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Greenwald MK, Akcasu N, Baal P, Outlaw AY, Cohn JA, Lundahl LH. Cannabis and complementary/alternative self-treatment approaches for symptom management among African American persons living with HIV. AIDS Care 2023; 35:78-82. [PMID: 34743619 PMCID: PMC9076753 DOI: 10.1080/09540121.2021.1998311] [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] [Received: 11/10/2020] [Accepted: 10/21/2021] [Indexed: 10/19/2022]
Abstract
Persons living with HIV (PLWH) experience symptoms from disease progression and side effects of antiretroviral treatment. This study examines in African American PLWH (N = 259) commonly-endorsed symptoms, types and self-rated efficacy of therapies for symptom alleviation. Analyses were stratified by gender (n = 178 males, n = 81 females) and cannabis use typology: non-users (n = 90), mostly recreational use (n = 46), mixed recreational/therapeutic use (n = 51), or mostly therapeutic use (n = 72). Females reported greater severity for pain, fatigue, depression, weight change and tingling in extremities, but there were no gender differences for ratings of poor sleep, anxiety, poor appetite, or headache. Both marijuana (used therapeutically by females more than males) and medication(s) were among the 3 top methods for managing pain, poor sleep, anxiety, and headache. Marijuana was most often used for poor appetite, and medications for depression. Perceived efficacy of self-treatment approaches was moderately good. Among African American PLWH, symptom severity was higher for females and for therapeutic users of cannabis. Marijuana and medicine were often used to self-treat symptoms, but many participants did nothing. These results highlight the need for careful evaluation and management of symptoms in this underserved population.
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Affiliation(s)
- Mark K. Greenwald
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI
| | - Nora Akcasu
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI
| | - Paige Baal
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI
| | - Angulique Y. Outlaw
- Department of Family Medicine and Public Health Sciences, Wayne State University School of Medicine, Detroit, MI
| | - Jonathan A. Cohn
- Department of Internal Medicine, Wayne State University School of Medicine, Detroit, MI
| | - Leslie H. Lundahl
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI
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2
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Kang CR, Yang SJ. Risk factors for depressive symptoms by age group among human immunodeficiency virus-infected adults in Korea. AIDS Care 2022; 34:1522-1529. [PMID: 34612099 DOI: 10.1080/09540121.2021.1981225] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
We identified factors associated with depressive symptoms according to age group. We used data from a city-wide, cross-sectional survey conducted by the Seoul Metropolitan Government in 2014. Multivariable logistic regression analyses were performed to explore factors related to depressive symptoms. Depressive symptoms were assessed using a single item from the Korea National Health and Nutrition Examination Survey. Of the 370 subjects, 37.3% had depressive symptoms during the past 12 months. Compared to an age of ≥50 years, being 20-39 (adjusted odds ratio, 2.45; 95% confidence interval, 1.26-4.75) or 40-49 years (2.58; 1.32-5.06) of age was positively associated with depressive symptoms. In addition, a history of acquired immune deficiency syndrome-defining opportunistic disease (3.29; 1.09-9.92) and perceived discrimination (1.93; 1.16-3.20) in subjects aged 20-39 years, and poor subjective health (4.97; 1.42-17.32) in subjects aged 40-49 years, were associated with depressive symptoms, but no factor exhibited a significant association in subjects aged ≥ 50 years. In conclusion, a screening program that considers the factors identified in this study to prioritize patients with depression should be implemented.
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Affiliation(s)
- Cho Ryok Kang
- Division of Nursing Science, Ewha Womans University, Seoul, Korea.,Infectious Disease Control Division, Seoul Metropolitan Government, Seoul, Korea
| | - Sook Ja Yang
- Division of Nursing Science, Ewha Womans University, Seoul, Korea
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3
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Davis VH, Nixon SA, Murphy K, Cameron C, Bond VA, Hanass-Hancock J, Kimura L, Maimbolwa MC, Menon JA, Nekolaichuk E, Solomon P. How the Term 'Self-Management' is Used in HIV Research in Low- and Middle-Income Countries: A Scoping Review. AIDS Behav 2022; 26:3386-3399. [PMID: 35429310 DOI: 10.1007/s10461-022-03668-8] [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] [Accepted: 03/18/2022] [Indexed: 11/25/2022]
Abstract
This scoping review assessed how the term 'self-management' (SM) is used in peer-reviewed literature describing HIV populations in low- and middle-income countries (LMIC). This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. OVID Medline, Embase, CAB Abstracts, and EBSCO CINAHL, Scopus, and Cochrane Library were searched up to September 2021 for articles with SM in titles, key words, or abstracts. Two team members independently screened the titles and abstracts, followed by the full-text. A data extraction tool assisted with collecting findings. A total of 103 articles were included. Since 2015, there has been a 74% increase in articles that use SM in relation to HIV in LMIC. Fifty-three articles used the term in the context of chronic disease management and described it as a complex process involving active participation from patients alongside providers. Many of the remaining 50 articles used SM as a strategy for handling one's care by oneself, with or without the help of community or family members. This demonstrates the varied conceptualizations and uses of the term in LMIC, with implications for the management of HIV in these settings. Future research should examine the applicability of SM frameworks developed in high-income settings for LMIC.
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Affiliation(s)
- Victoria H Davis
- Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, 4th Floor, M5T 3M6, Toronto, Ontario, Canada.
| | - Stephanie A Nixon
- Department of Physical Therapy, University of Toronto, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Kathleen Murphy
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Cathy Cameron
- International Centre for Disability and Rehabilitation, Toronto, Canada
| | - Virginia A Bond
- Global and Health Development Department, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
- Zambart, School of Medicine, University of Zambia, Lusaka, Zambia
| | - Jill Hanass-Hancock
- School of Health Science, University of KwaZulu-Natal, Durban, South Africa
- Gender and Health Research Unit, South African Medical Research Council (SAMRC), Durban, South Africa
| | - Lauren Kimura
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | | | - J Anitha Menon
- Department of Psychology, University of Zambia, Lusaka, Zambia
| | - Erica Nekolaichuk
- Gerstein Science Information Centre, University of Toronto, Toronto, Canada
| | - Patricia Solomon
- School of Rehabilitation Science, McMaster University, Hamilton, Canada
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4
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Involvement of NLRP3 inflammasome in schizophrenia-like behaviour in young animals after maternal immune activation. Acta Neuropsychiatr 2020; 32:321-327. [PMID: 32660670 DOI: 10.1017/neu.2020.27] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To evaluate the involvement of nod-like receptor pyrin domain-containing protein 3 (NLRP3) inflammasome in schizophrenia-like behaviour in young animals exposed to maternal immune activation (MIA). METHODS To this aim, on the 15th gestational day, the females received an injection of lipopolysaccharides. When the animals completed 7, 14 and 45 postnatal days, they were killed and the whole brain was dissected for biochemical analysis. Animals with 45 postnatal days were submitted to behavioural tests of locomotor activity, social interaction and stereotyped movements. RESULTS It was observed that the animals presented schizophrenia-like behaviour at 45 postnatal days associated with the increase of NLRP3 inflammasome expression and IL-1β levels on 7, 14 and 45 postnatal days. CONCLUSION This study shows that MIA may be associated with a schizophrenia-like behaviour. This behaviour can be induced to a neuroinflammatory profile in the brain. These evidences may base future studies on the relationship between neuroinflammation and psychiatric disorders.
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Lin CJ, Cheng YI, Garvie PA, D’Angelo LJ, Wang J, Lyon ME. The Effect of FAmily-CEntered (FACE ®) Pediatric Advanced Care Planning Intervention on Family Anxiety: A Randomized Controlled Clinical Trial for Adolescents With HIV and Their Families. JOURNAL OF FAMILY NURSING 2020; 26:315-326. [PMID: 33283612 PMCID: PMC8015181 DOI: 10.1177/1074840720964093] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Clinicians fear pediatric advance care planning (pACP) for adolescents is too distressing for families. Multisite longitudinal randomized controlled trial of adolescents with HIV tested the effect of FAmily-CEntered (FACE®) pACP intervention on families' anxiety and depression. One hundred five adolescent/family dyads were randomized to FACE® (n = 54 dyads) or control (n = 51 dyads). Families were 90% African American, 37% HIV-positive, and 22% less than high school educated. Families reported lower anxiety 3 months post-FACE® intervention than control (β = -4.71, 95% confidence interval [CI] = [-8.20, -1.23], p = .008). Male family members were less anxious than female family members (β = -4.55, 95% CI = [-6.96, -2.138], p ≤ .001). Family members living with HIV reported greater depressive symptoms than HIV-uninfected families (β = 3.32, 95% CI = [0.254, 6.38], p = .034). Clinicians can be assured this structured, facilitated FACE® pACP model minimized family anxiety without increasing depressive symptoms. Adolescent/family dyads should be invited to have access to, and provision of, evidence-based pACP as part of patient-centered/family-supported care in the HIV continuum of care.
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Affiliation(s)
| | - Yao I. Cheng
- Children’s National Hospital & Center for Translational Research, Washington, DC, USA
| | | | | | - Jichuan Wang
- Children’s National Hospital, Washington, DC, USA
- George Washington University School of Medicine and Health Sciences, DC, USA
| | - Maureen E. Lyon
- Children’s National Hospital & Center for Translational Research, Washington, DC, USA
- George Washington University School of Medicine and Health Sciences, DC, USA
- Children’s National Research Institute, Washington, DC, USA
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6
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Stonbraker S, Porras T, Schnall R. Patient preferences for visualization of longitudinal patient-reported outcomes data. J Am Med Inform Assoc 2020; 27:212-224. [PMID: 31670816 PMCID: PMC7025335 DOI: 10.1093/jamia/ocz189] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 08/20/2019] [Accepted: 10/01/2019] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE The study sought to design symptom reports of longitudinal patient-reported outcomes data that are understandable and meaningful to end users. MATERIALS AND METHODS We completed a 2-phase iterative design and evaluation process. In phase I, we developed symptom reports and refined them according to expert input. End users then completed a survey containing demographics, a measure of health literacy, and items to assess visualization preferences and comprehension of reports. We then collected participants' perspectives on reports through semistructured interviews and modified them accordingly. In phase II, refined reports were evaluated in a survey that included demographics, validated measures of health and graph literacy, and items to assess preferences and comprehension of reports. Surveys were administered using a think-aloud protocol. RESULTS Fifty-five English- and Spanish-speaking end users, 89.1% of whom had limited health literacy, participated. In phase I, experts recommended improvements and 20 end users evaluated reports. From the feedback received, we added emojis, changed date and font formats, and simplified the y-axis scale of reports. In phase II, 35 end users evaluated refined designs, of whom 94.3% preferred reports with emojis, the favorite being a bar graph combined with emojis, which also promoted comprehension. In both phases, participants literally interpreted reports and provided suggestions for future visualizations. CONCLUSIONS A bar graph combined with emojis was participants' preferred format and the one that promoted comprehension. Target end users must be included in visualization design to identify literal interpretations of images and ensure final products are meaningful.
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Affiliation(s)
| | - Tiffany Porras
- Columbia University School of Nursing, New York, New York, USA
| | - Rebecca Schnall
- Columbia University School of Nursing, New York, New York, USA
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Alhadab AA, Rhein J, Tugume L, Musubire A, Williams DA, Abassi M, Nicol MR, Meya DB, Boulware DR, Brundage RC. Pharmacokinetics-pharmacodynamics of sertraline as an antifungal in HIV-infected Ugandans with cryptococcal meningitis. J Pharmacokinet Pharmacodyn 2019; 46:565-576. [PMID: 31584146 PMCID: PMC7004416 DOI: 10.1007/s10928-019-09657-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 09/25/2019] [Indexed: 01/16/2023]
Abstract
The ASTRO-CM dose-finding pilot study investigated the role of adjunctive sertraline for the treatment of HIV-associated cryptococcal meningitis in HIV-infected Ugandan patients. The present study is a post hoc pharmacokinetic-pharmacodynamic analysis of the ASTRO-CM pilot study to provide insight into sertraline exposure-response-outcome relationships. We performed a population pharmacokinetic analysis using sertraline plasma concentration data and correlated various predicted PK-PD indices with the percentage change in log10 CFU/mL from baseline. Sertraline clearance was 1.95-fold higher in patients receiving antiretroviral (ART), resulting in 49% lower drug exposure. To quantify the clinical benefit of sertraline, we estimated rates of fungal clearance from cerebrospinal fluid (CSF) of ASTRO-CM patients using Poisson model and compared the clearance rates to a historical control study (COAT) in which patients received standard Cryptococcus therapy of amphotericin B (0.7-1.0 mg/kg per day) and fluconazole (800 mg/day) without sertraline. Adjunctive sertraline significantly increased CSF fungal clearance rate compared to COAT trial and sertraline effect was dose-independent with no covariate found to affect fungal clearance including ART. Study findings suggest sertraline response could be mediated by different mechanisms than directly inhibiting the initiation of protein translation as previously suggested; this is supported by the prediction of unbound sertraline concentrations is unlikely to reach MIC concentrations in the brain. Study findings also recommend against the use of higher doses of sertraline, especially those greater than the maximum FDA-approved daily dose (200 mg/day), since they unlikely provide any additional benefits and come with greater costs and risk of adverse events.
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Affiliation(s)
- Ali A Alhadab
- Oncology Clinical Pharmacology, Pfizer Inc., 10555 Science Center Dr #2423C, La Jolla, San Diego, CA, 92121, USA.
| | - Joshua Rhein
- Infectious Diseases Institute, Makerere University, Kampala, Uganda
- Department of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Lillian Tugume
- Infectious Diseases Institute, Makerere University, Kampala, Uganda
| | - Abdu Musubire
- Infectious Diseases Institute, Makerere University, Kampala, Uganda
- Department of Medicine, Makerere University, Kampala, Uganda
| | - Darlisha A Williams
- Infectious Diseases Institute, Makerere University, Kampala, Uganda
- Department of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Mahsa Abassi
- Infectious Diseases Institute, Makerere University, Kampala, Uganda
- Department of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Melanie R Nicol
- Department of Experimental and Clinical Pharmacology, University of Minnesota, Minneapolis, MN, USA
| | - David B Meya
- Infectious Diseases Institute, Makerere University, Kampala, Uganda
- Department of Medicine, University of Minnesota, Minneapolis, MN, USA
- Department of Medicine, Makerere University, Kampala, Uganda
| | - David R Boulware
- Department of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Richard C Brundage
- Department of Experimental and Clinical Pharmacology, University of Minnesota, Minneapolis, MN, USA
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Courlet P, Guidi M, Glatard A, Alves Saldanha S, Cavassini M, Buclin T, Marzolini C, Eap CB, Decosterd LA, Csajka C. Escitalopram population pharmacokinetics in people living with human immunodeficiency virus and in the psychiatric population: Drug-drug interactions and probability of target attainment. Br J Clin Pharmacol 2019; 85:2022-2032. [PMID: 31144347 DOI: 10.1111/bcp.13994] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 05/15/2019] [Accepted: 05/19/2019] [Indexed: 02/03/2023] Open
Abstract
AIMS The aims of this study were to characterize escitalopram pharmacokinetic profile, to identify factors influencing drug exposure, notably drug-drug interactions with antiretrovirals, and to simulate expected exposure under standard dosage regimen. METHODS A population pharmacokinetic analysis was performed using NONMEM. A total of 159 plasma concentration measurements were obtained from 39 human immunodeficiency virus (HIV)-infected and 71 uninfected psychiatric patients. The influence of age, weight, sex, HIV and psychiatric cohorts, racemic citalopram treatment, and comedications on oral clearance was examined. Simulations served to calculate the percentage of patients expected to be under- or over-exposed, considering established therapeutic targets (15-80 ng/mL). RESULTS A 1-compartment model with first-order absorption and elimination described the data adequately. The average escitalopram clearance and volume of distribution were 23.1 L/h (interindividual variability 51%), and 920 L, respectively. Escitalopram disposition did not differ between HIV-infected and uninfected patients, and was not affected by antiretroviral treatments. Coadministration of at least 1 proton-pump inhibitor (CYP2C19 inhibitor) modestly influenced escitalopram elimination (clearance decreased by 19%), with limited clinical relevance. Model-based simulations showed that, under a standard regimen of 10 mg once daily, a significant proportion of patients (56%) might be under-exposed. CONCLUSION The variability in escitalopram disposition is large and poorly explained by demographic, clinical and environmental covariates, thus suggesting a role for dosage individualization based on therapeutic drug monitoring in case of poor clinical response. Escitalopram disposition is modestly impacted by comedications and therefore no a priori dosage adjustments are needed in patients receiving antiretroviral treatments, including boosted regimens.
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Affiliation(s)
- Perrine Courlet
- Service of Clinical Pharmacology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Monia Guidi
- Service of Clinical Pharmacology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.,School of Pharmaceutical Sciences, University of Geneva, University of Lausanne, Geneva, Switzerland
| | - Anaïs Glatard
- Service of Clinical Pharmacology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.,Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Hospital of Cery, Lausanne University Hospital and University of Lausanne, Prilly, Switzerland
| | - Susana Alves Saldanha
- Service of Clinical Pharmacology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Matthias Cavassini
- Service of Infectious Diseases, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Thierry Buclin
- Service of Clinical Pharmacology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Catia Marzolini
- Departments of Medicine and Clinical Research, University Hospital of Basel and University of Basel, Switzerland
| | - Chin B Eap
- School of Pharmaceutical Sciences, University of Geneva, University of Lausanne, Geneva, Switzerland.,Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Hospital of Cery, Lausanne University Hospital and University of Lausanne, Prilly, Switzerland
| | - Laurent A Decosterd
- Service of Clinical Pharmacology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Chantal Csajka
- Service of Clinical Pharmacology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.,School of Pharmaceutical Sciences, University of Geneva, University of Lausanne, Geneva, Switzerland
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9
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Fuller SM, Koester KA, Erguera XA, Wilde Botta E, von Beetzen F, Steward WT, Avery A. The collaborative care model for HIV and depression: Patient perspectives and experiences from a safety-net clinic in the United States. SAGE Open Med 2019; 7:2050312119842249. [PMID: 31044076 PMCID: PMC6446432 DOI: 10.1177/2050312119842249] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 03/14/2019] [Indexed: 12/22/2022] Open
Abstract
Objectives: Collaborative care models may improve outcomes for both HIV and depression. The model includes routine screening and re-assessment of depressive symptoms as well as care coordination services delivered by an ancillary provider focused on mental health. We sought to explore patient experiences and attitudes about the services received through the collaborative care model, including measurement-based care using the Patient Health Questionnaire-9. Methods: We conducted 17 qualitative interviews with patients in a collaborative care model implemented at an HIV primary care clinic in a safety-net hospital in the United States. Interviews were analyzed using Framework Analysis. Results: Our findings illustrate the ways in which the collaborative care model for depression may be meaningful to patients in HIV care settings. Participants appreciated the support offered through the collaborative care model. Most participants perceived measurement-based care as useful to their providers, and an additional subset used the Patient Health Questionnaire-9 for their own self-management and awareness of depression. Over time, the collaborative care model appeared to motivate some patients to address depressive symptoms. Conclusion: The collaborative care model may be particularly helpful to patients in the way that it reinforces how depressive symptoms can be measured and managed. Furthermore, routine screening and re-measurement for depressive symptoms using the Patient Health Questionnaire-9 hold promise as an additional self-management tool to complement other clinical and supportive services.
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Affiliation(s)
- Shannon M Fuller
- Division of Prevention Sciences, Center for AIDS Prevention Studies, The University of California, San Francisco, San Francisco, CA, USA
| | - Kimberly A Koester
- Division of Prevention Sciences, Center for AIDS Prevention Studies, The University of California, San Francisco, San Francisco, CA, USA
| | - Xavier A Erguera
- Division of Prevention Sciences, Center for AIDS Prevention Studies, The University of California, San Francisco, San Francisco, CA, USA
| | - Emma Wilde Botta
- Division of Prevention Sciences, Center for AIDS Prevention Studies, The University of California, San Francisco, San Francisco, CA, USA
| | - Fredrik von Beetzen
- Division of Prevention Sciences, Center for AIDS Prevention Studies, The University of California, San Francisco, San Francisco, CA, USA
| | - Wayne T Steward
- Division of Prevention Sciences, Center for AIDS Prevention Studies, The University of California, San Francisco, San Francisco, CA, USA
| | - Ann Avery
- MetroHealth Medical Center, Cleveland, OH, USA.,Case Western Reserve University, School of Medicine, Cleveland, OH, USA
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10
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Mannes ZL, Bryant VE, Burrell LE, Lu H, Ferguson EG, Zhou Z, Cook RL, Ennis N. The prevalence and patterns of substance use by birth cohort among HIV-positive adults in Florida. Aging Ment Health 2019; 23:515-523. [PMID: 29436844 PMCID: PMC6286223 DOI: 10.1080/13607863.2018.1430740] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVES Antiretroviral therapy is affording longer lifespans for people living with HIV (PLWH), yet factors such as substance use play an increasing role in morbidity and mortality in this population. Though previous studies have examined substance use differences between age cohorts of PLWH, no study has examined the influence of birth cohort on current substance use patterns. Thus, this study investigated the prevalence of past 12-month self-reported substance use between four birth cohorts, <1970 (M age = 54.1), 1970s (M age = 41.5), 1980s (M age = 31.3 years old), and 1990s (M age = 23.2 years old) of PLWH in Florida. METHODS PLWH (N = 934) recruited from community health clinics in Florida completed a questionnaire assessing sociodemographics, health status, and substance use. Multivariate logistic regressions utilizing the <1970 cohort as the referent group examined the relationship between birth cohort and substance use. RESULTS The 1980s cohort had significantly greater odds of marijuana use compared to the oldest cohort (<1970s), while the three younger cohorts (1970s, 1980s, and 1990s) evidenced a significantly greater odds of ecstasy use compared to the oldest group. Contrastingly, the three younger birth cohorts reported significantly less crack use than the oldest cohort, while the youngest group (1990s) also demonstrated an 80% reduction in injection drug use compared to the oldest group. CONCLUSION The older cohort evidenced significantly greater crack and injection drug use, while the younger cohorts evidenced greater marijuana and ecstasy use. Therefore, it is important to develop age-specific substance use interventions among PLWH.
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Affiliation(s)
- Zachary L. Mannes
- Corresponding Author: Zachary L. Mannes, NIDA Predoctoral Fellow, Department of Clinical & Health Psychology College of Public Health and Health Professions, University of Florida, P.O. Box 100165, 1225 Center Drive, Room 3146, Gainesville, FL 32610-0165, Phone: +1-(352)-273-6617,
| | - Vaughn E. Bryant
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, P.O. Box 100165, 1225 Center Drive, Room 3146 Gainesville, FL, 32610-0165, United States, ,+1-(352)-273-6617
| | - Larry E. Burrell
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, P.O. Box 100165, 1225 Center Drive, Room 3146 Gainesville, FL, 32610-0165, United States, ,+1-(352)-273-6617
| | - Huiyin Lu
- Department of Biostatistics, College of Public Health and Health Professions & College of Medicine, University of Florida, P.O. Box 117450, 2004 Mowry Road, 5th Floor CTRB, Gainesville, Florida, 32611-7450, United States, , (352)-294-5770
| | - Erin G. Ferguson
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, P.O. Box 100165, 1225 Center Drive, Room 3146 Gainesville, FL, 32610-0165, United States, ,+1-(352)-273-6617
| | - Zhi Zhou
- Department of Epidemiology, College of Public Health and Health Professions & College of Medicine, University of Florida, P.O. Box 100231, 2004 Mowry Road, Gainesville, FL 32610, United States, , (352) 294-5949
| | - Robert L. Cook
- Department of Epidemiology, College of Public Health and Health Professions & College of Medicine, University of Florida, P.O. Box 100231, 2004 Mowry Road, Gainesville, FL 32610, United States, , (352) 273-5869
| | - Nicole Ennis
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, P.O. Box 100165, 1225 Center Drive, Room 3146 Gainesville, FL, 32610-0165, United States, , +1-(352)-273-6617
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Abstract
BACKGROUND Depression is prevalent among people living with HIV/AIDS (PLWHA), but there are few longitudinal studies investigating the prevalence of depression among HIV respondents in Taiwan. OBJECTIVES This study examined the trend in the prevalence of depression and its main predictors among PLWHA in Taiwan. METHODS This study analyzed the 2-million random-sample data set of the Taiwanese longitudinal health research database using data from 2000 to 2011and applied the Internal Classification of Diseases, 9th Revision, Clinical Modification diagnostic codes for the detection of HIV infection and depression. Chi-square tests and logistic regression analyses were conducted to determine predictive factors for depression. RESULTS A total of 769 PLWHA who met the criterion of HIV infection were extracted from the database. Of these respondents, 20.03% had a diagnosis of depression after their HIV-positive diagnosis. The annual prevalence of depression among the study respondents increased significantly from 1.95% in 2000 to 6.93% in 2011 according to time trend analysis (χ = 6.428, df =11, p = .03). Multivariate, logistic regression analysis indicated a history of drug abuse was the main predictor of a diagnosis of depression. DISCUSSION The increasing trend in the prevalence of depression revealed an urgent need for the development of care programs for PLWHA with depression. Such programs should take into consideration a history of drug abuse as a strong risk factor for the development of depression.
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12
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George Dalmida S, Kraemer KR, Ungvary S, Di Valerio E, Koenig HG, Holstad MM. The Psychosocial and Clinical Well-Being of Women Living with Human Immunodeficiency Virus/AIDS. Nurs Clin North Am 2019; 53:203-225. [PMID: 29779514 DOI: 10.1016/j.cnur.2018.01.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
This study examined factors impacting the psychological well-being of women living with human immunodeficiency virus/AIDS and the impact of depression on clinical outcomes. Nearly two-thirds of participants in this cross-sectional study reported significant depressive symptoms. Compared with women living with human immunodeficiency virus/AIDS without depressive symptoms, those with depression reported significantly poorer health outcomes. Health care providers should regularly screen these women for and adequately treat depression, and must collaborate with mental health providers and pastoral care counselors to address the mental health needs of women living with human immunodeficiency virus/AIDS to optimize their human immunodeficiency virus-related outcomes.
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Affiliation(s)
- Safiya George Dalmida
- University of Alabama, Capstone College of Nursing, 650 University Boulevard, Tuscaloosa, AL 35487, USA.
| | - Kyle R Kraemer
- Department of Psychology, University of Alabama, Box 870348, Tuscaloosa, AL 35487-0348, USA
| | - Stephen Ungvary
- Department of Psychology, University of Alabama, Box 870348, Tuscaloosa, AL 35487-0348, USA
| | - Elizabeth Di Valerio
- Department of Biological Sciences, University of Alabama, Box 870344, Tuscaloosa, AL 35487, USA
| | - Harold G Koenig
- Department of Psychiatry, Duke University Medical Center, 10 Duke Medicine Circle, Durham, NC 27710, USA; Department of Medicine, King Abdulaziz University, Jeddah 22252, Saudi Arabia
| | - Marcia McDonnell Holstad
- Emory University, Nell Hodgson Woodruff School of Nursing, 1520 Clifton Road, Atlanta, GA 30322, USA
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13
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Lu HF, Sheng WH, Liao SC, Chang NT, Wu PY, Yang YL, Hsiao FH. The changes and the predictors of suicide ideation and suicide attempt among HIV-positive patients at 6-12 months post diagnosis: A longitudinal study. J Adv Nurs 2018; 75:573-584. [PMID: 30334591 DOI: 10.1111/jan.13883] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 08/19/2018] [Accepted: 09/13/2018] [Indexed: 02/05/2023]
Abstract
AIMS This study examined the changes and the predictors of suicide ideation/suicide attempt and the moderating effects of psychosocial factors on the suicide ideation/suicide attempts among human immunodeficiency virus (HIV)-positive patients at 6-12 months post-diagnosis. BACKGROUND Suicide behaviours are prevalent among newly diagnosed HIV-positive patients, but the changes in suicide behaviours after diagnosis and the role of psychosocial factors in these behaviours are not well studied. DESIGN This study used a prospective longitudinal design. METHODS A total of 113 participants diagnosed as HIV-positive for 6-12 months were recruited from the outpatient department. Data were collected from June 2015 - October 2016. They were asked to complete Beck's Scale for Suicide Ideation, the Beck Depression Inventory-II, the Body Image Scale, the Meaning in Life Questionnaire and the Multidimensional Scale of Perceived Social Support at baseline, the third month and the sixth month. RESULTS The results showed the high occurrence rates for suicide ideation ranging from 27.2%, 21.6%, and 25.8% and suicide attempt ranging from 14.7%, 8.6%, and 13.3% at the baseline, the third month and the sixth month, respectively. The education level, social support from family and depressive symptoms were the predictors of suicide ideation. The history of depression disorders, depressive symptoms and social support from friends significantly predicted suicide attempt. Meaning in life-presence moderated the relationship between depressive symptoms and suicide ideation. CONCLUSIONS After diagnosed for 6-12 months, HIV-positive patients remain the high-risk group for suicide ideation and attempt. Suicide intervention targeting the risk and protective factors are required for HIV-positive patients.
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Affiliation(s)
- Hsing-Fei Lu
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan.,Department of Nursing, Hsin Sheng Junior College of Medical Care and Management, Taoyuan, Taiwan
| | - Wang-Huei Sheng
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Shih-Cheng Liao
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
| | - Nien-Tzu Chang
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Pei-Ying Wu
- Department of Infectious disease, National Taiwan University Hospital, Taipei, Taiwan
| | - Ya-Ling Yang
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Fei-Hsiu Hsiao
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan.,Nursing Department, National Taiwan University Hospital, Taipei, Taiwan
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14
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Depression and Quality of Life among Patients Living with HIV/AIDS in the Era of Universal Treatment Access in Vietnam. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15122888. [PMID: 30562949 PMCID: PMC6313339 DOI: 10.3390/ijerph15122888] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 11/23/2018] [Accepted: 12/10/2018] [Indexed: 11/17/2022]
Abstract
Although antiretroviral treatment (ART) access has been universal in recent years, few studies have examined if this policy contributes to the mental health of the patients. This study assessed depression and its relations with health-related quality of life (HRQOL), which is defined as the status of general well-being, physical, emotional, and psychological, among HIV patients. A cross-sectional study was conducted in 482 patients at five outpatient clinics. Patient Health Questionnaire-9 (PHQ-9) and EuroQol-5 dimensions-5 levels (EQ-5D-5L) were used to assess the severity of depression and HRQOL. About one-fifth of patients reported symptoms of depression. According to the result of a multivariate logistic regression model, patients who had a lower number of CD4 cells at the start of ART, who received ART in the clinic without HIV counseling and testing (HCT) services, who had a physical health problem, and who experienced discrimination were more likely to have depression. Depression was associated with significantly decreased HRQOL. Depression is prevalent and significantly negatively associated with HRQOL of HIV/AIDS patients. We recommend screening for depression and intervening in the lives of depressed individuals with respect to those who start ART late, and we also recommend community-based behavioral change campaigns to reduce HIV discrimination.
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15
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Chen WT, Shiu C, Yang JP, Wang K, Zhang L, Zhang J, Reynolds NR, Kennedy HP, Khoshnood K, Chen LC, Bao M, Zhao H, Lu H. Quality of life in HIV-infected Chinese women and their family caregivers: an intervention study. AIDS Care 2018; 30:1572-1579. [PMID: 30111163 DOI: 10.1080/09540121.2018.1510095] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
China is experiencing a rapid increase in the number of HIV-infected women. In this study, we describe the development and preliminary evaluation of an intervention tailored for Chinese HIV-infected women and caregivers to improve their self- and family management, with goals of enhancing their physical quality of life (QOL) and decreasing their depressive symptomatology. Forty-one HIV-infected women and their caregivers were recruited from two premier Chinese hospitals from July 2014 through March 2016. Participants were randomized to either the control or intervention arm for the Self- and Family Management Intervention (SAFMI). Each study dyad in the intervention arm received three counseling sessions with a nurse interventionist. At baseline, immediate post-intervention (month 1) and follow-up (month 3), the participants were assessed by a self-reported survey. Generalized Hierarchical Linear Modeling was used to evaluate the efficacy of the intervention. Chinese HIV-infected women in the intervention arm had significantly higher probability of higher physical QOL at month 1 and lower probability of clinically meaningful depressive symptomatology at month 3 compared with women in the control arm. In contrast, the effects of the intervention were less salient for caregivers. This study represents one of the first in China to include family caregivers in HIV management. Feasibility and acceptability were high, in that family members were willing to join the study, learn about HIV, and practice new skills to support the HIV-infected women in their lives. A larger trial is needed to fully evaluate this intervention which shows promising preliminary effects in promoting physical QOL and decreasing depressive symptomatology among Chinese HIV-infected women.
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Affiliation(s)
- Wei-Ti Chen
- a School of Nursing , University of California Los Angeles , Los Angeles , CA , USA
| | - Chengshi Shiu
- a School of Nursing , University of California Los Angeles , Los Angeles , CA , USA
| | - Joyce P Yang
- b Department of Psychiatry and Behavioral Sciences , Stanford University School of Medicine , Stanford , CA , USA
| | - Kerong Wang
- c Beijing, Ditan Hospital , Capital Medical University , Beijing , People's Republic of China
| | - Lin Zhang
- d Shanghai Public Health Clinical Center , Fudan University , Shanghai , People's Republic of China
| | - Jing Zhang
- d Shanghai Public Health Clinical Center , Fudan University , Shanghai , People's Republic of China
| | - Nancy R Reynolds
- e School of Nursing , John Hopkins University , Baltimore , MD , USA
| | | | - Kaveh Khoshnood
- g School of Public Health , Yale University , New Haven , CT , USA
| | - Li-Chen Chen
- d Shanghai Public Health Clinical Center , Fudan University , Shanghai , People's Republic of China
| | - Meijuan Bao
- h School of Nursing , National Cheng Kung University , Tainan , Taiwan
| | - Hongxin Zhao
- i AIDS Unit, Beijing, Ditan Hospital , Capital Medical University , Beijing , People's Republic of China
| | - Hongzhou Lu
- d Shanghai Public Health Clinical Center , Fudan University , Shanghai , People's Republic of China
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16
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Iribarren S, Siegel K, Hirshfield S, Olender S, Voss J, Krongold J, Luft H, Schnall R. Self-Management Strategies for Coping with Adverse Symptoms in Persons Living with HIV with HIV Associated Non-AIDS Conditions. AIDS Behav 2018; 22:297-307. [PMID: 28488165 DOI: 10.1007/s10461-017-1786-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
People living with HIV (PLWH) are living longer, but many are now affected by HIV-associated non-AIDS (HANA) conditions and their associated adverse symptoms. An online survey was conducted with 769 PLWH with HANA conditions in the US. Information was elicited on symptoms experienced, self-management strategies employed, and the helpfulness of these strategies. Open ended responses were collected for self-management strategies. A qualitative data analytic approach was used to organize the 4036 self-management strategies into thematic categories, with eight main categories emerging, including: taking medication, modifying activity, altering diet, seeking help, waiting, substance use, managing thoughts and attitudes, and altering the physical environment. Of the self-management strategy subcategories, social support was the most helpful self-management strategy with waiting/doing nothing being the least helpful approach. Findings can be used to inform the development of self-management interventions and to support health care professionals in recommending symptom self-management strategies to their patients.
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17
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Drummond KL, Painter JT, Curran GM, Stanley R, Gifford AL, Rodriguez-Barradas M, Rimland D, Monson TP, Pyne JM. HIV patient and provider feedback on a telehealth collaborative care for depression intervention. AIDS Care 2016; 29:290-298. [PMID: 27871183 DOI: 10.1080/09540121.2016.1255704] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
In the HIV Translating Initiatives for Depression into Effective Solutions project, we conducted a randomized controlled effectiveness and implementation trial comparing depression collaborative care with enhanced usual care in Veterans Health Administration HIV clinics in the US. An offsite HIV depression care team including a psychiatrist, a depression care manager (DCM), and a clinical pharmacist provided collaborative care using a stepped-care model of treatment and made recommendations to providers through the electronic health record system. The DCM delivered care management to HIV patients through phone calls, performing routine assessments and providing counseling in self-management and problem-solving. The DCM documented all calls in each patient's electronic medical record. In this paper we present results from interviews conducted with patients and clinical staff in a multi-stage formative evaluation (FE). We conducted semi-structured FE interviews with 26 HIV patients and 30 clinical staff at the three participating sites during and after the trial period to gather their experiences and perspectives concerning the intervention components. Interviews were transcribed verbatim and analyzed using rapid content analysis techniques. Patients reported high satisfaction with the depression care manager (DCM) phone calls. Both HIV and mental health providers reported that the DCM's chart notes in the electronic health record were very helpful, and most felt that a dedicated DCM for HIV patients is ideal to meet patient needs. Sites encountered barriers to achieving and maintaining universal depression screening, but had greater success when such screening was incorporated into routine intake processes. FE results demonstrated that depression care management via telehealth from an offsite team is acceptable and helpful to both HIV patients and their providers. Given that a centralized offsite depression care team can deliver effective, cost-effective, cost-saving services for multiple HIV clinics in different locations with high patient and provider satisfaction, broad implementation should be considered.
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Affiliation(s)
- Karen L Drummond
- a Central Arkansas Veterans Healthcare System , North Little Rock , AR , USA
| | - Jacob T Painter
- a Central Arkansas Veterans Healthcare System , North Little Rock , AR , USA
| | - Geoffrey M Curran
- a Central Arkansas Veterans Healthcare System , North Little Rock , AR , USA
| | - Regina Stanley
- a Central Arkansas Veterans Healthcare System , North Little Rock , AR , USA
| | - Allen L Gifford
- b Edith Nourse Rogers Memorial VA Medical Center , Bedford , MA , USA
| | | | - David Rimland
- d Atlanta Veterans Affairs Medical Center , Atlanta , GA , USA
| | - Thomas P Monson
- a Central Arkansas Veterans Healthcare System , North Little Rock , AR , USA
| | - Jeffrey M Pyne
- a Central Arkansas Veterans Healthcare System , North Little Rock , AR , USA
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18
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Golub SA, Thompson LI, Kowalczyk WJ. Affective differences in Iowa Gambling Task performance associated with sexual risk taking and substance use among HIV-positive and HIV-negative men who have sex with men. J Clin Exp Neuropsychol 2016; 38:141-57. [PMID: 26745769 DOI: 10.1080/13803395.2015.1085495] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
We investigated the relationship between emotional distress and decision making in sexual risk and substance use behavior among 174 (ages 25 to 50 years, 53% black) men who have sex with men (MSM), a population at increased risk for HIV. The sample was stratified by HIV status. Measures of affective decision making, depression, anxiety, sex acts, and substance use during the past 60 days were collected at our research center. Negative binomial regression models were used to examine the relationship between age, HIV status, anxiety, depression, and IGT performance in the prediction of number of risky sex acts and substance use days. Among those without anxiety or depression, both number of risky sex acts and drug use days decreased with better performance during risky trials (i.e., last two blocks) of the IGT. For those with higher rates of anxiety, but not depression, IGT risk trial performance and risky sex acts increased concomitantly. Anxiety also interacted with IGT performance across all trials to predict substance use, such that anxiety was associated with greater substance use among those with better IGT performance. The opposite was true for those with depression, but only during risk trials. HIV-positive participants reported fewer substance use days than HIV-negative participants, but there was no difference in association between behavior and IGT performance by HIV status. Our findings suggest that anxiety may exacerbate risk-taking behavior when affective decision-making ability is intact. The relationship between affective decision making and risk taking may be sensitive to different profiles of emotional distress, as well as behavioral context. Investigations of affective decision making in sexual risk taking and substance use should examine different distress profiles separately, with implications for HIV prevention efforts.
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Affiliation(s)
- Sarit A Golub
- a Department of Psychology , Hunter College of the City University of New York (CUNY) , New York , NY , USA.,b Doctoral Program in Psychology , The Graduate Center of the City University of New York (CUNY) , New York , NY , USA
| | - Louisa I Thompson
- b Doctoral Program in Psychology , The Graduate Center of the City University of New York (CUNY) , New York , NY , USA
| | - William J Kowalczyk
- c Clinical Pharmacology & Therapeutics Branch , Intramural Research Program, National Institute on Drug Abuse , Baltimore , MD , USA
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19
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Kee MK, Lee SY, Kim NY, Lee JS, Kim JM, Choi JY, Ku NS, Kang MW, Kim MJ, Woo JH, Kim SW, Song JY, Baek JH, Choi BY, Kim SS. Anxiety and depressive symptoms among patients infected with human immunodeficiency virus in South Korea. AIDS Care 2015. [PMID: 26197063 DOI: 10.1080/09540121.2015.1035861] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Patients infected with human immunodeficiency virus (HIV) may develop mental health problems such as anxiety and depression, which negatively impact of disease progression. We investigated factors associated with the prevalence of anxiety and depression symptoms among HIV-infected patients in Korea. A total of 840 HIV-infected patients who participated in the Korea HIV/AIDS Cohort Study from 2006 to 2012 were evaluated. Socio-demographic, epidemiologic, and clinical variables were obtained through standardized questionnaires. The State-Trait Anxiety Inventory and Beck Depression Inventory were used to assess the symptoms of anxiety and depression. Multiple logistic regression analyses were performed to identify factors associated with symptoms of anxiety and depression. The prevalence of anxiety and depressive symptoms among HIV-infected patients was 32% and 36%, respectively. Ex-smoker and persistent symptoms for more than one week within the past six months and diagnosis of HIV infection within one year were associated with increased anxiety symptoms (odds ratio [OR] 1.71, 95% confidence interval [CI] 1.09-2.69; OR 1.52, 95% CI 1.09-2.11; OR 1.49, 95% CI 1.02-2.20) and current smoking and persistent symptoms were also associated with increased depressive symptoms (OR 2.10, 95% CI 1.31-3.30; OR 1.87, 95% CI 1.25-2.79). Marital status, current smoking, current drinking, and persistent symptoms were associated with both increased anxiety and depressive symptoms (OR 1.75, 95% CI 1.07-2.88; OR 1.66, 95% CI 1.06-2.61; OR 1.88, 95% CI 1.18-2.99). The prevalence of anxiety and depressive symptoms among HIV-infected patients is higher than those estimated for the general population. This study shows the necessity to evaluate symptoms of anxiety and depression and suggest psychological support for HIV-infected patients who smoke or have persistent symptoms or have sexual partner or drink.
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Affiliation(s)
- Mee-Kyung Kee
- a Division of AIDS , Center for Immunology and Pathology, Korea National Institute of Health , Chungbuk , Republic of Korea
| | - Sae-Young Lee
- a Division of AIDS , Center for Immunology and Pathology, Korea National Institute of Health , Chungbuk , Republic of Korea
| | - Na-Young Kim
- a Division of AIDS , Center for Immunology and Pathology, Korea National Institute of Health , Chungbuk , Republic of Korea
| | - Joo-Shil Lee
- b Korea National Institute of Health , Chungbuk , Republic of Korea
| | - June Myung Kim
- c Department of Internal Medicine , Yonsei University College of Medicine , Seoul , Republic of Korea.,d AIDS Research Institute, Yonsei University College of Medicine , Seoul , Republic of Korea
| | - Jun Yong Choi
- c Department of Internal Medicine , Yonsei University College of Medicine , Seoul , Republic of Korea.,d AIDS Research Institute, Yonsei University College of Medicine , Seoul , Republic of Korea
| | - Nam Su Ku
- c Department of Internal Medicine , Yonsei University College of Medicine , Seoul , Republic of Korea.,d AIDS Research Institute, Yonsei University College of Medicine , Seoul , Republic of Korea
| | - Moon Won Kang
- e Division of Infectious Diseases, Department of Internal Medicine , College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea , Seoul , Republic of Korea
| | - Min Ja Kim
- f Division of Infectious Diseases, Department of Internal Medicine , Korea University College of Medicine , Seoul , Republic of Korea
| | - Jun Hee Woo
- g Department of Infectious Diseases , Asan Medical Center, University of Ulsan College of Medicine , Seoul , Republic of Korea
| | - Shin-Woo Kim
- h Department of Internal Medicine , School of Medicine, Kyungpook National University , Daegu , Republic of Korea
| | - Joon Young Song
- f Division of Infectious Diseases, Department of Internal Medicine , Korea University College of Medicine , Seoul , Republic of Korea
| | - Ji-Hyeon Baek
- i Department of Internal Medicine , Inha University School of Medicine , Incheon , Republic of Korea
| | - Bo Youl Choi
- j Department of Preventive Medicine , College of Medicine, Hanyang University , Seoul , Republic of Korea
| | - Sung Soon Kim
- a Division of AIDS , Center for Immunology and Pathology, Korea National Institute of Health , Chungbuk , Republic of Korea
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20
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Solomon D, Adams J. The use of complementary and alternative medicine in adults with depressive disorders. A critical integrative review. J Affect Disord 2015; 179:101-13. [PMID: 25863008 DOI: 10.1016/j.jad.2015.03.031] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Revised: 03/18/2015] [Accepted: 03/18/2015] [Indexed: 01/16/2023]
Abstract
BACKGROUND Depression has been identified as one of the most frequent indications for CAM use and is a strong predictor of CAM use. The present article provides a critical review of CAM use for depressive disorders including bipolar depression by addressing prevalence of CAM use and CAM users׳ characteristics, motivation, decision-making and communication with healthcare providers. METHODS A comprehensive search of 2003-2014 international literature in the Medline, CINAHL, AMED, and SCOPUS databases was conducted. The search was confined to peer-reviewed articles published in English with abstracts and reporting new empirical research findings regarding CAM use and depressive disorders. RESULTS A considerable level of CAM use was observed among both general and clinical populations of people suffering from depressive disorders, many of whom use CAM concurrently with their conventional medicine. In particular, high rates of CAM use were found among those with bipolar disorder, an illness known to cause substantial impairments in health-related quality of life. Concomitant prescription medication use ranged from 0.52% to as high as 100%. LIMITATIONS Study design such as the inclusion of bipolar and depression in the same diagnostic category hamper the differentiation and attribution of CAM usage for symptoms. CONCLUSION Findings of our review show that enduring impairments in function and persistence of symptoms (as reflected by increased CAM use proportional to severity of illness and comorbidity) are the impetus for sufferers of depressive illness to seek out CAM. The psychosocial factors associated with CAM use in depressive illnesses and severe mental illness are yet to be established. Subsequent research amongst those with depressive disorders would be informative in clarifying the range of motivations associated with mental illness.
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Affiliation(s)
- Daniela Solomon
- Black Dog Institute, University of New South Wales, Hospital Road, Randwick, NSW 2031, Australia.
| | - Jon Adams
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, 235-253 Jones St Ultimo, NSW 2007, Australia.
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21
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Dawson Rose C, Cuca YP, Kamitani E, Eng S, Zepf R, Draughon J, Lum P. Using Interactive Web-Based Screening, Brief Intervention and Referral to Treatment in an Urban, Safety-Net HIV Clinic. AIDS Behav 2015; 19 Suppl 2:186-93. [PMID: 25963770 DOI: 10.1007/s10461-015-1078-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Substance use among people living with HIV is high, and screening, brief intervention, and referral to treatment (SBIRT) is an evidence-based approach to addressing the issue. We examined whether patients would participate in a technology-based SBIRT program in an urban HIV clinic. An SBIRT intervention was programmed into the clinic's web-based patient portal linked to their personal health record. We examined: demographic, health, HIV, and substance use characteristics of participants who completed the web-based intervention compared to those who did not. Fewer than half of the 96 participants assigned to the web-based SBIRT completed it (n = 39; 41 %). Participants who completed the web-based intervention had significantly higher amphetamine SSIS scores than those who did not complete the intervention. Participants whose substance use is more harmful may be more motivated to seek help from a variety of sources. In addition, it is important that technology-based approaches to behavioral interventions in clinics take into consideration feasibility, client knowledge, and comfort using technology.
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22
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Paparello J, Zeller I, While A. Meeting the complex needs of individuals living with HIV: a case study approach. Br J Community Nurs 2015; 19:526-33. [PMID: 25381847 DOI: 10.12968/bjcn.2014.19.11.526] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This article critically discusses the nursing care and management of a person living with the human immunodeficiency virus (HIV) infection as a long-term condition, requiring highly complex HIV care. Complex HIV care is managed in the secondary care setting. However, recent legislation has motivated shifts in HIV care to the community care setting. This article aims to enhance health professionals' understanding in order to equip practice and district nurses to deliver HIV care provision. Antiretroviral adherence is a prerequisite for disease survival as well as an essential component of complete HIV self-care management. It is therefore imperative that nurses tailor adherence strategies according to each patient's requirements. Case management strategies such as the use of cognitive behavioural therapy to alleviate depressive symptoms will be considered. Furthermore, the use of motivational interviewing for antiretroviral adherence is highlighted as a potential intervention to help patients overcome the physical, psychological and physiological challenges of living with HIV-associated comorbidities. The delivery of integrated HIV care is pivotal for the management of the person living with HIV, as is the facilitation of a self-caring behaviour.
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Steiner JP, Bachani M, Wolfson-Stofko B, Lee MH, Wang T, Li G, Li W, Strayer D, Haughey NJ, Nath A. Interaction of paroxetine with mitochondrial proteins mediates neuroprotection. Neurotherapeutics 2015; 12:200-16. [PMID: 25404050 PMCID: PMC4322069 DOI: 10.1007/s13311-014-0315-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
There are severe neurological complications that arise from HIV infection, ranging from peripheral sensory neuropathy to cognitive decline and dementia for which no specific treatments are available. The HIV proteins secreted from infected macrophages, gp120 and Tat, are neurotoxic. The goal of this study was to screen, identify and develop neuroprotective compounds relevant to HIV-associated neurocognitive disorders (HAND). We screened more than 2000 compounds that included FDA approved drugs for protective efficacy against oxidative stress-mediated neurodegeneration and identified selective serotonin reuptake inhibitors (SSRIs) as potential neuroprotectants. Numerous SSRIs were then extensively evaluated as protectants against neurotoxicity as measured by changes in neuronal cell death, mitochondrial potential, and axodendritic degeneration elicited by HIV Tat and gp120 and other mitochondrial toxins. While many SSRIs demonstrated neuroprotective actions, paroxetine was potently neuroprotective (100 nM potency) against these toxins in vitro and in vivo following systemic administration in a gp120 neurotoxicity model. Interestingly, the inhibition of serotonin reuptake by paroxetine was not required for neuroprotection, since depletion of the serotonin transporter had no effect on its neuroprotective properties. We determined that paroxetine interacts selectively and preferentially with brain mitochondrial proteins and blocks calcium-dependent swelling but had less effect on liver mitochondria. Additionally, paroxetine induced proliferation of neural progenitor cells in vitro and in vivo in gp120 transgenic animals. Therefore, SSRIs such as paroxetine may provide a novel adjunctive neuroprotective and neuroregenerative therapy to treat HIV-infected individuals.
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Affiliation(s)
- Joseph P. Steiner
- />Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287 USA
- />Translational Neuroscience Center, National Institute of Neurological Diseases and Stroke, National Bldg 10, Room 7C-105, 10 Center Drive, Bethesda, MD 20892 USA
| | - Muznabanu Bachani
- />Translational Neuroscience Center, National Institute of Neurological Diseases and Stroke, National Bldg 10, Room 7C-105, 10 Center Drive, Bethesda, MD 20892 USA
| | - Brett Wolfson-Stofko
- />Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287 USA
| | - Myoung-Hwa Lee
- />Section of Infections of the Nervous System, National Institute of Neurological Diseases and Stroke, National Institute of Health, Bldg 10, Room 7C103, 10 Center Drive, Bethesda, MD 20892 USA
| | - Tonguang Wang
- />Translational Neuroscience Center, National Institute of Neurological Diseases and Stroke, National Bldg 10, Room 7C-105, 10 Center Drive, Bethesda, MD 20892 USA
| | - Guanhan Li
- />Section of Infections of the Nervous System, National Institute of Neurological Diseases and Stroke, National Institute of Health, Bldg 10, Room 7C103, 10 Center Drive, Bethesda, MD 20892 USA
| | - Wenxue Li
- />Section of Infections of the Nervous System, National Institute of Neurological Diseases and Stroke, National Institute of Health, Bldg 10, Room 7C103, 10 Center Drive, Bethesda, MD 20892 USA
| | - David Strayer
- />Department of Pathology, Anatomy and Cell Biology, Thomas Jefferson University, Philadelphia, PA 19107 USA
| | - Norman J. Haughey
- />Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287 USA
| | - Avindra Nath
- />Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287 USA
- />Translational Neuroscience Center, National Institute of Neurological Diseases and Stroke, National Bldg 10, Room 7C-105, 10 Center Drive, Bethesda, MD 20892 USA
- />Section of Infections of the Nervous System, National Institute of Neurological Diseases and Stroke, National Institute of Health, Bldg 10, Room 7C103, 10 Center Drive, Bethesda, MD 20892 USA
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Kitshoff C, Campbell L, Naidoo SS. The association between depression and adherence to antiretroviral therapy in HIV-positive patients, KwaZulu-Natal, South Africa. S Afr Fam Pract (2004) 2014. [DOI: 10.1080/20786204.2012.10874194] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
- C Kitshoff
- Department of Family Medicine, University of KwaZulu-Natal
| | - L Campbell
- Department of Family Medicine, University of KwaZulu-Natal
| | - SS Naidoo
- Department of Family Medicine, University of KwaZulu-Natal
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Goodness TM, Palfai TP, Cheng DM, Coleman SM, Bridden C, Blokhina E, Krupitsky E, Samet JH. Depressive symptoms and antiretroviral therapy (ART) initiation among HIV-infected Russian drinkers. AIDS Behav 2014; 18:1085-93. [PMID: 24337725 DOI: 10.1007/s10461-013-0674-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The impact of depressive symptoms on ART initiation among Russian HIV-infected heavy drinkers enrolled in a secondary HIV prevention trial (HERMITAGE) was examined. We assessed 133 participants eligible for ART initiation (i.e., CD4 count <350 cells/μl) who were not on ART at baseline. Depressive symptom severity and ART use were measured at baseline, 6- and 12-months. Association between depressive symptoms and subsequent ART initiation was evaluated using GEE logistic regression adjusting for gender, past ART use, injection drug use and heavy drinking. Depressive symptom severity was not significantly associated with lower odds of initiating ART. Cognitive depression symptoms were not statistically significant (global p = 0.05); however, those with the highest level of severity had an AOR of 0.25 (95 % CI 0.09-0.71) for delayed ART initiation. Although the effect of depression severity was not significant, findings suggest a potential role of cognitive depression symptoms in decisions to initiate ART in this population.
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Affiliation(s)
- Tracie M Goodness
- Department of Psychology, Boston University, 648 Beacon Street, 4th Floor, Boston, MA, 02215, USA,
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Dawson Rose C, Webel A, Sullivan KM, Cuca YP, Wantland D, Johnson MO, Brion J, Portillo CJ, Corless IB, Voss J, Chen WT, Phillips JC, Tyer-Viola L, Rivero-Méndez M, Nicholas PK, Nokes K, Kemppainen J, Sefcik E, Eller LS, Iipinge S, Kirksey K, Chaiphibalsarisdi P, Davila N, Hamilton MJ, Hickey D, Maryland M, Reid P, Holzemer WL. Self-compassion and risk behavior among people living with HIV/AIDS. Res Nurs Health 2014; 37:98-106. [PMID: 24510757 PMCID: PMC4158433 DOI: 10.1002/nur.21587] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2013] [Indexed: 11/12/2022]
Abstract
Sexual risk behavior and illicit drug use among people living with HIV/AIDS (PLWHA) contribute to poor health and onward transmission of HIV. The aim of this collaborative multi-site nursing research study was to explore the association between self-compassion and risk behaviors in PLWHA. As part of a larger project, nurse researchers in Canada, China, Namibia, Puerto Rico, Thailand and the US enrolled 1211 sexually active PLWHA using convenience sampling. The majority of the sample was male, middle-aged, and from the US. Illicit drug use was strongly associated with sexual risk behavior, but participants with higher self-compassion were less likely to report sexual risk behavior, even in the presence of illicit drug use. Self-compassion may be a novel area for behavioral intervention development for PLWHA.
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Affiliation(s)
- Carol Dawson Rose
- UCSF School of Nursing, Dept. of Community Health Systems, San Francisco, CA 94143-0608, T: (415) 713-5252, F: (415) 476-4076
| | - Allison Webel
- Case Western Reserve University, Bolten School of Nursing
| | | | | | - Dean Wantland
- Office of Research & Evaluation, Rutgers College of Nursing
| | | | - John Brion
- The Ohio State University College of Nursing
| | | | | | | | | | | | | | | | - Patrice K. Nicholas
- Global Health and Academic Partnerships, Brigham and Women's Hospital and MGH Institute of Health Professions
| | | | | | | | | | | | - Kenn Kirksey
- Nursing Strategic Initiatives, Lyndon B. Johnson Hospital – Executive Administration, Harris Health System
| | | | | | | | - Dorothy Hickey
- Momentum AIDS Program & Assistant Adjunct Clinical Professor at New York City College of Technology
| | - Mary Maryland
- Chicago State University College of Health Sciences, Department of Nursing
| | - Paula Reid
- School of Nursing, The University of North Carolina at Wilmington
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Dalmida SG, Koenig HG, Holstad MM, Wirani MM. The psychological well-being of people living with HIV/AIDS and the role of religious coping and social support. Int J Psychiatry Med 2014; 46:57-83. [PMID: 24547610 DOI: 10.2190/pm.46.1.e] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE This study examined correlates of depressive symptoms, particularly the role of religious coping (RCOPE), among people living with HIV/AIDS (PLWHA). The study also examined social support as a possible mediator of the proposed association between religious coping and depressive symptoms and the impact of depressive symptomatology on health outcomes such as HIV medication adherence, immune function, and health-related quality of life (HRQOL) among PLWHA. METHOD A convenience sample of 292 PLWHA were recruited from an out-patient infectious disease clinic and AIDS-service organizations in the Southeastern United States. RESULTS 56.7% reported depressive symptoms. PLWHA with depressive symptomatology reported significantly poorer health outcomes, including poorer HIV medication adherence, lower CD4 cell count, and poorer HRQOL. The odds of being depressed was significantly associated with birth sex (female: OR = 0.43, 95% CI = .23-.80), sexual orientation (gay/bisexual: OR = 1.95, 95% CI = 1.04-3.65), marital status (single: OR = .52, 95% CI = .27-.99), social support satisfaction (OR = 0.65, 95% CI = .49-.86), and negative RCOPE (OR = 1.22, 95% CI = 1.14-1.31). Social support partially mediated the relationship between religious coping and depressive symptoms. CONCLUSIONS High rates of depressive symptoms are present in PLWHA, which negatively impact health outcomes. Religious coping, perceived stress, and social support satisfaction serve an important role in depressive symptomatology among PLWHA. These findings underscore the need for healthcare providers to regularly screen PLWHA for and adequately treat depression and collaborate with mental health providers, social workers, and pastoral care counselors to address PLWHA's mental, social, and spiritual needs and optimize their HIV-related outcomes.
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Siccardi M, Marzolini C, Seden K, Almond L, Kirov A, Khoo S, Owen A, Back D. Prediction of drug-drug interactions between various antidepressants and efavirenz or boosted protease inhibitors using a physiologically based pharmacokinetic modelling approach. Clin Pharmacokinet 2014; 52:583-92. [PMID: 23479398 DOI: 10.1007/s40262-013-0056-7] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND AND OBJECTIVE The rate of depression in patients with HIV is higher than in the general population. The use of antidepressants can have a beneficial effect, improving antiretroviral therapy adherence and consequently their efficacy and safety. Efavirenz and protease inhibitor boosted with ritonavir are major components of the antiretroviral therapy and are inducers and/or inhibitors of several cytochrome P450 (CYP) isoforms. Although antidepressants are prescribed to a significant proportion of patients treated with antiretrovirals, there are limited clinical data on drug-drug interactions. The aim of this study was to predict the magnitude of drug-drug interactions among efavirenz, boosted protease inhibitors and the most commonly prescribed antidepressants using an in vitro-in vivo extrapolation (IVIVE) model simulating virtual clinical trials. METHODS In vitro data describing the chemical characteristics, and absorption, distribution, metabolism and elimination (ADME) properties of efavirenz, boosted protease inhibitors and the most commonly prescribed antidepressants were obtained from published literature or generated by standard methods. Pharmacokinetics and drug-drug interaction were simulated using the full physiologically based pharmacokinetic model implemented in the Simcyp™ ADME simulator. The robustness of our modeling approach was assessed by comparing the magnitude of simulated drug-drug interactions using probe drugs to that observed in clinical studies. RESULTS Simulated pharmacokinetics and drug-drug interactions were in concordance with available clinical data. Although the simulated drug-drug interactions with antidepressants were overall weak to moderate according to the classification of the US FDA, fluoxetine and venlafaxine represent better candidates from a pharmacokinetic standpoint for patients on efavirenz and venlafaxine or citalopram for patients on boosted protease inhibitors. CONCLUSION The modest magnitude of interaction could be explained by the fact that antidepressants are substrates of multiple isoforms and thus metabolism can still occur through CYPs that are weakly impacted by efavirenz or boosted protease inhibitors. These findings indicate that IVIVE is a useful tool for predicting drug-drug interactions and designing prospective clinical trials, giving insight into the variability of exposure, sample size and time-dependent induction or inhibition.
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Affiliation(s)
- Marco Siccardi
- Department of Molecular and Clinical Pharmacology, Institute of Translational Medicine, University of Liverpool, 70 Pembroke Place, Liverpool, L69 3GF, UK.
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Lorenc A, Robinson N. A review of the use of complementary and alternative medicine and HIV: issues for patient care. AIDS Patient Care STDS 2013; 27:503-10. [PMID: 23991688 DOI: 10.1089/apc.2013.0175] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
HIV/AIDS is a chronic illness, with a range of physical symptoms and psychosocial issues. The complex health and social issues associated with living with HIV mean that people living with HIV/AIDS (PLWHA) have historically often turned to complementary and alternative medicine (CAM). This article provides an overview of the literature on HIV and CAM. Databases were searched using keywords for CAM and HIV from inception to December 2012. Articles in English and in Western countries were included; letters, commentaries, news articles, articles on specific therapies and basic science studies were excluded. Of the 282 articles identified, 94 were included. Over half reported prevalence and determinants of CAM use. Lifetime use of CAM by PLWHA ranged from 30% to 90%, with national studies suggesting CAM is used by around 55% of PLWHA, practitioner-based CAM by 15%. Vitamins, herbs, and supplements were most common, followed by prayer, meditation, and spiritual approaches. CAM use was predicted by length of time since HIV diagnosis, and a greater number of medications/symptoms, with CAM often used to address limitations or problems with antiretroviral therapy. CAM users rarely rejected conventional medicine, but a number of CAM can have potentially serious side effects or interactions with ART. CAM was used as a self-management approach, providing PLWHA with an active role in their healthcare and sense of control. Clinicians, particularly nurses, should consider discussing CAM with patients as part of patient-centered care, to encourage valuable self-management and ensure patient safety.
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Affiliation(s)
- Ava Lorenc
- London South Bank University, London, United Kingdom
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Kotzé M, Visser M, Makin J, Sikkema K, Forsyth B. The coping strategies used over a two-year period by HIV-positive women who had been diagnosed during pregnancy. AIDS Care 2013; 25:695-701. [DOI: 10.1080/09540121.2013.772277] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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31
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Huang YT. Challenges and responses in providing palliative care for people living with HIV/AIDS. Int J Palliat Nurs 2013; 19:218, 220-5. [DOI: 10.12968/ijpn.2013.19.5.218] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Yu-Te Huang
- PhD student Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street W, Toronto, Ontario, M5S 1V4, Canada
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32
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Symptom manageability in Swiss HIV-infected patients. Appl Nurs Res 2013; 26:110-5. [PMID: 23481487 DOI: 10.1016/j.apnr.2013.01.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2012] [Revised: 01/27/2013] [Accepted: 01/28/2013] [Indexed: 11/23/2022]
Abstract
BACKGROUND Managing symptoms in daily life is a challenging problem for people living with HIV. As traditional parameters used to identify symptoms needing management do not integrate aspects of daily living with symptoms, we introduced 'perceived symptom manageability' to fill this gap. AIM The aim of this study was to quantitatively explore 'perceived symptom manageability' in a sample of 268 persons living with HIV. METHODS Secondary analysis of existing cross-sectional data. Social support, gender, age, depressive and anxiety symptoms were bivariately and multivariately analyzed and related to symptom experience and manageability as measured by the HIV Symptom Assessment Scale and the HIV Symptom Manageability Scale. RESULTS Least manageable symptoms were hair loss, vomiting and insomnia. Multivariately, age (beta=-.11; p=.024), symptom distress (beta=-.62; p<.001) and total anxiety and depressive symptoms (beta=-.18; p=.003) were statistically significant correlates of symptom manageability. CONCLUSIONS Although a promising concept to identify symptoms needing management, further research employing primary data is recommended.
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Abstract
To identify psychosocial variables related to the use of coping strategies by HIV-positive South African women diagnosed during pregnancy, structured interviews were conducted with 224 HIV-positive women at antenatal clinics over a period of 2 years. Two coping styles, active and avoidant coping, were assessed using an adapted version of the Brief COPE. Psychosocial variables associated with changes in coping over time were identified with mixed linear analysis. Increases in active coping were associated with decreasing levels of internalized stigma and depression, increasing self-esteem and positive social support, knowing someone who is living with HIV, being physically healthy and living above the poverty line. Increases in avoidant coping were associated with increasing internalized stigma and depression, lower levels of self-esteem, HIV-knowledge and lower levels of education. Recommendations are made for psychological support services to strengthen women's ability to cope and enhance their health and that of their infants.
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Schadé A, van Grootheest G, Smit JH. HIV-infected mental health patients: characteristics and comparison with HIV-infected patients from the general population and non-infected mental health patients. BMC Psychiatry 2013; 13:35. [PMID: 23343356 PMCID: PMC3577506 DOI: 10.1186/1471-244x-13-35] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2012] [Accepted: 01/09/2013] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES HIV-infected patients are at increased risk of developing mental health symptoms, which negatively influence the treatment of the HIV-infection. Mental health problems in HIV-infected patients may affect public health. Psychopathology, including depression and substance abuse, can increase hazardous sexual behaviour and, with it, the chance of spreading HIV. Therefore, it is important to develop an optimal treatment plan for HIV-infected patients with mental health problems. The majority of HIV-infected patients in the Netherlands (almost 60%) are homosexual men.The main objectives of this study were to describe the clinical and demographic characteristics of patients with HIV who seek treatment for their mental health symptoms in the Netherlands. Secondly, we tested whether HIV infected and non-infected homosexual patients with a lifetime depressive disorder differed on several mental health symptoms. METHODS We compared a cohort of 196 patients who visited the outpatient clinic for HIV and Mental Health with HIV-infected patients in the general population in Amsterdam (ATHENA-study) and with non-HIV infected mental health patients (NESDA-study). DSM-IV diagnoses were determined, and several self-report questionnaires were used to assess mental health symptoms. RESULTS Depressive disorders were the most commonly occurring diagnoses in the cohort and frequent drug use was common. HIV-infected homosexual men with a depressive disorder showed no difference in depressive symptoms or sleep disturbance, compared with non-infected depressive men. However, HIV-positive patients did express more symptoms like fear, anger and guilt. Although they showed significantly more suicidal ideation, suicide attempts were not more prevalent among HIV-infected patients. Finally, the HIV-infected depressive patients displayed a considerably higher level of drug use than the HIV-negative group. CONCLUSION Habitual drug use is a risk factor for spreading HIV. It is also more often diagnosed in HIV-infected homosexual men with a lifetime depression or dysthymic disorder than in the non-infected population. Untreated mental health problems, such as depressive symptoms and use of drugs can have serious repercussions. Therefore, general practitioners and internists should be trained to recognize mental health problems in HIV-infected patients.
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Affiliation(s)
- Annemiek Schadé
- Expert and Treatment Center on HIV and Mental Health, GGZ inGeest, VU University Medical Center, AJ Ernststraat 1187, Amsterdam 1081 HL, The Netherlands.
| | - Gerard van Grootheest
- Expert and Treatment Center on HIV and Mental Health, GGZ inGeest, VU University Medical Center, AJ Ernststraat 1187, Amsterdam, 1081 HL, The Netherlands
| | - Johannes H Smit
- Expert and Treatment Center on HIV and Mental Health, GGZ inGeest, VU University Medical Center, AJ Ernststraat 1187, Amsterdam, 1081 HL, The Netherlands
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Eller LS, Kirksey KM, Nicholas PK, Corless IB, Holzemer WL, Wantland DJ, Willard SS, Robinson L, Hamilton MJ, Sefcik EF, Moezzi S, Mendez MR, Rosa M, Human S. A randomized controlled trial of an HIV/AIDS Symptom Management Manual for depressive symptoms. AIDS Care 2012; 25:391-9. [PMID: 22880943 DOI: 10.1080/09540121.2012.712662] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Abstract Depressive symptoms are highly prevalent, underdiagnosed, and undertreated in people living with HIV/AIDS (PLWH), and are associated with poorer health outcomes. This randomized controlled trial examined the effects of the HIV/AIDS Symptom Management Manual self-care symptom management strategies compared with a nutrition manual on depressive symptoms in an international sample of PLWH. The sample consisted of a sub-group (N=222) of participants in a larger study symptom management study who reported depressive symptoms. Depressive symptoms of the intervention (n=124) and control (n=98) groups were compared over three months: baseline, one-month, and two-months. Use and effectiveness of specific strategies were examined. Depressive symptom frequency at baseline varied significantly by country (χ (2) 12.9; p=0.04). Within the intervention group there were significant differences across time in depressive symptom frequency [F(2, 207) = 3.27, p=0.05], intensity [F(2, 91) = 4.6, p=0.01], and impact [F(2, 252) = 2.92, p= 0.05), and these were significantly lower at one month but not at two months, suggesting that self-care strategies are effective in reducing depressive symptoms, however effects may be short term. Most used and most effective self-care strategies were distraction techniques and prayer. This study suggests that people living with HIV can be taught and will employ self-care strategies for management of depressive symptoms and that these strategies are effective in reducing these symptoms. Self-care strategies are noninvasive, have no side-effects, and can be readily taught as an adjunct to other forms of treatment. Studies are needed to identify the most effective self-care strategies and quantify optimum dose and frequency of use as a basis for evidence-based practice.
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Affiliation(s)
- Lucille S Eller
- College of Nursing, Rutgers, The State University of New Jersey, Newark, NJ, USA.
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White W, Grant JS, Pryor ER, Keltner NL, Vance DE, Raper JL. Do Social Support, Stigma, and Social Problem-Solving Skills Predict Depressive Symptoms in People Living With HIV? A Mediation Analysis. Res Theory Nurs Pract 2012; 26:182-204. [DOI: 10.1891/1541-6577.26.3.182] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Social support, stigma, and social problem solving may be mediators of the relationship between sign and symptom severity and depressive symptoms in people living with HIV (PLWH). However, no published studies have examined these individual variables as mediators in PLWH. This cross-sectional, correlational study of 150 PLWH examined whether social support, stigma, and social problem solving were mediators of the relationship between HIV-related sign and symptom severity and depressive symptoms. Participants completed self-report questionnaires during their visits at two HIV outpatient clinics in the Southeastern United States. Using multiple regression analyses as a part of mediation testing, social support, stigma, and social problem solving were found to be partial mediators of the relationship between sign and symptom severity and depressive symptoms, considered individually and as a set.
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