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Liu Y, Yang Y, Fu C, Lin H, Wang T, Wang S, Kuang J, Chen X, Wang J. Loneliness and depressive symptoms among men who have sex with men in China: A cross-sectional study. Front Psychiatry 2023; 14:1179703. [PMID: 37091698 PMCID: PMC10117785 DOI: 10.3389/fpsyt.2023.1179703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 03/21/2023] [Indexed: 04/25/2023] Open
Abstract
Background While psychosocial problems and their related factors in men who have sex with men (MSM) have been well documented in developed countries, there are still not many studies addressing this issue in China and the results are inconsistent. This study aimed to assess the prevalence of loneliness and depressive symptoms among MSM, examine their associated factors, and investigate potential factors moderating the link between depressive symptoms and loneliness. Methods A cross-sectional study was conducted in Taizhou of Zhejiang Province in China between April and November 2021. Loneliness was assessed using the 3-item UCLA Loneliness Scale (UCLA-3), and depressive symptoms were measured using the Patient Health Questionaire-9 (PHQ-9). Data from 655 MSM were eligible for analysis. Logistic regression models were used to examine the associations between independent variables and the outcomes of loneliness and depression. The interaction terms were added in the models to assess the moderating effects. Results Of the MSM sample, 13.28 and 7.48% perceived loneliness and reported moderate-to-severe depressive symptoms, respectively. We found that participants who experienced loneliness were more likely to have younger age (OR 0.44, 95% CI 0.21, 0.93, 15-32 years as reference group), low social support (OR 3.60, 95% CI 2.14, 6.04), low self-esteem (OR 3.03, 95% CI 1.45, 6.32) and moderate-to-severe depressive symptoms (OR 5.45, 95% CI 2.66, 11.15). The participants with moderate-to-severe depressive symptoms were more likely to have low self-esteem (OR 6.78, 95% CI 3.08, 14.95) and feelings of loneliness (OR 5.51, 95% CI 2.66, 11.40). Stratified analyzes showed that the magnitude of the associations between depressive symptoms and loneliness varied in MSM with different age, marital status, and self-esteem. Conclusion Our study suggests that we need to pay attention to feelings of loneliness and depressive symptoms and their closely associated factors such as social support and self-esteem among MSM in China. The MSM who were young, not married, and had low self-esteem were especially vulnerable to the impact of depressive symptoms on loneliness.
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Affiliation(s)
- Yuhan Liu
- NHC Key Laboratory of Health Technology Assessment, School of Public Health, Fudan University, Shanghai, China
| | - Yuting Yang
- NHC Key Laboratory of Health Technology Assessment, School of Public Health, Fudan University, Shanghai, China
| | - Chaowei Fu
- NHC Key Laboratory of Health Technology Assessment, School of Public Health, Fudan University, Shanghai, China
| | - Haijiang Lin
- Taizhou City Center for Disease Prevention and Control, Taizhou, China
| | - Tingting Wang
- Taizhou City Center for Disease Prevention and Control, Taizhou, China
| | - Shanling Wang
- Taizhou City Center for Disease Prevention and Control, Taizhou, China
| | - Jiawen Kuang
- NHC Key Laboratory of Health Technology Assessment, School of Public Health, Fudan University, Shanghai, China
| | - Xiaoxiao Chen
- NHC Key Laboratory of Health Technology Assessment, School of Public Health, Fudan University, Shanghai, China
- Taizhou City Center for Disease Prevention and Control, Taizhou, China
- Xiaoxiao Chen,
| | - Jingyi Wang
- NHC Key Laboratory of Health Technology Assessment, School of Public Health, Fudan University, Shanghai, China
- *Correspondence: Jingyi Wang,
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Fonseca Lima RA, Miranda-Filho DDB, Montarroyos UR, Cavalcanti ATDAE, Ximenes RADA. Adherence to antiretroviral therapy and factors associated with non-adherence: a cohort study at two referral services in Brazil. AIDS Care 2022; 35:961-969. [PMID: 35100884 DOI: 10.1080/09540121.2022.2029814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This cohort study evaluated non-adherence to antiretrovirals at referral services in Pernambuco, Brazil, 2016/2017, through self-report. A generalized mixed-effects model for binary outcomewas used. We assessed 542 participants with an adherence rate of 85.50%. A greater chance of non-adherence was associated with:a low/moderate level of nicotine dependence (OR = 2.79, p = 0.00, IC = 1.44-5.41); ≥7 tablets/day (OR = 6.14, p = 0.00, IC = 3.42-11.02); LPV/r (OR = 1.49, p = 0.6, IC = 0.98-2.26), ddI (OR = 3.34, p = 0.03, IC = 1.12-9.97), ABC (OR = 4.02, p = 0.05, IC = 1.01-16.03), RAL (OR = 2.49, p = 0.01, IC = 1.32-4.70) and DTG (OR = 4.65, p = 0.01, IC = 1.42-15.16); 6-10 year seropositive diagnosis (OR = 2.17, p = 0.01, IC = 1.20-3.92) and symptoms of depression (OR = 1.55, p = 0.03, IC = 1.03-2.33). Protective factors for non-adherence weres: ≥50 years (OR = 0.67, p = 0.06, IC = 0.45-1.01), secondary/higher education (OR = 0.48, p = 0.00, IC = 0.34-0.70), embarrassment at health service (OR = 0.49, p = 0.04, IC = 0.24-0.97), good understanding of antiretrovirals (OR = 0.62, p = 0.03, IC = 0.40-0.96), adverse event (OR = 0.74, p = 0,06, IC = 0.54-1.01), use of TDF (OR = 0.62, p = 0.01, IC = 0.43-0.90), NVP (OR = 0.41, p = 0.05, IC = 0.71-1.00) and EFZ (OR = 0.48, p = 0.01, IC = 0.29-0.80) and good knowledge of HIV/AIDS/ART. (OR = 0.67, p = 0.07, IC = 0.43-1.04). Variables with stronger association were those linked to ART. Systematic use of self-report adherence is recommended for priority groups.
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Affiliation(s)
- Rosário Antunes Fonseca Lima
- Faculdade Enfermagem Nossa Senhora das Graças, Universidade de Pernambuco, Recife, Brazil
- Programa de Pós-graduação de Ciências da Saúde, Universidade de Pernambuco, Recife, Brazil
| | - Demócrito de Barros Miranda-Filho
- Programa de Pós-graduação de Ciências da Saúde, Universidade de Pernambuco, Recife, Brazil
- Faculdade de Ciências Médicas, Universidade de Pernambuco, Recife, Brazil
| | - Ulísses Ramos Montarroyos
- Programa de Pós-graduação de Ciências da Saúde, Universidade de Pernambuco, Recife, Brazil
- Instituto de Ciências Biológicas, Universidade de Pernambuco, Recife, Brazil
| | - Aracele Tenório de Almeida e Cavalcanti
- Programa de Pós-graduação de Ciências da Saúde, Universidade de Pernambuco, Recife, Brazil
- Hospital das Clínicas, Universidade Federal de Pernambuco, Recife, Brazil
| | - Ricardo Arraes de Alencar Ximenes
- Programa de Pós-graduação de Ciências da Saúde, Universidade de Pernambuco, Recife, Brazil
- Faculdade de Ciências Médicas, Universidade de Pernambuco, Recife, Brazil
- Departamento de Medicina Tropical, Universidade Federal de Pernambuco, Recife, Brazil
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Woodward H, Du Bois SN, Tully T, Fraine S, Guy AA. Results of a Brief, Peer-Led Intervention Pilot on Cognitive Escape Among African American Adults Living With HIV, Comorbid Serious Mental Illness, and a History of Adverse Childhood Experiences. J Assoc Nurses AIDS Care 2021; 32:512-521. [PMID: 34171886 DOI: 10.1097/jnc.0000000000000245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Honor Woodward
- Honor Woodward, BS, is a PhD Student, Illinois Institute of Technology, Chicago, Illinois, USA. Steve N. Du Bois, PhD, is a licensed Clinical Psychologist and Assistant Professor of psychology, Illinois Institute of Technology, Chicago, Illinois, USA. Timothy Tully, BS, is a Research Assistant, Illinois Institute of Technology, Chicago, Illinois, USA. Shawn Fraine, MS, is a PhD Student, Illinois Institute of Technology, Chicago, Illinois, USA. Arryn A. Guy, PhD, is a Postdoctoral Research Fellow, Center for Alcohol and Addiction Studies, Brown University School of Public Health and the Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island, USA
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Hill LM, Golin CE, Gottfredson NC, Pence BW, DiPrete B, Carda-Auten J, Groves JS, Napravnik S, Wohl D, Knight K, Flynn PM. Drug Use Mediates the Relationship Between Depressive Symptoms and Adherence to ART Among Recently Incarcerated People Living with HIV. AIDS Behav 2019; 23:2037-2047. [PMID: 30535731 DOI: 10.1007/s10461-018-2355-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Depression is a known risk factor for antiretroviral therapy (ART) non-adherence, but little is known about the mechanisms explaining this relationship. Identifying these mechanisms among people living with HIV (PLHIV) after release from prison is particularly important, as individuals during this critical period are at high risk for both depression and poor ART adherence. 347 PLHIV recently released from prison in North Carolina and Texas were included in analyses to assess mediation of the relationship between depressive symptoms at 2 weeks post-release and ART adherence (assessed by unannounced telephone pill counts) at weeks 9-21 post-release by the hypothesized explanatory mechanisms of alcohol use, drug use, adherence self-efficacy, and adherence motivation (measured at weeks 6 and 14 post-release). Indirect effects were estimated using structural equation models with maximum likelihood estimation and bootstrapped confidence intervals. On average, participants achieved 79% ART adherence. The indirect effect of depression on adherence through drug use was statistically significant; greater symptoms of depression were associated with greater drug use, which was in turn associated with lower adherence. Lower adherence self-efficacy was associated with depressive symptoms, but not with adherence. Depression screening and targeted mental health and substance use services for depressed individuals at risk of substance use constitute important steps to promote adherence to ART after prison release.
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Affiliation(s)
- Lauren M Hill
- Department of Health Behavior, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Carol E Golin
- Department of Health Behavior, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Division of Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Nisha C Gottfredson
- Department of Health Behavior, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Brian W Pence
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Bethany DiPrete
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jessica Carda-Auten
- Department of Health Behavior, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jennifer S Groves
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Sonia Napravnik
- Division of Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - David Wohl
- Division of Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Kevin Knight
- Department of Psychology, Texas Christian University, Fort Worth, TX, USA
| | - Patrick M Flynn
- Department of Psychology, Texas Christian University, Fort Worth, TX, USA
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Su X, Zhou AN, Li J, Shi LE, Huan X, Yan H, Wei C. Depression, Loneliness, and Sexual Risk-Taking Among HIV-Negative/Unknown Men Who Have Sex with Men in China. ARCHIVES OF SEXUAL BEHAVIOR 2018; 47:1959-1968. [PMID: 29147806 PMCID: PMC5955768 DOI: 10.1007/s10508-017-1061-y] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Revised: 06/20/2017] [Accepted: 08/11/2017] [Indexed: 05/09/2023]
Abstract
Research conducted among men who have sex with men (MSM) in high-income countries has demonstrated that negative mental health is one of the significant drivers of HIV infection, and few studies have examined the status of mental health among MSM in China. We sought to describe depression and loneliness and identify their correlates among Chinese MSM. A cross-sectional study was conducted among HIV-negative or unknown status MSM in 2014. Time-location sampling and online convenience sampling methods were employed. Depression was measured via a short version of CES-D (CES-D 10). Loneliness was measured from a single item in CES-D 10. Multivariable logistic regressions were conducted to identify independent correlates of depression and loneliness. A total of 507 individuals participated in the study. Of them, 26.8 and 35.5% reported moderate-to-severe symptoms of depression and feeling lonely, respectively. Depressed participants were more likely to have a sense of hopelessness for the future (AOR 3.20, 95% CI 1.90, 5.20) and report higher levels of internalized homophobia (AOR 2.32, 95% CI 1.47, 3.67). Participants who reported feeling lonely were more likely to have had condomless receptive anal intercourse in the past 6 months (AOR 1.67, 95% CI 1.08, 2.58) and feel hopeless for the future (AOR 2.40, 95% CI 1.60, 3.70). MSM in China have significant rates of depression and loneliness. HIV prevention efforts should address the mental health needs of Chinese MSM such as providing safe environments for social support and role models.
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Affiliation(s)
- Xiaoyou Su
- School of Public Health, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - A Ning Zhou
- Department of Psychiatry, University of California, San Francisco, CA, USA
| | - Jianjun Li
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Ling-En Shi
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Xiping Huan
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Hongjing Yan
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Chongyi Wei
- Department of Epidemiology and Biostatistics & Global Health Sciences, University of California, 50 Beale St., Suite 1300, San Francisco, CA, 94105, USA.
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Rooks-Peck CR, Adegbite AH, Wichser ME, Ramshaw R, Mullins MM, Higa D, Sipe TA. Mental health and retention in HIV care: A systematic review and meta-analysis. Health Psychol 2018; 37:574-585. [PMID: 29781655 PMCID: PMC6103311 DOI: 10.1037/hea0000606] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Mental health (MH) diagnoses, which are prevalent among persons living with HIV infection, might be linked to failed retention in HIV care. This review synthesized the quantitative evidence regarding associations between MH diagnoses or symptoms and retention in HIV care, as well as determined if MH service utilization (MHSU) is associated with improved retention in HIV care. METHOD A comprehensive search of the Centers for Disease Control and Prevention's HIV/AIDS Prevention Research Synthesis database of electronic (e.g., MEDLINE, EMBASE, PsycINFO) and manual searches was conducted to identify relevant studies published during January 2002-August 2017. Effect estimates from individual studies were pooled by using random-effects meta-analysis, and a moderator analysis was conducted. RESULTS Forty-five studies, involving approximately 57,334 participants in total, met the inclusion criteria: 39 examined MH diagnoses or symptoms, and 14 examined MHSU. Overall, a significant association existed between MH diagnoses or symptoms, and lower odds of being retained in HIV care (odds ratio, OR = 0.94; 95% confidence interval [CI] [0.90, 0.99]). Health insurance status (β = 0.004; Z = 3.47; p = .001) significantly modified the association between MH diagnoses or symptoms and retention in HIV care. In addition, MHSU was associated with an increased odds of being retained in HIV care (OR = 1.84; 95% CI [1.45, 2.33]). CONCLUSIONS Results indicate that MH diagnoses or symptoms are a barrier to retention in HIV care and emphasize the importance of providing MH treatment to HIV patients in need. (PsycINFO Database Record
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Affiliation(s)
| | | | | | | | - Mary M Mullins
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention
| | - Darrel Higa
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention
| | - Theresa Ann Sipe
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention
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Latkin CA, Van Tieu H, Fields S, Hanscom BS, Connor M, Hanscom B, Hussen SA, Scott HM, Mimiaga MJ, Wilton L, Magnus M, Chen I, Koblin BA. Social Network Factors as Correlates and Predictors of High Depressive Symptoms Among Black Men Who Have Sex with Men in HPTN 061. AIDS Behav 2017; 21:1163-1170. [PMID: 27480454 PMCID: PMC5288401 DOI: 10.1007/s10461-016-1493-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Depression is linked to a range of poor HIV-related health outcomes. Minorities and men who have sex with men (MSM), suffer from high rates of depression. The current study examined the relationship between depressive symptoms and social network characteristics among community-recruited Black MSM in HPTN 061 from 6 US cities. A social network inventory was administer at baseline and depression was assessed with the CES-D at baseline, 6, and 12-months. At baseline, which included 1167 HIV negative and 348 HIV positive participants, size of emotional, financial, and medical support networks were significantly associated with fewer depressive symptoms. In longitudinal mixed models, size of emotional, financial, and medical support networks were significantly associated with fewer depressive symptoms as was the number of network members seen weekly. In the multivariate analyses, size of medical appointment network remained statistically significant (aOR 0.89, CI 0.81-0.98). These findings highlight the importance of network support of medical care on depression and suggest the value of support mobilization.
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Affiliation(s)
- Carl A Latkin
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, 737 Hampton House, Baltimore, MD, 21205, USA.
| | - Hong Van Tieu
- School of Medicine, Columbia University, New York, NY, USA
| | - Sheldon Fields
- Mervyn M. Dymally School of Nursing, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
| | - Brett S Hanscom
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Matt Connor
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Brett Hanscom
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Sophia A Hussen
- Hubert Department of Global Health, Rollins School of Public Health Division of Infectious Diseases, School of Medicine, Emory University, Atlanta, GA, USA
| | - Hyman M Scott
- San Francisco Department of Public Health, San Francisco, CA, USA
| | - Matthew J Mimiaga
- Department of Behavioral & Social Health Sciences and Epidemiology, School of Public Health, Brown University, Providence, RI, USA
| | - Leo Wilton
- Department of Human Development, State University of New York at Binghamton, Binghamton, NY, USA
| | - Manya Magnus
- Milken Institute School of Public Health, Department of Epidemiology and Biostatistics, George Washington University, Washington, USA
| | - Iris Chen
- School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Beryl A Koblin
- Laboratory of Infectious Disease Prevention Member, Lindsley F. Kimball Research Institute, New York Blood Center, New York, NY, USA
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Gómez CA, Tat SA, Allen D, Gordon D, Browe D. What Will It Take to End the HIV/AIDS Epidemic? Linking the Most Disenfranchised Into Care Through Outreach. AIDS Patient Care STDS 2017; 31:122-128. [PMID: 28282248 DOI: 10.1089/apc.2016.0241] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The 2015 National HIV/AIDS Strategy renewed its goal of increasing access to care for people living with HIV/AIDS (PLWHA) and called for an increased focus on linkage to care efforts. As many PLWHA face multiple barriers to care and live on the margins of society, adoption of intensive outreach activities is necessary to engage the most disenfranchised PLWHA into care and to ultimately end the HIV epidemic. The Bay Area Network for Positive Health (BANPH), comprising 12+ agencies, established a network outreach model for our linkage-to-care project to engage the hardest-to-reach populations in the San Francisco Bay Area. During the years 2010-2013, BANPH agencies conducted street outreach, analyzed internal tracking systems to identify out-of-care individuals and individuals experiencing tenuous care, and surveyed participants using Apple iPod Touch devices. During the 3-year project, BANPH agencies engaged 602 out-of-care PLWHA and linked 440 to care. On average, outreach workers made 10 contact attempts with a client to link them to care. Sixty-three percent of participants were linked to care on an average of 56 days after initial contact. Factors, including lack of case management, lack of transportation, competing concerns, substance abuse, and HIV stigma, were significantly associated with linkage-to-care outcomes. Intensive outreach efforts could help to reduce barriers to care for hard-to-reach PLWHA, but these efforts require a tremendous amount of time and resources. A network outreach model could help facilitate sharing of limited resources and increase regional outreach capacity for linkage-to-care programs.
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Affiliation(s)
- Cynthia A. Gómez
- Health Equity Institute, San Francisco State University, San Francisco, California
| | - Susana A. Tat
- Health Equity Institute, San Francisco State University, San Francisco, California
| | - Debra Allen
- Health Equity Institute, San Francisco State University, San Francisco, California
| | - Danielle Gordon
- Health Equity Institute, San Francisco State University, San Francisco, California
| | - Dennis Browe
- Health Equity Institute, San Francisco State University, San Francisco, California
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Zuniga JA, Yoo-Jeong M, Dai T, Guo Y, Waldrop-Valverde D. The Role of Depression in Retention in Care for Persons Living with HIV. AIDS Patient Care STDS 2016; 30:34-8. [PMID: 26544915 DOI: 10.1089/apc.2015.0214] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Individuals infected with HIV experience high rates of depression when compared to their sero-negative counterparts. Although symptoms of depression have been consistently linked to poor medication adherence among persons living with HIV/AIDS, their relation to retention in care are less well-known. The purpose of this study was to examine whether clusters of depressive symptoms influence retention in care and if so, whether these clusters had different relations to retention in care. This is a secondary data analysis of a larger study that investigated the role of health literacy, cognitive impairment, and social determinants on retention in HIV care. Individuals with HIV were recruited from South Florida from August 2009 to May 2011. A total of 210 participants were included in the current analyses. A measure of visit constancy was calculated to represent the number of 4-month intervals with at least one kept visit. Individual items on the Center for Epidemiological Studies Depression Scale short form (CES-D10) and factor analysis of the CES-D10 were independent variables. Overall, there was a high prevalence of depressive symptoms in the study participants. Furthermore, factor analysis showed that certain clusters of depressive symptoms were significantly associated with visit constancy. Specifically, negative mood/somatic symptoms were associated with a greater odds of missing a visit in any of the observed 4-month time periods than positive mood factor. Those patients reporting somatic symptoms and negative mood may need additional intervention and support to be effectively retained in care and successfully follow through with appointments and care.
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Affiliation(s)
- Julie Ann Zuniga
- School of Nursing, The University of Texas at Austin, Austin, Texas
| | - Moka Yoo-Jeong
- Nell Hodgson School of Nursing, Emory University, Atlanta, Georgia
| | - Tian Dai
- Rollins School of Public Health of Department of Biostatistics and Bioinformatics, Emory University, Atlanta, Georgia
| | - Ying Guo
- Rollins School of Public Health of Department of Biostatistics and Bioinformatics, Emory University, Atlanta, Georgia
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Rongkavilit C, Wang B, Naar-King S, Bunupuradah T, Parsons JT, Panthong A, Koken JA, Saengcharnchai P, Phanuphak P. Motivational interviewing targeting risky sex in HIV-positive young Thai men who have sex with men. ARCHIVES OF SEXUAL BEHAVIOR 2015; 44:329-340. [PMID: 24668304 PMCID: PMC4177013 DOI: 10.1007/s10508-014-0274-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Revised: 08/08/2013] [Accepted: 08/29/2013] [Indexed: 05/28/2023]
Abstract
Motivational interviewing (MI) has been shown to reduce sexual risks among HIV-positive men who have sex with men (HMSM) in the US. We conducted a randomized trial of Healthy Choices, a 4-session MI intervention, targeting sexual risks among 110 HIV-positive youth ages 16-25 years in Thailand. Risk assessments were conducted at baseline, 1 month, and 6 months post-intervention. This report presents the analysis of 74 HMSM in the study. There were 37 HMSM in the Intervention group and 37 in the control group. The proportions of participants having anal sex and having sex with either HIV-uninfected or unknown partners in past 30 days were significantly lower in Intervention group than in Control group at 6 months post-intervention (38 vs. 65 %, p = .04; and 27 vs. 62 %, p < .01, respectively). There were no significant differences in general mental health scores and HIV stigma scores between the two groups at any study visit. Thirty-five (95 %) HMSM in the Intervention group vs. 31 (84 %) in control group attended ≥ 3 sessions. Loss to follow-up was 8 and 30 %, respectively (p = .04). Healthy Choices for young Thai HMSM was associated with sexual risk reduction. Improvements in mental health were noted in Intervention group. Healthy Choices is a promising behavioral intervention and should be further developed to serve the needs of young HMSM in resource-limited countries.
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Affiliation(s)
- Chokechai Rongkavilit
- The Carman and Ann Adams Department of Pediatrics, Wayne State University School of Medicine, 3901 Beaubien Blvd., Detroit, MI, 48201, USA,
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11
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Pantalone DW, Huh D, Nelson KM, Pearson CR, Simoni JM. Prospective predictors of unprotected anal intercourse among HIV-seropositive men who have sex with men initiating antiretroviral therapy. AIDS Behav 2014; 18:78-87. [PMID: 23640652 DOI: 10.1007/s10461-013-0477-1] [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: 11/24/2022]
Abstract
Contemporary HIV prevention efforts are increasingly focused on those already living with HIV/AIDS (i.e., "prevention with positives"). Key to these initiatives is research identifying the most risky behavioral targets. Using a longitudinal design, we examined socio-demographic and psychosocial factors that prospectively predicted unprotected anal intercourse (UAI) in a sample of 134 HIV-seropositive men who have sex with men (MSM) initiating, changing, or re-starting an antiretroviral therapy regimen as part of a behavioral intervention study. Computer-based questionnaires were given at baseline and 6 months. In a sequential logistic regression, baseline measures of UAI (step 1), socio-demographic factors such as Latino ethnicity (step 2), and psychosocial factors such as crystal methamphetamine use, greater life stress, and lower trait anxiety (step 3) were predictors of UAI at 6 months. Problem drinking was not a significant predictor. Prevention efforts among MSM living with HIV/AIDS might focus on multiple psychosocial targets, like decreasing their crystal methamphetamine use and teaching coping skills to deal with life stress.
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Affiliation(s)
- David W Pantalone
- Department of Psychology, University of Massachusetts, 100 Morrissey Boulevard, Boston, MA, 02125, USA,
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