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Omann LR, Dushimiyimana V, Musoni-Rwililiza E, Arnbjerg CJ, Niyonkuru VU, Iyamuremye JD, Gasana M, Carlsson J, Kallestrup P, Kraef C. Prevalence of Mental Health Disorders and Their Associated Risk Factors Among People Living with HIV in Rwanda: A Cross-Sectional Study. AIDS Behav 2024; 28:2666-2682. [PMID: 38736005 PMCID: PMC11286631 DOI: 10.1007/s10461-024-04358-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2024] [Indexed: 05/14/2024]
Abstract
While life expectancy of people living with HIV is increasing, their burden of non-communicable diseases, including mental health disorders, is growing as well. The aim of this study is to investigate the prevalence and identify the risk factors associated with mental health disorders among this population in Rwanda. This cross-sectional study enrolled people living with HIV from 12 HIV clinics across Rwanda using random sampling. Trained HIV nurses conducted the Mini International Neuropsychiatric Interview to estimate the prevalence of major depressive episode, post-traumatic stress disorder, and generalized anxiety disorder. Sociodemographic, psychosocial, and HIV-related data were also collected. Associated risk factors for being diagnosed with one of the mental health disorders were assessed using modified Poisson regression with robust error variance. Of 428 participants, 70 (16.4%) had at least one mental health disorder with major depressive episode being most prevalent (n = 60, 14.0%). Almost all participants were adherent to antiretroviral therapy (n = 424, 99.1%) and virally suppressed (n = 412, 96.9%). Of those diagnosed with a mental health disorder, only few were aware of (n = 4, 5.7%) or under treatment for this mental health disorder (n = 5, 7.2%). Mental health disorders were associated with experiences of HIV-related stigma and discrimination (aRR = 2.14, 95%CI 1.30-3.53, p = 0.003). The results demonstrate underdiagnosis and undertreatment of mental health disorders among Rwandan People Living with HIV. Using HIV nurses to diagnose mental health disorders could serve as a low-cost strategy for integrating mental health care with existing HIV services and could inspire the implementation in other low-resource settings.
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Affiliation(s)
- Laura Risbjerg Omann
- Department of Public Health, Center for Global Health, Aarhus University, Aarhus, Denmark.
| | | | - Emmanuel Musoni-Rwililiza
- Department of Public Health, Center for Global Health, Aarhus University, Aarhus, Denmark
- College of Medicine and Health Sciences University of Rwanda, Kigali, Rwanda
- Mental Health Department, University Teaching Hospital of Kigali, Kigali, Rwanda
| | - Caroline Juhl Arnbjerg
- Department of Public Health, Center for Global Health, Aarhus University, Aarhus, Denmark
- College of Medicine and Health Sciences University of Rwanda, Kigali, Rwanda
| | | | | | | | - Jessica Carlsson
- Competence Centre for Transcultural Psychiatry, Mental Health Centre Ballerup, Copenhagen University Hospital-Mental Health Services CPH, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Per Kallestrup
- Department of Public Health, Center for Global Health, Aarhus University, Aarhus, Denmark
- Research Unit for General Practice, Aarhus, Denmark
| | - Christian Kraef
- Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark
- Centre of Excellence for Health, Immunity and Infections (CHIP), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany
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Wang X, Wu Y, Chen Y, Xu J, Gao Q, Zang S. Traffic-related pollution and symptoms of depression and anxiety among Chinese adults: A population-based study. J Affect Disord 2024; 352:101-109. [PMID: 38360369 DOI: 10.1016/j.jad.2024.02.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 02/09/2024] [Accepted: 02/12/2024] [Indexed: 02/17/2024]
Abstract
BACKGROUND Limited understanding exists regarding the associations of traffic-related pollution with depression and anxiety symptoms in individuals residing within low- and middle-income countries. METHODS Data for this study were extracted from the Psychology and Behavior Investigation of Chinese Residents (PBICR) survey, implemented between June 20 and August 31, 2023. We determined residential proximity to major roadways through self-reports and evaluated depression symptoms using the Patient Health Questionnaire-9 (PHQ-9), along with anxiety symptoms assessed through the Generalized Anxiety Disorder-7 (GAD-7). We examined the associations between residential proximity to major roadways and depression and anxiety symptoms using logistic regressions and generalized linear models, while controlling for potential confounding variables. RESULTS This study comprised a total of 22,723 participants. The adjusted odds ratios (OR) for depression symptoms were 1.34 (95 % confidence interval (CI) 1.20, 1.51), 1.29 (95 % CI 1.17, 1.43), 1.34 (95 % CI 1.20, 1.49), and 1.32 (95 % CI 1.17, 1.49) among individuals residing within <50 m, 50-100 m, 101-200 m, and 201-300 m, respectively, in comparison to those residing >300 m from a major roadway. Individuals residing <50 m, 50-100 m, 101-200 m, and 201-300 m from a major roadway exhibited adjusted OR for anxiety symptoms of 1.49 (95 % CI 1.30, 1.69), 1.21 (95 % CI 1.07, 1.37), 1.38 (95 % CI 1.21, 1.56), and 1.38 (95 % CI 1.20, 1.59), respectively, in contrast to those residing >300 m. CONCLUSIONS This study provides valuable insights into the associations between environmental factors and mental health. The findings underscore the importance of integrating environmental considerations into comprehensive mental health frameworks, especially for individuals residing near high-traffic areas.
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Affiliation(s)
- Xue Wang
- Department of Community Nursing, School of Nursing, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province 110122, China
| | - Yibo Wu
- School of Public Health, Peking University, No.38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Yifei Chen
- Department of Interventional Radiology, The First Hospital of China Medical University, No.155 Nanjing North Street, Heping District Area, Shenyang, Liaoning Province 110002, China
| | - Jiayi Xu
- Department of Community Nursing, School of Nursing, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province 110122, China
| | - Qian Gao
- Department of Environmental Health, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province 110122, China
| | - Shuang Zang
- Department of Community Nursing, School of Nursing, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province 110122, China.
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Bondarchuk C, Lemon T, Earnshaw V, Rousseau E, Sindelo S, Bekker LG, Butler L, Katz I. Disclosure Events and Psychosocial Well-Being Among Young South African Adults Living with HIV. Int J Behav Med 2024:10.1007/s12529-024-10291-5. [PMID: 38658438 DOI: 10.1007/s12529-024-10291-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND Poor psychological well-being is both prevalent among South Africans living with HIV and has been associated with poor HIV clinical outcomes. However, the relationship between disclosure and psychological well-being remains unclear. This analysis sought to examine the relationship between two disclosure-related variables, disclosure status and reaction received, and psychosocial well-being among a sample of young adults living with HIV (YALWH) in urban South Africa. METHOD This was a secondary analysis using observational data from Standing Tall, a randomized controlled trial that recruited 100 participants ages 18-24 who tested positive for HIV after initially presenting to two well-established mobile clinics for HIV testing. Interviews investigating primary and secondary outcomes of interest were done at baseline and 6 months following recruitment. RESULTS About half (51%) of participants disclosed their HIV status within 6 months after recruitment. Simple linear regression analyses revealed that disclosure of HIV status within 6 months after study enrollment predicted significantly lower levels of disclosure concerns and internalized stigma (p < 0.05). Reactions to disclosure were not significantly associated with any of the measures of psychosocial well-being considered in this analysis (p > 0.05). CONCLUSION The results suggest that the act of disclosure among newly diagnosed YALWH may be associated with reductions in internalized stigma. In addition, the finding that the act of disclosure may be a more important determinant of psychosocial well-being than the reaction to disclosure has important implications for interventions designed to promote disclosure and psychosocial well-being in YALWH.
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Affiliation(s)
| | - Tiffany Lemon
- Harvard Global Health Institute, Harvard University, Cambridge, MA, USA
| | - Valerie Earnshaw
- Department of Human Development and Family Services, University of Delaware, Newark, DE, USA
| | - Elzette Rousseau
- The Desmond Tutu Health Foundation, University of Cape Town, Cape Town, Republic of South Africa
| | - Siyaxolisa Sindelo
- The Desmond Tutu Health Foundation, University of Cape Town, Cape Town, Republic of South Africa
| | - Linda-Gail Bekker
- The Desmond Tutu Health Foundation, University of Cape Town, Cape Town, Republic of South Africa
| | - Lisa Butler
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT, USA
| | - Ingrid Katz
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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Freibott CE, Biondi BE, Rao SR, Blokhina E, Dugas JN, Patts G, Bendiks S, Krupitsky E, Chichetto NE, Samet JH, Freiberg MS, Stein MD, Tindle HA. Is Abstinence from Alcohol and Smoking Associated with Less Anxiety and Depressive Symptoms Among People with HIV? AIDS Behav 2024; 28:1447-1455. [PMID: 38285292 DOI: 10.1007/s10461-023-04231-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2023] [Indexed: 01/30/2024]
Abstract
Achieving abstinence from alcohol, tobacco, or both may improve mental health, but is understudied in people with HIV (PWH). The St PETER HIV randomized clinical trial compared varenicline, cytisine, and nicotine replacement therapy on alcohol and smoking behavior among 400 PWH in Russia. The primary exposure was thirty-day point prevalence abstinence (PPA) from (1) alcohol, (2) smoking, (3) both, or (4) neither and was assessed at 1, 3, 6 and 12-months as were the study outcomes of anxiety (GAD-7) and depressive (CES-D) symptoms. The primary aim was to examine the association between smoking and/or alcohol abstinence and subsequent symptoms of depression and anxiety. Primary analysis used repeated measures generalized linear modeling to relate PPA with mental health scores across time. In secondary analyses, Kruskal-Wallis tests related PPA with mental health scores at each timepoint. Primary analyses did not identify significant differences in anxiety or depressive symptoms between exposure groups over time. Secondary analyses found CES-D scores across PPA categories were similar at 1-month (11, 10, 11, 11) and 6-months (10, 10, 11, 11) but differed at 3-months (9, 11, 10, 12; p = 0.035) and 12-months (10, 6, 11, 10; p = 0.019). GAD-7 scores did not vary across PPA categories at any time point. While abstinence was associated with fewer depressive symptoms at times, findings were not consistent during follow-up, perhaps reflecting intermittent relapse. PWH with polysubstance use and mental health comorbidity are complex, and larger samples with sustained abstinence would further elucidate effects of abstinence on mental health.
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Affiliation(s)
- Christina E Freibott
- Department of Health Law, Policy and Management, Boston University School of Public Health, 715 Albany Street Talbot Building, Boston, MA, 02118, USA.
| | - Breanne E Biondi
- Department of Health Law, Policy and Management, Boston University School of Public Health, 715 Albany Street Talbot Building, Boston, MA, 02118, USA
| | - Sowmya R Rao
- Department of Global Health, Boston University School of Public Health, Boston, MA, 02118, USA
| | - Elena Blokhina
- First Pavlov State Medical University of St. Petersburg, St. Petersburg, Russian Federation
| | - Julianne N Dugas
- Biostatistics and Epidemiology Data Analytics Center (BEDAC), Boston University School of Public Health, Boston, MA, USA
| | - Gregory Patts
- Biostatistics and Epidemiology Data Analytics Center (BEDAC), Boston University School of Public Health, Boston, MA, USA
| | - Sally Bendiks
- Department of Medicine, Section of General Internal Medicine, Clinical Addiction Research and Education (CARE) Unit, Boston Medical Center, Boston, MA, USA
| | - Evgeny Krupitsky
- First Pavlov State Medical University of St. Petersburg, St. Petersburg, Russian Federation
- Department of Addictions, V.M. Bekhterev National Medical Research Center for Psychiatry and Neurology, St. Petersburg, Russian Federation
| | - Natalie E Chichetto
- Department of Epidemiology, College of Public Health and Health Professions & College of Medicine, University of Florida, Gainesville, FL, 32611, USA
| | - Jeffrey H Samet
- Department of Medicine, Section of General Internal Medicine, Clinical Addiction Research and Education (CARE) Unit, Boston University School of Medicine, Boston Medical Center, Boston, MA, USA
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA
| | - Matthew S Freiberg
- Vanderbilt Center for Clinical Cardiovascular Trials Evaluation (V-C3REATE), Cardiovascular Division, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Michael D Stein
- Department of Health Law, Policy and Management, Boston University School of Public Health, 715 Albany Street Talbot Building, Boston, MA, 02118, USA
| | - Hilary A Tindle
- Vanderbilt Center for Tobacco, Addiction and Lifestyle (VITAL), Division of Internal Medicine & Public Health and Vanderbilt Ingram Cancer Center (VICC), Vanderbilt University Medical Center, Nashville, TN, USA
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Ramos SD, Vincent W, Siconolfi DE, Pollack LM, Horvath KJ, Campbell CK, Tebbetts S, Kegeles SM, Storholm ED. Differential Associations of Depressive Symptomology to HIV Care Engagement Among Young Black Sexual Minority Men with HIV (YBSMM+) in the US South: A Multi-Group Analysis of Mood, Intimate Partner Violence, and Alcohol Use. AIDS Behav 2024; 28:774-785. [PMID: 37796375 DOI: 10.1007/s10461-023-04186-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2023] [Indexed: 10/06/2023]
Abstract
Young Black Sexual Minority Men with HIV (YBSMM+) in the US South encounter multiple socio-structural challenges that contribute to disproportionately poor HIV-related outcomes across the care continuum. Depression, anxiety, intimate partner violence (IPV), and alcohol use are prominent factors that negatively impact engagement with HIV care. Syndemic theory posits that these multiple factors interact synergistically to promote poor outcomes; however, depression itself is highly heterogeneous in presentation, which may pose issues when examining associations to HIV care engagement. This study sought to better understand the associations of specific depressive symptomology subtypes, generalized anxiety, experienced IPV, and alcohol use on HIV care engagement for YBSMM+. Results showed that interpersonally oriented depressive symptomatology was associated with increased HIV care engagement among YBSMM + who abstained from alcohol. On the other hand, among YBSMM + who frequently binge drank, combined negative affect and somatic components of depressive symptomatology and frequency of IPV experiences were associated with decreased HIV care engagement while generalized anxiety was associated with increased HIV care engagement. The findings suggest that the negative affect and somatic components of depression may be particularly salient for HIV care engagement among YBSMM + who binge drink frequently. Developing targeted interventions that address these specific conditions while accounting for the nuances of mood-based symptomatology could improve intervention efforts geared towards improving HIV care engagement among YBSMM+.
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Affiliation(s)
- Stephen D Ramos
- Department of Medicine, Division of Infectious Disease and Global Public Health, University of California San Diego, 6475 Alvarado Road, Suite 118, San Diego, CA, 92120, USA.
- SDSU Research Foundation, San Diego State University, San Diego, CA, USA.
| | - Wilson Vincent
- Department of Psychology, Temple University, Philadelphia, PA, USA
| | | | - Lance M Pollack
- Center for AIDS Prevention Studies, Division of Prevention Science, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Keith J Horvath
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | | | - Scott Tebbetts
- Center for AIDS Prevention Studies, Division of Prevention Science, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Susan M Kegeles
- Center for AIDS Prevention Studies, Division of Prevention Science, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Erik D Storholm
- Division of Health Promotion and Behavioral Science, San Diego State University, San Diego, CA, USA
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Zaleta AK, Fortune EE, Miller MF, Olson JS, Hollis-Hansen K, Dohn SK, Kwait JL. HIV Support Source: Development of a Distress Screening Measure for Adults with HIV. AIDS Behav 2024; 28:713-727. [PMID: 38261220 DOI: 10.1007/s10461-023-04261-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/26/2023] [Indexed: 01/24/2024]
Abstract
To provide an effective, multidimensional, and psychometrically valid measure to screen for distress among people with HIV, we developed and assessed the psychometric properties of HIV Support Source, a distress screening, referral, and support program designed to identify the unmet needs of adults with HIV and link them to desired resources and support. Development and testing were completed in three phases: (1) item generation and initial item pool testing (N = 375), (2) scale refinement via exploratory factor analysis (N = 220); external/internal item quality, and judging theoretical and practical implications of items, and (3) confirmatory validation (N = 150) including confirmatory factor analysis along with reliability and validity analyses to corroborate dimensionality and psychometric properties of the final measure. Nonparametric receiver operating characteristic (ROC) curve analyses determined scoring thresholds for depression and anxiety risk subscales. The final measure comprises 17-items representing four domains of concern: emotional well-being, financial and practical needs, physical well-being, and HIV treatment and sexual health, plus one screening item assessing tobacco and substance use. Our analyses showed strong internal consistency reliability, a replicable factor structure, and adequate convergent, discriminant, and known groups validity. Sensitivity of 2-item depression and 2-item anxiety risk subscales was 0.90 and 0.79, respectively. HIV Support Source is a reliable and valid multidimensional measure of distress that also screens for risk for clinically significant depression and anxiety. It can be implemented within a distress screening, referral, and follow-up program to rapidly assess and support the unmet needs of adults with HIV.
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Affiliation(s)
- Alexandra K Zaleta
- Cancer Support Community, Research and Training Institute, 520 Walnut Street, Suite 1170, Philadelphia, PA, 19106, USA
- Cancer Care, New York, NY, USA
| | - Erica E Fortune
- Cancer Support Community, Research and Training Institute, 520 Walnut Street, Suite 1170, Philadelphia, PA, 19106, USA
| | - Melissa F Miller
- Cancer Support Community, Research and Training Institute, 520 Walnut Street, Suite 1170, Philadelphia, PA, 19106, USA.
| | - Julie S Olson
- Cancer Support Community, Research and Training Institute, 520 Walnut Street, Suite 1170, Philadelphia, PA, 19106, USA
| | - Kelseanna Hollis-Hansen
- Cancer Support Community, Research and Training Institute, 520 Walnut Street, Suite 1170, Philadelphia, PA, 19106, USA
- UT Southwestern Medical Center, O'Donnell School of Public Health, Dallas, TX, USA
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Karram S, Sanger C, Convery C, Brantley A. Social Determinants of Health Among Persons Living with HIV Impact Important Health Outcomes in Michigan. AIDS Behav 2024; 28:547-563. [PMID: 38180620 DOI: 10.1007/s10461-023-04243-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2023] [Indexed: 01/06/2024]
Abstract
Addressing social determinants of health (SDOH) is a national priority for improving quality of life and addressing obstacles to accessing care for people living with HIV (PLWH). Utilizing the Oregon Social Determinants of HIV Health Index and CDC's Medical Monitoring Project, we examined the association between social determinants of health and various HIV clinical outcomes and quality of life indicators, including stigma and mental health, for people living with HIV in Michigan. We calculated estimates of SDOHs, clinical outcomes, stigma, and mental health using weighted percentages and prevalence ratios with predicted marginal means, adjusting for age, race/ethnicity, and gender/sexual orientation. Compared with PLWH reporting 0-1 SDOH challenges, those reporting ≥ 4 SDOH challenges were more likely to miss ≥ 1 HIV care appointment (aPR: 2.57, 95% CI 1.70-3.88), have symptoms of depression (aPR: 4.03, 95% CI 2.68-6.05) and anxiety (aPR: 3.55, 95% CI 2.25-5.61), and less likely to have 100% antiretroviral therapy (ART) adherence (aPR: 0.62, 95% CI 0.50-0.78) and sustained viral suppression (aPR: 0.77, 95% CI 0.65-0.90). Stigma scores were highest for those reporting ≥ 4 SDOH challenges. Our findings indicate significant associations between SDOH and adverse HIV health and quality of life outcomes which can inform and direct federal, state, and local strategies aimed at improving these outcomes. Linking PLWH to social support services and providing mental health screening and care services could benefit their mental and emotional well-being, leading to better healthcare outcomes.
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Affiliation(s)
- S Karram
- Michigan Department of Health and Human Services, Bureau of HIV and STI Programs, Lansing, MI, USA.
| | - C Sanger
- Michigan Department of Health and Human Services, Bureau of HIV and STI Programs, Detroit, MI, USA
| | - C Convery
- Michigan Department of Health and Human Services, Bureau of HIV and STI Programs, Detroit, MI, USA
| | - A Brantley
- Michigan Department of Health and Human Services, Bureau of HIV and STI Programs, Detroit, MI, USA
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O'Grady T, Inman N, Younger A, Huang B, Bouton TO, Kim H, DeLorenzo E. The Characteristics and HIV-Related Outcomes of People Living with Co-occurring HIV and Mental Health Conditions in the United States: A Systematic Review of Literature from 2016 to 2021. AIDS Behav 2024; 28:201-224. [PMID: 37563293 PMCID: PMC10803443 DOI: 10.1007/s10461-023-04150-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2023] [Indexed: 08/12/2023]
Abstract
Considering advances in HIV prevention and treatment, jurisdictional efforts to end the HIV/AIDS epidemic, and reduced stigma towards people living with HIV infection and mental health conditions, the authors systematically reviewed studies published between 2016 and 2021 and identified 45 studies that met the eligibility criteria. The review found that stigma towards mental health conditions still acts as a barrier to accessing HIV treatment, which impacts treatment outcomes. Additionally, social determinants of health, such as housing instability and poverty, appear to impact mental health and, therefore, HIV-related outcomes. The review also highlighted the mutually reinforcing effects of HIV, mental health, and substance use conditions, providing valuable insights into the syndemic effects of these co-occurring conditions. Overall, the review highlights the need to address stigma and social determinants of health in HIV prevention and treatment efforts and to integrate mental health services into HIV care to improve outcomes for people living with both HIV and mental health conditions.
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Affiliation(s)
- Thomas O'Grady
- New York State Department of Health, AIDS Institute, Albany, NY, USA.
- New York State Department of Health, Corning Tower, ESP, Room 760, Albany, NY, 12237-0627, USA.
- Department of Epidemiology and Biostatistics, University at Albany School of Public Health, 1 University Pl, Rensselaer, NY, 12144, USA.
| | - Nina Inman
- New York State Department of Health, AIDS Institute, Albany, NY, USA
| | - Alitasha Younger
- New York State Department of Health, AIDS Institute, Albany, NY, USA
| | - Bishan Huang
- New York State Department of Health, AIDS Institute, Albany, NY, USA
- Department of Epidemiology and Biostatistics, University at Albany School of Public Health, 1 University Pl, Rensselaer, NY, 12144, USA
| | | | - Heeun Kim
- New York State Department of Health, AIDS Institute, Albany, NY, USA
| | - Emily DeLorenzo
- New York State Department of Health, AIDS Institute, Albany, NY, USA
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Sun Y, Song B, Zhen C, Zhang C, Cheng J, Jiang T. The mediating effect of psychological resilience between social support and anxiety/depression in people living with HIV/AIDS-a study from China. BMC Public Health 2023; 23:2461. [PMID: 38066520 PMCID: PMC10709980 DOI: 10.1186/s12889-023-17403-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 12/04/2023] [Indexed: 12/18/2023] Open
Abstract
Objective To understand the relationship between psychological resilience in social support and anxiety/depression in people living with HIV/AIDS and to verify whether there is a mediating effect. Methods The questionnaire was administered to 161 people living with HIV/AIDS in a hospital. The questionnaire contained a general questionnaire, the Hospital Anxiety and Depression Scale (HADS), the Psychological Resilience Inventory (CD-RICS), and the Social Collaborative Support Scale (PSSS), and Pearson correlation analyses were used to explore the correlation between the factors and anxiety/depression, stratified linear regression analyses were used to validate the mediation model, and the bootstrap method was used to test for mediating effects. Results Anxiety was negatively correlated with psychological resilience and social support (r=-0.232, P < 0.01; r=-0.293, P < 0.01); depression was negatively correlated with psychological resilience and social support (r=-0.382, P < 0.01; r=-0.482, P < 0.01); there was a mediation effect model of social support between psychological resilience and anxiety/depression; psychological resilience played a fully mediating role in social support and anxiety/depression, with an effect contribution of 68.42%/59.34% and a 95% CI(-0.256~-0.036)/(-0.341 to~-0.106). Conclusion Psychological resilience plays a complete mediating effect between social support and anxiety/depression. It is recommended that more channels of social support be provided to patients with HIV/AIDS, thereby enhancing their psychological resilience and reducing anxiety/depression levels.
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Affiliation(s)
- Yongbing Sun
- The Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Bing Song
- The Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Cheng Zhen
- The Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Chao Zhang
- The Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Juan Cheng
- The Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Tianjun Jiang
- The Fifth Medical Center of Chinese PLA General Hospital, Beijing, China.
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Wang X, Wu Y, Zhao F, Sun W, Pang C, Sun X, Zang S. Subjective dry eye symptoms and associated factors among the national general population in China during the COVID-19 pandemic: A network analysis. J Glob Health 2023; 13:06052. [PMID: 38038375 PMCID: PMC10691301 DOI: 10.7189/jogh.13.06052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2023] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic has presented numerous challenges to public health, including the emergence of subjective dry eye symptoms among individuals. However, there is currently a dearth of comprehensive knowledge regarding the associated factors with subjective dry eye symptoms in the general population. Methods A nationwide survey in China was carried out from 20 June to 31 August 2022, involving 21 916 participants. Subjective dry eye symptoms were assessed using the Ocular Surface Disease Index-6. We employed random forest classification to select potential associated factors based on the socioecological model. We also conducted univariate and multivariable logistic regression analyses to explore the factors associated with subjective dry eye symptoms. Network analyses were employed to explore the network structure of subjective dry eye symptoms and associated factors. Results The item "watching TV (or similar task)" displayed the highest node strength and exhibited the highest predictability within the network. The results of the multivariate logistic regression analysis demonstrated significant associations between subjective dry eye symptoms and several factors, including loneliness (odds ratio (OR) = 1.29; 95% confidence interval (CI) = 1.26 to 1.32), problematic Internet use (OR = 1.08; 95% CI = 1.08 to 1.09), family communication (OR = 1.01; 95% CI = 1.00 to 1.01), the presence of depression (OR = 1.53; 95% CI = 1.39 to 1.68) and anxiety (OR = 1.31; 95% CI = 1.17 to 1.47) symptoms, older age (OR = 1.01; 95% CI = 1.01 to 1.01), self-rated health status (OR = 0.99; 95% CI = 0.98 to 0.99), family health (OR = 0.97; 95% CI = 0.96 to 0.97), health literacy (OR = 0.98; 95% CI = 0.97 to 0.99) and the agreeableness personality trait (OR = 0.97; 95% CI = 0.95 to 0.99). Conclusions These findings have important implications for public health interventions targeting the prevention and management of subjective dry eye symptoms in the general population. Strategies addressing individual risk factors and supporting psychological well-being may prove beneficial in mitigating the burden associated with subjective dry eye symptoms.
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Affiliation(s)
- Xue Wang
- Department of Community Nursing, School of Nursing, China Medical University, Shenyang, China
| | - Yibo Wu
- School of Public Health, Peking University, Beijing, China
| | - Fangkun Zhao
- Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - Wei Sun
- Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - Chang Pang
- Department of Gerontology and Geriatrics, The Second Affiliated Hospital of Shenyang Medical College, Shenyang, China
| | - Xuange Sun
- Department of Community Nursing, School of Nursing, China Medical University, Shenyang, China
| | - Shuang Zang
- Department of Community Nursing, School of Nursing, China Medical University, Shenyang, China
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11
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Shuter J, Weinberger AH, Kahan A, Duitz D, Duitz J, Chander G, Kim RS, Stanton CA. People with HIV who smoke cigarettes non-daily. AIDS Care 2023; 35:1768-1774. [PMID: 36924135 DOI: 10.1080/09540121.2023.2188161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 02/28/2023] [Indexed: 03/18/2023]
Abstract
Cigarette smoking is a leading cause of mortality in people with HIV (PWH) in the United States (US). A rising proportion of US tobacco users smoke non-daily, a phenomenon that is common among PWH. PWH who smoke non-daily may be attractive targets for cessation efforts, and, thus, a fuller understanding of non-daily smoking in PWH is important. We merged datasets from two randomized controlled tobacco treatment trials for PWH conducted in three cities from 2014-2020. The final dataset included 872 PWH. We analyzed sociodemographic characteristics and behavioral measures, such as nicotine dependence, motivation to quit, anxiety, and other substance use for associations with non-daily smoking, and we assessed non-daily smoking as a predictor of cessation. 13.4% of the sample smoked non-daily. In multivariable analyses, non-White race, higher anxiety, and higher motivation to quit were associated with non-daily smoking. PWH who smoked non-daily had 2.14 times the odds of those who smoked daily of quitting at six-months (95% C.I.:1.30-3.51, P=0.002). PWH who smoke non-daily differ in some demographic and behavioral characteristics from those who smoke daily. PWH reporting non-daily smoking were more likely to quit in our trials and targeting them should be a priority of future cessation efforts.
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Affiliation(s)
- Jonathan Shuter
- Montefiore Medical Center AIDS Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | | | - Abner Kahan
- Macaulay Honors College at Hunter College, New York, NY, USA
| | - David Duitz
- Salanter Akiba Riverdale High School, Bronx, NY, USA
| | - Jack Duitz
- Salanter Akiba Riverdale High School, Bronx, NY, USA
| | | | - Ryung S Kim
- Montefiore Medical Center AIDS Center, Albert Einstein College of Medicine, Bronx, NY, USA
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12
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McCree DH, Beer L, Crim SM, Kota KK, Baugher A, Jeffries WL, Patel D, Marcus R, Yuan XA, Luke Shouse R. Intersectional Discrimination in HIV Healthcare Settings Among Persons with Diagnosed HIV in the United States, Medical Monitoring Project, 2018-2019. AIDS Behav 2023; 27:3623-3631. [PMID: 37166687 DOI: 10.1007/s10461-023-04076-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2023] [Indexed: 05/12/2023]
Abstract
Experiences with stigma and discrimination in healthcare settings are associated with negative health outcome for persons with HIV (PWH). PWH may experience discrimination due to the intersection of multiple marginalized social identities. Describing these experiences is important for informing interventions and strategies to reduce stigma and discrimination. We report experiences with discrimination in HIV healthcare settings attributed to multiple characteristics, e.g., sexual orientation, race/ethnicity, income, or social class, and/or injection drug use, among a nationally representative sample of persons with diagnosed HIV in the United States using data from the Medical Monitoring Project (MMP). We calculated weighted prevalences and associated 95% confidence intervals for any discrimination and discrimination attributed to multiple characteristics (intersectional discrimination). Among those experiencing discrimination, nearly 1 in 4 persons reported intersectional discrimination, with a higher burden among key populations of focus for HIV prevention and treatment. Discrimination was attributed to HIV status (62.5%), sexual orientation (60.4%), and race/ethnicity (54.3%). Persons who experienced intersectional discrimination were less likely to have a regular HIV care provider, have trust in HIV care or treatment information from healthcare providers, and be antiretroviral treatment or HIV care visit adherent. Future studies should explore methods to operationalize and assess experiences with intersectional stigma and discrimination and use the outcomes to inform qualitative research that provides more context and a deeper understanding of experiences with intersectional discrimination among PWH.
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Affiliation(s)
- Donna Hubbard McCree
- National Center for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Linda Beer
- National Center for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Stacy M Crim
- National Center for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Amy Baugher
- National Center for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - William L Jeffries
- National Center for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Deesha Patel
- National Center for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ruthanne Marcus
- National Center for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - R Luke Shouse
- National Center for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
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13
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Kota KK, Luo Q, Beer L, Dasgupta S, McCree DH. Stigma, Discrimination, and Mental Health Outcomes Among Transgender Women With Diagnosed HIV Infection in the United States, 2015-2018. Public Health Rep 2023; 138:771-781. [PMID: 36129230 PMCID: PMC10467496 DOI: 10.1177/00333549221123583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Transgender women with diagnosed HIV experience social and structural factors that could negatively affect their overall health and HIV-related health outcomes. We describe estimates from the Centers for Disease Control and Prevention Medical Monitoring Project (MMP) of sociodemographic characteristics, HIV stigma, discrimination, and mental health outcomes among transgender women with diagnosed HIV. METHODS We analyzed pooled data of all transgender women with diagnosed HIV (N = 217) from the 2015 through 2018 MMP cycles. We reported unweighted frequencies, weighted percentages, and 95% CIs for all characteristics. We post-stratified data to known population totals by age, race and ethnicity, and sex at birth from the National HIV Surveillance System. RESULTS Approximately 46% of transgender women with diagnosed HIV identified as Black or African American, 67% lived at or below the federal poverty level, 18% had experienced homelessness in the past year, 26% experienced mild to severe symptoms of depression, 30% experienced mild to severe anxiety symptoms, 32% reported physical violence by an intimate partner, and 30% reported forced sex during their lifetime. Despite 80% being very satisfied with their current HIV care, 94% experienced current HIV stigma and 20% experienced health care-related discrimination since being diagnosed with HIV. Among transgender women with diagnosed HIV who experienced discrimination, 46% and 51% experienced health care discrimination attributed to their gender and sexual orientation or sexual practices, respectively. CONCLUSIONS Our findings underscore a need to address unmet ancillary services, such as housing, intimate partner violence, and mental health needs, and the need for strategies to reduce experiences with HIV stigma and discrimination in care for transgender women with diagnosed HIV in the United States.
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Affiliation(s)
- Krishna Kiran Kota
- Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA
| | | | - Linda Beer
- Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Sharoda Dasgupta
- Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Donna Hubbard McCree
- Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
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14
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Zheng Y, Li X, Xia Y, Li X, Yang G, Shi R, Feng Y. Analysis of the Mediation Effects of Adverse Mental Health Outcomes in HIV-Infected Women of Childbearing Age from Multiple Perspectives Including Discrimination Perception. Psychol Res Behav Manag 2023; 16:3447-3459. [PMID: 37664137 PMCID: PMC10473399 DOI: 10.2147/prbm.s421071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 08/17/2023] [Indexed: 09/05/2023] Open
Abstract
Objective To Analysis of the mediation effects of adverse mental health outcomes in HIV-infected women of childbearing age from multiple perspectives including discrimination perception, social capital, and other factors. Methods A cross-sectional survey was conducted among 553 people in Xinjiang region of China using Survey scale. AMOS was used to identify factors that influenced the "discrimination perception/mental resilience/social capital-depression-poor mental health outcomes" pathway. Results A total of 44.85% and 42.13% of the study participants had anxiety and depression symptoms, as perceived discrimination increased, the higher the level of depression in HIV-infected women of childbearing age. Correlation coefficient among depression with poor mental health outcomes was also significant. Psychological resilience, social capital and depression have mediating effects on perceived discrimination and poor mental health outcomes, discrimination perception had an indirect effect on depression through social capital and an indirect effect on adverse mental health outcomes through depression and psychological resilience. The modified model has a good fitting effect. Conclusion Discrimination perception was shown to affect adverse mental health outcomes by impacting mental resilience, depression, and social capital. The findings suggest the need for measures to reduce adverse mental health outcomes by decreasing discrimination perception, increasing social capital, and enhancing psychological resilience.
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Affiliation(s)
- Yinxia Zheng
- Urumqi Maternal and Child Health Hospital, Urumqi, Xinjiang, People’s Republic of China
| | - Xianfeng Li
- Urumqi Maternal and Child Health Hospital, Urumqi, Xinjiang, People’s Republic of China
| | - Yan Xia
- Urumqi Maternal and Child Health Hospital, Urumqi, Xinjiang, People’s Republic of China
| | - Xiaoqin Li
- Urumqi Maternal and Child Health Hospital, Urumqi, Xinjiang, People’s Republic of China
| | - Genglin Yang
- Urumqi Maternal and Child Health Hospital, Urumqi, Xinjiang, People’s Republic of China
| | - Rui Shi
- Urumqi Maternal and Child Health Hospital, Urumqi, Xinjiang, People’s Republic of China
| | - Ying Feng
- Urumqi Maternal and Child Health Hospital, Urumqi, Xinjiang, People’s Republic of China
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15
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Reyes JV, Myles RL, Luo Q, Beer L, Burton DC. Sociodemographic and Clinical Characteristics Associated With Recent Incarceration Among People With HIV, United States, 2015-2017. Public Health Rep 2023; 138:610-618. [PMID: 35848105 PMCID: PMC10291169 DOI: 10.1177/00333549221106646] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023] Open
Abstract
OBJECTIVES We examined sociodemographic, clinical, and behavioral factors associated with previous incarceration among people with diagnosed HIV to inform HIV care efforts for this population. METHODS We used 2015-2017 data from a cross-sectional, nationally representative sample of US adults with diagnosed HIV (N = 11 739). We computed weighted percentages and 95% CIs to compare the characteristics of people with HIV incarcerated in the past 12 months (ie, recently) with people with HIV not recently incarcerated. We used adjusted prevalence ratios (aPRs) with predicted marginal means to examine associations between selected factors and incarceration status. RESULTS Adults with HIV who were recently incarcerated, when compared with those who were not, were more likely to be aged 18-29 years (prevalence ratio [PR] = 2.51), non-Hispanic Black (PR = 1.39), less educated ( CONCLUSIONS Among people with HIV, recent incarceration was associated with increased health risks and worse health outcomes. Pre- and postrelease linkage-to-care interventions and reentry services might improve the health of recently incarcerated people with HIV.
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Affiliation(s)
- Jovanni V. Reyes
- Division of HIV Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ranell L. Myles
- Office of the Director, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Qingwei Luo
- Strategic Innovative Solutions, LLC, Clearwater, FL, USA
| | - Linda Beer
- Division of HIV Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Deron C. Burton
- Office of the Director, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
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16
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Kim K, Jang S, Rim HD, Kim SW, Chang HH, Woo J. Attachment Insecurity and Stigma as Predictors of Depression and Anxiety in People Living With HIV. Psychiatry Investig 2023; 20:418-429. [PMID: 37253467 DOI: 10.30773/pi.2022.0271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 01/26/2023] [Indexed: 06/01/2023] Open
Abstract
OBJECTIVE The purpose of this study was to examine whether attachment insecurity, stigma, and certain demographic and medical factors predict depression and anxiety in people living with HIV (PLWH). METHODS Participants were 147 PLWH who visited the outpatient infection clinic in Kyungpook National University Hospital (KNUH; Daegu, South Korea) between June 2020 and January 2021. We measured HIV-related stigma, attachment anxiety and avoidance, depressive symptoms, and anxiety symptoms. RESULTS Logistic regression analysis showed that unemployment, longer time receiving antiretroviral therapy, higher attachment avoidance, and higher attachment anxiety were significant predictors of depression. Results also showed that longer time receiving antiretroviral therapy, higher attachment anxiety, and concern with public attitudes were significant predictors of anxiety. CONCLUSION In addition to education to reduce public stigma, interventions to reduce PLWH's self-stigma should continue. We suggest attachment-based psychotherapy as an effective intervention to improve PLWH's mental health.
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Affiliation(s)
- Kyungmin Kim
- Department of Psychiatry, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Seoyoung Jang
- Department of Psychiatry, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Hyo-Deog Rim
- Department of Psychiatry, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Shin-Woo Kim
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Hyun-Ha Chang
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Jungmin Woo
- Department of Psychiatry, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
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17
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Jones MC, Byun JY, Billings R, Shorten A, Kempf MC, Vance DE, Puga F. Tools for Screening and Measuring Anxiety Among Women Living with HIV of Reproductive Age: A Scoping Review. AIDS Behav 2023:10.1007/s10461-023-03990-9. [PMID: 36757556 DOI: 10.1007/s10461-023-03990-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2023] [Indexed: 02/10/2023]
Abstract
Emerging evidence suggests that women living with HIV (WLWH) may experience higher rates of anxiety than men living with HIV and women living without HIV. To date, relatively little knowledge exists on valid anxiety screening and diagnostic tools and how they are used among WLWH, specifically WLWH of reproductive age. Thus, the purpose of this scoping review was to describe what is known in the published literature about anxiety among WLWH and the tools used to measure and screen for anxiety in clinical and research contexts. The Arksey and O'Malley methodological framework was used to guide a scoping review of published articles in PsycINFO, Scopus, Sociological Abstracts, and PubMed databases. Twenty-one measures of anxiety were used across the 52 articles identified in the search. Most measures used were self-report. Inconsistencies in standardized screening tools and cutoff scores were observed across studies. Further, measures to assess anxiety varied among studies focused on WLWH. Based on the results from this review, there is a need for consistent, valid measures of anxiety to advance research and clinical practice to support the well-being of WLWH.
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Affiliation(s)
- Meghan C Jones
- School of Nursing, University of Alabama at Birmingham, 1701 University Blvd, 35294-1210, Birmingham, AL, USA.
| | - Jun Y Byun
- School of Nursing, University of Alabama at Birmingham, 1701 University Blvd, 35294-1210, Birmingham, AL, USA
| | - Rebecca Billings
- UAB Libraries, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Allison Shorten
- School of Nursing, University of Alabama at Birmingham, 1701 University Blvd, 35294-1210, Birmingham, AL, USA
| | - Mirjam-Colette Kempf
- School of Nursing, University of Alabama at Birmingham, 1701 University Blvd, 35294-1210, Birmingham, AL, USA
| | - David E Vance
- School of Nursing, University of Alabama at Birmingham, 1701 University Blvd, 35294-1210, Birmingham, AL, USA
| | - Frank Puga
- School of Nursing, University of Alabama at Birmingham, 1701 University Blvd, 35294-1210, Birmingham, AL, USA
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18
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Ramirez Garcia MP, Leclerc-Loiselle J, Côté J, Brouillette MJ, Thomas R. Effect of autogenic training on quality of life and symptoms in people living with HIV: A mixed method randomized controlled trial. Complement Ther Clin Pract 2023; 50:101716. [PMID: 36528982 DOI: 10.1016/j.ctcp.2022.101716] [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: 09/12/2022] [Revised: 11/16/2022] [Accepted: 12/11/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Quality of life of people living with HIV is strongly affected by sleep problems, fatigue, pain, anxiety, and depression symptoms. This study set out to evaluate the effects of autogenic training (AT) on quality of life and symptoms within this population. METHODS A mixed method randomized controlled trial was conducted. Participants were randomly assigned to either the AT group (n = 32) or the control group (CG) (n = 31). Quality of life and symptoms were measured in both groups three times: prior to intervention (T0), immediately after intervention (T3), and three months after intervention (T6). Fourteen individual interviews were conducted. RESULTS Results show a significant improvement in social and mental dimensions of quality of life for the two groups at T6. They also show a significant improvement in sleep for AT participants at T3. Qualitative results are consistent with quantitative ones. CONCLUSION AT seems to improve sleep quality and could improve some dimensions of quality of life and other symptoms among people living with HIV. Further studies are needed to confirm these results. TRIAL REGISTRATION NUMBER NCT01901016.
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Affiliation(s)
- Maria Pilar Ramirez Garcia
- Faculty of Nursing, Université de Montréal, Montréal, QC, Canada; Research Center of the Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada; AIDS and Infectious Disease Network (SIDA-MI), Canada; Quebec Network on Nursing Intervention Research (RRISIQ), QC, Canada.
| | | | - José Côté
- Faculty of Nursing, Université de Montréal, Montréal, QC, Canada; Research Center of the Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada; AIDS and Infectious Disease Network (SIDA-MI), Canada; Quebec Network on Nursing Intervention Research (RRISIQ), QC, Canada.
| | - Marie-Josée Brouillette
- AIDS and Infectious Disease Network (SIDA-MI), Canada; Department of Psychiatry, McGill University, Montréal, QC, Canada; McGill University Health Centre, Canada.
| | - Réjean Thomas
- AIDS and Infectious Disease Network (SIDA-MI), Canada; Clinique Médicale l'Actuel, Montréal, QC, Canada.
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19
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Lang R, Hogan B, Zhu J, McArthur K, Lee J, Zandi P, Nestadt P, Silverberg MJ, Parcesepe AM, Cook JA, Gill MJ, Grelotti D, Closson K, Lima VD, Goulet J, Horberg MA, Gebo KA, Camoens RM, Rebeiro PF, Nijhawan AE, McGinnis K, Eron J, Althoff KN. The prevalence of mental health disorders in people with HIV and the effects on the HIV care continuum. AIDS 2023; 37:259-269. [PMID: 36541638 PMCID: PMC9782734 DOI: 10.1097/qad.0000000000003420] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To describe the prevalence of diagnosed depression, anxiety, bipolar disorder, and schizophrenia in people with HIV (PWH) and the differences in HIV care continuum outcomes in those with and without mental health disorders (MHDs). DESIGN Observational study of participants in the North American AIDS Cohort Collaboration on Research and Design. METHODS PWH (≥18 years) contributed data on prevalent schizophrenia, anxiety, depressive, and bipolar disorders from 2008 to 2018 based on International Classification of Diseases code mapping. Mental health (MH) multimorbidity was defined as having two or more MHD. Log binomial models with generalized estimating equations estimated adjusted prevalence ratios (aPR) and 95% confidence intervals for retention in care (≥1 visit/year) and viral suppression (HIV RNA ≤200 copies/ml) by presence vs. absence of each MHD between 2016 and 2018. RESULTS Among 122 896 PWH, 67 643 (55.1%) were diagnosed with one or more MHD: 39% with depressive disorders, 28% with anxiety disorders, 10% with bipolar disorder, and 5% with schizophrenia. The prevalence of depressive and anxiety disorders increased between 2008 and 2018, whereas bipolar disorder and schizophrenia remained stable. MH multimorbidity affected 24% of PWH. From 2016 to 2018 (N = 64 684), retention in care was marginally lower among PWH with depression or anxiety, however those with MH multimorbidity were more likely to be retained in care. PWH with bipolar disorder had marginally lower prevalence of viral suppression (aPR = 0.98 [0.98-0.99]) as did PWH with MH multimorbidity (aPR = 0.99 [0.99-1.00]) compared with PWH without MHD. CONCLUSION The prevalence of MHD among PWH was high, including MH multimorbidity. Although retention and viral suppression were similar to people without MHD, viral suppression was lower in those with bipolar disorder and MH multimorbidity.
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Affiliation(s)
- Raynell Lang
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Medicine, University of Calgary, Calgary, Canada
| | - Brenna Hogan
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Jiafeng Zhu
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore
| | - Kristen McArthur
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore
| | - Jennifer Lee
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Peter Zandi
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Paul Nestadt
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Michael J Silverberg
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Angela M Parcesepe
- Department of Maternal and Child Health, Gillings School of Global Public Health and the Carolina Population Center, University of North Carolina Chapel Hill, Chapel Hill, North Carolina
| | - Judith A Cook
- Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois
| | - M John Gill
- Department of Medicine, University of Calgary, Calgary, Canada
| | - David Grelotti
- Department of Psychiatry, University of California, San Diego, California, USA
| | - Kalysha Closson
- School of Population and Public Health, University of British Columbia
| | - Viviane D Lima
- University of British Columbia & BC Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
| | - Joseph Goulet
- Yale School of Medicine & VA Connecticut Healthcare System, West Haven, Connecticut
| | - Michael A Horberg
- Mid-Atlantic Permanente Research Institute, Kaiser Permanente Mid-Atlantic States, Rockville
| | - Kelly A Gebo
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | | | - Peter F Rebeiro
- Departments of Medicine & Biostatistics, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Ank E Nijhawan
- University of Texas Southwestern Medical Center, Dallas, Texas
| | - Kathleen McGinnis
- Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut
| | - Joseph Eron
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Keri N Althoff
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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20
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Chowdhury PP, Beer L, Crim SM, Bosh KA, Desamu-Thorpe RG, Shouse LR. Clinical Outcomes of Adults With Diagnosed HIV Living in Ending the HIV Epidemic Priority Areas, Medical Monitoring Project, 2018. Public Health Rep 2023; 138:107-113. [PMID: 35137642 PMCID: PMC9730174 DOI: 10.1177/00333549221074339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES The Ending the HIV Epidemic (EHE) initiative prioritizes treatment and prevention efforts in counties where most new HIV diagnoses occur and states with substantial incidence of new HIV diagnoses in rural areas. Understanding the characteristics of adults with HIV living in EHE priority areas, and how these characteristics compare with adults with HIV living in non-EHE priority areas, can inform EHE efforts. METHODS We analyzed data from the 2018 Medical Monitoring Project (MMP) to understand the characteristics of adults with HIV living in 36 of 48 EHE priority counties; San Juan, Puerto Rico; and 1 of 7 EHE priority states. We calculated weighted percentages of sociodemographic characteristics, behaviors, and clinical outcomes of adults with diagnosed HIV living in MMP EHE priority areas and compared them with characteristics of adults who did not live in MMP EHE priority areas using prevalence ratios (PRs) with predicted marginal means. RESULTS Living in an MMP EHE priority area was more common among adults who were non-Hispanic Black or Hispanic, experienced homelessness, or were food insecure compared with adults who were non-Hispanic White (59.3% and 58.4% vs 41.0%), not experiencing homelessness (60.9% vs 51.9%), or not food insecure (59.8% vs 51.0%). Adults who lived in MMP EHE priority areas were significantly less likely to be adherent to their HIV medications (PR = 0.95; 95% CI, 0.91-0.99) and durably virally suppressed (PR = 0.94; 95% CI, 0.91-0.97), and more likely to miss scheduled appointments for HIV care (PR = 1.31; 95% CI, 1.10-1.56) than adults who did not live in MMP EHE priority areas. CONCLUSION To increase viral suppression and reduce HIV transmission, it is essential to strengthen public health efforts to improve medication and appointment adherence in this population.
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Affiliation(s)
- Pranesh P. Chowdhury
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Linda Beer
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Stacy M. Crim
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Karin A. Bosh
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Rodel G. Desamu-Thorpe
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Luke R. Shouse
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
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21
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Islam JY, Nogueira L, Suneja G, Coghill A, Akinyemiju T. Palliative Care Use Among People Living With HIV and Cancer: An Analysis of the National Cancer Database (2004-2018). JCO Oncol Pract 2022; 18:e1683-e1693. [PMID: 35867956 PMCID: PMC9663140 DOI: 10.1200/op.22.00181] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 05/23/2022] [Accepted: 06/16/2022] [Indexed: 01/14/2023] Open
Abstract
PURPOSE People living with HIV (PLWH) diagnosed with cancer are less likely to receive quality cancer treatment compared with HIV-negative patients. Timely provision of palliative care (PC) during cancer treatment can increase patient's survival and improve quality of life. Our objective was to compare the use of PC by HIV status among adults diagnosed with cancer in the United States. METHODS More than 19 million individuals age 18-90 years diagnosed with the 11 most common cancers among PLWH were selected from the National Cancer Database (2004-2018). The National Cancer Database defined PC as any surgery, radiation, systemic therapy, or pain management treatment with noncurative intent. Multivariable logistic regression was used to examine associations between HIV status and PC receipt by cancer site and stage after adjustment for covariates. RESULTS The study population included 52,306 HIV-positive (average age: 56.5 years) and 19,115,520 HIV-negative (average age: 63.7 years) cancer cases. PLWH diagnosed with stage I-III cancer were more likely to receive PC compared with their HIV-negative counterparts (adjusted odds ratio [aO]: 1.96; 95% CI, 1.80 to 2.14); however, they were also less likely to receive curative cancer treatment (aOR, 0.48; 95% CI, 0.40 to 0.59). PLWH diagnosed with stage IV cancer were less likely to receive PC (aOR, 0.70; 95% CI, 0.66 to 0.74) compared with HIV-negative patients. When evaluated by cancer site, PLWH diagnosed with stage IV lung (aOR, 0.80; 95% CI, 0.73 to 0.87) and colorectal (aOR, 0.72, 95% CI, 0.54 to 0.95) cancers were less likely to receive PC than HIV-negative patients. CONCLUSION PLWH diagnosed with stage IV cancer, particularly lung and colorectal cancers, were less likely to receive PC compared with cancer patients without HIV. PLWH with nonmetastatic disease were more likely to receive PC but less likely to receive curative treatment, reinforcing that clinical strategies are needed to improve the quality of care among PLWH.
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Affiliation(s)
- Jessica Y. Islam
- Cancer Epidemiology Program, Center for Immunization and Infection in Cancer, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
- Department of Population Health Sciences, Duke University, Durham, NC
| | | | - Gita Suneja
- Deparment of Radiation Oncology, University of Utah, Salt Lake City, Utah
| | - Anna Coghill
- Cancer Epidemiology Program, Center for Immunization and Infection in Cancer, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Tomi Akinyemiju
- Department of Population Health Sciences, Duke University, Durham, NC
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22
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Hussen SA, Doraivelu K, Camp DM, Moore SJ, Kalokhe AS, Wade R, Leong T, Ali MK, Farber EW. Burden and Correlates of Mental Health Symptoms Among Young Black Gay, Bisexual, and Other Men Who Have Sex with Men Engaged in HIV Care in Atlanta. AIDS Behav 2022; 26:2844-2854. [PMID: 35199249 DOI: 10.1007/s10461-022-03629-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2022] [Indexed: 11/01/2022]
Abstract
Mental health comorbidities are prevalent among young Black gay, bisexual, and other men who have sex with men (YB-GBMSM) living with HIV and can adversely impact HIV-related outcomes. We conducted a cross-sectional survey study with 100 YB-GBMSM recruited from two HIV care centers in Atlanta, and constructed multivariable logistic and linear regression models to examine correlates of depression, anxiety, trauma symptoms, and general well-being. In adjusted models, full-time employment was associated with fewer depressive symptoms, while HIV stigma and substance use were associated with higher levels of depressive symptoms. Younger age and full-time employment were negatively associated with severe anxiety, while HIV stigma was positively associated with severe anxiety and trauma symptoms. Trust in physicians, lower HIV stigma, full-time employment, and lack of substance use were associated with higher average general well-being scores. In conclusion, we found high frequency of depressive, anxiety, and trauma-related symptoms among this sample of YB-GBMSM living with HIV. Unemployment, substance use, and HIV stigma emerged as particularly salient correlates of psychological morbidity, suggesting a need for structural and community-level interventions to address mental health in this population.
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Affiliation(s)
- Sophia A Hussen
- Hubert Department of Global Health, Emory University Rollins School of Public Health, 1518 Clifton Road NE, Mailstop 1518-002-7BB, Atlanta, GA, 30322, USA.
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA.
| | - Kamini Doraivelu
- Hubert Department of Global Health, Emory University Rollins School of Public Health, 1518 Clifton Road NE, Mailstop 1518-002-7BB, Atlanta, GA, 30322, USA
| | - Daniel M Camp
- Hubert Department of Global Health, Emory University Rollins School of Public Health, 1518 Clifton Road NE, Mailstop 1518-002-7BB, Atlanta, GA, 30322, USA
| | - Shamia J Moore
- Hubert Department of Global Health, Emory University Rollins School of Public Health, 1518 Clifton Road NE, Mailstop 1518-002-7BB, Atlanta, GA, 30322, USA
| | - Ameeta S Kalokhe
- Hubert Department of Global Health, Emory University Rollins School of Public Health, 1518 Clifton Road NE, Mailstop 1518-002-7BB, Atlanta, GA, 30322, USA
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Ryan Wade
- School of Social Work, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Traci Leong
- Department of Biostatistics, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Mohammed K Ali
- Hubert Department of Global Health, Emory University Rollins School of Public Health, 1518 Clifton Road NE, Mailstop 1518-002-7BB, Atlanta, GA, 30322, USA
- Department of Family and Preventive Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Eugene W Farber
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
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23
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Emanuel KM, Runner K, Brodnik ZD, Morsey BM, Lamberty BG, Johnson HS, Acharya A, Byrareddy SN, España RA, Fox HS, Gaskill PJ. Deprenyl reduces inflammation during acute SIV infection. iScience 2022; 25:104207. [PMID: 35494221 PMCID: PMC9046124 DOI: 10.1016/j.isci.2022.104207] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 02/28/2022] [Accepted: 04/01/2022] [Indexed: 11/30/2022] Open
Abstract
In the era of antiretroviral therapy, inflammation is a central factor in numerous HIV-associated comorbidities, such as cardiovascular disease, cognitive impairment, and neuropsychiatric disorders. This highlights the value of developing therapeutics that both reduce HIV-associated inflammation and treat associated comorbidities. Previous research on monoamine oxidase inhibitors (MAOIs) suggests this class of drugs has anti-inflammatory properties in addition to neuropsychiatric effects. Therefore, we examined the impact of deprenyl, an MAOI, on SIV-associated inflammation during acute SIV infection using the rhesus macaque model of HIV infection. Our results show deprenyl decreased both peripheral and CNS inflammation but had no effect on viral load in either the periphery or CNS. These data show that the MAOI deprenyl may have broad anti-inflammatory effects when given during the acute stage of SIV infection, suggesting more research into the anti-inflammatory effects of this drug could result in a beneficial adjuvant for antiretroviral therapy.
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Affiliation(s)
- K M Emanuel
- Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - K Runner
- Department of Pharmacology and Physiology, Drexel University College of Medicine, Philadelphia, PA 19102, USA
| | - Z D Brodnik
- Department of Neurobiology and Anatomy, Drexel University College of Medicine, Philadelphia, PA 19129, USA
- Center on Compulsive Behaviors, NIH Intramural Research Program, Baltimore, MD 21224, USA
- Integrative Neuroscience Research Branch, Neuronal Networks Section, Baltimore, MD 21224, USA
| | - B M Morsey
- Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - B G Lamberty
- Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - H S Johnson
- Department of Pharmacology and Physiology, Drexel University College of Medicine, Philadelphia, PA 19102, USA
| | - A Acharya
- Department of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - S N Byrareddy
- Department of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - R A España
- Department of Neurobiology and Anatomy, Drexel University College of Medicine, Philadelphia, PA 19129, USA
| | - H S Fox
- Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - P J Gaskill
- Department of Pharmacology and Physiology, Drexel University College of Medicine, Philadelphia, PA 19102, USA
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24
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Wu K, Tie Y, Dasgupta S, Beer L, Marcus R. Injection and Non-Injection Drug Use Among Adults with Diagnosed HIV in the United States, 2015-2018. AIDS Behav 2022; 26:1026-1038. [PMID: 34536178 DOI: 10.1007/s10461-021-03457-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2021] [Indexed: 10/20/2022]
Abstract
Understanding behavioral characteristics and health outcomes of people with HIV (PWH) who inject drugs and PWH who use drugs, but do not inject, can help inform public health interventions and improve HIV clinical outcomes. However, recent, nationally representative estimates are lacking. We used 2015-2018 Medical Monitoring Project data to examine health outcome differences among adults with diagnosed HIV who injected drugs or who only used non-injection drugs in the past year. Data were obtained from participant interviews and medical record abstraction. We reported weighted percentages and prevalence ratios with predicted marginal means to assess differences between groups (P < 0.05). PWH who injected drugs were more likely to engage in high-risk sex; experience depression and anxiety symptoms, homelessness, and incarceration; and have lower levels of care retention, antiretroviral therapy adherence, and viral suppression. Tailored, comprehensive interventions are critical for improving outcomes among PWH who use drugs, particularly among those who inject drugs.
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25
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Beer L, Tie Y, Dasgupta S, McManus T, Chowdhury PP, Weiser J. The COVID-19 pandemic and unemployment, subsistence needs and mental health among adults with HIV in the United States. AIDS 2022; 36:739-744. [PMID: 34873083 PMCID: PMC11299507 DOI: 10.1097/qad.0000000000003142] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate whether reported prevalence of unemployment, subsistence needs, and symptoms of depression and anxiety among adults with diagnosed HIV during the COVID-19 pandemic were higher than expected. DESIGN The Medical Monitoring Project (MMP) is a complex sample survey of adults with diagnosed HIV in the United States. METHODS We analyzed 2015-2019 MMP data using linear regression models to calculate expected prevalence, along with corresponding prediction intervals (PI), for unemployment, subsistence needs, depression, and anxiety for June-November 2020. We then assessed whether observed estimates fell within the expected prediction interval for each characteristic, overall and among specific groups. RESULTS Overall, the observed estimate for unemployment was higher than expected (17% vs. 12%) and exceeded the upper limit of the PI. Those living in households with incomes ≥400% of FPL were the only group where the observed prevalence of depression and anxiety during the COVID-19 period was higher than the PIs; in this group, the prevalence of depression was 9% compared with a predicted value of 5% (75% higher) and the prevalence of anxiety was 11% compared with a predicted value 5% (137% higher). We did not see elevated levels of subsistence needs, although needs were higher among Black and Hispanic compared with White persons. CONCLUSIONS Efforts to deliver enhanced employment assistance to persons with HIV and provide screening and access to mental health services among higher income persons may be needed to mitigate the negative effects of the US COVID-19 pandemic.
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Affiliation(s)
- Linda Beer
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd. NE, MS-E46, Atlanta, GA, USA
| | - Yunfeng Tie
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd. NE, MS-E46, Atlanta, GA, USA
| | - Sharoda Dasgupta
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd. NE, MS-E46, Atlanta, GA, USA
| | - Tim McManus
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd. NE, MS-E46, Atlanta, GA, USA
| | - Pranesh P. Chowdhury
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd. NE, MS-E46, Atlanta, GA, USA
| | - John Weiser
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd. NE, MS-E46, Atlanta, GA, USA
| | - Medical Monitoring Project
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd. NE, MS-E46, Atlanta, GA, USA
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26
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Lee KW, Ang CS, Lim SH, Siau CS, Ong LTD, Ching SM, Ooi PB. Prevalence of mental health conditions among people living with HIV during the COVID-19 pandemic: A rapid systematic review and meta-analysis. HIV Med 2022; 23:990-1001. [PMID: 35304829 PMCID: PMC9111307 DOI: 10.1111/hiv.13299] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 12/28/2021] [Accepted: 03/01/2022] [Indexed: 12/24/2022]
Abstract
Background The COVID‐19 pandemic has generated many mental health problems worldwide. People living with HIV (henceforth known as PLHIV) bear a higher mental health burden in comparison with the general population. Therefore, their risk of mental health problems may be elevated during the pandemic. Methods We conducted a systematic review and meta‐analysis to assess the prevalence of depression, anxiety, psychological stress, insomnia and loneliness among PLHIV during the COVID‐19 pandemic. Observational studies in four databases published from 1 January 2020 to 30 April 2021 investigating the prevalence of mental health conditions during the COVID‐19 pandemic were searched, and 197 articles were retrieved. After the processes of duplication removal, eligibility screening and full‐text assessment, 10 articles were included in the systematic review and six articles for meta‐analyses. A random‐effects model was applied to derive the pooled prevalence of mental health conditions. The risk of bias was assessed using the STROBE checklist. Results Overall, the pooled prevalence rates of (moderate‐to‐severe) depression and anxiety among PLHIV were 16.9% [95% confidence interval (CI): 3.8%–30.0%] and 23.0% (95% CI: 12.0%–34.0%), respectively. Conclusions More research is needed to investigate the mechanism by which the pandemic affects the mental health of PLHIV. Support and programmes are needed to ameliorate the mental health problems in this marginalized population.
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Affiliation(s)
- Kai Wei Lee
- Department of Pre-Clinical Sciences, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Kajang, Malaysia.,Centre for Research on Communicable Diseases, Universiti Tunku Abdul Rahman, Kajang, Malaysia
| | - Chin Siang Ang
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Sin How Lim
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Ching Sin Siau
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Lai Teik Derek Ong
- Department of Marketing Strategy and Innovation, Sunway University Business School (SUBS), Sunway University, Bandar Sunway, Selangor, Malaysia
| | - Siew Mooi Ching
- Department of Family Medicine, Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, Kajang, Malaysia.,Malaysian Research Institute on Ageing, Universiti Putra Malaysia, Serdang, Malaysia.,Department of Medical Sciences, School of Medical and Life Sciences, Sunway University, Bandar Sunway, Malaysia
| | - Pei Boon Ooi
- Department of Medical Sciences, School of Medical and Life Sciences, Sunway University, Bandar Sunway, Malaysia
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27
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Sherrill-Mix S, Yang M, Aldrovandi GM, Brenchley JM, Bushman FD, Collman RG, Dandekar S, Klatt NR, Lagenaur LA, Landay AL, Paredes R, Tachedjian G, Turpin JA, Serrano-Villar S, Lozupone CA, Ghosh M. A Summary of the Sixth International Workshop on Microbiome in HIV Pathogenesis, Prevention, and Treatment. AIDS Res Hum Retroviruses 2022; 38:173-180. [PMID: 34969255 PMCID: PMC9009592 DOI: 10.1089/aid.2021.0173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
In October of 2020, researchers from around the world met online for the sixth annual International Workshop on Microbiome in HIV Pathogenesis, Prevention, and Treatment. New research was presented on the roles of the microbiome on immune response and HIV transmission and pathogenesis and the potential for alterations in the microbiome to decrease transmission and affect comorbidities. This article presents a summary of the findings reported.
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Affiliation(s)
- Scott Sherrill-Mix
- Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Address correspondence to: Scott Sherrill-Mix, Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, 424 Johnson Pavilion, 3610 Hamilton Walk, Philadelphia, PA 19104, USA
| | - Michelle Yang
- Department of Epidemiology, The George Washington University, Washington, District of Columbia, USA
| | - Grace M. Aldrovandi
- Department of Pediatrics, University of California, Los Angeles, California, USA
| | | | - Frederic D. Bushman
- Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Ronald G. Collman
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Satya Dandekar
- Department of Medical Microbiology and Immunology, University of California, Davis, Davis, California, USA
| | - Nichole R. Klatt
- Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA
| | | | - Alan L. Landay
- Division of Gerontology, Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Roger Paredes
- Institut de Recerca de la SIDA IrsiCaixa i Unitat VIH, Universitat Autònoma de Barcelona, Universitat de Vic, Catalonia, Spain
| | | | - Jim A. Turpin
- Divison of AIDS, NIAID, NIH, Bethesda, Maryland, USA
| | - Sergio Serrano-Villar
- Department of Infectious Diseases, Hospital Universitario Ramon y Cajal, Madrid, Spain
| | | | - Mimi Ghosh
- Department of Epidemiology, The George Washington University, Washington, District of Columbia, USA
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28
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Unmet needs for HIV ancillary care services by health care coverage and Ryan White HIV/AIDS program assistance. AIDS 2022; 36:1399-1407. [PMID: 35212670 DOI: 10.1097/qad.0000000000003205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To investigate unmet needs for HIV ancillary care services by health care coverage type and Ryan White HIV/AIDS Program (RWHAP) assistance among adults with HIV. DESIGN We analyzed data using the 2017-2019 cycles of the CDC Medical Monitoring Project, an annual, cross-sectional study designed to produce nationally representative estimates of characteristics among adults with diagnosed HIV. METHODS Unmet need was defined as needing, but not receiving, ≥1 HIV ancillary care service. We estimated prevalence ratios (PRs) and 95% confidence intervals (CIs) using predicted marginal means to examine associations between health care coverage type and unmet needs for HIV ancillary care services, adjusting for age. Associations were stratified by receipt of RWHAP assistance. RESULTS Unmet needs for HIV ancillary care services were highest among uninsured persons (58.7%) and lowest among those with private insurance living ≥400% of the federal poverty level (FPL; 21.7%). Uninsured persons who received RWHAP assistance were less likely than those who did not receive RWHAP assistance to have unmet needs for HIV clinical support services (aPR: 0.21; 95% CI: 0.16-0.28) and other medical services (aPR: 0.75; 95% CI: 0.59-0.96), but not subsistence services (aPR: 0.97; 95% CI: 0.74-1.27). Unmet needs for other medical services and subsistence services did not differ by RWHAP assistance among those with Medicaid, Medicare, or other health care coverage. CONCLUSIONS RWHAP helped reduce some needs for uninsured persons. However, with growing socioeconomic inequities following the COVID-19 pandemic, expanding access to needed services for all people with HIV could improve key outcomes.
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29
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Henry-Okafor Q, Walker J, Pfieffer ML, Ott M. Management of Mental Health Disorders in Patients With Human Immunodeficiency Virus. J Nurse Pract 2022. [DOI: 10.1016/j.nurpra.2022.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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30
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Gutiérrez-Velilla E, Barrientos-Casarrubias V, Cruz-Maycott R, Perrusquia-Ortiz LE, Alvarado-de la Barrera C, Ávila-Ríos S, Caballero-Suárez NP. Assessment of anxiety in Mexican persons living with HIV using a culturally-adapted version of the GAD-7 test. J Health Psychol 2022; 27:2875-2886. [PMID: 35042393 DOI: 10.1177/13591053211072687] [Citation(s) in RCA: 2] [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
Our aim was to assess the severity of anxiety in PLWHA in Mexico City and obtain the psychometric properties of the culturally-adapted Spanish version of GAD-7. Thirteen percent of participants presented moderate to severe symptoms. Reliability (α = 0.82) and construct validity (single-factor explained 48.9% of variance) were evaluated in 411 participants. Confirmatory Factor Analysis was performed in a second sample of 527 participants. Model fit adequately (CFI = 0.991; CMIN/DF = 1.924; RMSEA = 0.042; and SRMR = 0.026). The adapted version of GAD-7 was adequate for the assessment of anxiety in Mexican PLWHA.
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Affiliation(s)
- Ester Gutiérrez-Velilla
- Centro de Investigación en Enfermedades Infecciosas (CIENI) del Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas" (INER), Mexico.,Universidad Nacional Autónoma de México (UNAM), Mexico
| | - Vania Barrientos-Casarrubias
- Centro de Investigación en Enfermedades Infecciosas (CIENI) del Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas" (INER), Mexico
| | - Rosa Cruz-Maycott
- Centro de Investigación en Enfermedades Infecciosas (CIENI) del Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas" (INER), Mexico
| | - Lydia E Perrusquia-Ortiz
- Centro de Investigación en Enfermedades Infecciosas (CIENI) del Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas" (INER), Mexico
| | - Claudia Alvarado-de la Barrera
- Centro de Investigación en Enfermedades Infecciosas (CIENI) del Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas" (INER), Mexico
| | - Santiago Ávila-Ríos
- Centro de Investigación en Enfermedades Infecciosas (CIENI) del Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas" (INER), Mexico
| | - Nancy Patricia Caballero-Suárez
- Centro de Investigación en Enfermedades Infecciosas (CIENI) del Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas" (INER), Mexico
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31
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Millon EM, Lehrer PM, Shors TJ. Meditation and Aerobic Exercise Enhance Mental Health Outcomes and Pattern Separation Learning Without Changing Heart Rate Variability in Women with HIV. Appl Psychophysiol Biofeedback 2022; 47:27-42. [PMID: 35040014 PMCID: PMC8763305 DOI: 10.1007/s10484-021-09530-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2021] [Indexed: 01/01/2023]
Abstract
Mental and physical (MAP) training targets the brain and the body through a combination of focused-attention meditation and aerobic exercise. The following feasibility pilot study tested whether 6 weeks of MAP training improves mental health outcomes, while enhancing discrimination learning and heart rate variability (HRV) in a group of women living with human immunodeficiency virus (HIV) and other stress-related conditions. Participants were assigned to training (n = 18) or no-training control (n = 8) groups depending on their ability and willingness to participate, and if their schedule allowed. Training sessions were held once a week for 6 weeks with 30 min of meditation followed by 30 min of aerobic exercise. Before and after 6 weeks of training, participants completed the Behavioral Pattern Separation Task as a measure of discrimination learning, self-report questionnaires of ruminative and trauma-related thoughts, depression, anxiety, and perceived stress, and an assessment of HRV at rest. After training, participants reported fewer ruminative and trauma-related thoughts, fewer depressive and anxiety symptoms, and less perceived stress (p’s < 0.05). The positive impact on ruminative thoughts and depressive symptoms persisted 6 months after training. They also demonstrated enhanced discrimination of similar patterns of information (p < 0.05). HRV did not change after training (p > 0.05). Combining mental and physical training is an effective program for enhancing mental health and aspects of cognition in women living with HIV, although not necessarily through variance in heart rate.
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Affiliation(s)
- Emma M Millon
- Behavioral and Systems Neuroscience, Department of Psychology, Rutgers University, Piscataway, New Jersey, USA.
| | - Paul M Lehrer
- Department of Psychiatry, Rutgers-Robert Wood Johnson Medical School, Piscataway, New Jersey, USA
| | - Tracey J Shors
- Behavioral and Systems Neuroscience, Department of Psychology, Rutgers University, Piscataway, New Jersey, USA.,W.M. Keck Center for Collaborative Neuroscience, Rutgers University, Piscataway, New Jersey, USA
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32
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Stanton MC, Ali SB, the SUSTAIN Center Team. A typology of power in implementation: Building on the exploration, preparation, implementation, sustainment (EPIS) framework to advance mental health and HIV health equity. IMPLEMENTATION RESEARCH AND PRACTICE 2022; 3:26334895211064250. [PMID: 37091105 PMCID: PMC9978699 DOI: 10.1177/26334895211064250] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Persistent inequities in HIV health are due, in part, to barriers to successful HIV-related mental health intervention implementation with marginalized groups. Implementation Science (IS) has begun to examine how the field can promote health equity. Lacking is a clear method to analyze how power is generated and distributed through practical implementation processes and how this power can dismantle and/or reproduce health inequity through intervention implementation. The aims of this paper are to (1) propose a typology of power generated through implementation processes, (2) apply this power typology to expand on the Exploration, Preparation, Implementation, Sustainment (EPIS) framework to advance HIV and mental health equity and (3) articulate questions to guide the explicit examination and distribution of power throughout implementation. Methods This paper draws on the work of an Intermediary Purveyor organization implementing trauma-informed care and harm reduction organizational change with HIV service organizations. The expanded framework was developed through analyzing implementation coaching field notes, grant reporting, and evaluation documents, training feedback, partner evaluation interviews, and existing implementation literature. Results The authors identify three types of power working through implementation; (1) discursive power is enacted through defining health-related problems to be targeted by intervention implementation, as well as through health narratives that emerge through implementation; (2) epistemic power influences whose knowledge is valued in decision-making and is recreated through knowledge generation; and (3) material power is created through resource distribution and patterns of access to health resources and acquisition of health benefits provided by the intervention. Decisions across all phases and related to all factors of EPIS influence how these forms of power striate through intervention implementation and ultimately affect health equity outcomes. Conclusions The authors conclude with a set of concrete questions for researchers and practitioners to interrogate power throughout the implementation process. Plain language summary Over the past few years, Implementation Science researchers have committed increased attention to the ways in which the field can more effectively address health inequity. Lacking is a clear method to analyze how implementation processes themselves generate power that has the potential to contribute to health inequity. In this paper, the authors describe and define three types of power that are created and distributed through intervention implementation; discursive power, epistemic power, and material power. The authors then explain how these forms of power shape factors and phases of implementation, using the well-known EPIS (exploration, preparation, implementation, sustainment) framework. The authors draw from their experience working with and Intermediary Purveyor supporting HIV service organizations implementing trauma-informed care and harm reduction organizational change projects. This paper concludes with a set of critical questions that can be used by researchers and practitioners as a concrete tool to analyze the role of power in intervention implementation processes.
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Affiliation(s)
- Megan C. Stanton
- Department of Sociology, Anthropology, Criminology and Social Work, Eastern Connecticut State University, Willimantic, CT, USA
| | - Samira B. Ali
- Graduate College of Social Work, University of Houston, Houston, TX, USA
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Beer L, Tie Y, McCree DH, Demeke HB, Marcus R, Padilla M, Khalil G, Shouse RL. HIV Stigma Among a National Probability Sample of Adults with Diagnosed HIV-United States, 2018-2019. AIDS Behav 2022; 26:39-50. [PMID: 34374919 PMCID: PMC11317914 DOI: 10.1007/s10461-021-03414-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2021] [Indexed: 11/27/2022]
Abstract
HIV stigma is a barrier to achieving the goals of the US Ending the HIV Epidemic initiative. We analyzed data from the Medical Monitoring Project (MMP) collected during 6/2018-5/2019 from 4050 US adults with diagnosed HIV. We reported national estimates of HIV stigma and assessed their associations with sociodemographic and clinical characteristics. Disclosure concerns and stigma related to negative public attitudes were common. Stigma was higher among younger age groups, women and transgender people, Black and Hispanic/Latino men and women, and Black and Hispanic/Latino men who have sex with men. Stigma was associated with lower antiretroviral therapy use and adherence, missed HIV care visits, and symptoms of depression or anxiety. The estimates presented provide a benchmark from which the nation can monitor its progress. The findings suggest the need for enhanced stigma-reduction efforts among specific groups and the importance of addressing stigma around disclosure and community attitudes.
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Affiliation(s)
- Linda Beer
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd. NE, MS-E46, Atlanta, GA, USA.
| | - Yunfeng Tie
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd. NE, MS-E46, Atlanta, GA, USA
| | - Donna Hubbard McCree
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd. NE, MS-E46, Atlanta, GA, USA
| | - Hanna B Demeke
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd. NE, MS-E46, Atlanta, GA, USA
| | - Ruthanne Marcus
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd. NE, MS-E46, Atlanta, GA, USA
| | - Mabel Padilla
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd. NE, MS-E46, Atlanta, GA, USA
| | - George Khalil
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd. NE, MS-E46, Atlanta, GA, USA
| | - R Luke Shouse
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd. NE, MS-E46, Atlanta, GA, USA
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Hoare J, Sevenoaks T, Mtukushe B, Williams T, Heany S, Phillips N. Global Systematic Review of Common Mental Health Disorders in Adults Living with HIV. Curr HIV/AIDS Rep 2021; 18:569-580. [PMID: 34792706 PMCID: PMC8600343 DOI: 10.1007/s11904-021-00583-w] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2021] [Indexed: 02/01/2023]
Abstract
PURPOSE OF THE REVIEW By reviewing the most recent common mental health disorders (CMHD) studies in people living with HIV (PLWH) (2018-2020), this review discusses the prevalence of CMHD, factors associated with CMHD in PLWH, mental health in PLWH from vulnerable groups, the impact of CMHD on HIV disease progression and adherence to antiretroviral therapy and the efficacy of different treatment approaches. RECENT FINDINGS After screening for eligibility 142 studies were included in the final systematic review. Only 27% of studies were conducted in Sub-Saharan Africa, which carries the highest burn of HIV disease globally. Despite the well-established increased risk of CMHD in PLWH, the current prevalence remains high, with studies reporting 28%-62% of PLWH having mental health symptoms. CONCLUSION Despite the significant challenges that CMHDs present to successful HIV treatment, there are many mental health treatments and interventions which can improve outcomes in PLWH and opportunities to task-shift and integrate mental health care with HIV care.
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Affiliation(s)
- Jacqueline Hoare
- Division of Liaison Psychiatry, Department of Psychiatry and Mental health, University of Cape Town, Anzio Road Observatory, Cape Town, 7925, South Africa.
- Faculty of Health Sciences, Penisula Medical School, University of Plymouth, Plymouth, UK.
| | - Tatum Sevenoaks
- Division of Liaison Psychiatry, Department of Psychiatry and Mental health, University of Cape Town, Anzio Road Observatory, Cape Town, 7925, South Africa
| | - Bulelwa Mtukushe
- Division of Liaison Psychiatry, Department of Psychiatry and Mental health, University of Cape Town, Anzio Road Observatory, Cape Town, 7925, South Africa
| | - Taryn Williams
- Division of Liaison Psychiatry, Department of Psychiatry and Mental health, University of Cape Town, Anzio Road Observatory, Cape Town, 7925, South Africa
| | - Sarah Heany
- Division of Liaison Psychiatry, Department of Psychiatry and Mental health, University of Cape Town, Anzio Road Observatory, Cape Town, 7925, South Africa
| | - Nicole Phillips
- Division of Liaison Psychiatry, Department of Psychiatry and Mental health, University of Cape Town, Anzio Road Observatory, Cape Town, 7925, South Africa
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Caniglia EC, Khan M, Ban K, Braithwaite RS. Integrating Screening and Treatment of Unhealthy Alcohol Use and Depression with Screening and Treatment of Anxiety, Pain, and Other Substance Use Among People with HIV and Other High-Risk Persons. AIDS Behav 2021; 25:339-346. [PMID: 33829369 PMCID: PMC8610949 DOI: 10.1007/s10461-021-03245-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2021] [Indexed: 02/06/2023]
Abstract
We review and synthesize results from a series of analyses estimating the benefit of screening for unhealthy alcohol use, depression, and tobacco to detect individuals at heightened risk for co-occurring anxiety, pain, depression, unhealthy alcohol use, and other substance use among people with HIV and HIV-uninfected individuals in the Veterans Aging Cohort Study. We also examine the potential impact of reducing unhealthy alcohol use and depressive symptoms on the incidence of co-occurring conditions. We found that screening for alcohol and depression may help identify co-occurring symptoms of anxiety, depression, and pain interference, treating unhealthy alcohol use may improve co-occurring pain interference and substance use, and improving depressive symptoms may improve co-occurring anxiety, pain interference, and smoking. We propose that an integrated approach to screening and treatment for unhealthy alcohol use, depression, anxiety, pain, and other substance use may facilitate diagnostic assessment and treatment of these conditions, improving morbidity and mortality.
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Diaz-Martinez J, Tamargo JA, Delgado-Enciso I, Liu Q, Acuña L, Laverde E, Barbieri MA, Trepka MJ, Campa A, Siminski S, Gorbach PM, Baum MK. Resilience, Anxiety, Stress, and Substance Use Patterns During COVID-19 Pandemic in the Miami Adult Studies on HIV (MASH) Cohort. AIDS Behav 2021; 25:3658-3668. [PMID: 34009479 PMCID: PMC8132028 DOI: 10.1007/s10461-021-03292-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2021] [Indexed: 01/11/2023]
Abstract
We evaluated mental health and substance use during the COVID-19 pandemic in 196 participants from the Miami Adult Studies on HIV (MASH) Cohort. A survey was administered between July-August of 2020, including validated measures of resilience and anxiety, a scale to measure COVID-19-related worry, and self-reported substance use. Compared to HIV-uninfected participants (n = 80), those living with HIV (n = 116) reported fewer anxiety symptoms, less COVID-19-related worry, and higher resilience. Those with more anxiety symptoms and lower resilience engaged in more frequent alcohol consumption, binge drinking, and cocaine use. Alcohol misuse was more common among HIV-uninfected participants. Cocaine use was reported by 21% fewer participants during the pandemic compared with 7.3 ± 1.5 months earlier. Possibly due to their experiences with HIV, PLWH responded with higher resilience and reduced worry and anxiety to the adversities brought by the COVID-19 pandemic.
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Affiliation(s)
- Janet Diaz-Martinez
- Robert Stempel College of Public Health, Florida International University, Miami, FL, USA
| | - Javier A Tamargo
- Robert Stempel College of Public Health, Florida International University, Miami, FL, USA
| | | | - Qingyun Liu
- Robert Stempel College of Public Health, Florida International University, Miami, FL, USA
| | - Leonardo Acuña
- College of Arts, Sciences & Education, Florida International University, Miami, FL, USA
| | - Eduardo Laverde
- College of Arts, Sciences & Education, Florida International University, Miami, FL, USA
| | - Manuel A Barbieri
- College of Arts, Sciences & Education, Florida International University, Miami, FL, USA
| | - Mary Jo Trepka
- Robert Stempel College of Public Health, Florida International University, Miami, FL, USA
| | - Adriana Campa
- Robert Stempel College of Public Health, Florida International University, Miami, FL, USA
| | | | - Pamina M Gorbach
- Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - Marianna K Baum
- Robert Stempel College of Public Health, Florida International University, Miami, FL, USA.
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Dasgupta S, Tie Y, Beer L, Weiser J. Unmet needs for ancillary care services are associated with HIV clinical outcomes among adults with diagnosed HIV. AIDS Care 2021; 34:606-614. [PMID: 34180733 PMCID: PMC8712612 DOI: 10.1080/09540121.2021.1946001] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Ancillary care services are essential for supporting care engagement and viral suppression among persons with HIV. Estimating unmet needs for ancillary care services may help address care barriers and improve clinical outcomes, but recent, nationally representative estimates are lacking. Using CDC Medical Monitoring Project data from 2015-2018, we report representative estimates of unmet needs for ancillary care services and associations with HIV clinical outcomes among U.S. adults with HIV. Data were collected through interview and medical record abstraction. We described weighted percentages for all characteristics and associations with HIV clinical outcomes using prevalence ratios with predicted marginal means, adjusting for potential confounding. Substantial unmet needs were reported; unmet needs were higher among persons with social determinants of poor health, persons who engaged in drug use or binge drinking, and those who experienced depression or anxiety. Having unmet needs for care was associated with adverseHIV clinical outcomes, with a dose response effect between number of unmet needs and outcomes. Expanding ancillary care access based on a comprehensive care model, strengthening partnerships between providers to connect patients to essential services, and tailoring services based on need may help reduce disparities in unmet needs and improve outcomes.
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Affiliation(s)
- Sharoda Dasgupta
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Yunfeng Tie
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Linda Beer
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - John Weiser
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Ali S, Aquino-Adriatico G, Lewis-White R, Stoker C, Arms D, Grant C, Green-Sofola L. Multilevel factors associated with anxiety symptoms among people living with HIV in the US South. AIDS Care 2021; 34:805-811. [PMID: 34044721 DOI: 10.1080/09540121.2021.1924352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
People living with HIV are more likely than people not living with HIV to experience Generalized Anxiety Disorder (GAD) Symptoms. Scholars have found that 19%-23% of people living with HIV experience GAD Symptoms. Current studies overwhelmingly examine individual factors among national samples and are not conducted in the US South, where HIV rates have increased significantly in recent years. Even fewer studies examine the multilevel factors that are associated with anxiety in this US South. Thus, this study examined the multilevel factors associated with anxiety symptoms in a large US Southern City. A multivariate linear regression was conducted to examine multilevel factors associated with anxiety symptoms among 111 people living with HIV. Two structural variables, housing satisfaction and mental health service needs and one intrapersonal variable, health quality of life, were significantly associated with symptoms of anxiety. The study points to the needs of focusing multilevel interventions not only on housing conditions, but also attention to participants' satisfaction of their housing.
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Affiliation(s)
- Samira Ali
- Graduate College of Social Work, University of Houston, Houston, TX, USA
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Pizzirusso M, Carrion-Park C, Clark US, Gonzalez J, Byrd D, Morgello S. Physical and Mental Health Screening in a New York City HIV Cohort During the COVID-19 Pandemic: A Preliminary Report. J Acquir Immune Defic Syndr 2021; 86:e54-e60. [PMID: 33148994 PMCID: PMC7878300 DOI: 10.1097/qai.0000000000002564] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 10/05/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Mental health consequences of the COVID-19 pandemic have been observed. Psychiatric symptoms in people living with HIV, and their relationship to physical symptomatology and prior psychopathology, are not yet reported. SETTING An HIV cohort sheltering-in-place in New York City. METHODS Forty-nine participants in a longitudinal study were contacted by telephone in April 2020. A structured interview queried COVID-19-associated physical symptoms, and mental health screens were performed with the generalized anxiety disorder-2 (GAD-2) and patient health questionnaire-2 (PHQ-2). Prior medical and neuropsychiatric data were obtained from preceding study visits. Post-hoc analyses were performed. RESULTS The mean age of respondents was 62.1 years, 39% were women, and 35% African American, 37% Latinx, and 28% Caucasian. COVID-19-indicator symptoms were present in 69%; 41% had respiratory and 61% extra-pulmonary symptoms. Mental health symptoms were endorsed in 45% with PHQ-2 and 43% with GAD-2, although threshold for major depression was met in only 4% and for GAD in 14%. Higher PHQ scores were associated with respiratory symptoms, but not prior mood or anxiety disorders. GAD-2 scores were higher with past mood disorders, but not with prior anxiety disorders or respiratory symptoms. CONCLUSIONS Physical symptoms were frequent and mild psychiatric symptoms were common, but serious anxiety and depression were not often endorsed by this group of people living with HIV at the acute height of the New York City COVID-19 pandemic. Reasons for this are unclear, as this preliminary report is descriptive in nature. Short- and long-term consequences of acute mental health symptoms require further study.
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Affiliation(s)
- Maria Pizzirusso
- Department of Neurology, The Icahn School of Medicine at Mount Sinai, New York, NY
| | - Cira Carrion-Park
- Department of Neurology, The Icahn School of Medicine at Mount Sinai, New York, NY
| | - Uraina S. Clark
- Department of Neurology, The Icahn School of Medicine at Mount Sinai, New York, NY
| | - Jairo Gonzalez
- Department of Neurology, The Icahn School of Medicine at Mount Sinai, New York, NY
| | - Desiree Byrd
- Department of Neurology, The Icahn School of Medicine at Mount Sinai, New York, NY
- Department of Psychology, Queens College, City University of New York, New York, NY; and
| | - Susan Morgello
- Department of Neurology, The Icahn School of Medicine at Mount Sinai, New York, NY
- Departments of Neuroscience and Pathology, The Icahn School of Medicine at Mount Sinai, New York, NY
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Millon EM, Shors TJ. How mental health relates to everyday stress, rumination, trauma and interoception in women living with HIV: A factor analytic study. LEARNING AND MOTIVATION 2021. [DOI: 10.1016/j.lmot.2020.101680] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Algarin AB, Sheehan DM, Varas-Diaz N, Fennie K, Zhou Z, Spencer EC, Cook CL, Cook RL, Ibanez GE. Enacted HIV-Related Stigma's Association with Anxiety & Depression Among People Living with HIV (PLWH) in Florida. AIDS Behav 2021; 25:93-103. [PMID: 32564164 DOI: 10.1007/s10461-020-02948-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Research has shown that HIV-related stigma contributes to people living with HIV having a higher risk of mental health disorders. Our study examines the association between enacted HIV-related stigma and symptoms of anxiety and depression among PLWH. We used baseline data from 932 PLWH collected from the Florida Cohort study between 2014 and 2018. The sample was majority 45 + years of age (63.5%), male (66.0%), and Black (58.1%). The majority had previously experienced enacted HIV-related stigma (53.1%). Additionally, 56.6% and 65.2% showed mild to moderate/severe levels of anxiety and depression, respectively. Those who experienced any levels of enacted HIV-related stigma (vs none) had significantly greater odds of mild and moderate/severe levels of anxiety (vs no/minimal) (AOR[CI] 1.54[1.13, 2.10], p = 0.006; AOR[CI] 3.36[2.14, 5.26], p < 0.001, respectively) and depression (AOR[CI] 1.61[1.19, 2.18], p = 0.002; AOR[CI] 3.66[2.32, 5.77], p < 0.001, respectively). Findings suggest a need to evaluate interventions for PLWH to reduce the deleterious effects of enacted HIV-related stigma on mental health.
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Mugisha J, Byansi PK, Kinyanda E, Bbosa RS, Damme TV, Vancampfort D. Moderate to severe generalized anxiety disorder symptoms are associated with physical inactivity in people with HIV/AIDS: a study from Uganda. Int J STD AIDS 2020; 32:170-175. [PMID: 33323069 DOI: 10.1177/0956462420942992] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The aim of this cross-sectional study was to explore the prevalence of moderate to severe generalized anxiety disorder (GAD) symptoms and its association with physical activity in people living with HIV (PLHIV) in Uganda. Two hundred and ninety-five PLHIV (median [interquartile range] age = 37.0 years [16.0]; 200 women) completed the GAD-7, Physical Activity Vital Sign, Patient Health Questionnaire-9, and the Alcohol Use Disorders Identification Test. An adjusted odds ratio for physical inactivity in people with moderate to severe GAD symptoms was calculated using binary logistic regression analyses. The prevalence of moderate to severe GAD symptoms was 9.1%. Those with moderate to severe GAD symptoms had a 16.8 times higher odds (95% CI = 5.0-55.9) for not complying with the physical activity recommendations. The current study shows that moderate to severe GAD symptoms are strongly associated with physical inactivity in PLHIV living in a country such as Uganda.
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Affiliation(s)
- James Mugisha
- Faculty of Arts and Social Sciences, Kyambogo University, Kampala, Uganda.,Butabika National Referral and Mental Health Hospital, Kampala, Uganda
| | - Peter K Byansi
- Africa Social Development & Health Initiatives, Kampala, Uganda.,Faculty of Health Sciences, Uganda Martyrs University, Kampala, Uganda
| | - Eugene Kinyanda
- Department of Psychiatry, Makerere University, Kampala, Uganda.,Mental Health Project, MRC/LSHTM/UVRI and Senior Wellcome Trust Fellow, Uganda
| | | | - Tine Van Damme
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium
| | - Davy Vancampfort
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium.,University Psychiatric Centre KU Leuven, Kortenberg, Belgium
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Zhu X, Ming Y, Liu J, Liu L, Cheng K, Mao P. Sleep Quality and Psychosocial Factors in Liver Transplant Recipients at an Outpatient Follow-Up Clinic in China. Ann Transplant 2020; 25:e920984. [PMID: 32066650 PMCID: PMC7047916 DOI: 10.12659/aot.920984] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Background Sleep disturbance is a common problem in liver transplant recipients, but few studies have confirmed the psychosocial factors associated with sleep quality in patients after liver transplantation. This study aimed to identify the psychosocial factors related to sleep quality among liver transplant patients during outpatient follow-up. Material/Methods A retrospective cross-sectional study was performed in 124 liver transplant patients during outpatient follow-up. All participants completed a general demographic questionnaire, the Pittsburgh Sleep Quality Index (PSQI), the Generalized Anxiety Disorder-7 scale (GAD-7), the Patient Health Questionnaire-9 (PHQ-9), and the perceived social support scale (PSSS). Results The mean global PSQI score was 6.57 (SD, 4.28), which was significantly higher than the mean score for people with normal sleep quality; 50 (40.3%) recipients were classified as having poor sleep quality (PSQI >7). Among the self-reported sleep problems, 62 (50.0%) participants reported that they had to go to the bathroom at night, 58 (43.5%) woke up in the middle of the night or early morning, 84 (67.7%) reported depression symptoms, and 116 (93.5%) had low-level social support. The global PSQI score was positively correlated with anxiety and depression scores, while the global PSSS score was negatively correlated with anxiety and depression scores (p<0.01). Multiple linear regression analysis showed that the length of the post-liver transplant period, the type of residence, BMI, depressive symptoms, and anxiety symptoms were important factors affecting sleep quality among liver transplant patients (p<0.05). Conclusions Our findings showed high prevalence and incidence of poor sleep quality in liver transplant recipients in outpatient follow-up, with significant correlations with anxiety, depression, and social support, and it was affected by multiple factors. This indicates a need for further research on the follow-up results of sleep and the benefits of comprehensive interventions involving psychosocial factors in liver transplant recipients in China.
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Affiliation(s)
- Xiao Zhu
- Research Center of Chinese Health Ministry on Transplantation Medicine Engineering and Technology, The Third Affiliated Hospital, Central South University, Changsha, Hunan, China (mainland)
| | - Yingzi Ming
- Research Center of Chinese Health Ministry on Transplantation Medicine Engineering and Technology, The Third Affiliated Hospital, Central South University, Changsha, Hunan, China (mainland)
| | - Jia Liu
- Research Center of Chinese Health Ministry on Transplantation Medicine Engineering and Technology, The Third Affiliated Hospital, Central South University, Changsha, Hunan, China (mainland)
| | - Lifang Liu
- Research Center of Chinese Health Ministry on Transplantation Medicine Engineering and Technology, The Third Affiliated Hospital, Central South University, Changsha, Hunan, China (mainland)
| | - Ke Cheng
- Research Center of Chinese Health Ministry on Transplantation Medicine Engineering and Technology, The Third Affiliated Hospital, Central South University, Changsha, Hunan, China (mainland)
| | - Ping Mao
- Research Center of Chinese Health Ministry on Transplantation Medicine Engineering and Technology, The Third Affiliated Hospital, Central South University, Changsha, Hunan, China (mainland).,Nursing School of Central South University, Changsha, Hunan, China (mainland)
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