Abuse and mental health concerns among HIV-infected Haitian women living in the United States

Effect of Stress Management Training on Stigma and Social Phobia in HIV-Positive Women

The purpose of this study was to investigate the effect of stress management training on stigma and social phobia among HIV-positive women. This quasi-experimental pre- and posttest study was performed on a single group of 55 HIV-positive females Hamadan city, Iran, in 2018. The samples were taken through a convenience sampling method and the data collection tool were Berger HIV Stigma and Connor Social Phobia Scale. The mean scores of the stigma were 119.98 ± 21.15 and 94.78 ± 16.34 and social phobia were 24 ± 17.4 and 11.2 ± 9.68 before and after the intervention, respectively. The results of the paired sample t test indicated a significant difference in the stigma and social phobia mean scores before and after the intervention in HIV-positive women (P < .05). The results of the study revealed that stigma and social phobia are big challenges for HIV-positive women since these people are always judged by others and are subjected to labeling and rejection.

Psychological Violence and Sexual Risk Behavior Among Predominantly African American Women

Physical and sexual violence are commonly researched as risk factors for human immunodeficiency virus (HIV). However, psychological violence and its relationship with HIV risk behaviors have received limited attention among African American/Black (Black) women. This study examined (a) the frequency of recent (past 3 months) psychological violence, physical violence, and sexual violence and (b) the association of HIV risk behaviors, including unprotected sex, sex under the influence of alcohol/drugs, and sex exchange for money/drugs/shelter, with psychological violence. Participants included 191 women (89.2% Black), who were recruited through information sessions held at community centers, Parent Teacher Association meetings, substance use and HIV counseling centers, radio public service announcements, and word of mouth. Interested women participated in a multisession HIV and substance use prevention program and completed a self-reported assessment at program baseline. The current study utilized baseline data collected for a longitudinal study. Results from descriptive analysis indicated that the rate of psychological violence was higher than physical violence or sexual violence, and it was strongly associated with physical and sexual violence. Furthermore, hierarchical logistic regression analysis showed that unprotected sex was significantly associated with recent psychological violence after controlling for covariates. Findings suggest that recent psychological violence is more common than physical or sexual violence and it relates to sexual risk behaviors among Black women. Recent psychological violence may indicate psychosocial and sexual vulnerability for HIV and warrants particular attention among Black women.

Global estimate of the prevalence of post-traumatic stress disorder among adults living with HIV: a systematic review and meta-analysis

OBJECTIVES

Although people living with HIV (PLWH) have been disproportionately affected by post-traumatic stress disorder (PTSD), the global prevalence of PTSD among PLWH is unknown. This study aimed to systematically review the prevalence of PTSD among PLWH worldwide and explore variation in prevalence across sociodemographic and methodological factors.

DESIGN

A meta-analysis using a random-effects model was conducted to pool the prevalence estimated from individual studies, and subgroup analyses were used to analyse heterogeneities.

SETTING, PARTICIPANTS AND MEASURES

Observational studies providing PTSD prevalence data in an adult HIV population were searched from January 2000 to November 2019. Measurements were not restricted, although the definition of PTSD had to align with the Diagnostic and Statistical Manual of Mental Disorders or the International Classification of Diseases diagnostic criteria.

RESULTS

A total of 38 articles were included among 2406 records identified initially. The estimated global prevalence of PTSD in PLWH was 28% (95% CI 24% to 33%). Significant heterogeneity was detected in the proportion of PLWH who reported PTSD across studies, which was partially explained by geographic area, population group, measurement and sampling method (p<0.05).

CONCLUSION

PTSD among PLWH is common worldwide. This review highlights that PTSD should be routinely screened for and that more effective prevention strategies and treatment packages targeting PTSD are needed in PLWH.

Association between intimate partner violence and HIV status among Haitian Women

The prevalence of intimate partner violence (IPV) among women living in Haiti increased from 25% in 2006-29% in 2012, with escalating reports of crisis in the last several years. We examined the association between IPV and HIV status among these women in Haiti. Participants were drawn from a larger sample of women (n = 513) with a history of IPV. Women living with HIV (n = 55) were matched to uninfected women (n = 110) to form a control group. Attitudes towards gender roles, mental and physical well-being, and partner violence were assessed and compared. Logistic regressions were utilised to calculate multivariable-adjusted odds ratios. Women living with HIV were more likely to report more severe forms of psychological violence (p < 0.01), and severe physical violence (p < 0.0001). Women who experienced severe forms of IPV were 3.5 times more likely to have an HIV positive status compared to those who did not experience severe IPV (p < 0.0001). There were significant associations between severe forms of IPV, and HIV status among Haitian women. IPV severity should be integrated into eligibility screening for biomedical strategies of prevention such as pre-exposure prophylaxis (PrEP) among Haitian women.

Experiences, Emotions, and Adjustments of HIV-Infected Men in HIV-Concordant Marital Relationship in Cambodia

Although it has been well documented that the HIV infection experience can be problematic for those affected, the experiences and perceptions of living with HIV among married males in Cambodia have not yet been examined until now. This study's purpose was to describe the revelations, emotions, reactions, and adjustments to HIV diagnosis among infected Cambodian males in seroconcordant heterosexual relationship. Fifteen qualitative in-depth interviews were conducted with 15 HIV-positive males using unstructured, open-ended questions and in the local Khmer language. Conventional content analysis method was employed for analyzing data. After analysis, four main categories were developed: knowledge of HIV-positive status; realization of self-deeds; discouraging news for both partners; and comparative improvement of life. Participants reported the appearance of physical symptoms as the only reason for pursuing HIV testing. Feelings ranged from sadness and guilt to acceptance of HIV infection in their lives. The participants' wives expressed anger and worry about being infected by their husbands. However, sufficient inspiration from medical personnel and peer groups, as well as a shared concern for their children, helped couples adjust to their dyadic relationship. The study results highlight the link between individual and couple experiences and emotions post-infection, with implications for designing and implementing coping interventions for this population. The findings of this study have public health implications in the design of couple-based intervention and counseling programs for HIV prevention and treatment with the input of the HIV-positive individuals' voices.

Anxiety symptoms and disorders among adults living with HIV and AIDS: A critical review and integrative synthesis of the empirical literature

There are over 35 million people worldwide infected with the Human Immunodeficiency Virus (HIV) and its progression to Acquired Immunodeficiency Syndrome (AIDS; WHO, 2014). With the advent of combined antiretroviral therapy (i.e., cART) in 1996, persons living with HIV/AIDS (PLWHA) now have much longer life expectancies. However, living with HIV remains challenging, as it is associated with a number of significant and recurrent (chronic) stressors including physical pain, side effects of cART, social stigma, and discrimination, among other social stressors. Presumably, as a result of these types of stressors, a disproportionately high number of PLWHA struggle with clinically-significant psychiatric symptoms and disorders. Although much scientific and clinical attention has focused on depressed mood and psychopathology among PLWHA, there has been comparably less focus on anxiety and its disorders. The paucity of work in this area is concerning from a public health perspective, as anxiety symptoms and disorders are the most common class of psychiatric disorders and often maintain a large negative impact on life functioning.

Sexual Behavior and Risk Practices of HIV Positive and HIV Negative Rwandan Women

It is not well understood how infection with HIV and prior experience of sexual violence affects sexual behavior in African women. We describe factors influencing current sexual practices of Rwandan women living with or without HIV/AIDS. By design, 75 % of participants were HIV positive and ~50 % reported having experienced genocidal rape. Univariate and multivariate logistic regression models were fit to describe demographic and clinical characteristics that influenced sexual behavior in the previous 6 months, condom use, history of transactional sex, and prior infection with a non-HIV sexually transmitted disease. Respondents' age, where they lived, whether or not they lived with a husband or partner, experience of sexual trauma, CD4 count, CES-D and PTSD scores were strongly associated with risky sexual behavior and infection with non-HIV STI. HIV positive women with a history of sexual violence in the contexts of war and conflict may be susceptible to some high-risk sexual behaviors.