1
|
Chen WT, Sun W, Huang F, Shiu CS, Kim B, Candelario J, Toma L, Wu G, Ah-Yune J. Lost in Translation: Impact of Language Barriers and Facilitators on the Health Care of Asian Americans Living with HIV. J Racial Ethn Health Disparities 2024; 11:2064-2072. [PMID: 37306920 PMCID: PMC10713860 DOI: 10.1007/s40615-023-01674-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 05/30/2023] [Accepted: 06/05/2023] [Indexed: 06/13/2023]
Abstract
Language barriers are major obstacles that Asian American immigrants face when accessing health care in the USA. This study was conducted to explore the impact of language barriers and facilitators on the health care of Asian Americans. Qualitative, in-depth interviews and quantitative surveys were conducted with 69 Asian Americans (Chinese, Filipino, Japanese, Malaysian, Indonesian, Vietnamese, and mixed Asian backgrounds) living with HIV (AALWH) in three urban areas (New York, San Francisco, and Los Angeles) in 2013 and from 2017 to 2020. The quantitative data indicate that language ability is negatively associated with stigma. Major themes emerged related to communication, including the impact of language barriers on HIV care and the positive impact of language facilitators-family members/friends, case managers, or interpreters-who can communicate with healthcare providers in the AALWH's native language. Language barriers negatively impact access to HIV-related services and thus result in decreased adherence to antiretroviral therapy, increased unmet healthcare needs, and increased HIV-related stigma. Language facilitators enhanced the connection between AALWH and the healthcare system by facilitating their engagement with health care providers. Language barriers experienced by AALWH not only impact their healthcare decisions and treatment choices but also increase levels of external stigma which may influence the process of acculturation to the host country. Language facilitators and barriers to health services for AALWH represent a target for future interventions in this population.
Collapse
Affiliation(s)
- Wei-Ti Chen
- School of Nursing, University of California Los Angeles, Los Angeles, CA, 90095, USA.
| | - Wenxiu Sun
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Feifei Huang
- School of Nursing, Fujian Medical University, Fuzhou, China
| | - Cheng-Shi Shiu
- School of Nursing, University of California Los Angeles, Los Angeles, CA, 90095, USA
- National Taiwan University, Department of Social Work, Taipei, Taiwan
| | - Boram Kim
- School of Nursing, University of California Los Angeles, Los Angeles, CA, 90095, USA
| | - Jury Candelario
- APAIT- A division of Special Service for Groups, Inc., Los Angeles, CA, USA
| | - Lance Toma
- San Francisco Community Health Center, San Francisco, CA, USA
| | - Gilbert Wu
- Chinese-American Planning Council, Inc., New York, NY, USA
| | - Judy Ah-Yune
- Chinese-American Planning Council, Inc., New York, NY, USA
| |
Collapse
|
2
|
Luu M, Haardörfer R, Nehl E, Escoffery C, Sales J. Factors associated with intention of HIV testing among Asian American men: a path analysis. J Behav Med 2024:10.1007/s10865-024-00502-5. [PMID: 38980458 DOI: 10.1007/s10865-024-00502-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 06/01/2024] [Indexed: 07/10/2024]
Abstract
Research has pointed to myriad cultural and socio-psychological factors associated with HIV testing, such as acculturation, social norms about HIV testing, masculinity, homonegativity, and constructs from the Theory of Planned Behavior. However, the interrelationships of these factors on the intentions of HIV testing among the population of Asian American men remains unknown. A dataset of 425 Asian American men in the U.S., collected online with convenience sampling method during 2020-2021, was analyzed to test a conceptual framework that aimed to fill this gap. Results from a path model with two endogenous variables (homonegativity and HIV testing intention) indicated that perceived social norms about HIV testing, attitude about HIV testing, and perceived HIV risk had directandindirect relationships with the intentions of HIV testing in the study population. However, social norms about HIV testing and perceived HIV risk showed stronger direct effects (standardized estimates = 0.37 and 0.34, respectively, p-value < 0.001). Additionally, we found that the relationships of these factors with HIV testing intention were also mediated by homonegativity. Findings from this study advance our understanding of pathways of associations between a host of cultural and socio-psychological factors with HIV testing intention among an understudied population - Asian American men. Our results will help inform the development of future intervention programs to increase HIV testing in this population.
Collapse
Affiliation(s)
| | - Regine Haardörfer
- Department of Behavioral, Social, and Health Education Sciences (BSHES), Rollins School of Public Health, Emory University, Atlanta, USA
| | - Eric Nehl
- Department of Behavioral, Social, and Health Education Sciences (BSHES), Rollins School of Public Health, Emory University, Atlanta, USA
| | - Cam Escoffery
- Department of Behavioral, Social, and Health Education Sciences (BSHES), Rollins School of Public Health, Emory University, Atlanta, USA
| | - Jessica Sales
- Department of Behavioral, Social, and Health Education Sciences (BSHES), Rollins School of Public Health, Emory University, Atlanta, USA
| |
Collapse
|
3
|
Zainal-Abidin A, Miptah H, Ariffin F, Razali S, Badlishah-Sham S. Association of coping mechanisms with medication adherence among young People living with HIV (PLHIV) in Klang Valley. Heliyon 2024; 10:e25740. [PMID: 38380003 PMCID: PMC10877255 DOI: 10.1016/j.heliyon.2024.e25740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 01/09/2024] [Accepted: 02/01/2024] [Indexed: 02/22/2024] Open
Abstract
Background As young People Living with HIV (PLHIV) will need to take antiretroviral therapy (ART) for life, there is a need to understand their coping mechanisms in living with the disease. Lack of coping mechanisms leads to poor medication adherence and hospital follow-up, poor health outcomes and shortened life expectancy. Objectives This study aimed to determine the pattern of coping mechanisms in young PLHIV and its association with medication adherence. Methods This study was a cross-sectional study amongst young PLHIV patients (aged 20-39 years old) attending two HIV clinics in Klang Valley. Data was collected between February to August 2022. The pattern of coping strategies was assessed using the 28-item Brief Coping Orientation to Problems Experienced (COPE) questionnaire in English and Malay language, which was validated and found to have good internal consistency. Self-reported medication adherence was measured using the one-item Medical Outcomes Study (MOS) Specific Adherence Scale. Statistical analysis included descriptive statistics, single and multiple logistic regression. Results A total of 395 respondents were recruited for the study. The mean scores for each coping mechanism were: 1) problem-focused coping 2.98 (SD 0.62), 2) emotion-focused coping 2.40 (SD 0.48), 3) dysfunctional coping 1.84 (SD 0.44) and 4) religion/spirituality coping 3.07 (SD 0.97). The majority of the respondents (66.8%) were adherent to their ART. Respondents who had a longer duration of medication [OR:1.014 (95% CI: 1.002,1.026)] and those who adopted less religion/spirituality coping mechanisms [OR: 0.495 (95% CI:0.246, 0.997)] were found to be significantly associated with medication adherence. Conclusion This study revealed an overall medication adherence rate of 66.8%. Patients with longer ART duration and who adopted less religion or spirituality coping had better medication adherence. These study findings provide input into the design of intervention by clinicians and healthcare policy makers for young PLHIV in clinical practice.
Collapse
Affiliation(s)
- A.N.I. Zainal-Abidin
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA, Selangor, Malaysia
- Hospital Al-Sultan Abdullah (HASA), UiTM Puncak Alam, Selangor, Malaysia
| | - H.N. Miptah
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA, Selangor, Malaysia
- Hospital Al-Sultan Abdullah (HASA), UiTM Puncak Alam, Selangor, Malaysia
| | - F. Ariffin
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA, Selangor, Malaysia
- Hospital Al-Sultan Abdullah (HASA), UiTM Puncak Alam, Selangor, Malaysia
| | - S. Razali
- Hospital Al-Sultan Abdullah (HASA), UiTM Puncak Alam, Selangor, Malaysia
- Department of Psychiatry, Faculty of Medicine, Universiti Teknologi MARA, Selangor, Malaysia
| | - S.F. Badlishah-Sham
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA, Selangor, Malaysia
- Hospital Al-Sultan Abdullah (HASA), UiTM Puncak Alam, Selangor, Malaysia
| |
Collapse
|
4
|
Huang FF, Chen WT, Shiu C, Yang JP, Zhao H. Relationships between spirituality and mental stress in people living with HIV in China: A cross-sectional study. Ment Health Relig Cult 2023; 26:276-289. [PMID: 37974904 PMCID: PMC10651058 DOI: 10.1080/13674676.2023.2219620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 05/24/2023] [Indexed: 11/19/2023]
Abstract
There are limited reports on the relationship between spirituality and mental stress in PLWH in China, who may be subject to anti-religious pressures from the government. In this study, we aimed to understand whether spirituality influences Chinese PLWH's mental stress and, if so, at what level. We recruited 200 PLWHs from Beijing's Ditan Hospital to complete a cross-sectional survey inquiring about their practice of spirituality as well as their level of mental stress. The study found that PLWH who presented with a mid-level of spirituality have the highest mental stress when compared to those who have a low level of spiritual beliefs or a high level of spiritual beliefs. This study points to the utility of healthcare providers taking PLWH's potential spirituality into consideration, perhaps in particular for those with a moderate level of spirituality, in order to provide the most comprehensive care possible.
Collapse
Affiliation(s)
- Fei Fei Huang
- School of Nursing, Fujian Medical University, Fuzhou, China
| | - Wei-Ti Chen
- School of Nursing, University of California Los Angeles, Los Angeles, CA, USA
| | - Chengshi Shiu
- National Taiwan University, Department of Social Work, Taipei, Taiwan
| | - Joyce P. Yang
- Department of Psychology, University of San Francisco, San Francisco, CA, USA
| | - Hongxin Zhao
- Beijing Ditan Hospital, Capital Medical University, Beijing, China
| |
Collapse
|
5
|
Huang F, Sun W, Zhang L, Lu H, Chen WT. Depressive symptoms mediate COVID-associated stigma and quality of life: Stigma instrument validation and path analysis. J Affect Disord 2022; 297:269-275. [PMID: 34699856 PMCID: PMC8541885 DOI: 10.1016/j.jad.2021.10.043] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 10/05/2021] [Accepted: 10/20/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND The aim of this study was to adapt and modify the HIV/AIDS Stigma Instrument-Patient to develop the COVID-19 Stigma Instrument-Patient (CSI-P) and validate its psychometric characteristics, as well as explore how affected individuals in China experienced COVID-related stigma and its associated variables, including depressive symptomology and quality of life (QOL). METHODS From September to October 2020, 151 COVID-19 survivors recruited in Shanghai, China, completed a set of measures of demographic characteristics, depression, stigma, and QOL. RESULTS The 15-item CSI-P-2 achieved a Cronbach's α of 0.67 to 0.91. The six-factor structure was obtained by exploratory factor analysis. The mean score for the CSI-P-2 in Chinese COVID survivors was 8.14 ± 9.98. Regression analysis showed that survivors' age, comorbid diseases, education levels, and loneliness level were the factors influencing their COVID-19 stigma, explaining 37.80% of the total variance (F = 19.25, p < 0.001). Also, stigma's effect on QOL was significant in direct and indirect paths mediated by depressive symptomology. LIMITATIONS First, this sample might limit the generalization of the findings to other Chinese-speaking regions. Second, future longitudinal or experimental studies are warranted for checking and further refinement of the scale. Finally, future studies are needed on the changing dynamics of stigma in different stages of the pandemic. CONCLUSIONS The 29-item CSI-P-2 with six domains is an instrument with sound psychometric properties that can be used to measure COVID-19 stigma during the COVID-19 outbreak and, later, for COVID-19 survivors. Future studies should explore how to integrate the significant demographic and psychological characteristics influencing the experience of stigma work on this study into the development of stigma-reducing interventions.
Collapse
Affiliation(s)
- Feifei Huang
- School of Nursing, Fujian Medical University, Fuzhou, China
| | - Wenxiu Sun
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Lin Zhang
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.
| | - Hongzhou Lu
- Shenzhen Third People's Hospital, the Second Afflilated Hospital of Souterhn University of Science and Technology, Shenzhen, China
| | - Wei-Ti Chen
- School of Nursing, University of California Los Angeles, Los Angeles, CA, USA.
| |
Collapse
|
6
|
Huang F, Chen WT, Shiu CS, Sun W, Toma L, Luu BV, Ah-Yune J. Acculturation, HIV-Related Stigma, Stress, and Patient-Healthcare Provider Relationships Among HIV-Infected Asian Americans: A Path Analysis. J Immigr Minor Health 2021; 22:1217-1224. [PMID: 32789735 PMCID: PMC7424136 DOI: 10.1007/s10903-020-01068-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Acculturation may limit HIV-positive Asian Americans’ active interactions with patient-healthcare providers (HCP) and utilization of HIV healthcare services; however, the specific mediation effect of acculturation still unknown. A bias-corrected factor score path analysis was performed to examine the proposed model of relations among acculturation, stigma, stress, and patient-HCP relationships. A convenience sample of 69 HIV-positive Asian Americans in San Francisco, Los Angeles, and New York City were recruited and collect data were collected on demographics, HIV-related stigma, stress, and patient-HCP relationships. HIV stigma and stress had a direct, negative effect on patient-HCP relationships. Acculturation had a positive total effect on patient-HCP relationships, and was mediated by HIV stigma and stress. A acculturation also had a direct impact on stigma and stress. Acculturation, HIV-related stigma, and stress are key elements to achieving good patient-HCP relationships, and provide insights on the design of culturally sensitive interventions to improve patient-HCP relationships.
Collapse
Affiliation(s)
- Feifei Huang
- School of Nursing, Fujian Medical University, Fuzhou, China.,School of Nursing, University of California Los Angeles, Los Angeles, CA, 90095, USA
| | - Wei-Ti Chen
- School of Nursing, University of California Los Angeles, Los Angeles, CA, 90095, USA.
| | - Cheng-Shi Shiu
- School of Nursing, University of California Los Angeles, Los Angeles, CA, 90095, USA.,Department of Social Work, National Taiwan University, Taipei, Taiwan
| | - Wenxiu Sun
- School of Nursing, University of California Los Angeles, Los Angeles, CA, 90095, USA.,Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Lance Toma
- San Francisco Community Health Center, San Francisco, CA, USA
| | - Binh Vinh Luu
- Chinese-American Planning Council, Inc, New York, NY, USA
| | - Judy Ah-Yune
- Chinese-American Planning Council, Inc, New York, NY, USA
| |
Collapse
|
7
|
Experiences and needs of family support for HIV-infected Asian Americans: A qualitative dyadic analysis. Appl Nurs Res 2021; 58:151395. [PMID: 33745550 DOI: 10.1016/j.apnr.2021.151395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 09/21/2020] [Accepted: 12/31/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND When coping with HIV-related challenges, family support is the first line that Asian Americans living with HIV (AALHIV) lean on; however, few studies have explored the dyadic aspects of family support among AALHIV. We aimed to explore the dyadic aspects of family support among AALHIV and their family caregivers. METHODS From September 2017 to January 2020, we recruited 18 dyads among AALHIV and their caregivers in Los Angeles and New York City by the purposive sampling method. Using qualitative dyadic analysis of semi-structured, in-depth interviews, we explored dyadic aspects of family support among participants based on Fitch's Supportive Care Framework. RESULTS We found that AALHIV obtained support from family caregivers to cover the domains of their physical, psychological, spiritual, informational, social, and practical supportive care. This dyadic analysis indicated congruence in most supportive care; however, there were also dissimilar in the support perceptions. CONCLUSIONS Our findings exemplify the physical, psychological, spiritual, informational, social, and practical support from AALHIV and their family caregivers. When developing a culturally sensitive intervention for AALHIV, we need to consider the different aspects of the support. Especially, family support can enhance patients-providers' relationships as well as health engagement with HIV care.
Collapse
|
8
|
Raya NAJ, Nilmanat K. Experience and management of stigma among persons living with HIV in Bali, Indonesia: A descriptive study. Jpn J Nurs Sci 2020; 18:e12391. [PMID: 33164323 DOI: 10.1111/jjns.12391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 09/12/2020] [Accepted: 09/23/2020] [Indexed: 11/28/2022]
Abstract
AIM This study aimed to describe the level of HIV stigma experience and the HIV stigma management strategies used by persons living with HIV (PLWH) in Bali, Indonesia. METHODS A cross-sectional descriptive study was conducted from March to May 2019. In total, 215 respondents were recruited using purposive sampling from hospitals and HIV private clinic. The research tools consisted of the demographic characteristics form, the 28-Item Internalized HIV Stigma Scale, and the Stigma Management Strategies Checklist. This study used descriptive statistics and non-parametric statistics to analyze the data. RESULTS Overall, the transformed mean score of HIV stigma experience was at a low level (mean = 42.88, SD ± 17.59). There was no statistically significant difference between demographic characteristics and HIV stigma (p > .05). Of the 38 stigma management strategies, prayer (70.7%) was reported as the most common, whereas forgiving one's spouse (4.1%) was the least utilized strategy of the respondents. The most often reported reason to manage stigma was to alleviate and/or avoid stress (68.8%). In addition, the most effective stigma management strategy was prayer (28.8%). Conversely, the least effective was staying alone (21.9%). CONCLUSIONS HIV stigma is present in Bali, Indonesia, and PLWH struggle to accept their HIV status. Furthermore, they use prayer as a stigma management strategy to get closer to God. The findings of this study could serve as evidence to inform HIV stigma reduction programs in the community. In addition, the development of faith-based stigma management interventions is recommended.
Collapse
Affiliation(s)
- Nyoman Agus Jagat Raya
- Nursing Study Program, Faculty of Medicine, Udayana University, Denpasar, Indonesia.,Adult and Gerontological Nursing Department, Faculty of Nursing, Prince of Songkla University, Hat Yai, Thailand
| | - Kittikorn Nilmanat
- Adult and Gerontological Nursing Department, Faculty of Nursing, Prince of Songkla University, Hat Yai, Thailand
| |
Collapse
|
9
|
Martawinarti RTSN, Sari PI, Berhimpong VM. Life Experience of Human Immunodeficiency Virus (HIV) Sufferers: A Qualitative Systematic Review. JURNAL NERS 2020. [DOI: 10.20473/jn.v14i3.17069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introduction: HIV is a chronic disease that continues to increase from year to year, with many symptoms or obstacles encountered by HIV sufferers when going about their day. The experience of HIV sufferers is important to know in order to find out what they have experienced for as long as they have had the disease. The objective of this qualitative systematic review is to describe the experiences of people living with HIV.Methods: The method used was searching for journals using the pre-determined keywords of ‘experience’, ‘living with HIV’ and ‘coping’ through the databases of Scopus, ProQuest, PubMed and Sage between 2014 and 2019.Results: The study results showed that there was still discrimination against people with HIV. They also experienced health problems due to the effects of the therapy, unpreparedness in accepting their conditions and the prevention of transmission to their family members.Conclusion: Understanding the role of uncertainty, stigma and resilience is important, since these factors may very well contribute to the patient’s mental health.
Collapse
|