1
|
Sardarzehi R, Seyed Alinaghi SA, Kianimoghadam AS, Masjedi-Arani A, Bakhtiari M, Dehghan Manshadi SA, Mohraz M. An empirical test of the chronic illness quality of life model: the prominent role of barrier to health care and social support. AIDS Care 2024:1-10. [PMID: 39047158 DOI: 10.1080/09540121.2024.2378375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 07/05/2024] [Indexed: 07/27/2024]
Abstract
The Chronic Illness Quality of Life (CIQOL) model highlights satisfaction with life in individuals with a chronic illness (i.e., HIV-related diseases) determined by factors such as barriers to health care, AIDS-related discrimination, social support, physical well-being, and engagement coping. Despite the empirical evidence supporting the CIQOL model, its validation in the Iranian population has not yet been conducted. This study aimed to validate the CIQOL model among Iranian patients with HIV-related diseases. Four hundred fifty-two patients completed the study questionnaire including Barriers to Care Scale (BACS), Satisfaction with Life Scale (SWLS), Chronic Illness Anticipated Stigma Scale (CIASS), Social Provision Scale (SPS), The Functional Assessment of Human Immunodeficiency Virus Infection (FAHI), and the Brief COPE Scale. Structural equation modeling (SEM) was used to analyze the data. The assumed model demonstrated an acceptable level of fit to study data. Findings showed that this model could explain 39% of variances in life satisfaction in Iranian patients with HIV-related diseases. Therefore, in psychological interventions aimed at enhancing life satisfaction, the CIQOL model factors especially barriers to health care and social support can be taken into consideration.
Collapse
Affiliation(s)
- Reyhaneh Sardarzehi
- Department of Clinical Psychology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Ahmad Seyed Alinaghi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Sam Kianimoghadam
- Department of Clinical Psychology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abbas Masjedi-Arani
- Department of Clinical Psychology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Bakhtiari
- Department of Clinical Psychology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Ali Dehghan Manshadi
- Department of Infectious Diseases and Tropical Medicine, Imam-Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Minoo Mohraz
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
2
|
Stockman JK, Anderson KM, Fernandez DeSoto A, Campbell DM, Tsuyuki K, Horvath KJ. A Trauma-Informed HIV Intervention (LinkPositively) to Improve HIV Care Among Black Women Affected by Interpersonal Violence: Protocol for a Pilot Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e46325. [PMID: 37405824 DOI: 10.2196/46325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 05/31/2023] [Accepted: 05/31/2023] [Indexed: 07/06/2023] Open
Abstract
BACKGROUND Black women bear a disproportionate burden of HIV, accounting for nearly 60% of new diagnoses among US women. Black women living with HIV often experience mutually reinforcing epidemics, known as syndemics, including interpersonal violence and substance use. Syndemics are associated with decreased HIV care engagement and treatment adherence and worsening HIV outcomes. Few HIV services and resources are tailored to be culturally and gender-responsive and trauma informed for Black women living with HIV. Technology-based, psychoeducational, and peer navigation programs offer promising pathways to tailored HIV support and improved HIV care outcomes. Therefore, the web-based, trauma-informed intervention LinkPositively was developed in collaboration with Black women living with HIV to promote uptake of HIV care and ancillary support services. OBJECTIVE This study primarily determines the feasibility and acceptability of the LinkPositively intervention among Black women living with HIV affected by interpersonal violence. The secondary aim is to examine the preliminary impact of the LinkPositively intervention on retention in HIV care, antiretroviral therapy adherence, and viral suppression while evaluating the role of mechanism of change variables (eg, social support) in the associations. METHODS The LinkPositively trial is a pilot randomized controlled trial conducted in California, United States, among 80 adult Black women living with HIV who have experienced interpersonal violence. Core components of LinkPositively include one-on-one peer navigation with phone and SMS text message check-ins; 5 weekly one-on-one video sessions to build coping and care navigation skills; and a mobile app that contains a peer support social networking platform, an educational database with healthy living and self-care tips, a GPS-enabled HIV and ancillary care resource locator, and a medication self-monitoring and reminder system. Participants are randomly assigned to the intervention (n=40) or control (Ryan White standard of care; n=40) arm, with follow-up at 3 and 6 months. At each assessment, participants complete an interviewer-administered survey and submit hair samples for the assessment of HIV medication adherence. All research staff and investigators adhere to ethical principles and guidelines for conducting research activities. Data will be analyzed using generalized estimating equations. RESULTS Final development and testing of the LinkPositively app were completed in July 2021. As of May 2023, we have screened 97 women for eligibility. Of the 97 women screened, 27 (28%) were eligible and have been enrolled in the study. The dissemination of preliminary results will occur in 2024. CONCLUSIONS This trial will advance HIV prevention science by harnessing technology to promote engagement in HIV care while improving social support through peers and social networking-all while being trauma informed for Black women living with HIV with experiences of interpersonal violence. If shown to be feasible and acceptable, LinkPositively has the potential to improve HIV care outcomes among Black women, a marginalized key population. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/46325.
Collapse
Affiliation(s)
- Jamila K Stockman
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, United States
| | - Katherine M Anderson
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, United States
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Alexandra Fernandez DeSoto
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, United States
| | - Danielle M Campbell
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, United States
| | - Kiyomi Tsuyuki
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, United States
| | - Keith J Horvath
- Department of Psychology, San Diego State University, San Diego, CA, United States
| |
Collapse
|
3
|
Krause KD, Brennan-Ing M, Halkitis PN. Assessing the Factor Structure and Psychometric Properties of the HIV-Related Resilience Screener: The GOLD Studies. AIDS Behav 2022; 27:1703-1715. [PMID: 36369501 DOI: 10.1007/s10461-022-03902-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/14/2022] [Indexed: 11/15/2022]
Abstract
People who are 50 and older constitute the majority of those living with HIV/AIDS (PLWHA) in the US. Aging PLWHA face myriad biopsychosocial health challenges related to HIV/AIDS and the aging process. Resilience may act as a buffer to the negative impact of these challenges however measuring it among PLWHA has been inconsistent, so the HIV-Related Resilience Screener (HIV-RRS) was developed. Data for the present study are drawn from 250 sociodemographically diverse HIV-positive gay men ages 50-69 in NYC. Tests of reliability and validity were conducted, and an Exploratory Factor Analysis indicated a three-factor model was the most parsimonious solution. Items were examined for their underlying relationships and labeled: adaptive coping, optimism, and effective coping. The total HIV-RRS yielded a Cronbach's α of 0.84. Convergent and face validity were established using psychosocial and physical outcomes. The HIV-RRS is a psychometrically sound instrument to assess resilience among older HIV-positive gay men.
Collapse
|
4
|
Castell N, Guerrero-Martin SM, Rubin LH, Shirk EN, Brockhurst JK, Lyons CE, Najarro KM, Queen SE, Carlson BW, Adams RJ, Morrell CN, Gama L, Graham DR, Zink C, Mankowski JL, Clements JE, Metcalf Pate KA. Effect of Single Housing on Innate Immune Activation in Immunodeficiency Virus-Infected Pigtail Macaques ( Macaca nemestrina ) as a Model of Psychosocial Stress in Acute HIV Infection. Psychosom Med 2022; 84:966-975. [PMID: 36162063 PMCID: PMC9553260 DOI: 10.1097/psy.0000000000001132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 07/27/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Simian immunodeficiency virus (SIV) infection of macaques recapitulates many aspects of HIV pathogenesis and is similarly affected by both genetic and environmental factors. Psychosocial stress is associated with immune system dysregulation and worse clinical outcomes in people with HIV. This study assessed the impact of single housing, as a model of psychosocial stress, on innate immune responses of pigtailed macaques ( Macaca nemestrina ) during acute SIV infection. METHODS A retrospective analysis of acute SIV infection of 2- to si6-year-old male pigtailed macaques was performed to compare the innate immune responses of socially ( n = 41) and singly ( n = 35) housed animals. Measures included absolute monocyte count and subsets, and in a subset ( n ≤ 18) platelet counts and activation data. RESULTS SIV infection resulted in the expected innate immune parameter changes with a modulating effect from housing condition. Monocyte number increased after infection for both groups, driven by classical monocytes (CD14 + CD16 - ), with a greater increase in socially housed animals (227%, p < .001, by day 14 compared with preinoculation time points). Platelet numbers recovered more quickly in the socially housed animals. Platelet activation (P-selectin) increased by 65% ( p = .004) and major histocompatibility complex class I surface expression by 40% ( p = .009) from preinoculation only in socially housed animals, whereas no change in these measures occurred in singly housed animals. CONCLUSIONS Chronic psychosocial stress produced by single housing may play an immunomodulatory role in the innate immune response to acute retroviral infection. Dysregulated innate immunity could be one of the pathways by which psychosocial stress contributes to immune suppression and increased disease severity in people with HIV.
Collapse
|
5
|
Coulson NS, Buchanan H. The Role of Online Support Groups in Helping Individuals Affected by HIV and AIDS: Scoping Review of the Literature. J Med Internet Res 2022; 24:e27648. [PMID: 35881456 PMCID: PMC9364165 DOI: 10.2196/27648] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 09/29/2021] [Accepted: 04/29/2022] [Indexed: 11/13/2022] Open
Abstract
Background Online support groups provide opportunities for individuals affected by HIV and AIDS to seek information, advice, and support from peers. However, whether and how engagement with online support groups helps individuals affected by HIV and AIDS remains unclear, as does the nature of the evidence on this topic. Objective This scoping review sought to explore whether engagement with HIV and AIDS–related online support groups benefits members in terms of psychosocial well-being and illness management, whether members experienced any negative aspects of these groups, and what types of social support are exchanged within HIV and AIDS–related online support groups. Methods A scoping review of English-language articles (including both qualitative and quantitative studies) was undertaken using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The databases searched included MEDLINE, PubMed, EMBASE, CINAHL, PsycINFO, CENTRAL (Cochrane Register of Controlled Trials), and Scopus. Key findings were synthesized using a narrative and thematic approach. Results A total of 22 papers met the inclusion criteria from an initial pool of 3332 abstracts. These papers included 23% (5/22) quantitative studies, 9% (2/22) mixed methods studies, and 68% (15/22) qualitative studies published between 2007 and 2019. Cross-sectional evidence suggests that engagement with HIV and AIDS–related online support groups is empowering for members and may lead to a range of psychosocial benefits. Furthermore, qualitative evidence suggests that these groups provide an opportunity to connect with similar people and share experiences. This can help improve self-worth, reduce stigma, facilitate improved illness management, and gain greater confidence when interacting with health professionals. However, online support groups are not without their limitations as qualitative evidence suggests that users may encounter examples of interpersonal conflict between members as well as be exposed to challenging content. Finally, HIV and AIDS–related online support groups are avenues through which individuals can solicit support, most commonly informational or emotional. Conclusions HIV and AIDS–related online support groups may have some benefits for members, particularly in terms of providing social support. There is a need for a systematic review of this literature that includes an assessment of the methodological quality of the available evidence.
Collapse
Affiliation(s)
- Neil S Coulson
- School of Medicine, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, United Kingdom
| | - Heather Buchanan
- School of Medicine, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, United Kingdom
| |
Collapse
|
6
|
Stockman JK, Anderson KM, Tsuyuki K, Horvath KJ. LinkPositively: A Trauma-Informed Peer Navigation and Social Networking WebApp to Improve HIV Care among Black Women Affected by Interpersonal Violence. J Health Care Poor Underserved 2021; 32:166-188. [PMID: 34934301 PMCID: PMC8687146 DOI: 10.1353/hpu.2021.0056] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
In the U.S., Black women living with HIV/AIDS (WLHA) are affected disproportionately by interpersonal violence, which often co-occurs with adverse mental health and/or substance use, and exacerbates existing poor HIV care outcomes. Peer navigation has been successful in improving HIV care; however, HIV clinics often lack resources for sustainability and may not account for socio-structural barriers unique to Black WLHA. To address this gap, we developed LinkPositively, a culturally-tailored, trauma-informed WebApp for Black WLHA affected by interpersonal violence to improve HIV care outcomes. Using focus group data from nine Black WLHA and peer navigators, we developed LinkPositively. Core components include: virtual peer navigation to facilitate skill-building to cope with barriers and navigate care; social networking platform for peer support; educational and self-care tips; GPS-enabled resource locator for HIV care and support service agencies; and medication self-monitoring/reminder system. If efficacious, LinkPositively will shift the HIV prevention and care paradigm for Black WLHA.
Collapse
Affiliation(s)
- Jamila K Stockman
- is an Associate Professor at the University of California, San Diego in the School of Medicine, Department of Medicine, Division of Infectious Diseases and Global Public Health and Director of the Disparities Core of the UC San Diego Center for AIDS Research. is a Clinical Research Coordinator at the University of California, San Diego in the School of Medicine, Department of Medicine, Division of Infectious Diseases and Global Public Health and a PhD Student at Emory University, Rollins School of Public Health in the Department of Behavioral, Social, and Health Education Sciences. is an Assistant Professor at the University of California, San Diego in the School of Medicine, Department of Medicine, Division of Infectious Diseases and Global Public Health. is an Associate Professor at San Diego State University in the Department of Psychology
| | - Katherine M Anderson
- is an Associate Professor at the University of California, San Diego in the School of Medicine, Department of Medicine, Division of Infectious Diseases and Global Public Health and Director of the Disparities Core of the UC San Diego Center for AIDS Research. is a Clinical Research Coordinator at the University of California, San Diego in the School of Medicine, Department of Medicine, Division of Infectious Diseases and Global Public Health and a PhD Student at Emory University, Rollins School of Public Health in the Department of Behavioral, Social, and Health Education Sciences. is an Assistant Professor at the University of California, San Diego in the School of Medicine, Department of Medicine, Division of Infectious Diseases and Global Public Health. is an Associate Professor at San Diego State University in the Department of Psychology
| | - Kiyomi Tsuyuki
- is an Associate Professor at the University of California, San Diego in the School of Medicine, Department of Medicine, Division of Infectious Diseases and Global Public Health and Director of the Disparities Core of the UC San Diego Center for AIDS Research. is a Clinical Research Coordinator at the University of California, San Diego in the School of Medicine, Department of Medicine, Division of Infectious Diseases and Global Public Health and a PhD Student at Emory University, Rollins School of Public Health in the Department of Behavioral, Social, and Health Education Sciences. is an Assistant Professor at the University of California, San Diego in the School of Medicine, Department of Medicine, Division of Infectious Diseases and Global Public Health. is an Associate Professor at San Diego State University in the Department of Psychology
| | - Keith J Horvath
- is an Associate Professor at the University of California, San Diego in the School of Medicine, Department of Medicine, Division of Infectious Diseases and Global Public Health and Director of the Disparities Core of the UC San Diego Center for AIDS Research. is a Clinical Research Coordinator at the University of California, San Diego in the School of Medicine, Department of Medicine, Division of Infectious Diseases and Global Public Health and a PhD Student at Emory University, Rollins School of Public Health in the Department of Behavioral, Social, and Health Education Sciences. is an Assistant Professor at the University of California, San Diego in the School of Medicine, Department of Medicine, Division of Infectious Diseases and Global Public Health. is an Associate Professor at San Diego State University in the Department of Psychology
| |
Collapse
|
7
|
Ataro Z, Mengesha MM, Abrham A, Digaffe T. Gender Differences in Perceived Stigma and Coping Strategies Among People Living with HIV/AIDS at Jugal Hospital, Harar, Ethiopia. Psychol Res Behav Manag 2020; 13:1191-1200. [PMID: 33364862 PMCID: PMC7750813 DOI: 10.2147/prbm.s283969] [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] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 12/02/2020] [Indexed: 11/23/2022] Open
Abstract
Background HIV/AIDS is among the most devastating diseases, having multiple effects on the health and well-being of people living with HIV/AIDS (PLWHA). There is a paucity of studies that examined the gender differences in perceived stigma among PLWHA and the different coping strategies that they use in Ethiopia. Objective To assess the gender differences in perceived stigma and coping strategies among PLWHA. Methods A comparative cross-sectional study was conducted at Jugal Hospital, Harar, eastern Ethiopia from May 01 to July 30, 2018. A total of 412 (206 females and 206 males) PLWHA were included. Face-to-face interviewer-administered data were collected. Perceived HIV stigma was assessed using the Berger HIV stigma scale. Similarly, the coping strategies were assessed using the Brief Coping Orientation to Problems Experienced (Brief COPE) scale. The data were analyzed using STATA version 13. Results The mean Berger stigma scale score was 65.3±11.3. The overall perceived stigma mean score was not statistically different between males and females (64.8±10.8 vs 65.8±11.7, p=0.407). Among the four subscales, women reported a higher level of disclosure stigma than men (21.1±5.5 vs 20.3±5.5; p=0.006). Regarding maladaptive coping strategies, men often used substances compared to women (2.8±1.5 vs 2.1±0.4; p<0.001). However, women use behavioral disengagement (4.6±1.1 vs 4.2±1.1; p=0.002) and self-distraction (5.9±1.5 vs 5.5±1.7; p=0.019) more often than men. Females used a higher level of adaptive coping strategies compared to males (42.5±4.9 vs 40.9±6.3, p=0.005). Furthermore, females were found to use more emotional-focused coping than males (27.6±3.2 vs 26.4±4.0; p<0.001). Conclusion Women reported a higher level of disclosure stigma than men and the types of coping strategies used vary between male and female. Thus, interventions to support PLWHA must take into account the gender differences in terms of perceived stigma.
Collapse
Affiliation(s)
- Zerihun Ataro
- Department of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Melkamu Merid Mengesha
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Aklilu Abrham
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tesfaye Digaffe
- Department of Human Resource Development, Federal Ministry of Health, Addis Ababa, Ethiopia
| |
Collapse
|
8
|
Remmert JE, Mosery N, Goodman G, Bangsberg DR, Safren SA, Smit JA, Psaros C. Breastfeeding Practices Among Women Living with HIV in KwaZulu-Natal, South Africa: An Observational Study. Matern Child Health J 2020; 24:127-134. [PMID: 31832911 DOI: 10.1007/s10995-019-02848-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Exclusive breastfeeding (EBF) is the safest infant feeding option in resource-limited settings, though women living with HIV have the lowest rates of EBF. Barriers to EBF in the absences of a formal intervention in women living with HIV in KwaZulu-Natal, where the prevalence of HIV among pregnant women is among the highest in the world, are understudied. Thus, this study sought to describe barriers to EBF and examine differences in social support, disclosure status, mood, and HIV-related stigma among women with different feeding methods. METHODS Women living with HIV enrolled in preventing mother-to-child transmission treatment (n = 156) were interviewed postpartum (M = 13.1 weeks) at a district hospital and self-reported infant feeding method, reasons not breastfeeding (if applicable), and HIV disclosure status. Mood, HIV-related stigma, functional social support, and HIV-related social support were also assessed. RESULTS No participants reported mixed feeding, 30% reported EBF, and 70% reported exclusive formula feeding. Commonly reported reasons for not breastfeeding included fear of HIV transmission to the infant and being away from the infant for extended periods of time. Social support (p = 0.02) and HIV-related social support (p < 0.01) were significantly higher in women who had attempted breastfeeding compared to women who never attempted breastfeeding. DISCUSSION Rates of EBF in this sample are lower than in other recent studies, suggesting this sample experiences multiple barriers to EBF. Healthcare providers should seek to correct misconceptions regarding HIV transmission and breastfeeding practices. Social and logistical support for EBF may be important considerations for future interventions.
Collapse
Affiliation(s)
- Jocelyn E Remmert
- Center for Weight, Eating and Lifestyle Science, Drexel University, Philadelphia, USA
| | - Nzwakie Mosery
- MatCH Research Unit (MRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Georgia Goodman
- Behavioral Medicine Program, Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, 1 Bowdoin Square, 7th Floor, Boston, MA, 02114, USA
| | - David R Bangsberg
- School of Public Health, Oregon Health Sciences University - Portland State University, Portland, OR, USA
| | - Steven A Safren
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Jennifer A Smit
- MatCH Research Unit (MRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa.,Discipline of Pharmaceutical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Christina Psaros
- Behavioral Medicine Program, Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, 1 Bowdoin Square, 7th Floor, Boston, MA, 02114, USA.
| |
Collapse
|
9
|
Aristide C, Mwakisole A, Mwakisole N, Emmanuel M, Laizer E, Kihunrwa A, Downs D, Wamoyi J, Downs J. Design and pilot testing of a church-based intervention to address interpersonal and intrapersonal barriers to uptake of family planning in rural Tanzania: a qualitative implementation study. BMJ SEXUAL & REPRODUCTIVE HEALTH 2020; 46:226-233. [PMID: 31937520 PMCID: PMC7392489 DOI: 10.1136/bmjsrh-2019-200505] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 12/17/2019] [Accepted: 12/22/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Use of family planning (FP) saves the lives of mothers and children, and contributes to better economic outcomes for households and empowerment for women. In Tanzania, the overall unmet need for FP is high. This study aimed: (1) to use focus group data to construct a theoretical framework to understand the multidimensional factors impacting the decision to use FP in rural Tanzania; (2) to design and pilot-test an educational seminar, informed by this framework, to promote uptake of FP; and (3) to assess acceptability and further refine the educational seminar based on focus group data collected 3 months after the education was provided. METHODS We performed a thematic analysis of 10 focus group discussions about social and religious aspects of FP from predominantly Protestant church attenders prior to any intervention, and afterwards from six groups of church leaders who had attended the educational seminar. RESULTS Key interpersonal influences included lack of support from husband/partner, family members, neighbours and church communities. Major intrapersonal factors impeding FP use were lack of medical knowledge and information, misconceptions, and perceived incompatibility of FP and Christian faith. Post-seminar, leaders reported renewed intrapersonal perspectives on FP and reported teaching these perspectives to community members. CONCLUSIONS Addressing intrapersonal barriers to FP use for leaders led them to subsequently address both intrapersonal and interpersonal barriers in their church communities. This occurred primarily by increasing knowledge and support for FP in men, family members, neighbours and church communities.
Collapse
Affiliation(s)
- Christine Aristide
- Center for Global Health, Weill Cornell Medical College, New York, New York, USA
| | | | | | - Mary Emmanuel
- St Paul College, Mwanza, United Republic of Tanzania
| | | | - Albert Kihunrwa
- Department of Gynecology and Obstetrics, Weill Bugando Medical Centre, Mwanza, United Republic of Tanzania
| | - David Downs
- Keble College, University of Oxford, Oxford, UK
| | - Joyce Wamoyi
- National Institute for Medical Research Mwanza Research Centre, Mwanza, United Republic of Tanzania
| | - Jennifer Downs
- Center for Global Health, Weill Cornell Medical College, New York, New York, USA
- Internal Medicine, Weill Bugando Medical Centre, Mwanza, United Republic of Tanzania
| |
Collapse
|
10
|
Cvitanović H, Milošević M, Bukvić-Bešlić I, Lugović-Mihić L. Determination of Psychological Stress, Serum Immune Parameters, and Cortisol Levels in Patients With Human Papilloma Virus. Clin Ther 2020; 42:783-799. [PMID: 32340917 DOI: 10.1016/j.clinthera.2020.03.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 03/30/2020] [Accepted: 03/30/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE Because the results of studies investigating the relation between human papilloma virus (HPV) infection and the effects of psychological stress are inconsistent, this study was conducted to expand on previous research by analyzing patient stress levels, serum immune parameters, and cortisol levels in patients with clinical HPV manifestations. It also looked for differences in clinical manifestations of HPV depending on patient level of experienced stress. METHODS This cross-sectional study included 213 subjects (94 women and 119 men aged ≥18 years; average age, 41 years) with clinical manifestations of HPV infection (165 subjects with extragenital manifestations and 48 with genital manifestations) who were treated at the Department of Dermatovenerology, Karlovac General Hospital, from January 1, 2012, to December 31, 2015. Psychological, neurohormonal and immune parameters (serum values of leukocytes, alpha2-globulins, beta-globulins, albumins, and proteins), and serum cortisol levels were analyzed. Questionnaires were used to determine patients' perception of stress: the Recent Life Changes Questionnaire, the Perceived Stress Scale, and the Brief Cope Test. One group of subjects had confirmed stressful experiences, defined by the Recent Life Changes Questionnaire as a period of 1 year with at least 500 life change units; the control group included patients with no significant stressful experiences. FINDINGS Patients with confirmed significant stress experience had a statistically significant higher degree of perception of stress. There were no statistically significant differences in terms of the impact of stress on clinical HPV manifestations (genital and extragenital), sex, lesional duration, or recurrence. In patients with significant stress experience, significantly higher values of leukocytes (6.68 × 109/L), alpha2-globulins (6.85 g/L), and beta-globulins (7.33 g/L) were observed. Adaptive coping and a lower perception of stress significantly reduced the chances of having extragenital manifestations by 2.63 times. A higher perception of stress significantly increased the likelihood of genital manifestations. IMPLICATIONS Although this study found that stress increased the values of leukocytes, alpha2-globulins, and beta-globulins, no evidence was found that it affected clinical manifestations of HPV infection. The redundancy of the immune system could account for this finding. This study is among the first to investigate the correlation between psychological, neurohormonal, and immune indicators of stress.
Collapse
Affiliation(s)
- Hrvoje Cvitanović
- Department of Dermatovenerology, Karlovac General Hospital, Karlovac, Croatia
| | - Milan Milošević
- University of Zagreb, School of Medicine, Andrija Stampar School of Public Health, Department for Environmental Health, Occupational and Sports Medicine, Zagreb, Croatia
| | - Iva Bukvić-Bešlić
- Clinical Department of Dermatovenerology, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia
| | - Liborija Lugović-Mihić
- Clinical Department of Dermatovenerology, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia.
| |
Collapse
|
11
|
Shattuck EC, Perrotte JK, Daniels CL, Xu X, Sunil TS. The Contribution of Sociocultural Factors in Shaping Self-Reported Sickness Behavior. Front Behav Neurosci 2020; 14:4. [PMID: 32038193 PMCID: PMC6992553 DOI: 10.3389/fnbeh.2020.00004] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 01/09/2020] [Indexed: 12/11/2022] Open
Abstract
Sickness behavior is an evolutionarily conserved phenomenon found across a diverse range of animals involving a change in motivational priorities to theoretically maximize energetic investment in immune function and recovery. Typical components of sickness behavior include reduced sociability and activity, changes in diet, and depressed affect. Importantly, however, sickness behavior appears to be subject to other demands of life history in animal models, including reproduction and offspring survival. Thus, "feeling sick" is often context dependent with possible effects on morbidity and mortality. While humans may not always face the same life history trade-offs, sociocultural norms and values may similarly shape sickness behavior by establishing internalized parameters for "socially appropriate sickness." We explore the role of these factors in shaping sickness behavior by surveying a national U.S. sample (n = 1,259). Self-reported and recalled sickness behavior was measured using the SicknessQ instrument, which has previously been validated against experimentally induced sickness behavior. After post-stratification weighting and correction for Type I error, generalized linear models showed that sickness behavior is significantly affected by various factors across sex and racial/ethnic groupings. Income below the national mean (b = 1.85, adj. p = 0.025), stoic endurance of pain and discomfort (b = 1.61, adj. p < 0.001), and depressive symptomology (b = 0.53, adj. p < 0.001) were each associated with greater sickness behavior scores. Familism (b = 1.59, adj. p = 0.008) was positively associated with sickness behavior in men, but not women. Endurance of pain and discomfort was associated with greater sickness behavior in Whites only (b = 1.94, adj. p = 0.002), while familism approached significance in African Americans only (b = 1.86, adj. p = 0.057). These findings may reflect different social contexts of sickness across demographic groups, which may in turn have important implications for pathogen transmission and recovery times, potentially contributing to health disparities.
Collapse
Affiliation(s)
- Eric C. Shattuck
- Institute for Health Disparities Research, College of Liberal and Fine Arts, The University of Texas at San Antonio, San Antonio, TX, United States
| | - Jessica K. Perrotte
- Department of Psychology, Texas State University, San Marcos, TX, United States
| | - Colton L. Daniels
- Department of Sociology, College of Liberal and Fine Arts, The University of Texas at San Antonio, San Antonio, TX, United States
| | - Xiaohe Xu
- Department of Sociology, College of Liberal and Fine Arts, The University of Texas at San Antonio, San Antonio, TX, United States
- School of Public Administration, Sichuan University, Chengdu, China
| | - Thankam S. Sunil
- Institute for Health Disparities Research, College of Liberal and Fine Arts, The University of Texas at San Antonio, San Antonio, TX, United States
- Department of Sociology, College of Liberal and Fine Arts, The University of Texas at San Antonio, San Antonio, TX, United States
| |
Collapse
|
12
|
Brown MJ, Serovich JM, Laschober TC, Kimberly JA, Lescano CM. Ways of coping and perceived HIV-related stigma among people living with HIV: moderation by sex and sexual orientation. PSYCHOL HEALTH MED 2019; 25:867-878. [PMID: 31631682 DOI: 10.1080/13548506.2019.1680852] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Perceived HIV-related stigma continues to persist among people living with HIV and coping strategies are crucial to overall health. Coping may be associated with perceived HIV-related stigma. However, research examining differences by sex and sexual orientation is lacking. Therefore, the aims of the study were to assess the association between ways of coping and perceived HIV-related stigma, and to examine the relationship by sex and sexual orientation. Data were obtained from 346 individuals (191 men and 155 women) living with HIV. Multiple linear regression models showed that overall, distancing, and attack/escape avoidance coping were positively associated with perceived HIV-related stigma among the overall population, among men who have sex with men (MSM), and among women overall and heterosexual women. Among men overall, distancing and attack/escape avoidance coping were positively associated with perceived HIV-related stigma. Among women who have sex with women (WSW), attack/escape avoidance coping was positively associated with perceived HIV-related stigma. Effect sizes indicated small effects for overall coping and medium to large effects for distancing and attack/escape avoidance coping. Interventions focused on reducing perceived HIV-related stigma among populations living with HIV should address distancing and attack/escape avoidance strategies especially among women, regardless of sexual orientation, and MSM.
Collapse
Affiliation(s)
- Monique J Brown
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina , Columbia, SC, USA.,South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina , Columbia, SC, USA.,Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina , Columbia, SC, USA.,Division of Biology and Medicine, Brown University , Providence, RI, USA.,Department of Mental Health Law and Policy, College of Behavioral and Community Sciences, University of South Florida , Tampa, FL, USA.,Office for the Study on Aging, Arnold School of Public Health, University of South Carolina , Columbia, SC, USA
| | - Julianne M Serovich
- College of Behavioral and Community Sciences, University of South Florida , Tampa, FL, USA
| | - Tanja C Laschober
- College of Behavioral and Community Sciences, University of South Florida , Tampa, FL, USA
| | - Judy A Kimberly
- Division of Biology and Medicine, Brown University , Providence, RI, USA
| | - Celia M Lescano
- Department of Mental Health Law and Policy, College of Behavioral and Community Sciences, University of South Florida , Tampa, FL, USA
| |
Collapse
|
13
|
Chan RCH, Mak WWS. Cognitive, Regulatory, and Interpersonal Mechanisms of HIV Stigma on the Mental and Social Health of Men Who Have Sex With Men Living With HIV. Am J Mens Health 2019; 13:1557988319873778. [PMID: 31690214 PMCID: PMC6728686 DOI: 10.1177/1557988319873778] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Revised: 07/11/2019] [Accepted: 07/27/2019] [Indexed: 11/16/2022] Open
Abstract
Public stigma surrounding HIV is related to heightened emotional distress, poor psychological functioning, and reduced subjective well-being in people living with HIV. For men who have sex with men (MSM) living with HIV, they may also face stigmatizing attitudes within the gay community, which create an additional burden to their health. Grounded in the psychological mediation framework, the present study examined the underlying psychological processes through which HIV stigma from the public and within the gay community influences the mental and social health of MSM living with HIV. Findings from 206 Chinese MSM living with HIV in Hong Kong indicated that negative self-concept, maladaptive coping, and peer isolation mediated the effect of HIV stigma on mental and social health. The study revealed the cognitive, regulatory, and interpersonal processes underlying HIV stigma and health. Feeling intense HIV stigma from the public and within the gay community may render MSM living with HIV more vulnerable to negative self-concept, maladaptive coping, and peer isolation, which contribute to poor mental and social health. To combat prejudice and discrimination against people living HIV, stigma reduction initiatives should be implemented not only in the public, but also in the gay community. Cognitive-behavioral interventions can also be used to restructure negative self-beliefs and build adaptive emotion regulation skills, which can improve stigma-related health outcomes among MSM living with HIV.
Collapse
Affiliation(s)
- Randolph C. H. Chan
- Department of Special Education and
Counselling, The Education University of Hong Kong, Tai Po, Hong Kong
| | - Winnie W. S. Mak
- Department of Psychology, The Chinese
University of Hong Kong, Shatin, Hong Kong
| |
Collapse
|
14
|
Gruszczyńska E, Rzeszutek M. Trajectories of Health-Related Quality of Life and Perceived Social Support Among People Living With HIV Undergoing Antiretroviral Treatment: Does Gender Matter? Front Psychol 2019; 10:1664. [PMID: 31396129 PMCID: PMC6664262 DOI: 10.3389/fpsyg.2019.01664] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Accepted: 07/02/2019] [Indexed: 12/22/2022] Open
Abstract
The study examined the trajectories of health-related quality of life (HRQoL) and perceived social support (PSS) among people living with HIV (PLWH), with a special focus on gender differences. The participants included 252 PLWH (18% female) undergoing antiretroviral therapy. HRQoL (WHO Quality of Life-BREF; WHOQOL Group, 1998) and PSS (Berlin Social Support Scales; Schulz and Schwarzer, 2003) were measured three times at six-month intervals. Using a univariate approach, three trajectories of HRQoL and four trajectories of PSS were identified. Gender and relationship status were significant covariates for PSS only, with overrepresentation of single women in the increasing trajectory. The dual trajectory approach revealed a match in the decrease of HRQoL and PSS, but only for 31% of the sample. In fact, decreasing PSS co-occurred with increasing as well as stable HRQoL. There was no significant gender effect in this regard. Although a clear correspondence for decreasing trajectories exists, the findings also highlight a discrepancy between HRQoL and PSS changes that are unrelated to gender.
Collapse
Affiliation(s)
- Ewa Gruszczyńska
- Faculty of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland
| | | |
Collapse
|
15
|
Schulte MT, Marelich W, Lanza HI, Goodrum NM, Armistead L, Murphy DA. Alcohol use, mental health, and parenting practices among HIV-positive mothers. JOURNAL OF HIV/AIDS & SOCIAL SERVICES 2019; 18:111-128. [PMID: 32774181 PMCID: PMC7413222 DOI: 10.1080/15381501.2019.1596185] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 02/08/2019] [Accepted: 03/12/2019] [Indexed: 06/11/2023]
Abstract
Mothers living with HIV (MLH) must balance childcare, their illness, and oftentimes other mental health problems/stressors. It is important to understand how a maladaptive coping strategy, (alcohol use) is linked to poorer parenting practices. We assessed the relationship between mental health/coping (anxiety, depression, alcohol use, social support) and parenting/family dimensions (communication, parenting style/stress, family routines/cohesion) among 152 MLH. Mothers reporting more psychiatric symptoms and less social support also reported poorer parenting practices and interactions. Further, MLH who used more alcohol reported less parenting involvement and fewer family interactions. Alcohol use, even at subclinical levels, can negatively impact the parent-child relationship.
Collapse
Affiliation(s)
- Marya T. Schulte
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles,
California, USA
| | - William Marelich
- Department of Psychology, California State University, Fullerton, Fullerton, California, USA
| | - H. Isabella Lanza
- Department of Human Development, California State University, Long Beach, Long Beach California, USA
| | - Nada M. Goodrum
- Department of Psychology, Georgia State University, Atlanta, Georgia, USA
| | - Lisa Armistead
- Department of Psychology, Georgia State University, Atlanta, Georgia, USA
| | - Debra A. Murphy
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles,
California, USA
| |
Collapse
|
16
|
Brown MJ, Serovich JM, Laschober TC, Kimberly JA, Lescano CM. Ways of coping and HIV disclosure among people living with HIV: mediation of decision self-efficacy and moderation by sex. AIDS Care 2019; 31:1001-1010. [PMID: 30974958 DOI: 10.1080/09540121.2019.1605045] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Individuals living with HIV/AIDS face several stressors and use varying strategies to cope. Disclosure (or nondisclosure) of HIV serostatus is an important consideration among individuals living with HIV. However, studies examining the association between coping and HIV disclosure are lacking, and more research examining potential mediators and moderators is needed. The transactional model of stress and coping and the theory of planned behavior may help in understanding the mediating relationship between coping, decision self-efficacy, and HIV disclosure. Therefore, the aims of this study were to examine the association between coping and HIV disclosure to sexual partners, assess the mediating role of decision self-efficacy, and examine moderation by sex. Baseline data from 262 individuals living with HIV who participated in a disclosure intervention were used for analysis. Descriptive statistics were used to assess sociodemographic characteristics. Principal component analysis was used to operationalize coping. Path analysis was then used to determine the mediating role of decision self-efficacy in the association between overall, adaptive, distancing, and attack/escape avoidance coping and HIV disclosure to sexual partners. After adjusting for age and time since diagnosis, direct associations between coping and decision self-efficacy, and decision self-efficacy and disclosure behavior varied by sex. Among the overall study population, decision self-efficacy mediated the associations between adaptive coping (β = 0.064, p = 0.003), attack/escape avoidance coping (β = -0.052, p = 0.009) and disclosure behavior. Disclosure intervention programs geared towards populations living with HIV should include decision self-efficacy and adaptive coping, and attenuate attack/escape avoidance coping.
Collapse
Affiliation(s)
- Monique J Brown
- a Department of Epidemiology and Biostatistics, Arnold School of Public Health , University of South Carolina , Columbia , SC , USA.,b South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health , University of South Carolina , Columbia , SC , USA
| | - Julianne M Serovich
- c College of Behavioral and Community Sciences , University of South Florida , Tampa , FL , USA
| | - Tanja C Laschober
- c College of Behavioral and Community Sciences , University of South Florida , Tampa , FL , USA
| | - Judy A Kimberly
- d Division of Biology and Medicine , Brown University , Providence , RI , USA
| | - Celia M Lescano
- e Department of Mental Health Law and Policy, College of Behavioral and Community Sciences , University of South Florida , Tampa , FL , USA
| |
Collapse
|
17
|
Schneiderman N, McIntosh RC, Antoni MH. Psychosocial risk and management of physical diseases. J Behav Med 2019; 42:16-33. [PMID: 30632000 PMCID: PMC6941845 DOI: 10.1007/s10865-018-00007-y] [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] [Received: 06/18/2018] [Accepted: 12/18/2018] [Indexed: 12/24/2022]
Abstract
During the 40 years since the Yale conference on Behavioral Medicine and the founding of the Journal of Behavioral Medicine considerable progress has been made in understanding the role of psychosocial risk and management of physical diseases. We here describe the development of these fundamental concepts from early research on stress through studies of the Type A behavior pattern to more contemporary approaches to the relationship between psychosocial risks and benefits in relation to disease processes. This includes the relationship of psychosocial risk to cancers, cardiovascular diseases (CVD), cardiometabolic disorders, Human Immunodeficiency Virus (HIV)/Acquired Human Immune Deficiency Syndrome. During the past 40 years the effects of prolonged distress responses in the pathogenesis of some cancers and CVD have been well-established and modifiable behavioral, cognitive and social factors have been shown to produce favorable outcome components in the management of such diseases as breast cancer, coronary heart disease and HIV.
Collapse
Affiliation(s)
- Neil Schneiderman
- Health Division, Department of Psychology, University of Miami, 5665 Ponce de Leon Boulevard, Coral Gables, FL, 33124, USA.
| | - Roger C McIntosh
- Health Division, Department of Psychology, University of Miami, 5665 Ponce de Leon Boulevard, Coral Gables, FL, 33124, USA
| | - Michael H Antoni
- Health Division, Department of Psychology, University of Miami, 5665 Ponce de Leon Boulevard, Coral Gables, FL, 33124, USA
| |
Collapse
|
18
|
Lyon ME, Garvie PA, D'Angelo LJ, Dallas RH, Briggs L, Flynn PM, Garcia A, Cheng YI, Wang J. Advance Care Planning and HIV Symptoms in Adolescence. Pediatrics 2018; 142:e20173869. [PMID: 30341154 PMCID: PMC6317555 DOI: 10.1542/peds.2017-3869] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/16/2018] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES To determine the effect of family-centered pediatric advance care planning (FACE pACP) on HIV-specific symptoms. METHODS In this single-blinded, randomized controlled trial conducted at 6 US hospital-based HIV clinics, 105 adolescent-family dyads, randomly assigned from July 2011 to June 2014, received 3 weekly sessions in either the FACE pACP arm ([1] pediatric advance care planning survey, [2] Respecting Choices interview, and [3] 5 Wishes directive) or the control arm ([1] developmental history, [2] safety tips, and [3] nutrition and exercise tips). The General Health Assessment for Children measured patient-reported HIV-specific symptoms. Latent class analyses clustered individual patients based on symptom patterns. Path analysis examined the mediating role of dyadic treatment congruence with respect to the intervention effect on symptom patterns. RESULTS Patients were a mean age of 17.8 years old, 54% male, and 93% African American. Latent class analysis identified 2 latent HIV-symptom classes at 12 months: higher symptoms and suffering (27%) and lower symptoms and suffering (73%). FACE pACP had a positive effect on dyadic treatment congruence (β = .65; 95% CI: 0.04 to 1.28), and higher treatment congruence had a negative effect on symptoms and suffering (β = -1.14; 95% CI: -2.55 to -0.24). Therefore, FACE pACP decreased the likelihood of symptoms and suffering through better dyadic treatment congruence (β = -.69; 95% CI: -2.14 to -0.006). Higher religiousness (β = 2.19; 95% CI: 0.22 to 4.70) predicted symptoms and suffering. CONCLUSIONS FACE pACP increased and maintained agreement about goals of care longitudinally, which lowered adolescents' physical symptoms and suffering, suggesting that early pACP is worthwhile.
Collapse
Affiliation(s)
- Maureen E Lyon
- Divisions of Adolescent and Young Adult Medicine and
- Department of Pediatrics, School of Medicine and Health Sciences, George Washington University, Washington, District of Columbia
| | - Patricia A Garvie
- Research Department, Children's Diagnostic and Treatment Center, Fort Lauderdale, Florida
| | - Lawrence J D'Angelo
- Divisions of Adolescent and Young Adult Medicine and
- Department of Pediatrics, School of Medicine and Health Sciences, George Washington University, Washington, District of Columbia
| | - Ronald H Dallas
- Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Linda Briggs
- Respecting Choices, Coalition to Transform Advanced Care Innovations, Washington, District of Columbia; and
| | - Patricia M Flynn
- Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Ana Garcia
- Department of Pediatrics, Division of Infectious Disease and Immunology, Batchelor Children's Research Institute, University of Miami Miller School of Medicine, Miami, Florida
| | - Yao I Cheng
- Biostatistics and Study Methodology, Center for Translational Science, Children's Research Institute, Children's National, Washington, District of Columbia
| | - Jichuan Wang
- Department of Pediatrics, School of Medicine and Health Sciences, George Washington University, Washington, District of Columbia
- Biostatistics and Study Methodology, Center for Translational Science, Children's Research Institute, Children's National, Washington, District of Columbia
| |
Collapse
|
19
|
Quality of life of persons living with HIV and congruence with surrogate decision-makers. Qual Life Res 2018; 28:47-56. [PMID: 30219937 DOI: 10.1007/s11136-018-2002-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2018] [Indexed: 01/23/2023]
Abstract
PURPOSE Physicians and caregivers rate patient quality of life (QOL) lower than patients rate their own QOL. This study investigated discrepancies between self-assessments of patient QOL by adults with HIV and their surrogate decision-makers. METHODS We collected baseline data from 223 adult dyads in the FAmily-CEntered (FACE) Advance Care Planning (ACP) clinical trial, consisting of HIV positive patients and their chosen surrogates. Participants independently completed the Medical Outcome Study-HIV Survey (MOS-HIV) and the Palliative care Outcome Scale (POS). We used Wilcoxon Signed-Rank Test to assess differences in overall patient-surrogate means. We used Prevalence Adjusted Bias Adjusted Kappa (PABAK) statistics to assess dyadic agreement, with surrogate HIV status and cohabitation status as grouping variables. RESULTS Patients were 56.1% male, 86.1% Black/African-American, aged 22-77 (mean = 50.83, SD = ± 12.33). Surrogates were 43.8% male, 84.1% Black/African-American, aged 18-82 (mean = 49.73, SD = ± 14.22). 46.2% of surrogates lived with the patient. 64.6% of surrogates reported negative HIV status. Surrogates were more likely to state patients were ill, p = 0.032. Among patient-surrogate dyads, most QOL assessments showed poor (0.00-0.39) or fair (0.40-0.59) agreement and agreement tended to be even poorer among patient-surrogate dyads where the surrogate had a shared HIV diagnosis. CONCLUSIONS QOL discrepancies are said to arise from healthy surrogates overestimating the effects of chronic illness. In this novel assessment, many surrogates had a shared HIV diagnosis, without increased agreement. These findings highlight the challenge of accurately assessing patient QOL by surrogates, even when there is a shared HIV diagnosis. Improved communication is needed between patients and surrogates about the patients' representation of illness. National Clinical Trial Number: NCT01775436.
Collapse
|
20
|
Rzeszutek M. A longitudinal analysis of posttraumatic growth and affective well-being among people living with HIV: The moderating role of received and provided social support. PLoS One 2018; 13:e0201641. [PMID: 30080882 PMCID: PMC6078301 DOI: 10.1371/journal.pone.0201641] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Accepted: 07/19/2018] [Indexed: 11/19/2022] Open
Abstract
Objectives The aim of this one-year longitudinal study was to examine the temporal relationship between the level of posttraumatic growth (PTG) and affective well-being, measured by the presence of positive and negative affect among people living with the HIV (PLWH). In addition, the moderating effects of received and provided support with respect to the above-mentioned relationship were investigated. Method Study participants completed the following psychometric inventories: the Posttraumatic Growth Inventory (PTGI), the Positive and Negative Affect Schedule (PANAS-X), and the Berlin Social Support Scales (BSSS). Three assessments were performed: 129 patients were recruited for the first assessment, 106 patients agreed to participate in the second assessment, and 82 of the initial 129 participants (63.6%) participated in all three assessments. Results An indirect association between PTG and positive affect was observed. However, no association was found between PTG and negative affect. Received support, but not provided support, completely moderated the relationship between PTG and positive affect. Conclusions This study adds to the literature by examining the temporal relationship between PTG and affective-wellbeing among PLWH. It appears from the results that in this patient group, PTG may enhance the positive affect over time. However, receiving support is vital in this process.
Collapse
Affiliation(s)
- Marcin Rzeszutek
- Faculty of Psychology, University of Warsaw, Stawki, Warsaw, Poland
- * E-mail:
| |
Collapse
|
21
|
White K, Issac MSM, Kamoun C, Leygues J, Cohn S. The THRIVE model: A framework and review of internal and external predictors of coping with chronic illness. Health Psychol Open 2018; 5:2055102918793552. [PMID: 30151224 PMCID: PMC6104221 DOI: 10.1177/2055102918793552] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
This article explores the ways in which people cope with social and clinical dimensions of their chronic conditions. Existing literature was reviewed to categorize factors identified as being key. They were sorted into six groupings which are reflected by the acronym THRIVE: therapeutic interventions, habit and routine, relational-social, individual differences, values and beliefs, and emotional factors. We found little evidence to suggest different conditions prompt unique coping responses; rather, a range of common factors were observed across diverse conditions. The THRIVE framework not only summarizes current literature but provides a starting point for further research and development of future interventions.
Collapse
Affiliation(s)
| | | | | | | | - Simon Cohn
- London School of Hygiene & Tropical Medicine, UK
| |
Collapse
|
22
|
Rzeszutek M. Health-related quality of life and coping strategies among people living with HIV: the moderating role of gender. Arch Womens Ment Health 2018; 21:247-257. [PMID: 29256068 PMCID: PMC5940709 DOI: 10.1007/s00737-017-0801-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 12/05/2017] [Indexed: 02/04/2023]
Abstract
The aim of the study was to explore gender differences in the level of health-related quality of life (HRQoL) and coping strategies among people living with the human immunodeficiency virus (HIV) (PLWH). In particular, the moderating role of participants' gender on the relationship between coping strategies and HRQoL was explored, while controlling for socio-medical data. A total of 444 HIV-infected men and 86 HIV-infected women were recruited to participate in the study. This was a cross-sectional study with the HRQoL assessed by the World Health Organization (WHO) Quality of Life-BREF (WHOQOL-BREF) and the coping strategies measured by the Brief COPE inventory. Although the HIV-infected men and HIV-infected women differed in terms of some HRQoL domains, these differences disappeared in the regression analysis after controlling for socio-demographic data (employment and higher education). In addition, several statistically significant interactions between participants' gender and coping strategies in relation to HRQoL domains were observed. Future research on gender differences in HRQoL among PLWH should take into account unique differences between HIV-infected men and HIV-infected women across, not only in respect to socio-medical factors but also regarding psychosocial variables.
Collapse
Affiliation(s)
- Marcin Rzeszutek
- Faculty of Psychology, University of Warsaw, Stawki 5/7, 00-183, Warsaw, Poland.
| |
Collapse
|
23
|
Guy AA, Niel K, Du Bois SN. Emotional Support, Active Coping, and ART Adherence in Young African American Men who have Sex With Men: A Pilot Mediation Model. J Assoc Nurses AIDS Care 2018; 29:612-618. [PMID: 29571685 DOI: 10.1016/j.jana.2018.02.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Accepted: 02/27/2018] [Indexed: 11/28/2022]
|
24
|
Davis DA, Aguilar JM, Arandi CG, Northbrook S, Loya-Montiel MI, Morales-Miranda S, Barrington C. "Oh, I'm Not Alone": Experiences of HIV-Positive Men Who Have Sex With Men in a Health Navigation Program to Promote Timely Linkage to Care in Guatemala City. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2017; 29:554-566. [PMID: 29283272 DOI: 10.1521/aeap.2017.29.6.554] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Men who have sex with men (MSM) are disproportionately affected by HIV in Guatemala and may benefit from health navigation programs designed to support timely linkage to HIV care. We conducted qualitative in-depth interviews with MSM (n = 19) linked to care within days of their diagnosis with the support of a health navigator. We used narrative analysis and systematic coding to identify themes related to HIV diagnosis and experiences with navigators. Participants experienced strong feelings of fear upon receiving a positive HIV test result. This fear led to social isolation and limited reliance on family and friend networks for support. Health navigators developed strong relationships with participants by providing the emotional support they were lacking and supporting them to overcome their fear and other structural barriers to HIV care, including stigma. Findings support the important role of navigation for MSM in Guatemala and could be transferable to other settings in Latin America.
Collapse
Affiliation(s)
- Dirk A Davis
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill
| | - Jose Manuel Aguilar
- HIV Unit, Centre for Health Studies, Del Valle University of Guatemala, Guatemala City, Guatemala
- Colectivo Amigos Contra el SIDS (CAS), Guatemala City, Guatemala
| | - Cesar Galindo Arandi
- HIV Unit, Centre for Health Studies, Del Valle University of Guatemala, Guatemala City, Guatemala
- Colectivo Amigos Contra el SIDS (CAS), Guatemala City, Guatemala
| | - Sanny Northbrook
- U.S. Centers for Disease Control and Prevention (CDC) Central America Region, Guatemala City, Guatemala
| | - M Itzel Loya-Montiel
- HIV Unit, Centre for Health Studies, Del Valle University of Guatemala, Guatemala City, Guatemala
| | | | - Clare Barrington
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill
| |
Collapse
|
25
|
White DA, McGuire AB, Luther L, Anderson AI, Phalen P, McGrew JH. Consumer factors predicting level of treatment response to illness management and recovery. Psychiatr Rehabil J 2017; 40:344-353. [PMID: 28910123 PMCID: PMC5739957 DOI: 10.1037/prj0000284] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE This study aims to identify consumer-level predictors of level of treatment response to illness management and recovery (IMR) to target the appropriate consumers and aid psychiatric rehabilitation settings in developing intervention adaptations. METHOD Secondary analyses from a multisite study of IMR were conducted. Self-report data from consumer participants of the parent study (n = 236) were analyzed for the current study. Consumers completed prepost surveys assessing illness management, coping, goal-related hope, social support, medication adherence, and working alliance. Correlations and multiple regression analyses were run to identify self-report variables that predicted level of treatment response to IMR. RESULTS Analyses revealed that goal-related hope significantly predicted level of improved illness self-management, F(1, 164) = 10.93, p < .001, R2 = .248, R2 change = .05. Additionally, we found that higher levels of maladaptive coping at baseline were predictive of higher levels of adaptive coping at follow-up, F(2, 180) = 5.29, p < .02, R2 = .38, R2 change = .02. Evidence did not support additional predictors. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Previously, consumer-level predictors of level of treatment response have not been explored for IMR. Although 2 significant predictors were identified, study findings suggest more work is needed. Future research is needed to identify additional consumer-level factors predictive of IMR treatment response in order to identify who would benefit most from this treatment program. (PsycINFO Database Record
Collapse
Affiliation(s)
- Dominique A White
- Department of Psychology, Indiana University-Purdue University Indianapolis
| | - Alan B McGuire
- Health Services Research and Development, Richard L. Roudebush, Veterans Affairs Medical Center
| | - Lauren Luther
- Department of Psychology, Indiana University-Purdue University Indianapolis
| | | | - Peter Phalen
- School of Psychological Sciences, University of Indianapolis
| | - John H McGrew
- Department of Psychology, Indiana University-Purdue University Indianapolis
| |
Collapse
|
26
|
Brier MJ, Williams RM, Turner AP, Henderson AW, Roepke AM, Norvell DC, Henson H, Czerniecki JM. Quality of Relationships With Caregivers, Depression, and Life Satisfaction After Dysvascular Lower Extremity Amputation. Arch Phys Med Rehabil 2017; 99:452-458. [PMID: 28987901 DOI: 10.1016/j.apmr.2017.09.110] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 07/26/2017] [Accepted: 09/08/2017] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To describe the relationship between caregiver-specific support and conflict, and psychosocial outcomes among individuals experiencing their first dysvascular lower extremity amputation (LEA). DESIGN Cross-sectional cohort study using self-report surveys. SETTING Department of Veterans Affairs, academic medical center, and level I trauma center. PARTICIPANTS Individuals undergoing their first major LEA because of complications of peripheral arterial disease (PAD) or diabetes who have a caregiver and completed measures of caregiver support and conflict (N=137; 94.9% men). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES The Patient Health Questionnaire-9 to assess depression and the Satisfaction With Life Scale to assess life satisfaction. RESULTS In multiple regression analyses, controlling for global levels of perceived support, self-rated health, age, and mobility, caregiver-specific support was found to be associated with higher levels of life satisfaction and caregiver-specific conflict was found to be associated with lower levels of life satisfaction and higher levels of depressive symptoms. CONCLUSIONS The specific relationship between individuals with limb loss and their caregivers may be an important determinant of well-being. Conflict with caregivers, which has received little attention thus far in the limb loss literature, appears to play a particularly important role. Individuals with limb loss may benefit from interventions with their caregivers that both enhance support and reduce conflict.
Collapse
Affiliation(s)
- Moriah J Brier
- Rehabilitation Care Service, VA Puget Sound Health Care System, Seattle, WA.
| | - Rhonda M Williams
- Rehabilitation Care Service, VA Puget Sound Health Care System, Seattle, WA; Department of Rehabilitation Medicine, University of Washington, Seattle, WA
| | - Aaron P Turner
- Rehabilitation Care Service, VA Puget Sound Health Care System, Seattle, WA; Department of Rehabilitation Medicine, University of Washington, Seattle, WA
| | - Alison W Henderson
- Rehabilitation Care Service, VA Puget Sound Health Care System, Seattle, WA
| | - Ann Marie Roepke
- Rehabilitation Care Service, VA Puget Sound Health Care System, Seattle, WA
| | | | - Helene Henson
- Physical Medicine and Rehabilitation, Houston VA Medical Center, Houston, TX
| | - Joseph M Czerniecki
- Rehabilitation Care Service, VA Puget Sound Health Care System, Seattle, WA; Department of Rehabilitation Medicine, University of Washington, Seattle, WA
| |
Collapse
|
27
|
Rzeszutek M, Gruszczyńska E, Firląg-Burkacka E. Coping profiles and subjective well-being among people living with HIV: less intensive coping corresponds with better well-being. Qual Life Res 2017; 26:2805-2814. [PMID: 28584892 PMCID: PMC5597686 DOI: 10.1007/s11136-017-1612-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2017] [Indexed: 01/07/2023]
Abstract
Purpose The aim of this study was to investigate the relationship between coping strategies and subjective well-being (SWB) among people living with HIV (PLWH) using the latent profile analysis (LPA) with control for socio-medical covariates. Methods The sample comprised five hundred and thirty people (N = 530) with a confirmed diagnosis of HIV+. The study was cross-sectional with SWB operationalized by satisfaction with life (Satisfaction with Life Scale) and positive and negative affect (PANAS-X). Coping with stress was measured by the Brief COPE Inventory, enriched by several items that assessed rumination and enhancement of positive emotional states. Additionally, the relevant socio-medical variables were collected. Results The one-step model of LPA revealed the following: (1) a solution with five different coping profiles suited the data best; (2) socio-medical covariates, except for education, were not related to the profiles’ membership. Further analysis with SWB as a distal outcome showed that higher intensity coping profiles have significantly worse SWB when compared with lower intensity coping profiles. However, the lowest SWB was noted for mixed intensity coping profile (high adaptive/low maladaptive). Conclusions The person-centered approach adopted in this study informs about the heterogeneity of disease-related coping among PLWH and its possible reactive character, as the highest SWB was observed among participants with the lowest intensity of coping.
Collapse
Affiliation(s)
- Marcin Rzeszutek
- Faculty of Psychology, University of Warsaw, Stawki 5/7, 00-183, Warsaw, Poland.
| | - Ewa Gruszczyńska
- Health Psychology Department, University of Social Sciences and Humanities, Chodakowska 19/31, 03-815, Warsaw, Poland
| | | |
Collapse
|
28
|
Ashaba S, Kaida A, Burns BF, O'Neil K, Dunkley E, Psaros C, Kastner J, Tsai AC, Bangsberg DR, Matthews LT. Understanding coping strategies during pregnancy and the postpartum period: a qualitative study of women living with HIV in rural Uganda. BMC Pregnancy Childbirth 2017; 17:138. [PMID: 28482821 PMCID: PMC5423027 DOI: 10.1186/s12884-017-1321-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Accepted: 05/03/2017] [Indexed: 01/03/2023] Open
Abstract
Background In sub-Saharan Africa, 58% of adults living with HIV are women. In Uganda, HIV prevalence is 8.3% for women compared to 6.1% for men. Access to antiretroviral therapy (ART) and prevention of mother to child transmission (PMTCT) programs have enabled women living with HIV (WLWH) to have children with minimal risk of perinatal transmission. Nevertheless, pregnant WLWH face many challenges. We explored women’s perceptions of how they cope with the challenges of pregnancy and the postpartum period as HIV-infected women. Methods We conducted semi-structured interviews with postpartum WLWH accessing ART who had a pregnancy within 2 years prior to recruitment between February–August, 2014. Childbearing associated stressors and coping strategies were discussed. We used content analysis to identify major themes and NVivo 10 software facilitated data analysis. Results Twenty women were interviewed with median age 33 (IQR: 28–35) years, CD4 cell count 677 cells/mm3 (IQR: 440–767), number of live births 4 (IQR: 2–6), and number of living children 3 (IQR: 2–4.3). We summarize five identified coping strategies within a socio-ecological framework according to Bronfenbrenner’s Ecological Model. Coping strategies on the individual level included acceptance of self and HIV status, and self-reliance. On the interpersonal level, participants reported coping through support from partners, family, and friends. On the organizational level, participants reported coping through HIV-related healthcare delivery and system supports. At the community level, women reported coping through support from church and spirituality. Conclusions The results highlight coping strategies used by WLWH to manage the myriad challenges faced during pregnancy and the postpartum period. Intervention programs for WLWH must emphasize psychosocial care and incorporate strategies that address psychosocial challenges in the HIV care package in order to optimize well-being. Additionally policies that support networks of WLWH should be put in place and funding support should be provided through existing funding mechanisms in order to respond to the needs and challenges of WLWH. Programmes that support WLWH for economic empowerment and improved livelihoods should be strengthened across all regions in the country. Electronic supplementary material The online version of this article (doi:10.1186/s12884-017-1321-9) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Scholastic Ashaba
- Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, Uganda.
| | - Angela Kaida
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | | | - Kasey O'Neil
- MGH Global Health, Massachusetts General Hospital, Boston, MA, USA
| | - Emma Dunkley
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - Christina Psaros
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Jasmine Kastner
- Research Institute McGill University Health Centre Montreal, Montreal, Canada
| | - Alexander C Tsai
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - David R Bangsberg
- MGH Global Health, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Lynn T Matthews
- MGH Global Health, Massachusetts General Hospital, Boston, MA, USA.,Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| |
Collapse
|
29
|
Ashaba S, Kaida A, Coleman JN, Burns BF, Dunkley E, O'Neil K, Kastner J, Sanyu N, Akatukwasa C, Bangsberg DR, Matthews LT, Psaros C. Psychosocial challenges facing women living with HIV during the perinatal period in rural Uganda. PLoS One 2017; 12:e0176256. [PMID: 28459866 PMCID: PMC5411062 DOI: 10.1371/journal.pone.0176256] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2016] [Accepted: 04/07/2017] [Indexed: 01/08/2023] Open
Abstract
The complexities of navigating pregnancy while living with HIV predispose women to additional stress. Finding ways to minimize psychosocial challenges during the perinatal period may maximize the well-being of mothers living with HIV and their children. The goal of this study was to explore psychosocial challenges experienced by women living with HIV (WLWH) during pregnancy and the postpartum. We conducted individual in-depth interviews with 20 WLWH recruited from an HIV treatment cohort study in Mbarara, Uganda as part of a larger study exploring perinatal depression. We conducted content analyses to identify themes related to challenges of WLWH during pregnancy and the postpartum. Participants had a median age of 33 years [IQR: 28-35], a median of 3 living children [IQR: 2-5], and 95% had achieved HIV-RNA suppression. Challenges were organized around the following themes: HIV -related stigma from health professionals, HIV status disclosure dilemma, unintended pregnancy and intimate partner violence, HIV and environmental structural barriers and distress and fear related to maternal and child health. Stigma centered on discrimination by health care professionals and personal shame associated with being pregnant as a WLWH. This led to difficulty engaging in HIV care, particularly when coupled with structural barriers, such as lack of transportation to clinic. Participants experienced intimate partner violence and lacked support from their partners and family members. Distress and fear about the health and uncertainty about the future of the unborn baby due to maternal deteriorating physical health was common. The perinatal period is a time of stress for WLWH. Challenges experienced by WLWH may compromise successful engagement in HIV care and may reduce quality of life for women and their children. Strategies aimed at alleviating the challenges of WLWH should involve the larger structural environment including partners, family and community member as well as policy makers, funders and program implementers to work together for the common cause. These consolidated efforts may not only lower the risk of psychological distress but has potential to create long lasting solutions to benefit the wider community.
Collapse
Affiliation(s)
- Scholastic Ashaba
- Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Angela Kaida
- Faculty of Health Sciences, Simon Fraser University, Vancouver, Canada
| | - Jessica N Coleman
- Behavioral Medicine Program, Department of Psychiatry, Massachusetts General Hospital (MGH), Boston, United States of America
| | - Bridget F Burns
- Division of Global Health, Massachusetts General Hospital (MGH), Boston, United States of America
| | - Emma Dunkley
- Faculty of Health Sciences, Simon Fraser University, Vancouver, Canada
| | - Kasey O'Neil
- Division of Global Health, Massachusetts General Hospital (MGH), Boston, United States of America
| | - Jasmine Kastner
- Research Institute, McGill University Health Centre, Montreal, Canada
| | - Naomi Sanyu
- Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Cecilia Akatukwasa
- Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, Uganda
| | - David R Bangsberg
- Oregon Health Sciences University-Portland State University School of Public Health, Portland, OR, United States of America
| | - Lynn T Matthews
- Division of Global Health, Massachusetts General Hospital (MGH), Boston, United States of America
- Division of Infectious Disease, Massachusetts General Hospital (MGH), Boston, United States of America
| | - Christina Psaros
- Behavioral Medicine Program, Department of Psychiatry, Massachusetts General Hospital (MGH), Boston, United States of America
- Harvard Medical School, Boston, MA
| |
Collapse
|
30
|
Change in urinary cortisol excretion mediates the effect of angry/hostile mood on 9 month diastolic blood pressure in HIV+ adults. J Behav Med 2017; 40:620-630. [PMID: 28155001 DOI: 10.1007/s10865-017-9827-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 01/07/2017] [Indexed: 01/16/2023]
Abstract
Cardiovascular disease is a growing concern in HIV disease management and nearly 1 out of 3 persons living with the virus is hypertensive. Biobehavioral factors such as anger, hostility, and HPA axis reactivity are emperically linked to blood pressure regulation. Whether HPA axis or mood disturbance increases risk for hypertension remains unclear in HIV disease. The aim of this study was to determine whether 9-month change in angry/hostile mood predicts alterations in systolic (SBP) or diastolic blood pressure (DBP), and whether this change is mediated by 24-h urinary cortisol (CORT) output. Sixty-one HIV positive adults, aged 41.1 ± 8.6 years, assigned to the control condition of a stress management intervention provided blood samples, 24-h urine specimens, blood pressure in-office, and self-reported mood at baseline and a 9-month follow-up. CORT was tested as a mediator in two separate models controlling for baseline BP, CD4 count, HIV-1 viral load, protease inhibitor use, body mass index, smoking status, and family history of cardiometabolic disease. Increase in angry/hostile mood was associated with greater SBP (β = 0.33, CI 0.09, 0.56, p = 0.01) and DBP (β = 0.39, CI 0.16, 0.62, p < 0.001) at follow-up. CORT partially mediated the effect of angry/hostile mood on DBP (β = 0.28, CI 0.03, 0.54, p = 0.03). Change in CORT was not related to SBP (β = 0.12, CI -0.20, 0.44, p = 0.46). The final mediation model accounted for 41.2% of the variance in 9-month DBP. Angry or hostile mood may contribute to increased risk for hypertension in persons treated for HIV via disturbance of the HPA-axis.
Collapse
|
31
|
Rzeszutek M. Social support and posttraumatic growth in a longitudinal study of people living with HIV: the mediating role of positive affect. Eur J Psychotraumatol 2017; 8:1412225. [PMID: 29296241 PMCID: PMC5738637 DOI: 10.1080/20008198.2017.1412225] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2017] [Accepted: 11/20/2017] [Indexed: 01/08/2023] Open
Abstract
Background: Psychological research in people living with HIV (PLWH) has been dominated by studies on the negative consequences of HIV infection. However, recently, positive changes following the diagnosis of HIV have been examined, namely the phenomenon of posttraumatic growth (PTG). Objectives: The aim of this one-year longitudinal study was to investigate the level of PTG and its relationship with social support dimensions (perceived support, need for support, actually received support) and positive and negative affect among PLWH. Specifically, this study explored the mediating role of positive and negative affect in the link between social support and PTG. Method: Participants filled out the following psychometric tools: Posttraumatic Growth Inventory (PTGI), Berlin Social Support Scales (BSSS) and Positive and Negative Affect Schedule (PANAS-X). Three assessments were performed. Altogether, 129 patients were recruited for the first assessment, 106 patients participated in the second assessment and 82 participants (63.6%) out of the initial sample of 129 participated in all three assessments. Results: The positive relationship between all examined social support dimensions and PTG was entirely mediated by positive affect. There was no association between negative affect and PTG. Selected socio-medical covariates (sex, employment, higher education, being in a stable relationship and HIV/AIDS status) were related to social support and PTG among participants. Conclusions: This study points to the need for more research on positive aspects of HIV/AIDS, notably PTG. More specifically, interventions focused on enhancement and sustainment of positive affect among PLWH should be an adjunct to traditional mental health screening among this patient group.
Collapse
|
32
|
Brashers DE, Basinger ED, Rintamaki LS, Caughlin JP, Para M. Taking Control: The Efficacy and Durability of a Peer-Led Uncertainty Management Intervention for People Recently Diagnosed With HIV. HEALTH COMMUNICATION 2017; 32:11-21. [PMID: 27119222 DOI: 10.1080/10410236.2015.1089469] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
HIV creates substantial uncertainty for people infected with the virus, which subsequently affects a host of psychosocial outcomes critical to successful management of the disease. This study assessed the efficacy and durability of a theoretically driven, one-on-one peer support intervention designed to facilitate uncertainty management and enhance psychosocial functioning for patients newly diagnosed with HIV. Using a pretest-posttest control group design, 98 participants received information and training in specific communication strategies (e.g., disclosing to friends and family, eliciting social support, talking to health care providers, using the Internet to gather information, and building social networks through AIDS service organizations). Participants in the experimental group attended six 1-hour sessions, whereas control participants received standard of care for 12 months (after which they received the intervention). Over time, participants in the intervention fared significantly better regarding (a) illness uncertainty, (b) depression, and (c) satisfaction with social support than did those in the control group. Given the utility and cost-effectiveness of this intervention and the uncertainty of a multitude of medical diagnoses and disease experiences, further work is indicated to determine how this program could be expanded to other illnesses and to address related factors, such as treatment adherence and clinical outcomes.
Collapse
Affiliation(s)
- Dale E Brashers
- a Department of Communication , University of Illinois at Urbana - Champaign
| | - Erin D Basinger
- a Department of Communication , University of Illinois at Urbana - Champaign
| | | | - John P Caughlin
- a Department of Communication , University of Illinois at Urbana - Champaign
| | | |
Collapse
|
33
|
Chang EC, Yu T, Jilani Z, Chang OD, Du Y, Hirsch JK, Kamble SV. Happiness among HIV-positive indian adults: Examining stress-related growth and coping as predictors of positive psychological adjustment. Asian J Psychiatr 2016; 24:147-148. [PMID: 27931899 DOI: 10.1016/j.ajp.2016.09.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2015] [Revised: 07/14/2016] [Accepted: 09/01/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Edward C Chang
- Department of Psychology, University of Michigan, Ann Arbor, MI 48109, United States.
| | - Tina Yu
- Department of Psychology, University of Michigan, Ann Arbor, MI 48109, United States
| | - Zunaira Jilani
- Department of Psychology, University of Michigan, Ann Arbor, MI 48109, United States
| | - Olivia D Chang
- Research in Action Academy™, Ann Arbor, MI, United States
| | - Yifeng Du
- Department of Psychology, University of San Diego, United States
| | - Jameson K Hirsch
- Department of Psychology, East Tennessee State University, United States
| | | |
Collapse
|
34
|
Mosack KE, Stevens PE, Brouwer AM, Wendorf AR. Shared Illness and Social Support Within Two HIV-Affected African American Communities. QUALITATIVE HEALTH RESEARCH 2016; 26:1495-1507. [PMID: 26515921 DOI: 10.1177/1049732315612044] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
A key source of resiliency within HIV-affected African American communities is informal social support. Data from dyadic conversations and focus groups were used to address the following research question: What are HIV-positive African Americans' social support experiences within their informal social networks in response to HIV-related problems? Circumstances that exacerbated HIV-related problems included others' fear of contagion, reticence to be involved, judgment and rejection, and disregard for privacy Support from HIV-negative others buffered the impact of problems when others communicate interest, take the initiative to help, or make a long-term investment in their success. Support from other HIV-positive persons was helpful given the shared connection because of HIV, the opportunity to commiserate about what is mutually understood, and the fight for mutual survival Based on these findings, we offer suggestions for future research and social network interventions aimed at bolstering connections between HIV-positive peers, reducing stigma, and improving family support.
Collapse
Affiliation(s)
- Katie E Mosack
- University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | | | | | - Angela R Wendorf
- University of Massachusetts Medical School, Worcester, Massachusetts, USA
| |
Collapse
|
35
|
Riggs SA, Vosvick M, Stallings S. Attachment Style, Stigma and Psychological Distress among HIV+ Adults. J Health Psychol 2016; 12:922-36. [DOI: 10.1177/1359105307082457] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study explored the role of adult attachment style in reported experiences of HIV-related stigma, stress and depression in a diverse sample of HIV+ adults. Participants ( N = 288) recruited from AIDS service organizations were administered the Experiences in Close Relationships Scale, Perceived Stress Scale, CES-D, HIV Stigma Scale and a health information questionnaire. Adult romantic attachment style was significantly associated with perceived stress, depression and HIV-related stigma. Results of regression analyses supported contentions that in addition to HIV symptomatology, other psychosocial risk factors such as attachment style and stigma contribute to perceived stress and depression among HIV+ men and women.
Collapse
|
36
|
Hendy HM, Joseph LJ, Can SH. Repressed anger mediates associations between sexual minority stressors and negative psychological outcomes in gay men and lesbian women. JOURNAL OF GAY & LESBIAN MENTAL HEALTH 2016. [DOI: 10.1080/19359705.2016.1166470] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
37
|
McIntosh RC, Hurwitz BE, Antoni M, Gonzalez A, Seay J, Schneiderman N. The ABCs of Trait Anger, Psychological Distress, and Disease Severity in HIV. Ann Behav Med 2015; 49:420-33. [PMID: 25385204 PMCID: PMC4623323 DOI: 10.1007/s12160-014-9667-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Trait anger consists of affective, behavioral, and cognitive (ABC) dimensions and may increase vulnerability for interpersonal conflict, diminished social support, and greater psychological distress. The concurrent influence of anger and psychosocial dysfunction on Human Immunodeficiency Virus (HIV) disease severity is unknown. PURPOSE The purpose of this study was to examine plausible psychosocial avenues (e.g., coping, social support, psychological distress), whereby trait anger may indirectly influence HIV disease status. METHODS Three hundred seventy-seven HIV seropositive adults, aged 18-55 years (58% AIDS-defined), completed a battery of psychosocial surveys and provided a fasting blood sample for HIV-1 viral load and T lymphocyte count assay. RESULTS A second-order factor model confirmed higher levels of the multidimensional anger trait, which was directly associated with elevated psychological distress and avoidant coping (p<.001) and indirectly associated with greater HIV disease severity (p<.01) (comparative fit index (CFI)=0.90, root-mean-square error of approximation (RMSEA)=0.06, standardized root-mean-square residual (SRMR)=0.06). CONCLUSION The model supports a role for the ABC components of anger, which may negatively influence immune function through various psychosocial mechanisms; however, longitudinal study is needed to elucidate these effects.
Collapse
Affiliation(s)
- Roger C McIntosh
- Department of Psychology, University of Miami, Coral Gables, FL, 33124, USA,
| | | | | | | | | | | |
Collapse
|
38
|
Faraji E, Sardashti S, Firouzeh MM, Aminabad FJ, Alinaghi SAS, Hajiabdolbaghi M. Perceived social support affects disease coping among people living with HIV: a study in Tehran, Iran. ASIAN PACIFIC JOURNAL OF TROPICAL DISEASE 2015. [DOI: 10.1016/s2222-1808(14)60806-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
39
|
Kyajja R, Muliira JK, Ayebare E. Personal coping strategies for managing the side effects of antiretroviral therapy among patients at an HIV/AIDS clinic in Uganda. AJAR-AFRICAN JOURNAL OF AIDS RESEARCH 2015; 9:205-11. [PMID: 25860625 DOI: 10.2989/16085906.2010.530171] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The side effects of antiretroviral (ARV) medications negatively impact patients' quality of life and adherence to treatment. This study describes the burden of side effects from ARV treatment as experienced by a sample of HIV/AIDS patients and identifies the personal strategies they used to cope with the side effects. A total of 166 participants were recruited from a non-governmental HIV/AIDS clinic in Entebbe, Uganda. Most of the participants (76%) were females and the mean age of the sample was 38 years. Although the participants had taken ARV medications for an average period of nine months, a large proportion (76%) could not name the medications they were taking. The mean side-effects burden for the participants was five side effects. The most common adverse effects reported were tiredness, nightmares, mood swings, nausea, poor appetite, insomnia, vomiting and dizziness. The main strategies the patients used for coping with the side effects were those categorised under information-seeking, social-support seeking and positive-emotion-focused coping. However, 27% of the participants reported non-adherence to their ARV medications as a strategy to cope with the side effects. The findings show a significant relationship between the side-effects burden and a patient's age (r = 0.530, p ≤ 0.01) and level of education (r = 0.394, p ≤ 0.01). The findings indicate that in the short term after initiating ARV treatment most patients are able to cope with the high burden of side effects through appropriate strategies, but a sizable portion will fail to cope appropriately and thus resort to non-adherence. Clinicians should assist patients with continuous health education and counselling that focuses on appropriate strategies to cope with the side effects of ARVs in order to buffer the negative impact of HIV treatment on patients' adherence and quality of life.
Collapse
Affiliation(s)
- Rogers Kyajja
- a Mulago National Referral Hospital , PO Box 22984 , Kampala , Uganda
| | | | | |
Collapse
|
40
|
Broaddus MR, Hanna CR, Schumann C, Meier A. "She makes me feel that I'm not alone": linkage to Care Specialists provide social support to people living with HIV. AIDS Care 2015; 27:1104-7. [PMID: 25854534 DOI: 10.1080/09540121.2015.1028882] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Wisconsin's Linkage to Care intervention incorporates elements of individually tailored patient navigation and case management designed to increase linkage and retention in HIV-related medical care. It is delivered by Linkage to Care Specialists in HIV medical clinics and community-based agencies. Researchers interviewed a diverse sample of clients to conduct preliminary evaluation of the pilot phase of this intervention. The participants' relationships with their Specialists emerged as a major unifying theme of the data. Comfortable and close relationships with Specialists served as motivation to adhere to medical care, mitigated negative feelings associated with HIV-related stigma, and resulted in increased comfort with medical care and positive health outcomes including engagement in care and undetectable viral load. As a result of the Specialists' support, many participants were reluctant to transition out of the Linkage to Care program. The positive effects demonstrated by Specialists are balanced against the costs of small caseloads that are potentially not feasible within traditional case management models. Future interventions to increase medical care engagement, among HIV+ individuals at risk of lack of engagement, should develop strategies to "personalize" the patient experiences within health care and psychosocial services delivery systems, as well as screening tools to triage clients into different levels of personal service provision intensity based on need and desire.
Collapse
Affiliation(s)
- Michelle R Broaddus
- a Department of Psychiatry & Behavioral Medicine, Center for AIDS Intervention Research , Medical College of Wisconsin , Milwaukee , WI , USA
| | - Christina R Hanna
- b Wisconsin Department of Health Services, AIDS/HIV Program , Madison, WI , USA
| | - Casey Schumann
- b Wisconsin Department of Health Services, AIDS/HIV Program , Madison, WI , USA
| | - Alison Meier
- b Wisconsin Department of Health Services, AIDS/HIV Program , Madison, WI , USA
| |
Collapse
|
41
|
Shah K, McMahon JM, Trabold N, Aidala AA, Chen M, Pouget ER, Simmons J, Klostermann K. Determinants of physical and global functioning in adult HIV-positive heterosexual men. AIDS Care 2015; 27:1079-86. [PMID: 25812466 DOI: 10.1080/09540121.2015.1026308] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Little is known about the psychosocial factors that might impact the functioning ability of heterosexual men living with HIV. We examined positive and negative coping, social support, and HIV stigma as predictors of physical and global functioning in a cross-sectional sample of 317 HIV-infected adult heterosexual male patients recruited from clinical and social service agencies in New York City. Study participants were primarily minority and low income. Sixty-four percent were African-American, 55% were single, and 90% were 40 years of age or older. The majority had long-term HIV (LTHIV), with an average duration of 15 years since diagnosis. After controlling for participant characteristics, structural equation modeling analyses revealed that positive coping and social support had a significant positive direct effect on global functioning, while stigma had a significant negative direct effect on global functioning. The physical functioning model revealed that negative coping and HIV stigma had significant negative direct effects, whereas social support had a significant positive indirect effect. Age and duration of HIV diagnosis were not associated with physical and global functioning. In conclusion, we found that heterosexual men living with LTHIV who have ineffective coping, less social support, and greater stigma have reduced functioning ability. Study findings have implications for developing interventions aimed at increasing and retaining functioning ability with the end goal of improving successful aging in this population.
Collapse
Affiliation(s)
- Krupa Shah
- a Department of Medicine , Highland Hospital , Rochester , NY , USA
| | - James M McMahon
- b School of Nursing , University of Rochester Medical Center , Rochester , NY , USA
| | - Nicole Trabold
- b School of Nursing , University of Rochester Medical Center , Rochester , NY , USA
| | - Angela A Aidala
- c Department of Sociomedical Sciences , Columbia University , New York , NY , USA
| | - Michael Chen
- d Department of Public Health Sciences , University of Rochester , Rochester , NY , USA
| | - Enrique R Pouget
- e National Development and Research Institutes , New York , NY , USA
| | - Janie Simmons
- e National Development and Research Institutes , New York , NY , USA
| | - Keith Klostermann
- f Department of Psychology and Counseling , Medaille College , Buffalo , NY , USA
| |
Collapse
|
42
|
Attonito J, Dévieux JG, Lerner BDG, Hospital MM, Rosenberg R. Antiretroviral treatment adherence as a mediating factor between psychosocial variables and HIV viral load. J Assoc Nurses AIDS Care 2014; 25:626-37. [PMID: 25305029 PMCID: PMC4194191 DOI: 10.1016/j.jana.2014.08.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Accepted: 08/02/2014] [Indexed: 01/29/2023]
Abstract
Psychosocial factors may directly impact HIV health measures such as viral load (VL) whether or not patients are taking antiretroviral treatment (ART) consistently. Structural equation modeling plus Baron and Kenny's (1986) four-step approach were used to test a mediated model predicting VL among 246 HIV-infected adults who were on ART. Exogenous variables were social support, barriers to adherence, and stress. Moderators were alcohol use, marijuana use, and neurocognitive impairment. A small positive association between marijuana use and ART adherence approached significance. Only barriers to adherence predicted a decrease in adherence rates and an increase in VL. No other factors were significantly associated with either VL or adherence, and no interaction effects between exogenous variables and moderators were identified. The association between barriers to adherence and VL was partially mediated by ART adherence. Findings provide modest support for a direct link between psychosocial variables and a virologic response to ART.
Collapse
|
43
|
Rzeszutek M, Oniszczenko W, Żebrowska M, Firląg-Burkacka E. HIV infection duration, social support and the level of trauma symptoms in a sample of HIV-positive Polish individuals. AIDS Care 2014; 27:363-9. [PMID: 25296635 DOI: 10.1080/09540121.2014.963018] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The aim of this study was to investigate the relationship between the average HIV infection duration and the level of quantitatively rated post-traumatic stress disorder (PTSD) symptoms and social support dimensions in a sample of 562 Polish HIV+ adults. Possible moderating effects of social support on the relationship between the average HIV infection duration and the level of PTSD symptoms were also analysed. The results of this study suggest that the average HIV infection duration may intensify PTSD symptoms and deteriorate the perceived availability of social support in HIV+ individuals. However, a positive relationship between HIV infection duration and the level of trauma symptoms was observed only in the group of HIV+ individuals with low perceived available social support, but not in the group of HIV-infected individuals with high perceived available social support. This research provided some new insight into the psychological and social aspects of living with HIV. In particular, our results suggest that although HIV infection duration may intensify trauma symptoms and deteriorate social support, perceived available social support may act as a buffer against HIV-related trauma symptoms.
Collapse
Affiliation(s)
- Marcin Rzeszutek
- a Faculty of Management and Finance , University of Finance and Management , Warsaw , Poland
| | | | | | | |
Collapse
|
44
|
Crawford KW, Wakabi S, Magala F, Kibuuka H, Liu M, Hamm TE. Evaluation of treatment outcomes for patients on first-line regimens in US President's Emergency Plan for AIDS Relief (PEPFAR) clinics in Uganda: predictors of virological and immunological response from RV288 analyses. HIV Med 2014; 16:95-104. [PMID: 25124078 DOI: 10.1111/hiv.12177] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2014] [Indexed: 02/05/2023]
Abstract
OBJECTIVES Viral load (VL) monitoring is recommended, but seldom performed, in resource-constrained countries. RV288 is a US President's Emergency Plan for AIDS Relief (PEPFAR) basic programme evaluation to determine the proportion of patients on treatment who are virologically suppressed and to identify predictors of virological suppression and recovery of CD4 cell count. Analyses from Uganda are presented here. METHODS In this cross-sectional, observational study, patients on first-line antiretroviral therapy (ART) (efavirenz or nevirapine+zidovudine/lamivudine) from Kayunga District Hospital and Kagulamira Health Center were randomly selected for a study visit that included determination of viral load (HIV-1 RNA), CD4 cell count and clinical chemistry tests. Subjects were recruited by time on treatment: 6-12, 13-24 or >24 months. Logistic regression modelling identified predictors of virological suppression. Linear regression modelling identified predictors of CD4 cell count recovery on ART. RESULTS We found that 85.2% of 325 subjects were virologically suppressed (viral load<47 HIV-1 RNA copies/ml). There was no difference in the proportion of virologically suppressed subjects by time on treatment, yet CD4 counts were higher in each successive stratum. Women had higher median CD4 counts than men overall (406 vs. 294 cells/μL, respectively; P<0.0001) and in each time-on-treatment stratum. In a multivariate logistic regression model, predictors of virological suppression included efavirenz use [odds ratio (OR) 0.47; 95% confidence interval (CI) 0.22-1.02; P=0.057], lower cost of clinic visits (OR 0.815; 95% CI 0.66-1.00; P=0.05), improvement in CD4 percentage (OR 1.06; 95% CI 1.014-1.107; P=0.009), and care at Kayunga vs. Kangulamira (OR 0.47; 95% CI 0.23-0.92; P=0.035). In a multivariate linear regression model of covariates associated with CD4 count recovery, time on highly active antiretroviral therapy (ART) (P<0.0001), patient satisfaction with care (P=0.038), improvements in total lymphocyte count (P<0.0001) and haemoglobin concentration (P=0.05) were positively associated, whereas age at start of ART (P=0.0045) was negatively associated with this outcome. CONCLUSIONS High virological suppression rates are achievable on first-line ART in Uganda. The odds of virological suppression were positively associated with efavirenz use and improvements in CD4 cell percentage and total lymphocyte count and negatively associated with the cost of travel to the clinic. CD4 cell reconstitution was positively associated with CD4 count at study visit, time on ART, satisfaction with care at clinic, haemoglobin concentration and total lymphocyte count and negatively associated with age.
Collapse
Affiliation(s)
- K W Crawford
- U.S. Military HIV Research Program (MHRP), Global Health Programs, Walter Reed Army Institute of Research, Bethesda, MD, USA; Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | | | | | | | | | | |
Collapse
|
45
|
Mgbere O, Khuwaja S, Bell TK, Rodriguez-Barradas MC, Arafat R, Essien EJ, Singh M, Aguilar J, Roland E. System and Patient Barriers to Care among People Living with HIV/AIDS in Houston/Harris County, Texas: HIV Medical Care Providers' Perspectives. J Int Assoc Provid AIDS Care 2014; 14:505-15. [PMID: 24943655 DOI: 10.1177/2325957414539045] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
In the United States, a considerable number of people diagnosed with HIV are not receiving HIV medical care due to some barriers. Using data from the Medical Monitoring Project survey of HIV medical care providers in Houston/Harris County, Texas, we assessed the HIV medical care providers' perspectives of the system and patient barriers to HIV care experienced by people living with HIV/AIDS (PLWHA). The study findings indicate that of the 14 HIV care barriers identified, only 1 system barrier and 7 patient barriers were considered of significant (P ≤ .05) importance, with the proportion of HIV medical care providers' agreement to these barriers ranging from 73.9% (cost of health care) to 100% (lack of social support systems and drug abuse problems). Providers' perception of important system and patient barriers varied significantly (P ≤ .05) by profession, race/ethnicity, and years of experience in HIV care. To improve access to and for consistent engagement in HIV care, effective intervention programs are needed to address the barriers identified especially in the context of the new health care delivery system.
Collapse
Affiliation(s)
- Osaro Mgbere
- Houston Department of Health and Human Services, Office of Surveillance and Public Health Preparedness, Houston, TX, USA
| | - Salma Khuwaja
- Houston Department of Health and Human Services, Office of Surveillance and Public Health Preparedness, Houston, TX, USA
| | - Tanvir K Bell
- Department of Internal Medicine, UTHEALTH Medical School, University of Texas Health Science Center, Houston, TX, USA
| | - Maria C Rodriguez-Barradas
- Infectious Diseases Section, Michael E. DeBakey VA Medical Center, Houston, TX, USA Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Raouf Arafat
- Houston Department of Health and Human Services, Office of Surveillance and Public Health Preparedness, Houston, TX, USA
| | - Ekere James Essien
- Institute of Community Health, University of Houston College of Pharmacy, Texas Medical Center, Houston, TX, USA
| | - Mamta Singh
- Houston Department of Health and Human Services, Office of Surveillance and Public Health Preparedness, Houston, TX, USA
| | - Jonathan Aguilar
- Houston Department of Health and Human Services, Office of Surveillance and Public Health Preparedness, Houston, TX, USA
| | - Eric Roland
- Houston Medical Monitoring Project Community Advisory Board, Houston, TX, USA
| |
Collapse
|
46
|
Rodkjaer L, Chesney M, Lomborg K, Ostergaard L, Laursen T, Sodemann M. HIV-infected individuals with high coping self-efficacy are less likely to report depressive symptoms: a cross-sectional study from Denmark. Int J Infect Dis 2014; 22:67-72. [DOI: 10.1016/j.ijid.2013.12.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Revised: 12/04/2013] [Accepted: 12/07/2013] [Indexed: 01/28/2023] Open
|
47
|
Capili B, Anastasi JK, Chang M, Ogedegbe O. Barriers and facilitators to engagement in lifestyle interventions among individuals with HIV. J Assoc Nurses AIDS Care 2014; 25:450-7. [PMID: 24630628 DOI: 10.1016/j.jana.2014.01.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Accepted: 01/15/2014] [Indexed: 01/17/2023]
|
48
|
Price CJ, Diana TM, Smith-Dijulio KL, Voss JG. Developing Compassionate Self-care Skills in Persons Living with HIV: a Pilot Study to Examine Mindful Awareness in Body-oriented Therapy Feasibility and Acceptability. Int J Ther Massage Bodywork 2013; 6:9-19. [PMID: 23730396 PMCID: PMC3666600 DOI: 10.3822/ijtmb.v6i2.197] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background Self-care skills for persons living with HIV (PLWH) are needed to better cope with the common symptoms and emotional challenges of living with this chronic illness. Purpose The purpose of this study was to examine the feasibility and acceptability of Mindful Awareness in Body-oriented Therapy (MABT) for individuals receiving medical management for HIV at an outpatient program. Setting A nonprofit outpatient day program that provided medical management to low-income individuals with HIV. Research Design A one group pre–post study design, nine participants were recruited to receive eight weekly MABT sessions of 1.25 hours each. Intervention MABT is designed to facilitate emotion regulation through teaching somatically-based self-care skills to respond to daily stressors. Main Outcome Measures To assess participant characteristics and study feasibility, a battery of health questionnaires and one week of wrist actigraphy was administered pre- and postintervention. A satisfaction survey and written questionnaire was administered postintervention to assess MABT acceptability. Results The results demonstrated recruitment and retention feasibility. The sample had psychological and physical health symptoms that are characteristic of PLWH. MABT acceptability was high, and participants perceived that they learned new mind-body self-care skills that improved HIV symptoms and their ability to manage symptoms. Conclusion The positive findings support a larger future study to examine MABT efficacy to improve coping with HIV symptoms among PLWH.
Collapse
Affiliation(s)
- Cynthia J Price
- Department of Biobehavioral Nursing and Health Systems, University of Washington, Seattle, WA, USA
| | | | | | | |
Collapse
|
49
|
Koelmeyer R, English DR, Smith A, Grierson J. Association of social determinants of health with self-rated health among Australian gay and bisexual men living with HIV. AIDS Care 2013; 26:65-74. [DOI: 10.1080/09540121.2013.793273] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
50
|
Graven LJ, Grant JS. Coping and health-related quality of life in individuals with heart failure: An integrative review. Heart Lung 2013; 42:183-94. [DOI: 10.1016/j.hrtlng.2012.12.002] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2012] [Revised: 11/21/2012] [Accepted: 12/04/2012] [Indexed: 10/27/2022]
|