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Daniels J, Nartey YA, Djankpa F, Simpore J, Obiri-Yeboah D. Characteristics and antiviral treatment eligibility of patients diagnosed with hepatitis B at a teaching hospital in Ghana: Implications for prevention and management. PLoS One 2024; 19:e0302086. [PMID: 39172867 PMCID: PMC11340950 DOI: 10.1371/journal.pone.0302086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 08/07/2024] [Indexed: 08/24/2024] Open
Abstract
Hepatitis B virus (HBV) infection poses a considerable public health challenge in limited-resource settings especially in the sub-Saharan African region. Even though HBV infection is incurable, timely treatment is effective in preventing disease progression to liver cirrhosis or hepatocellular carcinoma. However, not all infected patients require treatment. The aim of the study was to determine the clinical, immunological, and virological profiles of treatment naïve patients with HBV infection, seen at the outpatient clinic of the Cape Coast Teaching Hospital. Additionally, the study sought to determine the antiviral treatment eligibility rate based on the 2015 guidelines of the World Health Organization (WHO) compared with the new 2024 guidelines. A hospital-based cross-sectional study involving total sampling of 220 treatment naïve HBV surface antigen positive clients was carried out. A structured questionnaire was used to collect data that were analyzed with STATA version 16. The median age at diagnosis was 34 years (IQR 26.0-41.5) with a male to female ratio of 1:1.5. A total of 138 participants (62.7%) were diagnosed with HBV infection following voluntary testing. There was a median delay of 8.5 months (IQR 3.0-22.5) between initial diagnosis and patients' presentation for medical care. In all, 24 patients (10.9%) had abnormal clinical examination findings, 172 patients (78.2%) had HBV DNA levels ≤ 2000 IU/ml whereas 8 (3.6%) were seropositive for the HBV envelope antigen. A few patients had concomitant human immunodeficiency virus (2.7%) and hepatitis C virus (1.4%) infections. Treatment eligibility rate based on the WHO 2015 guidelines was 6.4% (n = 14), however, with the updated 2024 guidelines, treatment eligibility was 42.3% (n = 93). Increasing the screening rate among the general population, early linkage to clinical care of screen positives and vaccination of screen negatives will help reduce HBV-related clinical conditions in resource-limited settings.
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Affiliation(s)
- Joseph Daniels
- National Centre for Radiotherapy, Oncology and Nuclear Medicine, Korle Bu Teaching Hospital, Accra, Ghana
- Department of Microbiology and Immunology, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Yvonne A. Nartey
- Department of Internal Medicine and Therapeutics, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Francis Djankpa
- Department of Physiology, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Jacques Simpore
- Centre de Recherche Biomoléculaire Pietro Annigoni (CERBA), Ouagadougou, Burkina Faso
| | - Dorcas Obiri-Yeboah
- Department of Microbiology and Immunology, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana
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Nir J, Liberman A, Yackobovitch-Gavan M, Fraser D, Phillip M, Oron T. Nondisclosure of Type 1 Diabetes in Adolescence: A Single-Center Experience. Diabetes Spectr 2023; 37:124-129. [PMID: 38756425 PMCID: PMC11093764 DOI: 10.2337/ds23-0006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
Objective The aim of this study was to assess the extent of nondisclosure of type 1 diabetes in adolescents and investigate its association with several psychosocial parameters and clinical outcomes. Research design and methods This was a cross-sectional study based on data collected from 69 adolescents with type 1 diabetes who were 12-18 years of age and followed at our diabetes clinic. The degree of disclosure, demographics, diabetes management, and psychosocial issues were assessed via questionnaires. Clinical parameters were derived from medical records. Associations between nondisclosure status and clinical and psychosocial study variables were assessed. Results Fifty-three participants (77%) reported some extent of nondisclosure. Nondisclosure was associated with low self-esteem, reduced friend support, and increased diabetes-related worries. Nondisclosure was also found to be associated with diminished self-care behaviors related to insulin administration and with elevated A1C. Conclusion Our results demonstrate that nondisclosure of type 1 diabetes in adolescents may be more common than initially recognized and is likely associated with unfavorable psychological outcomes and reduced self-care and diabetes management. Our results emphasize the importance of social interactions and disclosure in adolescents and may serve as a potential stepping stone to address other social barriers hindering diabetes management.
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Affiliation(s)
- Judith Nir
- The Jesse Z. and Sara Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children’s Medical Center of Israel, Petah Tikva, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Alon Liberman
- The Jesse Z. and Sara Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children’s Medical Center of Israel, Petah Tikva, Israel
| | - Michal Yackobovitch-Gavan
- The Jesse Z. and Sara Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children’s Medical Center of Israel, Petah Tikva, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Drora Fraser
- Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beersheeba, Israel
| | - Moshe Phillip
- The Jesse Z. and Sara Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children’s Medical Center of Israel, Petah Tikva, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tal Oron
- The Jesse Z. and Sara Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children’s Medical Center of Israel, Petah Tikva, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Hashiba C, Imahashi M, Imamura J, Nakahata M, Kogure A, Takahashi H, Yokomaku Y. Factors Associated with Attrition: Analysis of an HIV Clinic in Japan. J Immigr Minor Health 2021; 23:250-256. [PMID: 32072376 PMCID: PMC7914243 DOI: 10.1007/s10903-020-00982-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This study evaluated the impact of a public medical interpreter on the follow-up clinic attendance rate of foreign-born people with HIV who live in Japan. Participants were patients who visited Nagoya Medical Center from 2009 to 2016. Lost to follow-up was defined as an absence from follow-up visits for more than six months without any notification. A log-rank test was conducted to compare the lost-to-follow-up rates by patients’ nation of origin and medical interpreter use. Of the 931 participants, 114 were foreign patients, whose overall attendance rate at 5 years was 75.5%, which was significantly lower than that of Japanese patients (94.1%, p < 0.001). There was no significant difference in regular attendance with respect to medical interpreter use (p = 0.09). Social support in addition to a medical interpreter may be needed to improve attendance rates in the study population.
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Affiliation(s)
- Chieko Hashiba
- Department of Nursing, Nagoya Medical Center, 4-1-1 Sannomaru, Naka-ku, Nagoya, 460-0001, Japan
| | - Mayumi Imahashi
- Department of Infectious Diseases, Nagoya Medical Center, 4-1-1 Sannomaru, Naka-ku, Nagoya, 460-0001, Japan.
| | - Junji Imamura
- Department of Infectious Diseases, Nagoya Medical Center, 4-1-1 Sannomaru, Naka-ku, Nagoya, 460-0001, Japan.,Department of Infectious Diseases, Sendai Medical Center, 2-8-8 Miyagino Miyagino-ku, Sendai, 983-8520, Japan
| | - Masashi Nakahata
- Department of Infectious Diseases, Nagoya Medical Center, 4-1-1 Sannomaru, Naka-ku, Nagoya, 460-0001, Japan
| | - Ayumi Kogure
- Department of Infectious Diseases, Nagoya Medical Center, 4-1-1 Sannomaru, Naka-ku, Nagoya, 460-0001, Japan
| | - Hideto Takahashi
- National Institute of Public Health, 2-3-6 Minami, Wako, 351-0197, Japan
| | - Yoshiyuki Yokomaku
- Department of Infectious Diseases, Nagoya Medical Center, 4-1-1 Sannomaru, Naka-ku, Nagoya, 460-0001, Japan
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Adekanle O, Komolafe AO, Olowookere SA, Ijarotimi O, Ndububa DA. Hepatitis B Infection: A Mixed Methods of Disclosure Pattern and Social Problems in the Nigerian Family. J Patient Exp 2020; 7:208-216. [PMID: 32851142 PMCID: PMC7427354 DOI: 10.1177/2374373519827965] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Background Hepatitis B virus (HBV) infection has a high prevalence rate in Nigeria. Disclosure of infection status to close partner and the public attracts support for infected people. This study looks at disclosure and social challenges of infected persons. Methods Mixed methods of patients' administered questionnaire and an in-depth interview conducted on HBV-infected respondents in a hospital in Nigeria were used. The study recruited all participants who satisfied the inclusion criteria. Data were entered into SPSS version 20 and analyzed using simple and inferential statistics and content analysis for the in-depth interview. Results A total of 205 participants completed the questionnaire study. Mean (standard deviation) age was 35.3 (±11.0) years. There were 121 married, 37 singles with noncohabiting partners and 47 singles without partners with disclosure rates being 96.7% versus 97.9% versus 89.2%, respectively. Singles disclosed infection more to their parents while married respondents disclosed infection more to their spouses. Singles had high rate of denial of sexual relationship (22.6%), emotional trauma (34.5%), broken relationships (11.4%), and surreptitious use of contraception for protection (67.6%). Married respondents had the highest rate of HBV vaccination of their family members (40.1%). Infection prevention and allaying fears of family members were their counseling needs. In-depth interview revealed that infected respondents usually expressed shock and depression at a positive test leading to fear and deception that put close associates at risk. Conclusion Hepatitis B virus-infected respondents have high rate of disclosure. Family problems of these people can therefore be solved through public enlightenment and individual counseling.
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Affiliation(s)
- Olusegun Adekanle
- Department of Medicine, Faculty of Clinical Sciences, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
- Olusegun Adekanle, Department of Medicine, Faculty of Clinical Sciences, Obafemi Awolwo University, Ile-Ife, Osun State, Nigeria.
| | - Akinwumi Oluwole Komolafe
- Department of Morbid Anatomy, Faculty of Basic Medical Sciences, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
| | - Samuel A Olowookere
- Department of Community Health, Faculty of Clinical Sciences, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
| | - Oluwasegun Ijarotimi
- Department of Medicine, Faculty of Clinical Sciences, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
| | - Dennis Amajuoyi Ndububa
- Department of Medicine, Faculty of Clinical Sciences, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
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Adjei CA, Stutterheim SE, Naab F, Ruiter RAC. "To die is better than to tell": reasons for and against disclosure of chronic hepatitis B status in Ghana. BMC Public Health 2020; 20:663. [PMID: 32398150 PMCID: PMC7216649 DOI: 10.1186/s12889-020-08811-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Accepted: 04/29/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND People with a condition subject to stigmatisation, such as chronic hepatitis B, face the dilemma of whether or not to disclose their status. In Ghana, 12.3% of the adult population has the hepatitis B virus (HBV). One key strategy for breaking the cycle of hepatitis B transmission is the disclosure of hepatitis B status by people with chronic hepatitis B (PWHB). Disclosure can facilitate preventive actions to reduce hepatitis B transmission (e.g., not sharing personal items and avoiding contact with blood and body fluids). Disclosure can also motivate family members of PWHB to get tested, linked to care and clinically managed in order to reduce the progression of hepatitis B to liver cirrhosis and cancer. Given the importance of disclosure, we set out to explore reasons for and against disclosure of chronic hepatitis B status in the Greater Accra and Upper East region of Ghana. METHODS In this exploratory qualitative study, 18 participants (10 from the Greater Accra region and 8 from the Upper East region) were recruited for semi-structured interviews. Interviews were recorded and transcribed verbatim. Data were then processed using QSR Nvivo version 10.0 and analysed for themes. RESULTS Participants were selective disclosers, disclosing in some contexts and not in others. Reasons for non-disclosure of chronic hepatitis B status were: 1) fear of stigmatisation and 2) previous negative experiences with disclosure. Reasons for disclosure were: 1) wanting close contacts to get tested or vaccinated, 2) trusting the disclosure target(s), and 3) needing social and/or financial support. CONCLUSIONS Our findings highlight various reasons for and against disclosure of chronic hepatitis B status in Ghana. Because anticipated, observed, and experienced stigma were important motivations for non-disclosure of chronic hepatitis B status, we recommend the development and implementation of theory and evidence-based stigma reduction interventions that are culturally appropriate, and that prioritize the participation of target populations. We also recommend the provision of counselling and support services that assist PWHB in their disclosure decision-making processes.
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Affiliation(s)
- Charles Ampong Adjei
- Department of Work and Social Psychology Maastricht University, Maastricht, The Netherlands.
- Department of Community Health Nursing, University of Ghana, Accra, Ghana.
| | - Sarah E Stutterheim
- Department of Work and Social Psychology Maastricht University, Maastricht, The Netherlands
| | - Florence Naab
- Department of Maternal and Child Health, University of Ghana, Accra, Ghana
| | - Robert A C Ruiter
- Department of Maternal and Child Health, University of Ghana, Accra, Ghana
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Cai S, Liu L, Wu X, Pan Y, Yu T, Ou H. Depression, Anxiety, Psychological Symptoms and Health-Related Quality of Life in People Living with HIV. Patient Prefer Adherence 2020; 14:1533-1540. [PMID: 32904595 PMCID: PMC7457589 DOI: 10.2147/ppa.s263007] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 08/13/2020] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE To investigate the levels of depression, anxiety, psychological symptoms and health-related quality of life (HRQOL) in people infected with human immunodeficiency virus (HIV) and to assess the risk factors. METHODS A total of 121 people living with HIV (PLWHIV) were included, and 61 health individuals were selected as healthy controls. Their sociodemographic information was collected. The Self-Rating Depression Scale, Self-Rating Anxiety Scale, Symptom Checklist 90 and Short-Form Health Survey-36 were used. RESULTS The depression score was higher in PLWHIV (47.83 ± 10.58 vs 36.52 ± 9.69 P<0.001). Similar results were observed in anxiety score (41.06 ± 11.24 vs 32.31 ± 7.99, P<0.001). Multivariable analysis revealed that younger age (OR=0.929, P=0.004) and smoking (OR=4.297, P=0.001) were identified as independent factors of depression while young age (OR=0.890, P=0.008) and alcohol consumption (OR=4.801, P=0.002) were independent factors of anxiety. Results of SCL-90 questionnaire showed that hostility, paranoia ideation were significantly more pronounced when PLWHIV had depression. Results of HRQOL showed that physical functioning (82.88 ± 14.73 vs 93.41 ± 9.22, P<0.001) and mental health (57.46 ± 17.64 vs 65.68 ± 17.44, P=0.012) were lower in PLWHIV with depression. For PLWHIV with anxiety, vitality (56.96 ± 14.61 vs 67.58 ± 17.57, P=0.004), social functioning (64.52 ± 23.97 vs 74.64 ± 21.47, P=0.036) and mental health (52.57 ± 14.21 vs 65.03 ± 17.98, P=0.001) were lower. High depression level was showed the independent risk factor associated with poor HRQOL (OR=0.370, P=0.001). CONCLUSION Depression and anxiety were very common in PLWHIV. Physicians should not only focus on the antiviral treatment of these patients but also monitor their mental status, especially that of younger patients. For PLWHIV with depression and anxiety, psychological intervention should be provided, and social role rebuilding may be good for depression and anxiety alleviation.
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Affiliation(s)
- Shaohang Cai
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, People’s Republic of China
| | - Lili Liu
- Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, People’s Republic of China
| | - Xiaolu Wu
- First Affiliated Hospital of Xiamen University, Xiamen, Fujian Province, People’s Republic of China
| | - Ye Pan
- First Affiliated Hospital of Xiamen University, Xiamen, Fujian Province, People’s Republic of China
| | - Tao Yu
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, People’s Republic of China
| | - Hongjie Ou
- First Affiliated Hospital of Xiamen University, Xiamen, Fujian Province, People’s Republic of China
- Correspondence: Hongjie Ou Email
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Hildebrandt T, Bode L, Ng JSC. Effect of 'lifestyle stigma' on public support for NHS-provisioned pre-exposure prophylaxis (PrEP) and preventative interventions for HPV and type 2 diabetes: a nationwide UK survey. BMJ Open 2019; 9:e029747. [PMID: 31444189 PMCID: PMC6707679 DOI: 10.1136/bmjopen-2019-029747] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVES This study examines how the perceived role of poor lifestyle and irresponsible behaviour in contracting HIV, human papilloma virus (HPV) and diabetes affects public support for government-provisioned prevention efforts in Britain. It assesses whether public attitudes on healthcare spending are broadly sensitive to 'lifestyle stigmas'. METHODS We conducted an online survey of 738 respondents in Britain and embedded three separate survey experiments to measure support for government-provisioned interventions for HIV, HPV and type 2 diabetes. In each experiment, we manipulated language used to describe the extent to which the diseases are caused by lifestyle choices. Most respondents participated in all three experiments, but assignment was randomised within each condition. Analysis compared support among respondents exposed to 'lifestyle' treatment (information emphasising the disease's lifestyle causes) versus control treatment. We estimated three separate t-tests in which support for government provision of interventions is the dependent variable. RESULTS Support for government-provisioned prevention was high for all three diseases. There was no statistical difference between treatment and control conditions for HIV (treatment mean=3.73, control mean=3.86, p=0.38). But in both HPV (treatment mean=3.96, control mean=4.43, p<0.01) and type 2 diabetes (treatment mean=3.53, control mean=4.03, p<0.01) experiments, support for government-provisioned interventions was significantly lower under lifestyle treatment conditions. CONCLUSIONS Public opinion on healthcare expenditures in Britain is unexpected and uneven. Consistent participant support for pre-exposure prophylaxis (PrEP) shows public attitudes are not always sensitive to lifestyle stigmas-but for other diseases, perceived relationships between individual behaviour and poor health can still shape public opinion about health expenditures. Policymakers and practitioners should remain attentive to how health problems are framed and discussed to ensure broad public support, and take advantage of policy windows like with PrEP as they may close.
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Affiliation(s)
- Timothy Hildebrandt
- Department of Social Policy, London School of Economics and Political Science, London, UK
| | - Leticia Bode
- Communication, Culture & Technology, Georgetown University, Washington, DC, USA
| | - Jessica S C Ng
- Department of Social Policy, London School of Economics and Political Science, London, UK
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Préau M, Beaulieu-Prévost D, Henry E, Bernier A, Veillette-Bourbeau L, Otis J. HIV serostatus disclosure: development and validation of indicators considering target and modality. Results from a community-based research in 5 countries. Soc Sci Med 2015; 146:137-46. [PMID: 26513123 DOI: 10.1016/j.socscimed.2015.10.034] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Revised: 09/14/2015] [Accepted: 10/15/2015] [Indexed: 10/22/2022]
Abstract
RATIONALE HIV serostatus disclosure is a complex challenge for persons living with HIV (PLHIV). Despite its beneficial effects, it can also lead to stigmatization and rejection. The current lack of multi-dimensional measurement tools impede an in-depth understanding of the dynamic of disclosure. OBJECTIVE To develop and validate complex measures of serostatus disclosure. METHODS This international community based research study was performed by joint research teams (researchers/community based organizations (CBO)) in five countries (Democratic Republic of the Congo, Ecuador, Mali, Morocco and Romania). A convenience sample of 1500 people living with HIV (PLHIV) in contact with local CBO were recruited in 2011 (300 in each country). Face-to-face interviews were performed using a 125-item questionnaire covering HIV status disclosure to 23 potential disclosure targets and related issues (including personal history with HIV, people's reaction to disclosure, sexuality). A principal component analysis and a hierarchical cluster analysis were performed, in order to identify the main components of HIV disclosure, create measures and classify participants into profiles. RESULTS Patterns of disclosure were summarized using two main measures: direct and indirect disclosure. Disclosure to sexual partners, whether steady or not, was different from patterns of disclosure to other targets. Among the participants, three profiles emerged - labelled Restricted disclosure, Mainly indirect disclosure and Mainly direct disclosure, respectively representing 61%, 13% and 26% of the total sample. The profiles were associated with different aspects of PLHIV's lives, including self-efficacy, functional limitations and social exclusion. Patterns varied across the five studied countries. CONCLUSION Results suggest that multi-dimensional constructs should be used to measure disclosure in order to improve understanding of the disclosure process.
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Affiliation(s)
- Marie Préau
- Social Psychology Research Group, Institute of Psychology, University of Lyon 2, Bron, France; Institut National de la Santé et de la Recherche Médicale U912 (SESSTIM), Marseille, France
| | | | | | | | | | - Joanne Otis
- CReCES, Université du Québec à Montréal, Canada
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Kittner JM, Brokamp F, Thomaidis T, Schmidt RE, Wiltink J, Galle PR, Jäger B. Disclosure and Experienced Social Support are not Related to Anxiety or Depression in a German HIV Patient Cohort. Infect Chemother 2014; 46:77-83. [PMID: 25024869 PMCID: PMC4091364 DOI: 10.3947/ic.2014.46.2.77] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Revised: 02/15/2014] [Accepted: 02/18/2014] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND It is unclear to which extent the rate of disclosure of the diagnosis "HIV" to the social environment and the nature of experienced responses are correlated with the current mental health status of HIV-infected patients living in Germany. MATERIALS AND METHODS Eighty consecutive patients of two German HIV outpatient clinics were enrolled. Patients performed the Hospital Anxiety and Depression Scale (HADS) in its German version. Disclosure behaviour and the experienced responses after disclosing as perceived by the participants were assessed using a questionnaire. In addition, patients were asked to state whether they felt guilty for the infection on a 1-4 point Likert scale. RESULTS Pathological results on the anxiety scale were reached by 40% of male and 73% of female patients, and on the depression scale by 30% of male and 47% of female patients, thus significantly exceeding recently assessed values in the German general population, except for depression in males. None of the HADS scale results was interrelated either with the rate of disclosure or the experienced responses. 36% of patients reported to feel guilty for the infection, which was positively correlated with results from the HADS. LIMITATION The time since the single disclosure events was not assessed, and the subgroup of women was comparably small. CONCLUSIONS Despite substantial improvement in treatment, HIV-infected patients in Germany still suffer from an elevated level of anxiety and, in part, depression. However, mental health status was neither related with disclosure behaviour nor with experienced responses. We hypothesize that internal beliefs may play a more important role.
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Affiliation(s)
- Jens M Kittner
- 1st Medical Department University Medical Centre Mainz, Mainz, Germany
| | | | - Thomas Thomaidis
- 1st Medical Department University Medical Centre Mainz, Mainz, Germany
| | - Reinhold E Schmidt
- Clinical Immunology and Rheumatology, Hanover Medical School, Hanover, Germany
| | - Jörg Wiltink
- Psychosmatics and Psychotherapy, University Medical Center Mainz, Mainz, Germany
| | - Peter R Galle
- 1st Medical Department University Medical Centre Mainz, Mainz, Germany
| | - Burkard Jäger
- Department of Psychosomatic and Psychotherapy, Hanover Medical School, Hanover, Germany
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