The nomological network of cognitive fusion among people living with HIV: Associations with rumination, shame, and depressive symptoms

Rumination influences the relationship between trauma and depression over time among youth living with HIV

BACKGROUND

Traumatizing events often result in long-term mental health symptoms. Identifying the features of the post-trauma experiences that can impact mental health symptoms is key to designing effective interventions.

METHODS

Youth living with HIV (YLH),1 predominantly sexual and gender minorities (SGM;2 84 % gay, bisexual, transgender, queer, pansexual identities), 78 % Black and Latino, (N = 170) were recruited in New Orleans, LA and Los Angeles, CA from 13 youth-serving agencies. They were assessed for trauma, rumination and depression, with 78 % reassessed for depression at 4 and 74 % at 8 months later. Relationships between these variables were examined using a Bayesian approach to structural equation modeling.

RESULTS

At recruitment, 78 % of YLH reported at least one traumatic event, and 21 % met the cut-off score indicating depression on the PHQ-9. Ruminations were reported by 41 % of YLH. While associations between trauma and depression were modest (rmean = 0.19), ruminations were moderately associated with depressive symptoms over time (rmean = 0.34). Ruminations were only modestly associated with trauma (rmean = 0.19) but had a robust negative association (λSTD = -0.29) with the slope of depressive symptoms such that the more ruminations YLH experienced, the smaller the decline in depression over time. The associations between trauma and depression were more modest (λSTD ≤ 0.12). Limitations The main limitations of this study are the lack of a scale to measure trauma and the use of a single item measure of rumination.

CONCLUSION

Ruminations appear to be associated with traumatic events for a large subset of young people, suggesting that future interventions should consider including components addressing ruminations.

CLINICALTRIALS

gov registration NCT03109431.

Healthcare needs of people living with human immunodeficiency virus: A qualitative descriptive study

AIM

A better understanding about the health care and support needs is beneficial to maintain the linkage between People Living with Human Immunodeficiency Virus (PLWH) and healthcare services. This study aims to explore the healthcare needs of PLWH from their perspectives.

DESIGN

A qualitative descriptive study design was undertaken in July 2017 to June 2018.

METHODS

Fourteen participants were recruited by purposive sampling technique. Face-to-face in-depth interview and focus-group discussion (FGD) were conducted and analysed using content analysis.

RESULTS

Data revealed five themes, namely the needs to be free from stigma and discrimination, strengthen life spirit, have safe sexual practices, social support, and have accessible and affordable healthcare services.

CONCLUSION

People Living with Human Immunodeficiency Virus have their own perspectives on their healthcare needs. Therefore, nurses and other healthcare providers need to explore, understand, and respond to the needs, and incorporate them into comprehensive and holistic care.