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Sun W, Lu H, Huang F, Shiu CS, Zhang L, Chen WT. Longitudinal trajectory of the association between quality of life and depression among people living with HIV in China: a mixed effects model. AIDS Care 2021; 34:966-973. [PMID: 34668807 PMCID: PMC9508898 DOI: 10.1080/09540121.2021.1991879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
ABSTRACTAlthough depression has been associated with low QOL, limited research has quantified the change of depression to improvement of QOL among naïve PLHIV using ART in Shanghai, China. This study examined the association between depression symptoms and QOL among Chinese PLWH in a six-month longitudinal study. Data were collected from 111 people living with HIV at baseline, 3rd month and 6th month after initiating ART, using the WHOQOL-HIV BREF and the Center for Epidemiologic Studies Depression Scale (CES-D), and analyzed using a mixed effects model. QOL is improved after initiating ART, while the symptoms of depression did not decrease significantly. The depression symptoms were strong and negatively associated with QOL and all domains of QOL, and the strength of this association decreased over time in the six months follow-up. ART had different impacts on depression symptoms and QOL. Besides, depression symptoms were strong and negatively associated with QOL among PLHIV over time. Mental health practitioners and nurses should consider the ART and time factors when designed interventions to improve QOL by targeting depression symptoms. Interventions designed to improve QOL and depression symptoms should be developed targeting both ART and self-management among PLHIV.
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Affiliation(s)
- Wenxiu Sun
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, People's Republic of China
| | - Hongzhou Lu
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, People's Republic of China
| | - Feifei Huang
- School of Nursing, Fujian Medical University, Fuzhou, People's Republic of China
| | - Cheng-Shi Shiu
- Department of Social Work, National Taiwan University, Taipei, Taiwan
| | - Lin Zhang
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, People's Republic of China
| | - Wei-Ti Chen
- School of Nursing, University of California Los Angeles, Los Angeles, CA, USA
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Xiao Y, Lin C, Li L, Ji G. Individual and family level factors associated with physical and mental health-related quality of life among people living with HIV in rural China. BMC Public Health 2019; 19:4. [PMID: 30606187 PMCID: PMC6318837 DOI: 10.1186/s12889-018-6352-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 12/20/2018] [Indexed: 01/10/2023] Open
Abstract
Background One of the major challenges faced by people living with HIV (PLH) is the compromised quality of life due to the negative impact of HIV on their health. HIV/AIDS control effort should go beyond laboratory and lay more emphasis on improving the health-related quality of life (HRQoL) for PLH. The objective of this study is to evaluate the physical and mental HRQoL of PLH in rural China, and explore the relationship between HRQoL and individual- and family-level factors. Methods A cross-sectional study was conducted among 522 PLH in Anhui, China. Participant’s sociodemographic characteristics, family status, and HIV-related factors were collected. Physical health summary score (PHS) and mental health summary score (MHS) of quality of life were measured. Multiple linear regressions were conducted to estimate the association of the individual- and family-level factors with MHS and PHS. Results Male were more likely to report a higher level of PHS and MHS than female (β = 0.123, P = 0.009; β = 0.150, P = 0.002). Age was significantly negatively associated with the PHS (β = − 0.232, P<0.001) when other variables were controlled. Family size remained negatively correlated with PHS (β = − 0.105, P = 0.021). Family annual income was significantly positively associated with PHS and MHS (β = 0.126, P = 0.003; β = 0.135, P = 0.002). Conclusions Future intervention should be carefully tailored to the specific needs of sub-populations (such as female and older PLH) considering their physical and mental HRQoL conditions. More attention and care should be provided to PLH with left-behind children in the family.
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Affiliation(s)
- Yongkang Xiao
- Department of HIV/AIDS Prevention, Anhui Provincial Center for Disease control and Prevention, Hefei, China
| | - Chunqing Lin
- Semel Institute for Neuroscience and Human Behavior, Center for Community Health, University of California at Los Angeles, Los Angeles, CA, USA
| | - Li Li
- Semel Institute for Neuroscience and Human Behavior, Center for Community Health, University of California at Los Angeles, Los Angeles, CA, USA
| | - Guoping Ji
- Anhui Provincial Center for Woman and Child Health, 38 Yonghong Road, Hefei, 230032, China.
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Lindayani L, Ibrahim K, Wang JD, Ko NY. Independent and synergistic effects of self- and public stigmas on quality of life of HIV-infected persons. AIDS Care 2017; 30:706-713. [PMID: 29115159 DOI: 10.1080/09540121.2017.1396282] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Stigma has a potential impact on the quality of life of HIV-infected individuals over time. There is little empirical evidence regarding the first appearance and dynamic changes among different types of stigma, self-stigma and public-stigma, and their impacts on quality of life over time in HIV-infected persons. The purpose of this study was to assess the dynamic changes in self-stigma and public-stigma along the time course and determined their independent and synergistic impacts on quality of life. A Cross-sectional study was conducted at Two HIV-designed hospitals and two branches of non-government an-AIDS organizations in Wes Java, Indonesia. Persons diagnosed with HIV completed self-report measures of stigma and the questionnaire of World Health Organization Quality of Life (WHOQOL)-HIV brief version. Kernel smoothing method and multivariate linear regression were applied for statistical analysis. Two hundred fifteen adult HIV-infected persons agreed to participate in this study, with a response rate of 85.3%. The kernel smoothing means showed that one-third of subjects developed self-stigma immediately after HIV diagnosis while a higher public-stigma felt 6 months later, and both seemed to last continually. Beginning at about 48 months after diagnosis, participants with stigma showed consistently lower scores for all domains of quality of life. After control of potential confounding through multiple linear regression analyses, we found scores of all four domains and items of mobility, fatigue, activity of daily living, positive feeling, self-esteem, social support, and physical environment of WHOQOL were independently associated with both self-stigma and public-stigma. While self-stigma also affects items related to personal psychological feelings, public stigma alone associates with lower scores of items related to social and environmental domains. Our findings underscore the need to explore and control the complex structure and possible synergistic effects of multiple stigmatizations.
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Affiliation(s)
- Linlin Lindayani
- a Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University , Tainan , Taiwan.,b Sekolah Tinggi Ilmu Keperawatan Persatuan Perawat Nasional Indonesia (PPNI) Jawa Barat , Bandung , Indonesia.,e Department of Nursing , College of Medicine, National Cheng Kung University , Tainan , Taiwan
| | - Kusman Ibrahim
- c Faculty of Nursing , Univeristas Padjadjaran , Bandung , Indonesia
| | - Jung-Der Wang
- d Department of Public Health , National Cheng Kung University College of Medicine , Tainan , Taiwan
| | - Nai-Ying Ko
- e Department of Nursing , College of Medicine, National Cheng Kung University , Tainan , Taiwan.,f Nursing Department , National Cheng Kung Univeristy Hospital , Tainan , Taiwan
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Krause DD, May WL. Is It a Trust Issue? Factors That Influence Trust for Persons Living With HIV/AIDS. Health Promot Pract 2016; 17:711-21. [PMID: 27095034 DOI: 10.1177/1524839916629388] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Trust in one's health care provider, trust in the health care system in general, and even trust in one's community affects engagement in HIV-related health care. This article examines the issue of trust among a random sample of HIV-infected individuals residing in Mississippi, an area hard-hit by the HIV/AIDS epidemic. Five constructs based on survey responses from these individuals were developed: (1) trust in one's provider to offer the best possible medical care, (2) trust in one's provider to protect patient privacy, (3) willingness to disclose HIV status to one's provider, (4) trust in the health care system, and (5) trust in one's community. Findings suggest that interventions to improve trust in providers to deliver the highest quality of care should be targeted to young people, African Americans, and the more highly educated. Interventions to increase trust in providers to protect privacy should focus on creating and strengthening social support groups or networks that build relationships and foster trust. Interventions aimed to increase community trust also should be targeted to young people. This information is useful to researchers, policy makers, health care providers, and organizations interested in prioritizing interventions and strategies that have the greatest potential to reduce health disparities in HIV diagnosis and treatment in the Deep South.
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Affiliation(s)
| | - Warren L May
- University of Mississippi Medical Center, Jackson, MI, USA
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Liu Z, Yang J. Health related quality of life: is it another comprehensive evaluation indicator of Chinese medicine on acquired immune deficiency syndrome treatment? J TRADIT CHIN MED 2015; 35:600-5. [PMID: 26591693 DOI: 10.1016/s0254-6272(15)30146-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Health related quality of life (HRQOL) can better reflect changes in acquired immune deficiency syndrome (AIDS) patients and inform economic evaluation of AIDS treatment services, and the assessment of HRQOL can help us to detect problems that may influence the progression of the disease, hence HRQOL has become a particularly important assessment indictor for HIV comprehensive interventions. Being a multi-angle, multi-level, and diversified complex intervention, roles of Chinese medicine (CM) in AIDS treatment have been recognized and accepted by more and more patients, and HRQOL has been widely used to evaluate the comprehensive management effects of CM on AIDS. In this article, the authors analyze the definition and measurement of HRQOL, measurement of HRQOL of HIV/AIDS patients and effects of CM on AIDS, and give some reasonable advices for the usage of the scale of HRQOL. The authors hold that some new HRQOL instruments specific for CM treatment of AIDS should be developed and further prospective studies should be carried out to demonstrate the practicality, reliability and validity of HRQOL as an evaluation indictor for CM treatment of AIDS.
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Krause DD, May WL. Using a Mandatory Reporting Database to Recruit Persons Living With HIV/AIDS to Study Access to Care in Mississippi. Health Promot Pract 2013; 15:189-98. [DOI: 10.1177/1524839913498086] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Using funds provided by the Ryan White Care Act, we conducted a statewide needs assessment of persons living with HIV/AIDS (PLWHA) in Mississippi as required by provisions of the Act. Most published research addressing access to care for PLWHA is based on convenience samples of persons already accessing care in specified clinic locations. For this study of a single state with a well-established mandatory reporting system, we conducted a cross-sectional study interviewing a random sample of PLWHA across the state of Mississippi. The Mississippi State Department of Health has maintained the Mississippi HIV/AIDS Reporting System since its inception in 1980. The database tracks all reported cases of HIV+ cases and includes name, age, last-known address, and other contact information. The sample was selected from a frame of all recorded PLWHA in Mississippi at that time, regardless of their association with care facilities. The purpose of this article is to describe the design and methodology of this study, difficulties encountered in locating this hard-to-reach population, multimethod recruiting strategies and outcomes, and lessons learned. Locating participants using a truly random sample from a mandatory reporting database was resource intensive. However, data collected as a result of these efforts have provided invaluable information on a number of topics important to PLWHA.
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Affiliation(s)
| | - Warren L. May
- University of Mississippi Medical Center, Jackson, MS, USA
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Krause DD, May WL, Butler KR. Determining unmet, adequately met, and overly met needs for health care and services for persons living with HIV/AIDS in Mississippi. AIDS Care 2012; 25:973-9. [PMID: 23252519 DOI: 10.1080/09540121.2012.748880] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
A statewide needs assessment of persons living with HIV/AIDS (PLWHA) was conducted to determine what is known about access to care, utilization of services, and perceived barriers to receiving care and services. Our objective was to determine which needs were being met or unmet among PLWHA in Mississippi to provide a better understanding of how effectively to allocate funding to provide for the needs of that group. In this cross-sectional study, a true random sample of PLWHA in Mississippi was interviewed in 2005-2006. Questions were asked to identify opinions about respondents' experiences with 23 health care services and 30 public or private assistance services. The kappa statistic was used to measure agreement between level of services needed and level of services provided. Services with the lowest kappa scores revealed which services were being either mostly unmet, or even overly met. Greatest service needs were HIV viral load test, Pap smear, CD4/T-cell count test, and medication for HIV/AIDS, which were reasonably well met. The most significantly unmet needs were dental care and dental exams, eye care and eye exams, help paying for housing, subsidized housing assistance, mental health therapy or counseling, access to emotional support groups, and job placement or employment. Overly met services included medical care at a physician's office or clinic and free condoms. This study identified needs perceived to be significantly unmet by PLWHA, as well as areas that were perceived to be adequately or overly met. This information may be used to target areas with the greatest impact for improvement and provide insight into how to effectively allocate health care resources and public/private assistance.
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Affiliation(s)
- Denise D Krause
- School of Dentistry, University of Mississippi Medical Center, Jackson, MS, USA.
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Ma Y, Qin X, Chen R, Li N, Chen R, Hu Z. Impact of individual-level social capital on quality of life among AIDS patients in China. PLoS One 2012; 7:e48888. [PMID: 23139823 PMCID: PMC3490922 DOI: 10.1371/journal.pone.0048888] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2012] [Accepted: 10/01/2012] [Indexed: 01/17/2023] Open
Abstract
Background With growing recognition of the social determinants of health, social capital is an increasingly important construct in international health. However, the application of social capital discourse in response to HIV infection remains preliminary. The aim of this study was to assess the impact of social capital on quality of life (QoL) among adult patients with acquired immune deficiency syndrome (AIDS). Methods A convenient sample of 283 patients receiving antiretroviral treatment (ART) was investigated in Anhui province, China. QoL data were collected using the Medical Outcomes Study HIV Survey (MOS-HIV) questionnaire. Social capital was measured using a self-developed questionnaire. Logistic regression models were used to explore associations between social capital and QoL. Results The study sample had a mean physical health summary (PHS) score of 50.13±9.90 and a mean mental health summary (MHS) score of 41.64±11.68. Cronbach's α coefficients of the five multi-item scales of social capital ranged from 0.44 to 0.79. When other variables were controlled for, lower individual levels of reciprocity and trust were associated with a greater likelihood of having a poor PHS score (odds ratio [OR] = 2.02) or PHS score (OR = 6.90). Additionally, the factors of social support and social networks and ties were associated positively with MHS score (OR = 2.30, OR = 4.17, respectively). Conclusions This is the first report to explore the effects of social capital on QoL of AIDS patients in China. The results indicate that social capital is a promising avenue for developing strategies to improve the QoL of AIDS patients in China, suggesting that the contribution of social capital should be fully exploited, especially with enhancement of QoL through social participation. Social capital development policy may be worthy of consideration.
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Affiliation(s)
- Ying Ma
- School of Health Service Management, Anhui Medical University, Hefei, China
- School of Public Health, Anhui Medical University, Hefei, China
| | - Xia Qin
- School of Health Service Management, Anhui Medical University, Hefei, China
| | - Ruoling Chen
- School of Health Service Management, Anhui Medical University, Hefei, China
| | - Niannian Li
- The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Ren Chen
- School of Health Service Management, Anhui Medical University, Hefei, China
| | - Zhi Hu
- School of Health Service Management, Anhui Medical University, Hefei, China
- * E-mail:
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