Social roles and health in women living with HIV/AIDS: A pilot study

The relationship between social roles and psychosocial adjustment in women with HIV: A structural equation model

BACKGROUND

The human immunodeficiency virus is a unique social phenomenon that affects almost all the aspects of the social and economic life of individuals. The present study was conducted for the path analysis of the relationship between social roles and psychosocial adjustment in women with AIDS.

METHODS

This cross-sectional study was conducted in 2019 on 240 women with HIV who referred to the Counseling Center for Behavioral Diseases of Imam Khomeini Hospital in Tehran. The eligible individuals entered the study through convenience sampling, and data were collected using five questionnaires, including the Psychosocial Adjustment to Illness Scale, the Perceived Social Support Scale, the Multidimensional Health Locus of Control Scales, the Illness Perception Questionnaire, the Experiences in Close Relationship Scale, and a socio-demographic checklist. Data were analyzed using SPSS 16 and Lisrel 8.8 software.

RESULTS

According to the results of the path analysis, internal health locus of control and patient's age have a significant positive relationship with psychosocial adjustment only through the direct path, and among them, patient's age has the greatest positive and direct relationship (B = 0.139). In the indirect path, education, external health locus of control, anxiety in experiences of close relationships, and perceived support have the greatest relationship with psychosocial adjustment, and among these variables, education has the highest positive relationship (B = 0.06). Illness perception, avoidance in experiences of close relationships, and chance locus of health control are associated with psychosocial adjustment through both direct and indirect paths, and among these variables, chance locus of health control has the greatest overall relationship with psychosocial adjustment (B = 0.238).

CONCLUSION

Based on the results, social roles and physical health are directly/indirectly associated with psychosocial adjustment, which emphasizes the need to pay more attention to all three aspects of psychosocial health, especially in this vulnerable group of the society.

The impacts of depression and anxiety on quality of life among patients with HIV/AIDS and their spouses: testing dyadic dynamics using the actor-partner interdependence model

HIV/AIDS not only affects the patients, but also their entire family. This study aimed to assess the impacts of the patients' and their spouses' anxiety and depression on their quality of life (QoL) at the dyadic level. A total of 120 serodiscordant husband-wife dyads from the voluntary counselling and testing center in Shiraz, Iran, were involved in this study from February to June 2015. The WHOQOL-BREEF, CESD-10, and Beck Anxiety Inventory instruments were used, respectively, to assess the QoL, depression, and anxiety scores of the participants. The actor-partner interdependence model (APIM) was used to estimate the effects of depression and anxiety of both the people living with HIV/AIDS (PLWHA) and their spouses on their own QoL (actor effect) as well as their partners' (partner effect). The APIM analysis revealed that both PLWHAs' and their spouses' depression and anxiety showed actor effects on their own QoL. Furthermore, spouses' depression showed a significant partner effect on PLWHAs' QoL and PLWHAs' anxiety had significant partner effects on spouses' QoL. Accordingly, this data can be used to develop targeted interventions aimed at guidance and assistance of PLWHAs and their spouses to find coping strategies that improve their own QoL as well as their partners'.

A preliminary validation of the Brief COPE instrument for assessing coping strategies among people living with HIV in China

BACKGROUND

The Brief COPE instrument has been utilized to conduct research on various populations, including people living with HIV (PLWH). However, the questionnaire constructs when applied to PLWH have not been subjected to thorough factor validation.

METHODS

A total of 258 PLWH were recruited from two provinces of China. They answered questions involving the scales of three instruments: the Brief COPE, the Perceived Social Support Scale, and the Perceived Discrimination Scale for PLWH. Confirmatory factor analysis (CFA) and exploratory factor analysis (EFA) were conducted.

RESULTS

The CFA found a poor goodness of fit to the data. The subsequent EFA identified six preliminary factors, forming subscales with Cronbach's alphas, which ranged from 0.61 to 0.80. Significant correlation coefficients between the subscales and measures of perceived social support and perceived discrimination were reported, giving preliminary support to the validity of the new empirical factor structure.

CONCLUSION

This study showed that the original factor structure of the Brief COPE instrument, when applied to PLWH in China, did not fit the data. Thus, the Brief COPE should be applied to various populations and cultures with caution. The new factor structure established by the EFA is only preliminary and requires further validation.

The role of social support among people living with HIV in rural Mozambique

A Positive Health, Dignity, and Prevention framework is being implemented in Mozambique to maintain the health of persons living with HIV (PLHIV) and prevent onward HIV transmission. An important intervention component is psycho-social support. However, coordinating support services has been challenging. Seventy in-depth individual interviews were conducted with PLHIV between January and June 2010 in three rural provinces to clarify the receipt and provision of support by PLHIV. Thematic coding and analysis were conducted to identify salient responses. PLHIV reported that the majority of social support received was instrumental, followed by emotional and informational support. Instrumental support included material, medical, and financial assistance. Emotional support was mentioned less frequently and was supplied most by family and friends. PLHIV also received informational support from a variety of sources, the most common being family members. Informational support from health providers was rarely mentioned, but this advice was valued and used to educate others. Although most participants described receiving social support from many sources, there were consistently identified needs. This study revealed that social support is central in the lives of PLHIV and identified areas where social support can be improved to better respond to the needs of PLHIV in the Mozambican context.

System and Patient Barriers to Care among People Living with HIV/AIDS in Houston/Harris County, Texas: HIV Medical Care Providers' Perspectives

In the United States, a considerable number of people diagnosed with HIV are not receiving HIV medical care due to some barriers. Using data from the Medical Monitoring Project survey of HIV medical care providers in Houston/Harris County, Texas, we assessed the HIV medical care providers' perspectives of the system and patient barriers to HIV care experienced by people living with HIV/AIDS (PLWHA). The study findings indicate that of the 14 HIV care barriers identified, only 1 system barrier and 7 patient barriers were considered of significant (P ≤ .05) importance, with the proportion of HIV medical care providers' agreement to these barriers ranging from 73.9% (cost of health care) to 100% (lack of social support systems and drug abuse problems). Providers' perception of important system and patient barriers varied significantly (P ≤ .05) by profession, race/ethnicity, and years of experience in HIV care. To improve access to and for consistent engagement in HIV care, effective intervention programs are needed to address the barriers identified especially in the context of the new health care delivery system.

Social Support Network among People Living with HIV/AIDS in Iran

This study considers social network interactions as a potential source of support for individuals living with HIV/AIDS in Iran. This cross-sectional study was conducted on 224 people with HIV/AIDS who refer to behavioral counseling centers. Participants were randomly selected among all people with HIV/AIDS from these centers. Relatives were more reported as sources of support than nonrelatives. They were closer to participants, but there was difference between the closest type among relative and nonrelative supporters (P = 0.01). Mean of functional support with considering the attainable range 0-384 was low (126.74  (SD = 76.97)). Social support of participants has been found to be associated with CD4 cell count (P = 0.000), sex (P = 0.049), and network size (P = 0.000) after adjusted for other variables in the final model. Totally, in this study, many of participants had the static social support network that contained large proportions of family and relatives. The findings contribute to the evidence for promotion of knowledge about social support network and social support of people living with HIV/AIDS.

Gender differences in quality of life outcomes of HIV/AIDS treatment in the latent feminization of HIV epidemics in Vietnam

Understanding gender-specific predictors of Health-related Quality of Life (HRQL) outcomes of HIV/AIDS treatment is necessary in the latent feminization of HIV epidemics in Vietnam. This study assessed HRQL and its predictors among men and women with HIV/AIDS. We conducted a cross-sectional study of 155 patients (36.8% women, mean age=31.4) registering for antiretroviral treatment (ART) at Vietnam-Sweden Uong Bi General Hospital, Quang Ninh Province. The Vietnamese version of the World Health Organization Quality of Life HIV brief version (WHOQOL-HIV BREF) was developed. Factor analysis was applied to assess the construct validity of the measurement. Six major domains of the Vietnamese WHOQOL-HIV BREF were determined, namely physical; performance; morbidity; environment; psychological; and social support. Internal consistency reliability of the six domains ranged from 0.52 to 0.71. Multivariate linear regression models, constructed using step-wise forward selection, determined different predictors of HRQL domain scores in men and women with HIV/AIDS. The results showed that men reported higher scores or better in Morbidity (p=0.02), Environment (p=0.07) and Psychological dimensions (p=0.02); meanwhile, women had higher scores in Performance (p=0.09). Alcohol and injection drug use negatively predicted HRQL outcomes in both men and women. Employment was associated with better performance in men, and better physical but poorer environment status in women. Female patients who have a child experienced decrements in social support, psychological, environment, and performance. Findings of this study highlight the need to develop comprehensive interventions for HIV/AIDS patients, including HIV/AIDS treatment support and gender-specific impact mitigation interventions strategies.

Self-help groups can improve utilization of postnatal care by HIV-infected mothers

HIV prevention within maternal-child health services has increased in many developing countries, but many HIV-infected women in developing countries still receive insufficient postnatal care. This study explored the experience of 30 HIV-infected women in Vietnam in accessing HIV-related postnatal care, the role of felt and enacted stigma in accessing services, and the effects of participation in a self-help group on utilization of available services. Many HIV-infected women were not provided with adequate information on postnatal care by health workers. Most women reported both felt and enacted stigma that affected their access to care. Involvement in self-help groups improved the women's self-esteem, increased knowledge about HIV, and had a positive effect on both felt and enacted stigma from family, community, and health services. These results suggest the need for better information provision and better referral systems within the health services and suggest that establishing self-help groups can diminish felt stigma and facilitate access to services for women and their children.

Social support and medication adherence in HIV disease in KwaZulu-Natal, South Africa

BACKGROUND

A supportive social environment is critical for those with HIV/AIDS. In KwaZulu-Natal, in South Africa, antiretroviral therapy is available to some HIV-positive individuals. Antiretroviral adherence is an important issue for limiting HIV infection. Adherence to therapy may be linked to social support, particularly amidst the stigma prevalent in HIV.

OBJECTIVE

The purpose of this study was to examine characteristics related to social support and antiretroviral medication adherence.

DESIGN

This cross-sectional, descriptive study explored the nature of the relationships among social support and other selected variables, including sociodemographic variables, quality of life, and adherence.

SETTINGS

After ethical review board approval, the sample of HIV-infected individuals who received care in outpatient clinics were recruited and completed the self-report instruments.

PARTICIPANTS

The sample included English and/or isiZulu-speaking (n=149) individuals over the age of 18 years receiving treatment for HIV/AIDS. A total of 149 patients with a diagnosis of HIV/AIDS agreed to participate and completed questionnaires after completing informed consent procedures. The study participants were recruited at four outpatient settings in Durban, KwaZulu-Natal province of South Africa.

METHODS

A descriptive, exploratory, cross-sectional design was utilized to explore the research questions: What are the characteristics of social support and the relationship to antiretroviral adherence in KwaZulu-Natal, South Africa? Descriptive statistics and regression analyses were used to answer the research questions.

RESULTS

Data analyses indicated that social support scores on the Medical Outcomes Study Social Support Survey were moderate (M=64.4; S.D.=14.7) among the study participants. The number of close friends and family were significantly correlated with a greater sense of social support. Despite this, the lowest scores on the quality-of-life measure using the Medical Outcomes Study Short Form 36 item survey were reported on the Social Functioning Scale.

CONCLUSIONS

In summary, the study findings suggest that a supportive social network is essential for those living with HIV/AIDS. However, social functioning and quality of life amidst the stigma of living with HIV in South Africa may be a concern and require further investigation.

Improving women's adjustment to HIV infection: results of the Positive Life Skills Workshop Project

Women face many challenges as they adjust to life with HIV infection. This report describes the results of a program designed to assist HIV-infected women to reframe negative meanings associated with HIV infection and adjust to HIV infection. The idea for the Positive Life Skills (PLS) workshop emerged from the results of a study of adjustment to chronic illness among HIV-infected women, guided by the cognitive appraisal model of stress and coping. Small-group sessions (6-15 women) met weekly for 10 consecutive weeks to identify and dialogue about personal and group learning needs. Women explored the power of art, science, and alternative therapies as venues for reframing the meaning of HIV in their lives. The workshop participants included 187 HIV-infected women (mean age, 39 years; range, 23-62 years). Responses from the workshop participants over a 6-year time frame suggested that the PLS workshop was effective at increasing antiretroviral adherence, improving mental well-being, and reducing stress.