. Baseline data from a faith-based anti-stigma intervention (Project FAITHH, N= 210) was used to assess associations between sociodemographic characteristics, spirituality, stigma, and HIV knowledge scores. Associations were examined with recursive partitioning. Statistical significance was determined at P< 0.05 with a two-sided test. Recursive partitioning revealed five distinct groups based on the data. HIV knowledge scores were highest among participants who attended some college (P < 0.001) with lower levels of individual stigma (P < 0.001). HIV knowledge scores were lowest among less educated individuals (P < 0.001) who had lower levels of perceived community stigma (P = 0.002). Future interventions designed to improve HIV knowledge in rural African Americans should consider tailoring content to those who have the greatest deficits in HIV knowledge, which may be based on perceived community stigma and education levels.
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16
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Verification of phycological factors related to health-related quality of life in elderly knee osteoarthritis: A prospective cohort study. J Orthop Sci 2020; 25:868-873. [PMID: 31771805 DOI: 10.1016/j.jos.2019.10.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 10/23/2019] [Accepted: 10/31/2019] [Indexed: 11/23/2022]
Abstract
BACKGROUND In recent years, locomotive syndrome, which is a condition requiring nursing care due to musculoskeletal disease, has been reported, and interest in knee osteoarthritis has been increasing. Several studies have reported the physical factors influencing the relationship between knee osteoarthritis and health-related quality of life (HRQOL), but there have been no reports verifying the changes over time in the relationship between psychosocial factors and HRQOL. This study aimed to investigate the influence of psychosocial factors on HRQOL in elderly patients with knee osteoarthritis. METHODS Evaluations were conducted at four time points: before exercise therapy intervention, 1 month into intervention, 3 months into intervention, and 1 month after completion of intervention. The items investigated were (1) Japanese Orthopedic Association (JOA) score, (2) Kellgren-Lawrence (K-L) grading system, (3) Fall Efficacy Scale (FES), (4) Frenchay Activities Index (FAI), (5) Geriatric Depression Scale (GDS), and (6) Short Form-8 (SF-8). RESULTS No significant differences were seen between each time point of exercise therapy intervention in depression and HRQOL scale but a significant improvement was seen in instrumental ADL and fear of falling at 3 months into intervention. On multiple regression analysis with SF-8 subscales, fear of falling and degree of depression were determined as significant factors affecting physical and mental summary scores. CONCLUSION Elderly patients with knee osteoarthritis require not only intervention for knee function, but also psychological intervention to address decreased activity and depression to improve their HRQOL.
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Subramanian A, Mohan A, Nandi PK, Rajeshwari K. Perceived social support, depression and their impact on quality of life of people living with HIV in India. AIDS Care 2020; 33:1329-1334. [PMID: 32851860 DOI: 10.1080/09540121.2020.1810620] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Universal access to Antiretroviral Treatment (ART) has transformed HIV/AIDS into a chronic disease and issues like social support and Quality of life (QOL) have emerged as important components of care. Perceived social support influences QOL in People Living with HIV (PLHIV), though this has not been studied well in India. PLHIV were assessed for Social Support using the Multidimensional Scale of Perceived Social Support (MSPSS) and QOL was assessed with the Medical Outcomes Study HIV Health Survey (MOS-HIV) questionnaire. The factors impacting social support and its effect of on QOL were analysed. Amongst the 109 study subjects, 62 (56.9%) were men, 47 (43.1%) were women, mean age was 35 ± 7.5 years, 85.3% had WHO stage 1 disease and 80 (73.4%) were receiving ART. Only 43.1% subjects perceived high overall social support. Social support (from family/friends/others) was associated positively with physical functioning (p = 0.001), social and cognitive functioning (p = 0.000) and significantly inversely associated with depression (p = 0.002). Higher perceived social support was seen to correlate with higher CD4 count (Peak, Nadir and Current; p < 0.05) and better adherence (p = 0.003). It is concluded that social support, including support from beyond family, have a significant impact on clinical endpoints and QOL in PLHIV.
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Affiliation(s)
- Anuradha Subramanian
- ART Center, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India
| | - Ayush Mohan
- ART Center, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India
| | - Pijush Kanti Nandi
- ART Center, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India
| | - Krishnan Rajeshwari
- ART Center, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India
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Velloza J, Heffron R, Amico KR, Rowhani-Rahbar A, Hughes JP, Li M, Dye BJ, Celum C, Bekker LG, Grant RM. The Effect of Depression on Adherence to HIV Pre-exposure Prophylaxis Among High-Risk South African Women in HPTN 067/ADAPT. AIDS Behav 2020; 24:2178-2187. [PMID: 31955360 DOI: 10.1007/s10461-020-02783-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Oral pre-exposure prophylaxis (PrEP) is highly efficacious but low adherence undermines effectiveness. Depression, common in African women, may be a barrier to consistent PrEP use. We aimed to assess the relationship between depression, psychosocial mediators, and PrEP adherence among South African women. We analyzed data from 174 South African women in HPTN 067, an open-label oral PrEP trial conducted from 2011 to 2013. Participants were followed for 24 weeks. PrEP adherence was measured via Wisepill™ and weekly self-report interview data. We considered participants "adherent" at week 24 if Wisepill™ and interviews indicated that ≥ 80% of expected doses were taken in the prior month. Elevated depressive symptoms were assessed using the 20-item Center for Epidemiological Studies-Depression (CES-D) scale. We used marginal structural models to estimate the effect of elevated symptoms at baseline on PrEP adherence at week 24 and to assess whether the direct effect changed meaningfully after accounting for mediating effects of stigma, social support, and PrEP optimism. High PrEP adherence occurred less often among women with elevated depressive symptoms (N = 35; 44.3%) compared with those without (N = 52; 54.7%; adjusted relative risk [aRR]: 0.79; 95% confidence interval [CI] 0.63-0.99). The effect of elevated depressive symptoms on PrEP adherence persisted in models accounting for the mediating influence of stigma (aRR: 0.74; 95% CI 0.51-0.97) and PrEP optimism (aRR: 0.75; 95% CI 0.55-0.99). We also found a direct effect of similar magnitude and direction when accounting for social support as the mediating variable, although this adjusted relative risk estimate was not statistically significant (aRR: 0.77; 95% CI 0.57-1.03). Depressive symptoms were common and associated with lower PrEP adherence among South African women. Future work is needed to determine whether depression services integrated with PrEP delivery could improve PrEP effectiveness among African women.
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Affiliation(s)
- Jennifer Velloza
- Department of Epidemiology, University of Washington, Seattle, WA, USA.
- Department of Global Health, University of Washington, Seattle, WA, USA.
- International Clinical Research Center, University of Washington, 325 Ninth Avenue, Box 359927, Seattle, WA, 98104, USA.
| | - Renee Heffron
- Department of Epidemiology, University of Washington, Seattle, WA, USA
- Department of Global Health, University of Washington, Seattle, WA, USA
| | | | | | - James P Hughes
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Maoji Li
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | | | - Connie Celum
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - Linda-Gail Bekker
- The Desmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa
| | - Robert M Grant
- University of California at San Francisco, San Francisco, CA, USA
- Gladstone Institute of Virology and Immunology, University of California at San Francisco, San Francisco, CA, USA
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Sarkar T, Karmakar N, Dasgupta A, Saha B. Quality of life of people living with HIV/AIDS attending antiretroviral clinic in the center of excellence in HIV care in India. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2019; 8:226. [PMID: 31867390 PMCID: PMC6905283 DOI: 10.4103/jehp.jehp_80_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 07/23/2019] [Indexed: 06/10/2023]
Abstract
INTRODUCTION HIV/AIDS is a serious challenge globally. A plethora of morbidities due to crippling immune system reduces quality of life (QOL). The advent of highly active antiretroviral treatment has changed this deadly disease to a chronic manageable illness with focus shifting from fighting virus to ensuring a good QOL. OBJECTIVE To assess the QOL among people living with HIV/AIDS (PLHA) and factors influencing, if any in Indian setting. MATERIALS AND METHODS An institutional-based cross-sectional study was carried out among 220 PLHA (male >15 years) attending Anti-Retroviral Therapy Centre of the center of excellence in HIV care in India (Calcutta School of Tropical Medicine, Kolkata) from May 2012 to April 2013. QOL was assessed using WHO-QOL-BREF questionnaire from January 2013 to December 2013. Statistical analysis was done using SPSS version 16; multivariate logistic regression was computed with adjusted odds ratio in 95% confidence interval; P < 0.05 was considered statistically significant. RESULTS In this study, all 220 PLHA men participated (response rate 96.5%) where more than half (55.5%) participants rated their QOL as neither poor nor good; only 28.2% replied good. One-third (38.6%) were dissatisfied while only one-fifth (19.1%) satisfied and 41.4% mentioned neither satisfied nor dissatisfied with their health. Mean score ± standard deviation on various domains and facets of WHOQOL-BREF were physical health score 56.2 ± 9.8, psychological health 63.1 ± 8.7, social relationship 48.9 ± 14.8, and environmental health 51.3 ± 13.7. CONCLUSION PLHA had good QOL on psychological, physical, and environmental domain that reflects better services provided at Calcutta School of Tropical Medicine (CSTM), Kolkata, but they scored poorly in social relationship domain, which may be suggestive of ineffective social services network. This study concludes that increase existing social and emotional support with innovation should be implemented to improve their QOL.
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Affiliation(s)
- Trinath Sarkar
- Department of Community Medicine, Medical College, Kolkata, West Bengal, India
| | - Nabarun Karmakar
- Department of Community Medicine, Tripura Medical College and Dr. BRAM Teaching Hospital, Agartala, Tripura, India
| | - Aparajita Dasgupta
- Department of Preventive and Social Medicine, All India Institute of Hygiene and Public Health, Kolkata, West Bengal, India
| | - Bibhuti Saha
- Department of Tropical Medicine, Calcutta School of Tropical Medicine, Kolkata, West Bengal, India
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Huang Y, Luo D, Chen X, Zhang D, Huang Z, Xiao S. Role of psychosocial status in predicting health-related quality of life at 1-year follow-up among newly diagnosed people living with HIV. PLoS One 2019; 14:e0224322. [PMID: 31644606 PMCID: PMC6808448 DOI: 10.1371/journal.pone.0224322] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 10/10/2019] [Indexed: 11/23/2022] Open
Abstract
Background Psychosocial problems are common among people living with HIV (PLWH) and have been cross-sectionally associated with health-related quality of life (HRQoL). We evaluated the longitudinal relationship between psychosocial status and HRQoL among PLWH during the first year after diagnosis. Method A consecutive sample of newly diagnosed PLWH was recruited from Changsha Center for Disease Control and Prevention in Hunan Province, China. Assessments were conducted at baseline and 1 year later. The measures used in this study included the Medical Outcomes Study HIV Survey (MOS-HIV), the 9-item Patient Health Questionnaire (PHQ-9), the HIV/AIDS Stress Scale (SS-HIV) and the Social Support Rating Scale (SSRS). The trajectories of depression from baseline to 1-year follow-up were categorized into four groups: never (PHQ-9 < 10 at two time points), new-onset (PHQ-9 < 10 at baseline & PHQ-9 ≥ 10 at follow-up), recovered (PHQ-9 ≥ 10 at baseline & PHQ-9 < 10 at follow-up) and persistent depression (PHQ-9 ≥ 10 at two time points). In addition, the trajectories of stress and social support were classified by calculating the proportions of participants whose stress and social support scores changed between baseline and 1-year follow-up by more than 0.5 effect size in either direction. Generalized linear models were used to examine the potential role of baseline and changes in psychosocial status in predicting the HRQoL at 1 year, after adjusting for socio-demographic and clinical characteristics. Results A total of 410 participants completed both the baseline and 1-year follow-up surveys. Higher stress levels at baseline predicted a lower HRQoL at 1 year, while baseline depression status and social support did not predict 1-year HRQoL scores. Compared to those who were never depressed at both baseline and follow-up, participants who experienced new-onset or persistent depression had lower HRQoL at 1 year. Additionally, the 1-year HRQoL score of participants who recovered from depression by follow-up was comparable to that of participants who were never depressed. Moreover, participants who experienced increases in stress levels by follow-up had lower HRQoL scores at 1 year than those with decreases in stress levels. Changes in social support did not predict 1-year HRQoL scores in this study. Conclusions Assessing psychosocial status regularly and implementing effective interventions targeted at psychosocial problems may be particularly important for PLWH to improve their HRQoL. Among PLWH, special attention should be given to those with new-onset or persistent depression and those with high stress levels at the time of diagnosis and increased stress levels 1 year after the new HIV diagnosis.
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Affiliation(s)
- Yunxiang Huang
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, People’s Republic of China
| | - Dan Luo
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, People’s Republic of China
- * E-mail:
| | - Xi Chen
- Hunan Provincial Center for Disease Prevention and Control, Changsha, Hunan, People’s Republic of China
| | - Dexing Zhang
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong, People’s Republic of China
| | - Zhulin Huang
- Changsha Center for Disease Prevention and Control, Changsha, Hunan, People’s Republic of China
| | - Shuiyuan Xiao
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, People’s Republic of China
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Jiang T, Zhou X, Wang H, Luo M, Pan X, Ma Q, Chen L. Psychosocial Factors Associated with Quality of Life in Young Men Who Have Sex with Men Living with HIV/AIDS in Zhejiang, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E2667. [PMID: 31349674 PMCID: PMC6696375 DOI: 10.3390/ijerph16152667] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 07/22/2019] [Accepted: 07/24/2019] [Indexed: 01/23/2023]
Abstract
OBJECTIVES To explore the quality of life (QOL) status and related factors in young human immunodeficiency virus (HIV)-infected men who have sex with men (MSM) aged 16 to 24 years in Zhejiang province. METHODS A cross-sectional study was conducted in 22 counties of Zhejiang province, and 395 subjects took part in our research. A t-test, one-way Analysis of variance (ANOVA), and multivariate stepwise linear regression analysis were used to investigate the factors associated with QOL in young HIV-infected MSM. RESULTS The total score on the QOL was 86.86 ± 14.01. The multivariate stepwise linear regression analysis revealed that self-efficacy and discrimination were associated with all domains on the QOL assessment, monthly income was associated with QOL for all domains except spirituality and consistent condom use during oral sex with men in the past three months was associated with QOL for all domains except the relationship domain. Those individuals within the group of young HIV-infected MSM who have higher self-efficacy, a higher monthly income, greater social support, safer sexual behaviors, a higher level of education, and a higher cluster of differentiation 4 (CD4) count have a better QOL. CONCLUSIONS These findings suggest that to improve the QOL of this population, greater emphasis should be placed on improving social support, self-efficacy, and antiviral therapy adherence and on reducing discrimination, disease progression, and high-risk behaviors.
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Affiliation(s)
- Tingting Jiang
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou 310051, China
| | - Xin Zhou
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou 310051, China
| | - Hui Wang
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou 310051, China
| | - Mingyu Luo
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou 310051, China
| | - Xiaohong Pan
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou 310051, China
| | - Qiaoqin Ma
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou 310051, China.
| | - Lin Chen
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou 310051, China.
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Tran BX, Phan HT, Latkin CA, Nguyen HLT, Hoang CL, Ho CSH, Ho RCM. Understanding Global HIV Stigma and Discrimination: Are Contextual Factors Sufficiently Studied? (GAP RESEARCH). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16111899. [PMID: 31146379 PMCID: PMC6603743 DOI: 10.3390/ijerph16111899] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 05/26/2019] [Accepted: 05/27/2019] [Indexed: 01/01/2023]
Abstract
Stigma and discrimination are among the greatest challenges that people living with human immunodeficiency virus (HIV) face, and both are known to negatively affect quality of life as well as treatment outcomes. We analyzed the growing research and current understanding of HIV-related stigma and contextual factors in HIV/AIDS (human Immunodeficiency virus/ acquired immunodeficiency syndrome) bibliography. A total of 5984 publications published from 1991 to 2017 were retrieved from the Web of Science database. The number of papers and their impacts have been considerably grown in recent years. Research landscapes related to stigma and discrimination include clinical, physical and mental health outcomes, risk behaviors of most-at-risk populations, and HIV-related services. We found a lack of empirical studies not only on social, cultural and economic contexts, but also on specific interventions for particular settings and sub-populations. This study highlights certain gaps and provides a basis for future studies and interventions on this critical issue given the changing drivers of HIV epidemics.
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Affiliation(s)
- Bach Xuan Tran
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam.
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21206, USA.
| | - Hai Thanh Phan
- Institute for Global Health Innovations, Duy Tan University, Da Nang 550000, Vietnam.
| | - Carl A Latkin
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21206, USA.
| | - Huong Lan Thi Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang 550000, Vietnam.
| | - Chi Linh Hoang
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam 700000, Vietnam.
| | - Cyrus S H Ho
- Department of Psychological Medicine, National University Hospital, Singapore 117599, Singapore.
| | - Roger C M Ho
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam 700000, Vietnam.
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117599, Singapore.
- Institute for Health Innovation and Technology (iHealthtech) National University of Singapore, Singapore 117599, Singapore.
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Brown MJ, Serovich JM, Laschober TC, Kimberly JA, Lescano CM. Mediating Effects of Depressive Symptoms on Perceived Social Support and HIV Disclosure: Assessing Moderation by Sex. AIDS Behav 2019; 23:636-648. [PMID: 30539497 DOI: 10.1007/s10461-018-2369-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
People living with HIV may decide to disclose their HIV-positive status after considering the benefits and costs. Studies have shown associations between perceived social support, depressive symptoms and HIV disclosure among men and women; however, research assessing the mediating pathway among these variables and the associated disparities by sex are lacking. Therefore, the aims of this study were to determine the association between perceived social support from family and friends and HIV disclosure to sexual partners; assess the mediating effects of depressive symptoms; and examine the disparities by sex. Participants included 147 men and 115 women living with HIV who took part in a disclosure intervention study. Mediation analyses were conducted to determine the direct and indirect associations between perceived social support from family and friends, depressive symptoms, and disclosure behavior. Depressive symptoms mediated the association between perceived social support (from family: β = 0.103, p = 0.019; and from friends: β = 0.111, p = 0.009) and HIV disclosure to sexual partners, specifically among women. However, these pathways were not statistically significant among men. Women living with HIV may benefit from two types of interventions: (1) Disclosure to sexual partners interventions, which aim to accentuate perceived social support from family and friends through attenuating depressive symptoms; and (2) Social support interventions, which may increase disclosure to sexual partners via reducing depressive symptoms.
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A scoping review of health-related stigma outcomes for high-burden diseases in low- and middle-income countries. BMC Med 2019; 17:17. [PMID: 30764819 PMCID: PMC6376728 DOI: 10.1186/s12916-019-1250-8] [Citation(s) in RCA: 148] [Impact Index Per Article: 29.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 01/02/2019] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Stigma is associated with health conditions that drive disease burden in low- and middle-income countries (LMICs), including HIV, tuberculosis, mental health problems, epilepsy, and substance use disorders. However, the literature discussing the relationship between stigma and health outcomes is largely fragmented within disease-specific siloes, thus limiting the identification of common moderators or mechanisms through which stigma potentiates adverse health outcomes as well as the development of broadly relevant stigma mitigation interventions. METHODS We conducted a scoping review to provide a critical overview of the breadth of research on stigma for each of the five aforementioned conditions in LMICs, including their methodological strengths and limitations. RESULTS Across the range of diseases and disorders studied, stigma is associated with poor health outcomes, including help- and treatment-seeking behaviors. Common methodological limitations include a lack of prospective studies, non-representative samples resulting in limited generalizability, and a dearth of data on mediators and moderators of the relationship between stigma and health outcomes. CONCLUSIONS Implementing effective stigma mitigation interventions at scale necessitates transdisciplinary longitudinal studies that examine how stigma potentiates the risk for adverse outcomes for high-burden health conditions in community-based samples in LMICs.
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Geriatric-HIV Medicine: the geriatrician’s role. Eur Geriatr Med 2018; 10:259-265. [DOI: 10.1007/s41999-018-0144-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 11/24/2018] [Indexed: 12/21/2022]
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Li Z, Morano JP, Khoshnood K, Hsieh E, Sheng Y. HIV-related stigma among people living with HIV/AIDS in rural Central China. BMC Health Serv Res 2018; 18:453. [PMID: 29903006 PMCID: PMC6003113 DOI: 10.1186/s12913-018-3245-0] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 05/29/2018] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND HIV-related stigma among people living with HIV/AIDS (PLWHA) has been associated with many negative consequences, including poor adherence to therapy and undue psychological stress. However, the relative influence of specific demographic and situational factors contributing to HIV-related stigma among rural PLWHA in central China remains unknown. The aim of this study was to explore the level of HIV-related stigma among rural PLWHA across specific demographic and situational factors in central China. METHODS A cross-sectional study was conducted among PLWHA receiving care through the Chinese Centers for Disease Control of Zhenping county in Henan Province, China. Participants completed a 55-item questionnaire which included demographic and disease-related factors, HIV-related stigma was measured utilizing the validated Berger HIV Stigma Scale which has good psychometric characteristics in Chinese PLWHA. RESULTS A total of 239 PLWHA completed the survey. The mean total HIV-related stigma score was 105.92 (SD = 12.35, 95% CI: 104.34, 107.49). Multivariable linear regression analysis revealed a higher level of HIV-related stigma in younger PLWHA (β = - 0.57, 95% CI = - 0.78,-0.35, p<0.001) and those who self-reported opportunistic infections (β = 6.26, 95% CI = 1.26, 11.26, p < 0.05). CONCLUSIONS The findings in the current study suggest that rural PLWHA in central China suffer from the burden of HIV-related stigma at a moderate to high level. Younger PLWHA and PLWHA that have opportunistic infections tend to perceive a higher level of HIV stigma.
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Affiliation(s)
- Zhen Li
- School of Nursing, Peking Union Medical College, Beijing, China
| | - Jamie P Morano
- Division of Infectious Diseases and International Medicine, University of South Florida, Tampa, FL, USA.,Yale University Center for Interdisciplinary Research on AIDS (CIRA), New Haven, USA
| | | | - Evelyn Hsieh
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Yu Sheng
- Department of Basic Nursing, School of Nursing, Peking Union Medical College, Beijing, China.
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Edelman EJ, Lunze K, Cheng DM, Lioznov DA, Quinn E, Gnatienko N, Bridden C, Chaisson CE, Walley AY, Krupitsky EM, Raj A, Samet JH. HIV Stigma and Substance Use Among HIV-Positive Russians with Risky Drinking. AIDS Behav 2017. [PMID: 28634662 DOI: 10.1007/s10461-017-1832-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
The link between HIV stigma with substance use is understudied. We characterized individuals with high HIV stigma and examined whether HIV stigma contributes to substance use among HIV-positive Russians reporting risky alcohol use. We analyzed data from HERMITAGE, a randomized controlled trial of 700 people living with HIV/AIDS (PLWHA) with past 6-month risky sex and risky alcohol use in St. Petersburg, Russia (2007-2011). Participants who were female and reported depressive symptoms and lower social support were more likely to endorse high HIV stigma (all p's < 0.001). In adjusted models, high HIV stigma was not significantly associated with the primary outcome unhealthy substance use and was not consistently associated with secondary substance use outcomes. Interventions to enhance social and mental health support for PLWHA, particularly women, may reduce stigma, though such reductions may not correspond to substantial decreases in substance use among this population.
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Affiliation(s)
- E Jennifer Edelman
- Yale University School of Medicine, PO Box 208025, New Haven, CT, 06520-8088, USA.
- Center for Interdisciplinary Research on AIDS, Yale University School of Public Health, New Haven, CT, USA.
| | - Karsten Lunze
- Boston University School of Medicine and Boston Medical Center, Boston, MA, USA
| | - Debbie M Cheng
- Boston University School of Public Health, Boston, MA, USA
| | - Dmitry A Lioznov
- First Pavlov State Medical University of St. Petersburg, St. Petersburg, Russian Federation
| | - Emily Quinn
- Boston University School of Public Health, Boston, MA, USA
| | - Natalia Gnatienko
- Boston University School of Medicine and Boston Medical Center, Boston, MA, USA
| | - Carly Bridden
- Boston University School of Medicine and Boston Medical Center, Boston, MA, USA
| | | | - Alexander Y Walley
- Boston University School of Medicine and Boston Medical Center, Boston, MA, USA
| | - Evgeny M Krupitsky
- First Pavlov State Medical University of St. Petersburg, St. Petersburg, Russian Federation
- St.-Petersburg Bekhterev Research Psychoneurological Institute, St. Petersburg, Russian Federation
| | - Anita Raj
- University of California - San Diego, San Diego, CA, USA
| | - Jeffrey H Samet
- Boston University School of Medicine and Boston Medical Center, Boston, MA, USA
- Boston University School of Public Health, Boston, MA, USA
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A Self-Report Measure to Detect Neurocognitive Impairment among Incarcerated People Living with HIV in Malaysian Context: An Exploratory Factor Analysis. Int J Ment Health Addict 2017; 15:812-825. [PMID: 29051714 DOI: 10.1007/s11469-017-9752-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
While neurocognitive impairment (NCI) among people living with HIV (PLWH) who use drugs and its impact on HIV treatment outcomes continue to be widely investigated, there remains a critical gap in NCI assessment among HIV-infected people who use drugs (PWUD) in Malaysian context. The present study, therefore, sought to improve the utility of the existing Neuropsychological Impairment Scale (NIS) as a screening tool for assessing NCI by establishing its psychometric properties in the Malaysian context. The NIS is a brief, self-report measure originally designed to assess NCI by having individuals rate a range of items that may influence cognitive functioning. HIV-infected male prisoners (N=301) administered the full 95-item NIS. An exploratory factor analysis (EFA) was conducted using principal axis factoring and orthogonal varimax rotation. Reliability was measured using Cronbach's alpha. The EFA resulted in an abbreviated, psychometrically sound, eight-factor structure (54-item) revised NIS - now referred to as the Brief Inventory of Neuro-cognitive Impairment-Malaysia (BINI-M). It is better designed to detect NCI in PLWH, ranging from generalized neurocognitive symptoms to more specific forms of impairment with excellent to average reliability. The BINI-M may serve as a useful tool for clinicians and researchers to assess NCI in PLWH and can inform enhanced treatment strategies in the Malaysian context.
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