1
|
Vondo N, Mabaso M, Ginyana T, Malope L, Moyo S, Zungu N, Shisana O. Determinants of psychological distress among individuals who are aware of their HIV serostatus in South Africa: findings from the 2017 national HIV prevalence, incidence, behavior, and communication survey. Front Public Health 2024; 12:1387878. [PMID: 38846607 PMCID: PMC11153803 DOI: 10.3389/fpubh.2024.1387878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Accepted: 05/10/2024] [Indexed: 06/09/2024] Open
Abstract
Introduction Psychological distress is a growing public health challenge among people living with HIV. This study investigated the prevalence of psychological distress among individuals who know their HIV positive or negative serostatus in South Africa using 2017 data from a nationwide cross-sectional household-based population survey. Methods The data for this secondary analysis was collected using a multi-stage stratified cluster randomized sampling design. Multivariable backward stepwise generalized linear regression models were fitted to determine factors associated with psychological distress as measured by the Kessler Scale (K10) among HIV-positive and HIV-negative individuals who know their serostatus in South Africa. Results Of 18,662 participants, psychological distress was 27.4% (95% CI: 25.3-29.7) among those HIV-positive and 20.1% (95% C: 18.8-21.4) among those HIV-negative. The odds of psychological distress were significantly higher among HIV-positive individuals who rated their health as fair/poor [AOR = 1.22 (95% CI: 1.09-1.35), p < 0.001], and the odds were lower among those residing in rural formal/farm areas [AOR = 0.85 (95% CI: 0.78-0.93), p < 0.001], and those with tertiary education level [AOR = 0.88 (95% CI: 0.78-0.99), p = 0.033]. The odds of psychological distress in HIV-negative individuals were significantly higher among females than males [AOR = 1.09 (95% CI: 1.05-1.14), p < 0.001], high-risk alcohol drinkers [AOR = 1.26 (95% CI: 1.02-1.57), p = 0.035] and hazardous alcohol drinkers [AOR = 1.09 (95% CI: 1.01-1.18), p = 0.028] than abstainers and those who rated their health as fair/poor rather than excellent/good [AOR = 1.18 (95% CI: 1.10-1.26), p < 0.001]. Conclusion The study underscores the importance of addressing, alcohol misuse and socio-structural inequalities linked to gender and race-based disparities, such as low educational attainment and unemployment, as critical factors associated with psychological distress in the study population.
Collapse
Affiliation(s)
- Noloyiso Vondo
- Public Health, Societies, and Belonging Division, Human Sciences Research Council, Pretoria, South Africa
| | - Musawenkosi Mabaso
- Public Health, Societies, and Belonging Division, Human Sciences Research Council, Pretoria, South Africa
| | - Thembelihle Ginyana
- Public Health, Societies, and Belonging Division, Human Sciences Research Council, Pretoria, South Africa
| | - Lesiba Malope
- Public Health, Societies, and Belonging Division, Human Sciences Research Council, Pretoria, South Africa
| | - Sizulu Moyo
- Public Health, Societies, and Belonging Division, Human Sciences Research Council, Pretoria, South Africa
- School of Nursing and Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Nompumelelo Zungu
- Public Health, Societies, and Belonging Division, Human Sciences Research Council, Pretoria, South Africa
- Nursing and Public Health, University of KwaZulu Natal, Durban, South Africa
| | - Olive Shisana
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
- EB Consulting, Pty, Ltd., Cape Town, South Africa
| |
Collapse
|
2
|
Skalski-Bednarz SB, Toussaint LL, Konaszewski K, Surzykiewicz J. Beyond HIV shame: the role of self-forgiveness and acceptance in living with HIV. AIDS Care 2024:1-10. [PMID: 38669668 DOI: 10.1080/09540121.2024.2343770] [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: 04/25/2023] [Accepted: 04/10/2024] [Indexed: 04/28/2024]
Abstract
Research is developing regarding the beneficial association of spirituality with numerous health outcomes in people living with HIV (PLWH); however, little attention has been paid to the association of these variables with forgiveness and acceptance of HIV status. This cross-sectional study used a sample of 648 PLWH from the United States aged 18-61 to test the mediating effects of forgiveness and acceptance of HIV status on the relationship of spirituality and life satisfaction. As expected, self-forgiveness and acceptance straightforwardly and serially explained the links between spirituality and life satisfaction, while forgiveness of others was not a significant mediator for this relationship. The data obtained suggest that spirituality and self-forgiveness are two important targets for future experimental research, and therapeutic interventions on these variables may have a synergistic effect of increasing acceptance and improving well-being in PLWH.
Collapse
Affiliation(s)
- Sebastian Binyamin Skalski-Bednarz
- Faculty of Philosophy and Education, Katholische Universität Eichstätt-Ingolstadt, Eichstätt, Germany
- School of Human Sciences, University of Economics and Human Sciences in Warsaw, Warsaw, Poland
| | | | | | - Janusz Surzykiewicz
- Faculty of Philosophy and Education, Katholische Universität Eichstätt-Ingolstadt, Eichstätt, Germany
- Faculty of Education, Cardinal Stefan Wyszyński University in Warsaw, Warsaw, Poland
| |
Collapse
|
3
|
Kabunga A, Kigongo E, Udho S, Auma AG, Tumwesigye R, Musinguzi M, Acup W, Ruth Akello A, Okalo P, Nabaziwa J, Mwirotsi Shikanga E, Halima N. An Analysis of Post-Traumatic Stress Disorder and Quality of Life Among Adults Living with HIV in Western Uganda. HIV AIDS (Auckl) 2024; 16:73-82. [PMID: 38476595 PMCID: PMC10929256 DOI: 10.2147/hiv.s449298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 02/27/2024] [Indexed: 03/14/2024] Open
Abstract
Background HIV/AIDS remains a significant global public health issue, profoundly impacting infected individuals. Living with HIV involves complex mental health dynamics, with post-traumatic stress disorder (PTSD) being a prevalent challenge. This study aims to examine the correlation between PTSD and quality of life among HIV-positive individuals in western Uganda. Material and Methods Conducted between May and July 2023, this facility-based cross-sectional study surveyed 439 participants from four HIV clinics in southwestern Uganda. Data were collected through interviewer-administered questionnaires, analyzed using descriptive statistics, simple linear regression, and multiple linear regression (p<0.05). Results Respondents had a mean age of 40.6 years, with 68.3% female, 54.9% married, and 55.1% lacking formal education. The reported PTSD prevalence among HIV-positive individuals was 33.7%, significantly correlating with reduced overall quality of life (β = -4.52; p<0.001). The social quality of life had the highest mean score of 14.24 (±3.45) while the environmental quality of life had the lowest mean score 11.89 (±2.68). Conclusion Our study reveals a concerning prevalence of PTSD, affecting 1 in 3 individuals, emphasizing the pressing need for comprehensive mental health support within HIV care settings. We observed a significant negative impact of PTSD on overall quality of life, particularly in physical and social aspects. Integrating mental health screening into routine HIV care is crucial, using validated tools like the PSTD Checklist Civilian Version, alongside training for healthcare providers to recognize PTSD symptoms in the context of HIV diagnosis and treatment.
Collapse
Affiliation(s)
- Amir Kabunga
- Department of Psychiatry, Faculty of Medicine, Lira University, Lira City, Uganda
| | - Eustes Kigongo
- Department of Environmental Health and Disease Control, Faculty of Public Health, Lira University, Lira City, Uganda
| | - Samson Udho
- Department of Midwifery, Faculty of Nursing and Midwifery, Lira University, Lira City, Uganda
| | - Anna Grace Auma
- Department of Midwifery, Faculty of Nursing and Midwifery, Lira University, Lira City, Uganda
| | - Raymond Tumwesigye
- Department of Midwifery, Faculty of Nursing and Midwifery, Lira University, Lira City, Uganda
| | - Marvin Musinguzi
- Department of Community Health, Faculty of Public Health, Lira University, Lira City, Uganda
| | - Walter Acup
- Department of Community Health, Faculty of Public Health, Lira University, Lira City, Uganda
| | - Anne Ruth Akello
- Department of Environmental Health and Disease Control, Faculty of Public Health, Lira University, Lira City, Uganda
| | - Ponsiano Okalo
- Department of Psychiatry, Faculty of Medicine, Lira University, Lira City, Uganda
| | - Jannat Nabaziwa
- Department of Community Health, Faculty of Public Health, Lira University, Lira City, Uganda
| | | | - Namata Halima
- Department of Mental Health, Makerere University, Kampala City, Uganda
| |
Collapse
|
4
|
Mesa-Vieira C, Didden C, Schomaker M, Mouton JP, Folb N, van den Heuvel LL, Gastaldon C, Cornell M, Tlali M, Kassanjee R, Franco OH, Seedat S, Haas AD. Post-traumatic stress disorder as a risk factor for major adverse cardiovascular events: a cohort study of a South African medical insurance scheme. Epidemiol Psychiatr Sci 2024; 33:e5. [PMID: 38314538 PMCID: PMC10894700 DOI: 10.1017/s2045796024000052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 01/02/2024] [Accepted: 01/04/2024] [Indexed: 02/06/2024] Open
Abstract
AIMS Prior research, largely focused on US male veterans, indicates an increased risk of cardiovascular disease among individuals with post-traumatic stress disorder (PTSD). Data from other settings and populations are scarce. The objective of this study is to examine PTSD as a risk factor for incident major adverse cardiovascular events (MACEs) in South Africa. METHODS We analysed reimbursement claims (2011-2020) of a cohort of South African medical insurance scheme beneficiaries aged 18 years or older. We calculated adjusted hazard ratios (aHRs) for associations between PTSD and MACEs using Cox proportional hazard models and calculated the effect of PTSD on MACEs using longitudinal targeted maximum likelihood estimation. RESULTS We followed 1,009,113 beneficiaries over a median of 3.0 years (IQR 1.1-6.0). During follow-up, 12,662 (1.3%) persons were diagnosed with PTSD and 39,255 (3.9%) had a MACE. After adjustment for sex, HIV status, age, population group, substance use disorders, psychotic disorders, major depressive disorder, sleep disorders and the use of antipsychotic medication, PTSD was associated with a 16% increase in the risk of MACEs (aHR 1.16, 95% confidence interval (CI) 1.05-1.28). The risk ratio for the effect of PTSD on MACEs decreased from 1.59 (95% CI 1.49-1.68) after 1 year of follow-up to 1.14 (95% CI 1.11-1.16) after 8 years of follow-up. CONCLUSION Our study provides empirical support for an increased risk of MACEs in males and females with PTSD from a general population sample in South Africa. These findings highlight the importance of monitoring cardiovascular risk among individuals diagnosed with PTSD.
Collapse
Affiliation(s)
- Cristina Mesa-Vieira
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Christiane Didden
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Department of Sociology, Ludwig-Maximilians-Universität Munich, Munich, Germany
| | - Michael Schomaker
- Department of Statistics, Ludwig-Maximilians-Universität Munich, Munich, Germany
- Centre for Infectious Disease Epidemiology & Research, School of Public Health, University of Cape Town, Cape Town, South Africa
| | - Johannes P. Mouton
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | | | - Leigh L. van den Heuvel
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- South African Medical Research Council/Stellenbosch University Genomics of Brain Disorders Research Unit, Stellenbosch University, Cape Town, South Africa
| | - Chiara Gastaldon
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Morna Cornell
- Centre for Infectious Disease Epidemiology & Research, School of Public Health, University of Cape Town, Cape Town, South Africa
| | - Mpho Tlali
- Centre for Infectious Disease Epidemiology & Research, School of Public Health, University of Cape Town, Cape Town, South Africa
| | - Reshma Kassanjee
- Centre for Infectious Disease Epidemiology & Research, School of Public Health, University of Cape Town, Cape Town, South Africa
| | - Oscar H. Franco
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Department of Global Public Health & Bioethics, University Medical Center Utrecht, Utrecht, Netherlands
| | - Soraya Seedat
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- South African Medical Research Council/Stellenbosch University Genomics of Brain Disorders Research Unit, Stellenbosch University, Cape Town, South Africa
| | - Andreas D. Haas
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| |
Collapse
|
5
|
Brown LL, Perkins JM, Shepherd BE, Ramasamy S, Wilkins M, Osman A, Turner M, Link T, Edgerton R, Suiter SV, Pettit AC. Piloting Safety and Stabilization: A Multi-component Trauma Intervention to Improve HIV Viral Suppression, Retention in Care, and Post-traumatic Stress Disorder in a Southern United States HIV Service Organization. AIDS Behav 2024; 28:174-185. [PMID: 37751108 PMCID: PMC10868717 DOI: 10.1007/s10461-023-04174-1] [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: 09/09/2023] [Indexed: 09/27/2023]
Abstract
In this observational study, we assessed the extent to which a community-created pilot intervention, providing trauma-informed care for persons with HIV (PWH), affected HIV care retention and viral suppression among PWH attending an HIV Services Organization in the Southern US. PWH with trauma exposure and/or trauma symptoms (N = 166) were offered a screening and referral to treatment (SBIRT) session. Per self-selection, 30 opted-out, 29 received SBIRT-Only, 25 received SBIRT-only but reported receiving other behavioral health care elsewhere, and 82 participated in the Safety and Stabilization (S&S) Intervention. Estimates from multivariable logistic regression analyses indicated S&S Intervention participants had increased retention in HIV care (adjusted odds ratio [aOR] 5.46, 95% CI 1.70-17.50) and viral suppression (aOR 17.74, 95% CI 1.83-172), compared to opt-out participants. Some evidence suggested that PTSD symptoms decreased for intervention participants. A randomized controlled trial is needed to confirm findings.
Collapse
Affiliation(s)
- Leslie Lauren Brown
- Psychiatry and Behavioral Sciences, Meharry Medical College, 1005 Dr. DB Todd Jr. Blvd, Nashville, TN, 37203, USA.
- Infectious Disease Division, Vanderbilt University School of Medicine, Nashville, TN, USA.
| | - Jessica M Perkins
- Human and Organizational Development, Vanderbilt University, Nashville, TN, USA
- Vanderbilt Institute for Global Health, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Bryan E Shepherd
- Infectious Disease Division, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Shobana Ramasamy
- Infectious Disease Division, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Megan Wilkins
- Infectious Disease Clinic, St. Jude Children's Research Hospital, Memphis, TN, USA
| | | | - Megan Turner
- Infectious Disease Division, Vanderbilt University School of Medicine, Nashville, TN, USA
| | | | - Ryan Edgerton
- Department of Family & Community Medicine, Meharry Medical College, Nashville, TN, USA
| | - Sarah V Suiter
- Human and Organizational Development, Vanderbilt University, Nashville, TN, USA
| | - April C Pettit
- Infectious Disease Division, Vanderbilt University School of Medicine, Nashville, TN, USA
| |
Collapse
|
6
|
Barrett BW, Meanley S, Brennan-Ing M, Haberlen SA, Ware D, Detels R, Friedman MR, Plankey MW. The Relationship Between Posttraumatic Stress Disorder and Alcohol Misuse and Smoking Among Aging Men Who Have Sex With Men: No Evidence of Exercise or Volunteering Impact. J Aging Health 2023:8982643231215475. [PMID: 37976419 DOI: 10.1177/08982643231215475] [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: 11/19/2023]
Abstract
OBJECTIVES To determine if the association between posttraumatic stress disorder (PTSD) and substance use (alcohol misuse or smoking tobacco) is mediated/moderated by exercise or volunteering among aging (≥40 years) men who have sex with men (MSM), and if this mediation/moderation differs by HIV serostatus. METHODS Multicenter AIDS Cohort Study data were used. Three datasets with PTSD measured during different time periods (10/1/2017-3/31/2018, 898 men; 4/1/2018-9/30/2018, 890 men; 10/1/2018-3/31/2019, 895 men) were analyzed. Longitudinal mediation analyses estimated the mediation effect of exercise and volunteering on the outcomes. RESULTS Nine percent of MSM had evidence of PTSD. There was no statistically significant mediation effect of exercise or volunteering regardless of substance use outcome. The odds of smoking at a future visit among MSM with PTSD were approximately double those of MSM without PTSD. Results did not differ by HIV serostatus. DISCUSSION There is a particular need for effective smoking cessation interventions for aging MSM with PTSD.
Collapse
Affiliation(s)
- Benjamin W Barrett
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Steven Meanley
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Mark Brennan-Ing
- Brookdale Center for Healthy Aging, The City University of New York, Hunter College, NY, New York, USA
| | - Sabina A Haberlen
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Deanna Ware
- Department of Medicine, Georgetown University Medical Center, Washington, DC, USA
| | - Roger Detels
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - M Reuel Friedman
- Department of Urban-Global Public Health, School of Public Health, Rutgers University, Newark, NJ, USA
| | - Michael W Plankey
- Department of Medicine, Georgetown University Medical Center, Washington, DC, USA
| |
Collapse
|
7
|
Skeen SJ, Tokarz S, Gasik RE, Solano CM, Smith EA, Sagoe MB, Hudson LV, Steele K, Theall KP, Clum GA. A Trauma-Informed, Geospatially Aware, Just-in-Time Adaptive mHealth Intervention to Support Effective Coping Skills Among People Living With HIV in New Orleans: Development and Protocol for a Pilot Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e47151. [PMID: 37874637 PMCID: PMC10630874 DOI: 10.2196/47151] [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: 03/14/2023] [Revised: 06/27/2023] [Accepted: 09/12/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND In 2020, Greater New Orleans, Louisiana, was home to 7048 people living with HIV-1083 per 100,000 residents, 2.85 times the US national rate. With Louisiana routinely ranked last in indexes of health equity, violent crime rates in Orleans Parish quintupling national averages, and in-care New Orleans people living with HIV surviving twice the US average of adverse childhood experiences, accessible, trauma-focused, evidence-based interventions (EBIs) for violence-affected people living with HIV are urgently needed. OBJECTIVE To meet this need, we adapted Living in the Face of Trauma, a well-established EBI tailored for people living with HIV, into NOLA GEM, a just-in-time adaptive mobile health (mHealth) intervention. This study aimed to culturally tailor and refine the NOLA GEM app and assess its acceptability; feasibility; and preliminary efficacy on care engagement, medication adherence, viral suppression, and mental well-being among in-care people living with HIV in Greater New Orleans. METHODS The development of NOLA GEM entailed identifying real-time tailoring variables via a geographic ecological momentary assessment (GEMA) study (n=49; aim 1) and place-based and user-centered tailoring, responsive to the unique cultural contexts of HIV survivorship in New Orleans, via formative interviews (n=12; aim 2). The iOS- and Android-enabled NOLA GEM app leverages twice-daily GEMA prompts to offer just-in-time, in-app recommendations for effective coping skills practice and app-delivered Living in the Face of Trauma session content. For aim 3, the pilot trial will enroll an analytic sample of 60 New Orleans people living with HIV individually randomized to parallel NOLA GEM (intervention) or GEMA-alone (control) arms at a 1:1 allocation for a 21-day period. Acceptability and feasibility will be assessed via enrollment, attrition, active daily use through paradata metrics, and prevalidated usability measures. At the postassessment time point, primary end points will be assessed via a range of well-validated, domain-specific scales. Care engagement and viral suppression will be assessed via past missed appointments and self-reported viral load at 30 and 90 days, respectively, and through well-demonstrated adherence self-efficacy measures. RESULTS Aims 1 and 2 have been achieved, NOLA GEM is in Beta, and all aim-3 methods have been reviewed and approved by the institutional review board of Tulane University. Recruitment was launched in July 2023, with a target date for follow-up assessment completion in December 2023. CONCLUSIONS By leveraging user-centered development and embracing principles that elevate the lived expertise of New Orleans people living with HIV, mHealth-adapted EBIs can reflect community wisdom on posttraumatic resilience. Sustainable adoption of the NOLA GEM app and a promising early efficacy profile will support the feasibility of a future fully powered clinical trial and potential translation to new underserved settings in service of holistic survivorship and well-being of people living with HIV. TRIAL REGISTRATION ClinicalTrials.gov NCT05784714; https://clinicaltrials.gov/ct2/show/NCT05784714. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/47151.
Collapse
Affiliation(s)
- Simone J Skeen
- Department of Social, Behavioral, and Population Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, United States
- Center for Community-Engaged Artificial Intelligence, Tulane University, New Orleans, LA, United States
- Department of Psychology, Hunter College, City University of New York, New York, NY, United States
| | - Stephanie Tokarz
- Department of Social, Behavioral, and Population Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, United States
| | - Rayna E Gasik
- Department of Social, Behavioral, and Population Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, United States
| | - Chelsea McGettigan Solano
- Department of Social, Behavioral, and Population Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, United States
| | - Ethan A Smith
- Department of Social, Behavioral, and Population Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, United States
| | - Momi Binaifer Sagoe
- Department of Social, Behavioral, and Population Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, United States
| | - Lauryn V Hudson
- Department of Social, Behavioral, and Population Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, United States
| | - Kara Steele
- Department of Social, Behavioral, and Population Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, United States
| | - Katherine P Theall
- Department of Social, Behavioral, and Population Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, United States
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, United States
| | - Gretchen A Clum
- Department of Social, Behavioral, and Population Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, United States
| |
Collapse
|
8
|
Toussaint LL, Skalski-Bednarz SB, Lanoix JP, Konaszewski K, Surzykiewicz J. The Relationship Between Forgiveness and Health Outcomes Among People Living with HIV: A Cross-Sectional Study in France. AIDS Behav 2023; 27:3332-3341. [PMID: 37093538 PMCID: PMC10516774 DOI: 10.1007/s10461-023-04052-w] [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] [Accepted: 03/29/2023] [Indexed: 04/25/2023]
Abstract
Research to date has shown that HIV infection is a highly stressful experience for individuals, and one of the key adaptive resources after such painful experiences may be forgiveness. The aim of the present study was to examine the associations between dispositional forgiveness (assessed using Mullet's Forgivingness Questionnaire and Toussaint's Forgiveness Scale), perceived stress (single-item measure of stress symptoms), health perception (EuroQol visual analogue version of the scale) and life satisfaction (Satisfaction With Life Scale) in people living with HIV (PLWH) in France. Paper surveys were completed by 222 PLWH aged 18-78 (57% male). Multiple regression analysis revealed that sensitivity to circumstances, unconditional forgiveness, self-forgiveness, and forgiveness of others were significant predictors of health and happiness. Mediation analysis showed that these relationships are completely mediated by perceived stress. The present findings suggest that forgiveness and perceived stress may be important variables for healing in PLWH. Interventions designed to improve forgiveness and self-forgiveness may result in improved health and life satisfaction in PLWH.
Collapse
Affiliation(s)
- Loren L. Toussaint
- Department of Psychology, Luther College, 700 College Dr, Decorah, IA 52101 USA
| | - Sebastian Binyamin Skalski-Bednarz
- Faculty of Education, Cardinal Stefan Wyszyński University in Warsaw, Warsaw, Poland
- Faculty of Philosophy and Education, Catholic University of Eichstätt-Ingolstadt, Eichstätt, Germany
| | - Jean-Philippe Lanoix
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD USA
| | | | - Janusz Surzykiewicz
- Faculty of Education, Cardinal Stefan Wyszyński University in Warsaw, Warsaw, Poland
- Faculty of Philosophy and Education, Catholic University of Eichstätt-Ingolstadt, Eichstätt, Germany
| |
Collapse
|
9
|
Marks S. A clinical review of antidepressants, their sexual side-effects, post-SSRI sexual dysfunction, and serotonin syndrome. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2023; 32:678-682. [PMID: 37495413 DOI: 10.12968/bjon.2023.32.14.678] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
Abstract
Depression and anxiety are common, with one in six people experiencing symptoms in any given week. Of these people, 8.32 million are prescribed antidepressants. People living with HIV are likely to experience psychiatric disorder, with one in three experiencing depression and anxiety, and being at greater risk of developing post-traumatic stress disorder. Sexual side-effects of psychotropic medication are very common, cause distress, and can persist even after the medication has been withdrawn. Antidepressants are powerful drugs and can have severe interactions with many other substances. This article seeks to raise awareness of sexual side-effects of psychotropic medications and draw attention to ethical issues related to post selective serotonin reuptake inhibitor sexual dysfunction (PSSD). Additional risk factors and interactions between psychotropic medications and recreational drugs are identified. Recommendations are made to improve care and clinical outcomes through the development of therapeutic alliances.
Collapse
Affiliation(s)
- Stephen Marks
- Senior Lecturer in Mental Health Nursing, Manchester Metropolitan University, Manchester
| |
Collapse
|
10
|
Velasco J, Sanmartín FJ, Gálvez-Lara M, Cuadrado F, Moriana JA. Psychological Effects of Professional Exposure to Trauma and Human Suffering: Systematic Review and Meta-Analysis. TRAUMA, VIOLENCE & ABUSE 2023; 24:1656-1676. [PMID: 35202557 DOI: 10.1177/15248380221074314] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Over the past decades, a growing interest has emerged toward understanding the impact that the exposure to human suffering produces in mental health professionals, leading to the identification of three constructs: vicarious traumatization (VT), compassion fatigue (CF), and secondary trauma (ST). However, little is known about how these conditions affect psychologists. A systematic review and a meta-analysis were conducted to examine the evidence about the effects of occupational exposure to trauma and suffering in studies that included psychologists among their samples. Fifty-two studies were included comprising 10,233 participants. Overall, the results showed that most professionals did not experience relevant distress due to their work, yet some of them developed clinically significant symptoms (i.e., PTSD). However, solid conclusions could not be drawn due to the numerous methodological difficulties found in this research field (i.e., group heterogeneity, lack of comparison groups, and conceptual overlap). Thus, it is necessary to further investigate this topic with scientific rigor to understand these stressors and develop evidence-based interventions.
Collapse
Affiliation(s)
- Judith Velasco
- Department of Psychology, University of Cordoba, Spain
- Maimonides Institute for Biomedical Research of Cordoba (IMIBIC), Spain
- Reina Sofia University Hospital, Spain
| | | | - Mario Gálvez-Lara
- Department of Psychology, University of Cordoba, Spain
- Maimonides Institute for Biomedical Research of Cordoba (IMIBIC), Spain
- Reina Sofia University Hospital, Spain
| | - Fátima Cuadrado
- Department of Psychology, University of Cordoba, Spain
- Maimonides Institute for Biomedical Research of Cordoba (IMIBIC), Spain
- Reina Sofia University Hospital, Spain
| | - Juan A Moriana
- Department of Psychology, University of Cordoba, Spain
- Maimonides Institute for Biomedical Research of Cordoba (IMIBIC), Spain
- Reina Sofia University Hospital, Spain
| |
Collapse
|
11
|
Koenig LJ, Khurana N, Islam MH, Gopalappa C, Farnham PG. Closing the gaps in the continuum of depression care for persons with HIV: modeling the impact on viral suppression in the United States. AIDS 2023; 37:1147-1156. [PMID: 36927810 PMCID: PMC10986188 DOI: 10.1097/qad.0000000000003536] [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] [Indexed: 03/18/2023]
Abstract
OBJECTIVE Depression is prevalent among persons with HIV (PWH) and is associated with poorer adherence and lack of viral load suppression (VLS). When treated for depression, PWH are more likely to stay in HIV care and adhere to medications; however, for many PWH, depression is not adequately diagnosed or treated. We adapted Progression and Transmission of HIV (PATH 3.0), a U.S. agent-based dynamic stochastic simulation model, by incorporating a continuum of depression care and estimating the impact on VLS of an enhanced depression diagnosis and care scenario (EDC). METHODS We compared EDC - whereby every PWH is assessed for depression, gets treatment if diagnosed, and of those, half achieve remission - to a status quo scenario (SQ) on VLS. Based on published findings, assumptions for SQ were: 34.7% depressed, 45% diagnosed, 55.3% treated and 33% of treated achieving remission. Compared to PWH without depression, we assumed the probability of being non-virally suppressed increased by 1.57 times for PWH with depression (PWH-D), and by 0.95 times for PWH with remitted depression. RESULTS There was an average increase of 14.6% (11.5-18.5) in the proportion of PWH-D who achieved VLS in EDC compared to SQ. Among all PWH, there was a 4.7% (3.4-6.0) increase in the proportion who achieved VLS in EDC compared to SQ. CONCLUSIONS Fully diagnosing and adequately treating depression would improve health and quality of life for a substantial proportion of PWH-D and result in a nearly 5% increase in expected rates of VLS in the United States, supporting national prevention goals.
Collapse
Affiliation(s)
- Linda J Koenig
- Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Nidhi Khurana
- Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Md Hafizul Islam
- Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Chaitra Gopalappa
- Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
- University of Massachusetts-Amherst, Amherst, Massachusetts, USA
| | - Paul G Farnham
- Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| |
Collapse
|
12
|
Kozlakidis Z, Shi P, Abarbanel G, Klein C, Sfera A. Recent Developments in Protein Lactylation in PTSD and CVD: Novel Strategies and Targets. BIOTECH 2023; 12:38. [PMID: 37218755 PMCID: PMC10204439 DOI: 10.3390/biotech12020038] [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: 02/18/2023] [Revised: 04/27/2023] [Accepted: 05/01/2023] [Indexed: 05/24/2023] Open
Abstract
In 1938, Corneille Heymans received the Nobel Prize in physiology for discovering that oxygen sensing in the aortic arch and carotid sinus was mediated by the nervous system. The genetics of this process remained unclear until 1991 when Gregg Semenza while studying erythropoietin, came upon hypoxia-inducible factor 1, for which he obtained the Nobel Prize in 2019. The same year, Yingming Zhao found protein lactylation, a posttranslational modification that can alter the function of hypoxia-inducible factor 1, the master regulator of cellular senescence, a pathology implicated in both post-traumatic stress disorder (PTSD) and cardiovascular disease (CVD). The genetic correlation between PTSD and CVD has been demonstrated by many studies, of which the most recent one utilizes large-scale genetics to estimate the risk factors for these conditions. This study focuses on the role of hypertension and dysfunctional interleukin 7 in PTSD and CVD, the former caused by stress-induced sympathetic arousal and elevated angiotensin II, while the latter links stress to premature endothelial cell senescence and early vascular aging. This review summarizes the recent developments and highlights several novel PTSD and CVD pharmacological targets. They include lactylation of histone and non-histone proteins, along with the related biomolecular actors such as hypoxia-inducible factor 1α, erythropoietin, acid-sensing ion channels, basigin, and Interleukin 7, as well as strategies to delay premature cellular senescence by telomere lengthening and resetting the epigenetic clock.
Collapse
Affiliation(s)
- Zisis Kozlakidis
- International Agency for Research on Cancer, World Health Organization (IARC/WHO), 69372 Lyon, France
| | - Patricia Shi
- Department of Psychiatry, Loma Linda University, Loma Linda, CA 92350, USA
| | - Ganna Abarbanel
- Patton State Hospital, University of California, Riverside, CA 92521, USA
| | | | - Adonis Sfera
- Patton State Hospital, University of California, Riverside, CA 92521, USA
- Department of Psychiatry, University of California, Riverside, CA 92521, USA
| |
Collapse
|
13
|
Taft TH, Carlson DA, Marchese SH, Pandolfino JE. Initial assessment of medical post-traumatic stress among patients with chronic esophageal diseases. Neurogastroenterol Motil 2023; 35:e14540. [PMID: 36703507 PMCID: PMC10133015 DOI: 10.1111/nmo.14540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/20/2022] [Accepted: 01/11/2023] [Indexed: 01/28/2023]
Abstract
BACKGROUND Diagnosis and management of chronic esophageal disease requires the use of potentially traumatic medical procedures, performed with or without sedation. Medical trauma and post-traumatic stress (PTS) are emerging as important considerations in patients with digestive illness. To date, no study assesses medical PTS from procedures in patients with esophageal disease. METHODS Adult patients with achalasia, eosinophilic esophagitis, gastroesophageal reflux disease, or functional esophageal disease at a university-based gastroenterology clinic completed: Post-Traumatic Stress Disorder Checklist for DSM-5 (PCL-5), Gastroesophageal Disease Questionnaire, Brief Esophageal Dysphagia Questionnaire, Northwestern Esophageal Quality of Life scale (HRQoL), NIH-PROMIS Depression scale, and a study-specific questionnaire about esophageal procedures (endoscopy with sedation; functional lumen imaging probe (FLIP) with sedation; high-resolution manometry (HRM); wireless pH testing; or 24-h pH-impedance testing). KEY RESULTS Half of 149 participants reported at least one traumatic procedure, with HRM most often cited. Only 2.7% met the cutoff for PTS on PCL-5. This increased to 7.1% for patients with a traumatic procedure combined with experiencing intense fear. Rates of moderate-severe PTS ranged from 7.4%-12% for all patients and 14%-29% for those with a traumatic procedure with fear. Medical PTS was associated with poorer HRQoL, and increased esophageal symptoms, depression, and hypervigilance and symptom anxiety. CONCLUSIONS & INFERENCES Preliminary evidence suggests medical PTS affects few patients with esophageal disease. However traumatic procedures, most often associated with HRM, significantly increase PTS symptoms. The potential impacts of medical PTS on esophageal patient assessment and outcomes are considerable and warrants further study.
Collapse
Affiliation(s)
- Tiffany H Taft
- Division of Gastroenterology & Hepatology Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Dustin A Carlson
- Division of Gastroenterology & Hepatology Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Sara H Marchese
- Division of Gastroenterology & Hepatology Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - John E Pandolfino
- Division of Gastroenterology & Hepatology Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| |
Collapse
|
14
|
Abas MA, Müller M, Gibson LJ, Derveeuw S, Dissanayake N, Smith P, Verhey R, Danese A, Chibanda D. Prevalence of post-traumatic stress disorder and validity of the Impact of Events Scale - Revised in primary care in Zimbabwe, a non-war-affected African country. BJPsych Open 2023; 9:e37. [PMID: 36794523 PMCID: PMC9970167 DOI: 10.1192/bjo.2022.621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND A critical step in research on the epidemiology of post-traumatic stress disorder (PTSD) in low-resource settings is the validation of brief self-reported psychometric tools available in the public domain, such as the Impact Event Scale - Revised (IES-R). AIMS We aimed to investigate the validity of the IES-R in a primary healthcare setting in Harare, Zimbabwe. METHOD We analysed data from a survey of 264 consecutively sampled adults (mean age 38 years; 78% female). We estimated the area under the receiver operating characteristic curve and sensitivity, specificity and likelihood ratios for different cut-off points of the IES-R, against a diagnosis of PTSD made using the Structured Clinical Interview for DSM-IV. We performed factor analysis to evaluate construct validity of the IES-R. RESULTS The prevalence of PTSD was 23.9% (95% CI 18.9-29.5). The area under the curve for the IES-R was 0.90. At a cut-off of ≥47, the sensitivity of the IES-R to detect PTSD was 84.1 (95% CI 72.7-92.1) and specificity was 81.1 (95% CI 75.0-86.3). Positive and negative likelihood ratios were 4.45 and 0.20, respectively. Factor analysis revealed a two-factor solution, with both factors showing good internal consistency (Cronbach's factor-1 α = 0.95, factor-2 α = 0.76). In a post hoc analysis, we found the brief six-item IES-6 also performed well, with an area under the curve of 0.87 and optimal cut-off of 15. CONCLUSIONS The IES-R and IES-6 had good psychometric properties and performed well for indicating possible PTSD, but at higher cut-off points than those recommended in the Global North.
Collapse
Affiliation(s)
- Melanie A Abas
- Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Monika Müller
- Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; and Clinic for Adult Psychiatry and Psychotherapy, University Hospital of Psychiatry Bern, Switzerland
| | - Lorna J Gibson
- Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, UK
| | - Sarah Derveeuw
- Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Nirosha Dissanayake
- Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Patrick Smith
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | | | - Andrea Danese
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK; Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK; and National and Specialist CAMHS Clinic for Trauma, Anxiety, and Depression, South London and Maudsley NHS Foundation Trust, UK
| | - Dixon Chibanda
- Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, UK; Friendship Bench, Harare, Zimbabwe; and Department of Psychiatry, University of Zimbabwe, Zimbabwe
| |
Collapse
|
15
|
Tang C, Goldsamt LA, Yu S, Zhao T, Wang H. Psychological pathways to HIV-related posttraumatic stress disorder symptoms among people living with HIV in China: the mediating role of rumination. AIDS Care 2023; 35:165-169. [PMID: 35749306 DOI: 10.1080/09540121.2022.2092713] [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: 10/17/2022]
Abstract
The occurrence of HIV-related posttraumatic stress disorder (PTSD) compromises the physical and mental health of people living with HIV (PLWH). This study examined the psychological pathways of HIV-related PTSD symptoms considering the influence of rumination in PLWH of China. A cross-sectional survey was conducted in Changsha, China. The data were collected using the PTSD Checklist-Civilian Version, the Ruminative Response Scale, the Multidimensional Scale of Perceived Social Support, and measures of sociodemographic and HIV-related clinic characteristics. A total of 602 PLWH were surveyed. The average score of HIV-related PTSD symptoms was (34.54 ± 13.58). The mediation model showed that perceived social stigma and physical health exhibited direct associations with PTSD symptoms (β = 0.093, -0.145, respectively), while the direct relations of family support, friend support and significant others support to PTSD symptoms were not significant. Rumination mediated the effect of perceived social stigma (β = 0.077), physical health (β = -0.150), family support (β = -0.144) and friend support (β = -0.105) on PTSD symptoms. The study findings underscore the importance of routinely assessing PTSD for PLWH, and developing trauma-focused interventions that alleviate HIV-related PTSD symptoms and reduce rumination while improving social support and physical health and reducing social stigma.
Collapse
Affiliation(s)
- Chulei Tang
- School of Nursing, Nanjing Medical University, Nanjing, People's Republic of China
- Xiangya School of Nursing, Central South University, Changsha, People's Republic of China
| | - Lloyd A Goldsamt
- Rory Meyers College of Nursing, New York University, New York, NY, USA
| | - Simin Yu
- Xiangya School of Nursing, Central South University, Changsha, People's Republic of China
| | - Ting Zhao
- Xiangya School of Nursing, Central South University, Changsha, People's Republic of China
| | - Honghong Wang
- Xiangya School of Nursing, Central South University, Changsha, People's Republic of China
| |
Collapse
|
16
|
Harris RM, Xavier Hall CD, Mills JC, Pence BW, Bgneris J, Wong FY. Beyond Viral Suppression-The Impact of Cumulative Violence on Health-Related Quality of Life Among a Cohort of Virally Suppressed Patients. J Acquir Immune Defic Syndr 2023; 92:59-66. [PMID: 36099083 PMCID: PMC11079852 DOI: 10.1097/qai.0000000000003099] [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: 12/28/2021] [Accepted: 09/06/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To elucidate how and in what ways cumulative violence affects health-related quality of life (HRQoL) among a clinical cohort of virally stable people living with HIV. DESIGN We used data from the University of North Carolina Center for AIDS Research HIV clinical cohort. Our analysis was limited to participants with an undetectable viral load (<200) and those who completed the Clinical, Sociodemographic, and Behavioral Survey between 2008 and 2017 ( n = 284). METHODS A path analysis was used to test our primary hypothesis that the effect of cumulative violence on HRQoL would be mediated through symptoms of post-traumatic stress disorder (PTSD), depressive symptoms, and HIV symptom distress. RESULTS The impact of cumulative violence on HRQoL was fully mediated by symptoms of PTSD, depressive symptoms, and HIV symptom distress. Greater exposure to violence was associated with higher odds of PTSD symptoms ( P <0.001), increased depressive symptoms ( P <0.001), and increased HIV symptom distress ( P < 0.01). HIV symptom distress displayed the largest association with HRQoL ( P < 0.001), followed by depressive symptoms ( P = 0.001) and PTSD symptoms ( P < 0.001). These factors explained approximately 51% of the variance in HRQoL ( R2 = 0.51, P < 0.001). CONCLUSIONS Our findings indicate that addressing physical and mental health symptoms rooted in violent victimization should be a point of focus in efforts to improve HRQoL among people living with HIV who are virally stable.
Collapse
Affiliation(s)
- Rachel M Harris
- Center for Population Sciences and Health Equity College of Social Work, Florida State University, FL
| | - Casey D Xavier Hall
- Institute for Sexual and Gender Minority Health and Wellbeing, Center for Population Sciences and Health Equity, Northwestern University, Florida State University, FL
| | - Jon C Mills
- College of Medicine, Center for Population Sciences and Health Equity, Florida State University, FL
| | - Brian W Pence
- Gillings School of Global Public Health, University of North Carolina, Chape Hill, NC
| | - Jessica Bgneris
- Center for Population Sciences and Health Equity, Graduate College of Social Work, Florida State University, University of Houston, TX; and
| | - Frankie Y Wong
- Center for Population Sciences and Health Equity, Florida State University, FL
| |
Collapse
|
17
|
Mallik I, Pasvol T, Frize G, Ayres S, Barrera A, Fidler S, Foster C. Psychotic disorders in young adults with perinatally acquired HIV: a UK case series. Psychol Med 2022; 52:2263-2269. [PMID: 33183361 DOI: 10.1017/s0033291720004134] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Increasing numbers of children with perinatally acquired HIV (PaHIV) are transitioning into adult care. People living with behaviourally acquired HIV are known to be at more risk of psychosis than uninfected peers. Young adults living with PaHIV face numerous risk factors; biological: lifelong exposure to a neurotrophic virus, antiretroviral medication and immune dysfunction during brain development, and environmental; social deprivation, ethnicity-related discrimination, and migration-related issues. To date, there is little published data on the prevalence of psychotic illness in young people growing up with PaHIV. METHODS We conducted a retrospective case note review of all individuals with PaHIV aged over 18 years registered for follow up at a dedicated clinic in the UK (n = 184). RESULTS In total, 12/184 (6.5%), median age 23 years (interquartile range 21-26), had experienced at least one psychotic episode. The presentation and course of the psychotic episodes experienced by our cohort varied from short-lived symptoms to long term illness and nine (75%) appear to have developed a severe and enduring mental illness requiring long term care. CONCLUSION The prevalence of psychosis in our cohort was clearly above the lifetime prevalence of psychosis in UK individuals aged 16-34 years, which has been reported to be 0.5-1.0%. This highlights the importance of clinical vigilance regarding the mental health of young people growing up with PaHIV and the need to integrate direct access to mental health services within the HIV centres providing medical care.
Collapse
Affiliation(s)
- I Mallik
- Buckinghamshire Healthcare NHS Trust, Aylesbury, UK
- Department of Medicine, Imperial College London, London, UK, and Imperial College NIHR BRC, London, UK
| | - T Pasvol
- 900 Clinic, Imperial College Healthcare NHS Trust, London, UK
| | - G Frize
- 900 Clinic, Imperial College Healthcare NHS Trust, London, UK
| | - S Ayres
- 900 Clinic, Imperial College Healthcare NHS Trust, London, UK
| | - A Barrera
- Oxford Health NHS Trust, Oxford, UK and Oxford University Department of Psychiatry, Oxford, UK
| | - S Fidler
- Department of Medicine, Imperial College London, London, UK, and Imperial College NIHR BRC, London, UK
- 900 Clinic, Imperial College Healthcare NHS Trust, London, UK
| | - C Foster
- 900 Clinic, Imperial College Healthcare NHS Trust, London, UK
| |
Collapse
|
18
|
de Wit JBF, Adam PCG, den Daas C, Jonas K. Sexually transmitted infection prevention behaviours: health impact, prevalence, correlates, and interventions. Psychol Health 2022; 38:675-700. [PMID: 35748408 DOI: 10.1080/08870446.2022.2090560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Sexually transmitted infections (STIs) remain a major public health threat, disproportionately affecting young people, and men who have sex with men. In this narrative review of the current state of behavioural science research on STI prevention, we consider the definition, health impacts, correlates and determinants, and interventions to promote STI prevention behaviour. Research on STI prevention behaviour has extended from a focus on abstinence, partner reduction and condom use, to also include novel preventive behaviours, notably treatment-as-prevention, pre-exposure prophylaxis (i.e., the preventive use of medicines by uninfected people), and vaccination for some STIs. Social-cognitive factors specified by, for instance the theory of planned behaviour, are critical proximal determinants of STI prevention behaviours, and related interventions can effectively promote STI prevention behaviours. Social-ecological perspectives highlight that individual-level determinants are embedded in more distal environmental influences, with social stigma especially affecting STI prevention behaviours and requiring effective intervention. Further to providing a major domain of application, STI prevention also poses critical challenges and opportunities for health psychology theory and research. We identify a need for health behaviour theory that addresses the processes linking multiple levels of influence on behaviour and provides practical guidance for multi-level behaviour change interventions adapted to specific contexts.
Collapse
Affiliation(s)
- John B. F. de Wit
- Department of Interdisciplinary Social Science, Utrecht University, Utrecht, The Netherlands
- Centre for Social Research in Health, UNSW Sydney, Kensington, Australia
| | - Philippe C. G. Adam
- Centre for Social Research in Health, UNSW Sydney, Kensington, Australia
- Institute for Prevention and Social Research, Bangkok, Thailand
| | - Chantal den Daas
- Department of Interdisciplinary Social Science, Utrecht University, Utrecht, The Netherlands
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, Scotland
| | - Kai Jonas
- Department of Work and Social Psychology, Maastricht University, Maastricht, The Netherlands
| |
Collapse
|
19
|
Arebo B, Ewach GF, Omara J, Oyella P, Aciro Lucky R, Kabunga A. Post-Traumatic Stress Disorder and Coping Strategies Among People with HIV in Lira District, Uganda: A Cross-Sectional Study. HIV AIDS (Auckl) 2022; 14:255-264. [PMID: 35669392 PMCID: PMC9166282 DOI: 10.2147/hiv.s358575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 05/26/2022] [Indexed: 01/06/2023] Open
Abstract
Background Post-traumatic stress disorder (PTSD) is the most commonly reported mental health consequence following traumatic events. However, little is known about how people with HIV cope with the PTSD burden in Lira city, northern Uganda. Materials and Methods This study was carried out in Lira District Health Centre IVs from February 10, 2022, to March 10, 2022. A facility-based cross-sectional study was employed among 390 people with HIV attending Lira Health Centre IVs. A consecutive sampling technique was used to select the sample size. Questionnaires were used to collect data. A binary logistic regression model was fitted to identify factors associated with independent variables, and AOR was employed to estimate the strength of association between independent and dependent variables. Results Results show that the estimated prevalence of PTSD was 254 (65.1%) and was higher among the females 191 (75.2%), those with no formal education 143 (56.3%), aged 40 years and above 121 (47.6%), and married 127 (50.0%). Results indicate that male respondents had a 51% reduced odds of developing PTSD burden compared to female respondents (AOR: 0.49; 95% CI: 0.30–0.81; P = 0.005). Individuals who did not use planning activities as a coping strategy had more than 2-fold increased odds of experiencing PTSD compared to those who planned activities (AOR: 2.43; 1.26–4.70; P = 0.008). Participants who did not have emotional support had close to 3-fold increased chances of developing PTSD compared to those who had emotional support (AOR: 2.94; 1.74–4.98; P ≤ 0.001). Participants who indicated they were not taking recourse to spirituality had more than 4-fold increased odds of experiencing PTSD compared to those who had spirituality (AOR: 4.40; 1.83–10.46; P = 0.001). Conclusion A considerable burden of PTSD among HIV clients attending health centre IVs in Lira District was notably higher and was associated with gender, planning activities, emotional support and spirituality. Early screening of PTSD among HIV clients is needed to alleviate the burden. There is also a need to include PTSD treatment services in the treatment programme of HIV care services in health centre IVs in Lira District.
Collapse
Affiliation(s)
- Benedict Arebo
- Department of Nursing and Midwifery, Lira University, Lira City, Uganda
| | | | - Jacob Omara
- Faculty of Medicine, Gulu University, Gulu city, Uganda
| | - Pamella Oyella
- Department of Nursing and Midwifery, Lira University, Lira City, Uganda
| | - Ruth Aciro Lucky
- Department of Psychiatry, Faculty of medicine, Lira University, Lira City, Uganda
| | - Amir Kabunga
- Department of Psychiatry, Faculty of medicine, Lira University, Lira City, Uganda
- Correspondence: Amir Kabunga, Department of Psychiatry, Faculty of medicine, Lira University, Lira City, Uganda, Email
| |
Collapse
|
20
|
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.
Collapse
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
| |
Collapse
|
21
|
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]
|
22
|
Folayan MO, Ibigbami O, ElTantawi M, Abeldaño GF, Ara E, Ayanore MA, Ellakany P, Gaffar B, Al-Khanati NM, Idigbe I, Ishabiyi AO, Jafer M, Khan ATA, Khalid Z, Lawal FB, Lusher J, Nzimande NP, Osamika BE, Popoola BO, Quadri MFA, Roque M, Shamala A, Al-Tammemi AB, Yousaf MA, Virtanen JI, Zuñiga RAA, Okeibunor JC, Nguyen AL. Factors associated with COVID-19 pandemic induced post-traumatic stress symptoms among adults living with and without HIV in Nigeria: a cross-sectional study. BMC Psychiatry 2022; 22:48. [PMID: 35062920 PMCID: PMC8777174 DOI: 10.1186/s12888-021-03617-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 11/24/2021] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Nigeria is a country with high risk for traumatic incidences, now aggravated by the COVID-19 pandemic. This study aimed to identify differences in COVID-19 related post-traumatic stress symptoms (PTSS) among people living and not living with HIV; to assess whether PTSS were associated with COVID-19 pandemic-related anger, loneliness, social isolation, and social support; and to determine the association between PTSS and use of COVID-19 prevention strategies. METHODS The data of the 3761 respondents for this analysis was extracted from a cross-sectional online survey that collected information about mental health and wellness from a convenience sample of adults, 18 years and above, in Nigeria from July to December 2020. Information was collected on the study's dependent variable (PTSS), independent variables (self-reported COVID-19, HIV status, use of COVID-19 prevention strategies, perception of social isolation, access to emotional support, feelings of anger and loneliness), and potential confounder (age, sex at birth, employment status). A binary logistic regression model tested the associations between independent and dependent variables. RESULTS Nearly half (47.5%) of the respondents had PTSS. People who had symptoms but were not tested (AOR = 2.20), felt socially isolated (AOR = 1.16), angry (AOR = 2.64), or lonely (AOR = 2.19) had significantly greater odds of reporting PTSS (p < 0.001). People living with HIV (AOR = 0.39), those who wore masks (AOR = 0.62) and those who had emotional support (AOR = 0.63), had lower odds of reporting PTSS (p < .05). CONCLUSION The present study identified some multifaceted relationships between post-traumatic stress, HIV status, facemask use, anger, loneliness, social isolation, and access to emotional support during this protracted COVID-19 pandemic. These findings have implications for the future health of those affected, particularly for individuals living in Nigeria. Public health education should be incorporated in programs targeting prevention and prompt diagnosis and treatment for post-traumatic stress disorder at the community level.
Collapse
Affiliation(s)
- Morenike Oluwatoyin Folayan
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria. .,Department of Child Dental Health, Obafemi Awolowo University, Ile-Ife, 22005, Nigeria.
| | - Olanrewaju Ibigbami
- grid.10824.3f0000 0001 2183 9444Department of Mental Health, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Maha ElTantawi
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.7155.60000 0001 2260 6941Department of Pediatric Dentistry and Dental public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Giuliana Florencia Abeldaño
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,School of Medicine, University of Sierra Sur, Oaxaca, Mexico
| | - Eshrat Ara
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.412997.00000 0001 2294 5433Government College for Women, Maulana Azad Road, Srinagar, J&K India
| | - Martin Amogre Ayanore
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.449729.50000 0004 7707 5975Department of Health Policy Planning and Management, School of Public Health, University of Health and Allied Sciences, Ho, Ghana
| | - Passent Ellakany
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.411975.f0000 0004 0607 035XDepartment of Substitutive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Balgis Gaffar
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.411975.f0000 0004 0607 035XDepartment of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Nuraldeen Maher Al-Khanati
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.449576.d0000 0004 5895 8692Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Syrian Private University, Damascus, Syria
| | - Ifeoma Idigbe
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.416197.c0000 0001 0247 1197Clinical Sciences Department, Nigerian Institute of Medical Research, Lagos, Nigeria
| | - Anthonia Omotola Ishabiyi
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.16463.360000 0001 0723 4123Centre for Rural Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Mohammed Jafer
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.411831.e0000 0004 0398 1027Department of Preventive Dental Sciences, Jazan University, Jazan, Saudi Arabia ,grid.5012.60000 0001 0481 6099Department of Health Promotion, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Abeedah Tu-Allah Khan
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.11173.350000 0001 0670 519XSchool of Biological Sciences, University of the Punjab, Quaid-e-Azam Campus, Lahore, Pakistan
| | - Zumama Khalid
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.11173.350000 0001 0670 519XSchool of Biological Sciences, University of the Punjab, Quaid-e-Azam Campus, Lahore, Pakistan
| | - Folake Barakat Lawal
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.9582.60000 0004 1794 5983Department of Periodontology and Community Dentistry, University of Ibadan and University College Hospital, Ibadan, Nigeria
| | - Joanne Lusher
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.449469.20000 0004 0516 1006Regent’s University London, London, United Kingdom
| | - Ntombifuthi P. Nzimande
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.9008.10000 0001 1016 9625Department of Economic and Social Geography, University of Szeged, Szeged, Hungary
| | - Bamidele Emmanuel Osamika
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.259956.40000 0001 2195 6763Department of Psychology, Miami University Oxford, Ohio, USA
| | - Bamidele Olubukola Popoola
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.9582.60000 0004 1794 5983Department of Child Oral Health, University of Ibadan, Ibadan, Nigeria
| | - Mir Faeq Ali Quadri
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.411831.e0000 0004 0398 1027Department of Preventive Dental Sciences, Division of Dental Public Health, College of Dentistry, Jazan University, Jazan, Kingdom of Saudi Arabia
| | - Mark Roque
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.412892.40000 0004 1754 9358Department of Maternity & Childhood Nursing, College of Nursing, Taibah University, Madinah, Kingdom of Saudi Arabia
| | - Anas Shamala
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.444917.b0000 0001 2182 316XDepartment of Preventive and Biomedical Science, College of Dentistry, University of Science & Technology, Sanaa, Yemen
| | - Ala’a B. Al-Tammemi
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.7122.60000 0001 1088 8582Department of Family and Occupational Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary ,grid.7122.60000 0001 1088 8582Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Muhammad Abrar Yousaf
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.11173.350000 0001 0670 519XInstitute of Zoology, University of the Punjab, Quaid-i-Azam Campus, Lahore, 54590 Pakistan
| | - Jorma I. Virtanen
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.1374.10000 0001 2097 1371Faculty of Medicine, University of Turku, Turku, Finland
| | - Roberto Ariel Abeldaño Zuñiga
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,Postgraduate Department, University of Sierra Sur, Oaxaca, Mexico
| | - Joseph Chukwudi Okeibunor
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.463718.f0000 0004 0639 2906Research Development and Innovations, Assistant Regional Director Cluster, WHO Regional Office for Africa, Brazzaville, Congo
| | - Annie Lu Nguyen
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.42505.360000 0001 2156 6853Department of Family Medicine, University of Southern California, Keck School of Medicine, Los Angeles, CA USA
| |
Collapse
|
23
|
Rzeszutek M, Gruszczyńska E, Pięta M, Malinowska P. HIV/AIDS stigma and psychological well-being after 40 years of HIV/AIDS: a systematic review and meta-analysis. Eur J Psychotraumatol 2021; 12:1990527. [PMID: 34868481 PMCID: PMC8635597 DOI: 10.1080/20008198.2021.1990527] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 09/27/2021] [Accepted: 09/27/2021] [Indexed: 01/01/2023] Open
Abstract
Background In June 2021, 40 years have passed since the first cases of HIV infection were detected. Nonetheless, people living with HIV (PLWH) still suffer from intense HIV-related distress and trauma, which is nowadays mostly linked to the still-existing stigmatization of PLWH. Objectives The aim of this systematic review and meta-analysis was to examine the association between HIV/AIDS stigma and psychological well-being among PLWH. We also explored whether this association varies as a function of sociodemographic and clinical characteristics as well as study publication year and stigma measurement. Method A structured literature search was performed on Web of Science, Scopus, PsyARTICLES, MedLine, ProQuest, and Google Scholar databases. The inclusion criteria were quantitative, peer-reviewed articles published in English between 1996 and 2020. Results After selection, 64 articles were accepted for further analysis (N = 25,294 participants). The random-effects pooled estimate revealed an overall negative and medium-strength association between stigma and well-being (r = -.31, 95% CI [-.35; -.26]). The participants' age modified this effect with a stronger association for older PLWH. Other sociodemographic and clinical variables as well as publication year and stigma measurement did not explain the variation in association between stigma and well-being across studies. Conclusions The present meta-analysis and systematic review not only showed an expected negative relationship between stigma and well-being but also revealed a substantial heterogeneity between studies that suggests a strong role of context of a given study. This finding calls for more advanced theoretical and analytical models to identify protective and vulnerability factors to effectively address them in clinical practice and interventions.
Collapse
Affiliation(s)
| | - Ewa Gruszczyńska
- Faculty of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland
| | | | - Paula Malinowska
- Faculty of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland
| |
Collapse
|
24
|
Smith PJ, Joseph Davey DL, Schmucker L, Bruns C, Bekker LG, Medina-Marino A, Thirumurthy H, Buttenheim AM. Participatory Prototyping of a Tailored Undetectable Equals Untransmittable Message to Increase HIV Testing Among Men in Western Cape, South Africa. AIDS Patient Care STDS 2021; 35:428-434. [PMID: 34739334 DOI: 10.1089/apc.2021.0101] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Daily antiretroviral therapy (ART) suppresses viral replication, rendering HIV undetectable through viral load (VL) testing. People living with HIV (PLWH) who have an undetectable VL cannot transmit HIV to sexual partners or through giving birth, a message commonly referred to as U = U (undetectable equals untransmittable). To increase knowledge and understanding of U = U among men, who have poorer HIV testing and treatment outcomes than women, we engaged men from high HIV burden communities in Cape Town in two interactive human-centered design cocreation workshops to develop local U = U messaging for men. Two trained workshop facilitators, explained the U = U message to 39 adult men (in two separate workshops), and asked them how to effectively communicate U = U to other men in the local language (isiXhosa). Participant-designed messages sought to inform men about U = U to help assuage fears of testing HIV positive (by removing the stigma of living with HIV and being a vector of disease), and to explain that ART enables PLWH to live normal healthy lives, making HIV "untransmittable" to sex partners. Participants' messages emphasized that when virally suppressed, "I cannot spread HIV to the other person" and "(the pill) keeps on killing the virus so I can live a normal life for the rest of my life." Men cocreated simple local U = U messages to address fears of testing HIV positive and emphasizing ART's positive effects. Cocreated tailored messaging may reduce stigma associated with living with HIV and improve the uptake of HIV testing and treatment among South African men. This study was registered at clinicaltrials.gov under NCT04364165.
Collapse
Affiliation(s)
- Philip J Smith
- The Desmond Tutu HIV Centre, Institute for Infectious Disease and Molecular Medicine, Faculty of Health Science, University of Cape Town, Cape Town, South Africa
| | - Dvora L Joseph Davey
- The Desmond Tutu HIV Centre, Institute for Infectious Disease and Molecular Medicine, Faculty of Health Science, University of Cape Town, Cape Town, South Africa
- Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, California, USA
- Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Laura Schmucker
- Medical Ethics and Health Policy, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Center for Health Incentives and Behavioral Economics, Medical Ethics and Health Policy, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Cal Bruns
- Matchboxology, Kalk Bay, Cape Town, South Africa
| | - Linda-Gail Bekker
- The Desmond Tutu HIV Centre, Institute for Infectious Disease and Molecular Medicine, Faculty of Health Science, University of Cape Town, Cape Town, South Africa
| | - Andrew Medina-Marino
- Division of Men's Health, Desmond Tutu HIV Centre, University of Cape Town, South Africa
- Department of Psychiatry, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Harsha Thirumurthy
- Medical Ethics and Health Policy, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Center for Health Incentives and Behavioral Economics, Medical Ethics and Health Policy, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Alison M Buttenheim
- Medical Ethics and Health Policy, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Center for Health Incentives and Behavioral Economics, Medical Ethics and Health Policy, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| |
Collapse
|
25
|
Onu DU. Adherence to antiretroviral therapy mediates the link between posttraumatic stress disorder symptoms and health-related quality of life. SOUTH AFRICAN JOURNAL OF PSYCHOLOGY 2021. [DOI: 10.1177/00812463211048122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Human immunodeficiency virus is one of the trauma-inducing chronic illnesses with attendant-negative impact on health-related quality of life. Substantial literature exists on the association of posttraumatic stress disorder symptoms and health-related quality of life among people living with human immunodeficiency virus, but little is known about the pathways explaining this link. This study therefore examined the mediating role of adherence to antiretroviral therapy in the association between posttraumatic stress disorder symptoms and health-related quality of life among people living with human immunodeficiency virus. Nine hundred and sixty-nine people living with human immunodeficiency virus in Nigeria who were on antiretroviral therapy completed measures of posttraumatic stress disorder symptoms, adherence to antiretroviral therapy, and health-related quality of life. Hayes PROCESS macro for SPSS was used to analyse the data. Adherence to antiretroviral therapy mediated the association between posttraumatic stress disorder symptoms and health-related quality of life in the relationship and treatment impact domains, implying that poor adherence to antiretroviral therapy is a pathway through which posttraumatic stress disorder symptoms exert negative influence on health-related quality of life of people living with human immunodeficiency virus. Interventions aimed at reducing the impact of posttraumatic stress disorder symptoms on quality of life of people living with human immunodeficiency virus should focus on improving clients’ level of adherence to antiretroviral therapy treatment.
Collapse
|
26
|
Thurston IB, Howell KH, Kaufman CC, Mandell JE, Decker KM. Parenting in matched pairs of women of color experiencing intimate partner violence and living with and without HIV. J Trauma Stress 2021; 34:1005-1015. [PMID: 34637554 DOI: 10.1002/jts.22737] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 06/22/2021] [Accepted: 06/24/2021] [Indexed: 11/11/2022]
Abstract
This study explored the associations between depression and parenting among women of color with low income levels who were exposed to intimate partner violence (IPV) and HIV. Participants were 60 Black, multiracial, and Hispanic/Latina mothers (Mage = 36.66, SD = 6.99) in the midsouth region of the United States. Mothers were recruited from community organizations and reported their experiences with IPV, HIV, depression, potentially traumatic events (PTE), parenting practices, and child maladaptive functioning. Participants living with HIV and experiencing recent IPV (i.e., cases) were matched on age, race, ethnicity, and educational attainment with mothers experiencing recent IPV (i.e., controls), for a matched sample of 30 pairs. Analyses were conducted to examine how HIV status moderated the associations between depressive symptoms and both negative and positive parenting while accounting for PTE, child maladaptive functioning, and IPV severity. The moderation model for negative parenting was significant, f2 = 0.58, but the moderation model for positive parenting was not, p = .346. Specifically, moderation was supported, B = 0.43, 95% CI [0.03, 0.83], t(53) = 2.17, p = .035, indicating that the association between depressive symptoms and negative parenting was moderated by HIV status. The findings highlight the added burden of a physical health condition on parenting practices. Given the role of negative parenting (i.e., inconsistency, poor monitoring, corporal punishment) in exacerbating poor health outcomes among children exposed to adversity, clinicians and researchers must develop family-based strategies to decrease these practices.
Collapse
Affiliation(s)
- Idia B Thurston
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, Texas, USA
- Department of Health Promotion and Community Health Sciences, Texas A&M Health, College Station, Texas, USA
| | - Kathryn H Howell
- Department of Psychology, The University of Memphis, Memphis, Tennessee, USA
| | - Caroline C Kaufman
- Department of Psychology, The University of Memphis, Memphis, Tennessee, USA
| | - Jessica E Mandell
- Department of Psychology, The University of Memphis, Memphis, Tennessee, USA
| | - Kristina M Decker
- Department of Psychology, The University of Memphis, Memphis, Tennessee, USA
| |
Collapse
|
27
|
El Hajj M. Prevalence and associated factors of post-traumatic stress disorder in Lebanon: A literature review. Asian J Psychiatr 2021; 63:102800. [PMID: 34340165 DOI: 10.1016/j.ajp.2021.102800] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 07/24/2021] [Accepted: 07/27/2021] [Indexed: 10/20/2022]
Abstract
Lebanon has been under continuous conflict for more than four decades, putting millions of Lebanese at a high risk for post-traumatic stress disorder (PTSD) and creating a complex collective trauma. This paper aimed to review all studies from Lebanon reporting on PTSD in order to describe the prevalence of PTSD and its associated risk factors among Lebanese adults. A search of the MEDLINE/PubMed database was conducted in February/March 2021 to identify research articles on PTSD in Lebanese adults. A total of 1064 articles were identified, out of which 11 articles (5875 participants) published between 2003 and 2020 were included. PTSD prevalence estimates were highly variable across the individual studies, ranging from 2 % to 98 %. Female sex, economic hardship, lower educational level, being unemployed, number of witnessed/experienced traumatic events, and presence of comorbid psychological disorders were associated with higher PTSD rates. In light of the increasing PTSD risk in the Lebanese population as a result of the recent Beirut blast and ongoing social and economic crises, further culturally competent research is needed to provide rigorous evidence on the prevalence, course, and severity of PTSD in Lebanon.
Collapse
|
28
|
Taft TH, Quinton S, Jedel S, Simons M, Mutlu EA, Hanauer SB. Posttraumatic Stress in Patients With Inflammatory Bowel Disease: Prevalence and Relationships to Patient-Reported Outcomes. Inflamm Bowel Dis 2021; 28:710-719. [PMID: 34137449 PMCID: PMC8344426 DOI: 10.1093/ibd/izab152] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Patients with chronic illness are at increased risk for traumatic stress because of medical trauma. Initial studies of posttraumatic stress (PTS) in patients with inflammatory bowel disease (IBD) have found that approximately one-third of patients may experience significant PTS symptoms including flashbacks, nightmares, hypervigilance, disrupted sleep, and low mood. We aim to better characterize PTS in IBD and its relationship with patient outcomes in a large cohort of patients with IBD. METHODS Adult patients registered with the Crohn's & Colitis Foundation/University of North Carolina IBD Partners database were invited to complete a supplementary survey between February and July 2020. The Post Traumatic Stress Disorder Checklist-5th edition was administered as a supplemental survey. Additional data from IBD Partners included disease severity, surgery and hospital history, demographics, and health care utilization. RESULTS A total of 797 patients participated (452 with Crohn disease, 345 with ulcerative colitis). No impacts on response patterns because of the COVID-19 pandemic were found. Although 5.6% of the sample reported an existing PTS diagnosis because of IBD experiences, 9.6% of participants met the full IBD-related PTS diagnostic criteria per the Post Traumatic Stress Disorder Checklist-5th edition. Female patients, younger patients, those with less educational attainment, non-White patients, and Hispanic patients reported higher levels of PTS symptoms. Patients with higher PTS symptoms were more likely to have been hospitalized, have had surgery, have more severe symptoms, and not be in remission. Increased PTS was also associated with increased anxiety, depression, pain interference, fatigue, and health care utilization. CONCLUSIONS The present findings support prior research that approximately one-quarter to one-third of patients with IBD report significant symptoms of PTS directly from their disease experiences, and certain demographic groups are at higher risk. In addition, PTS is associated with several IBD outcomes. Patients with higher PTS symptoms are less likely to be in remission and may utilize more outpatient gastrointestinal services. Intervention trials to mitigate PTS symptoms in patients with IBD are warranted.
Collapse
Affiliation(s)
- Tiffany H Taft
- Northwestern University Feinberg School of Medicine, Division of Gastroenterology and Hepatology, Chicago, Illinois, USA,Address correspondence to: Tiffany Taft, PsyD, MIS, 676 North Saint Clair Street, Suite 1400, Chicago, IL 60611 ()
| | - Sarah Quinton
- Northwestern University Feinberg School of Medicine, Division of Gastroenterology and Hepatology, Chicago, Illinois, USA
| | - Sharon Jedel
- Rush University, Department of Digestive Disease and Nutrition, Chicago, Illinois, USA
| | - Madison Simons
- Northwestern University Feinberg School of Medicine, Division of Gastroenterology and Hepatology, Chicago, Illinois, USA
| | - Ece A Mutlu
- Rush University, Department of Digestive Disease and Nutrition, Chicago, Illinois, USA
| | - Stephen B Hanauer
- Northwestern University Feinberg School of Medicine, Division of Gastroenterology and Hepatology, Chicago, Illinois, USA
| |
Collapse
|
29
|
Bantjes J, Kagee A. Suicide Prevention in HIV Treatment Centres: Population Attributable Risk Analysis of Treating Common Mental Disorders. AIDS Behav 2021; 25:1864-1872. [PMID: 33387136 DOI: 10.1007/s10461-020-03116-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2020] [Indexed: 11/24/2022]
Abstract
The aim was to establish the potential reduction in non-fatal suicidal behaviour (NFSB) that could be achieved by treating common mental disorders (CMDs) among persons receiving HIV treatment. Data were collected from antiretroviral therapy (ART) patients in South Africa (n = 688). Structured Clinical Interviews assessed CMDs and the Mini International Neuropsychiatric Interview assessed 1-month prevalence of NFSB and suicide risk. Population Attributable Risk (PAR) analysis established the potential reduction in prevalence of NFSB and suicide risk that could be achieved by treating CMDs, with the simplifying assumption of a causal relationship between psychopathology and suicidality. Treating CMDs could result in as much as a 63.9% proportional reduction in the prevalence of suicide ideation, 84.2% proportional reduction in the prevalence of suicide plan, and 63.4% proportional decrease in prevalence of suicide risk. There is potential to significantly reduce NFSB among ART patients. Pragmatic trials are needed to evaluate the effects of treating CMDs in HIV treatment centres.
Collapse
Affiliation(s)
- Jason Bantjes
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Private Bag X1, Matieland, 7602, South Africa.
| | - Ashraf Kagee
- Department of Psychology, Stellenbosch University, Private Bag X1, Matieland, 7602, South Africa
| |
Collapse
|
30
|
Jones DL, Morgan KE, Martinez PC, Rodriguez VJ, Vazquez A, Raccamarich PD, Alcaide ML. COVID-19 Burden and Risk Among People With HIV. J Acquir Immune Defic Syndr 2021; 87:869-874. [PMID: 33999015 PMCID: PMC8136457 DOI: 10.1097/qai.0000000000002656] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 02/01/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND This study evaluated COVID-19 risk and burden among people with HIV (PWH) in a US city with high rates of HIV and SARS-CoV-2 transmissions and examined the interrelationship between psychosocial factors and COVID-19 risk and burden. SETTING Participants were drawn from an existing consent to contact database of PWH. Database candidates were PWH, adults older than 18 years, people who had received HIV care at the University of Miami HIV clinics, people who spoke English or Spanish, and people who had agreed to be contacted for future research. METHODS An adapted version of the Multicenter AIDS Cohort Study/Women's Interagency HIV Study Combined Cohort Study COVID-19 survey was telephonically administered, requiring 15-30 minutes. RESULTS Psychological stress was a predictor of COVID-19 burden (financial and social burden) and COVID-19 risk (health factors associated with an increased risk of severe health outcomes due to infection with COVID-19). Having a history of traumatic events was associated with increased COVID-19 risk, and stress was associated with increased COVID-19 burden and COVID-19 risk. CONCLUSIONS Overall, results suggest that the intersection of the HIV and COVID-19 pandemics may be most profound among those who have experienced traumatic events; and traumatic events may be associated with heightened vigilance regarding illness and infection.
Collapse
Affiliation(s)
- Deborah L. Jones
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL
| | | | | | - Violeta J. Rodriguez
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL
- Department of Psychology, University of Georgia, Athens, GA; and
| | - Andres Vazquez
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL
| | - Patricia D. Raccamarich
- Division of Infectious Diseases, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL
| | - Maria L. Alcaide
- Division of Infectious Diseases, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL
| |
Collapse
|
31
|
Stadtler H, Shaw G, Neigh GN. Mini-review: Elucidating the psychological, physical, and sex-based interactions between HIV infection and stress. Neurosci Lett 2021; 747:135698. [PMID: 33540057 PMCID: PMC9258904 DOI: 10.1016/j.neulet.2021.135698] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 01/26/2021] [Accepted: 01/28/2021] [Indexed: 12/21/2022]
Abstract
Stress is generally classified as any mental or emotional strain resulting from difficult circumstances, and can manifest in the form of depression, anxiety, post-traumatic stress disorder (PTSD), or other neurocognitive disorders. Neurocognitive disorders such as depression, anxiety, and PTSD are large contributors to disability worldwide, and continue to affect individuals and communities. Although these disorders affect men and women, women are disproportionately represented among those diagnosed with affective disorders, a result of both societal gender roles and physical differences. Furthermore, the incidence of these neurocognitive disorders is augmented among People Living with HIV (PLWH); the physical ramifications of stress increase the likelihood of HIV acquisition, pathogenesis, and treatment, as both stress and HIV infection are characterized by chronic inflammation, which creates a more opportunistic environment for HIV. Although the stress response is facilitated by the autonomic nervous system (ANS) and the hypothalamic pituitary adrenal (HPA) axis, when the response involves a psychological component, additional brain regions are engaged. The impact of chronic stress exposure and the origin of individual variation in stress responses and resilience are at least in part attributable to regions outside the primary stress circuity, including the amygdala, prefrontal cortex, and hippocampus. This review aims to elucidate the relationship between stress and HIV, how these interact with sex, and to understand the physical ramifications of these interactions.
Collapse
Affiliation(s)
- Hannah Stadtler
- Department of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Gladys Shaw
- Department of Anatomy and Neurobiology, Virginia Commonwealth University, Richmond, VA, USA
| | - Gretchen N Neigh
- Department of Anatomy and Neurobiology, Virginia Commonwealth University, Richmond, VA, USA.
| |
Collapse
|
32
|
Glynn TR, Mendez NA, Jones DL, Dale SK, Carrico AW, Feaster DJ, Rodriguez AE, Safren SA. Trauma exposure, PTSD, and suboptimal HIV medication adherence among marginalized individuals connected to public HIV care in Miami. J Behav Med 2020; 44:147-158. [PMID: 33098541 DOI: 10.1007/s10865-020-00191-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 10/08/2020] [Indexed: 11/25/2022]
Abstract
Individuals living with HIV report disproportionately high levels of trauma exposure and PTSD symptoms, both which have been associated with suboptimal ART adherence. Often conflated, the question arises as to which construct is driving subsequent HIV self-care behavior. Given the HIV disparities among Black and Hispanic/Latinx individuals, and that Miami is a geographic region with a high racial/ethnic minority make up and a unique socioeconomic environment, it is important to explore factors related to HIV outcomes in Miami to mitigate its uncontrolled epidemic. This study aimed to examine the association of trauma exposure, PTSD symptoms, and relevant additional key factors with adherence to ART among a sample of majority Black and Hispanic/Latinx individuals who are economically marginalized receiving public HIV care in Miami, FL (N = 1237) via a cross-sectional survey. Sequential linear regression was used to examine the study aim in four blocks: (1) trauma, (2) PTSD symptoms, and key covariates of ART adherence including (3) depression and substance use (potential psychological covariates), and (4) indicators of socioeconomic status (potential structural covariates). In the first block, trauma exposure was associated with worse adherence. However, in the second block, the association with trauma dropped and PTSD was significantly associated with worse adherence. Of note, for those experiencing high levels of trauma exposure, adherence was negatively impacted regardless of PTSD. When other key factors associated with adherence were entered in the third and fourth blocks, neither trauma exposure nor PTSD were uniquely significant. In this final model, depression, substance use, and unstable housing were uniquely associated with worse adherence. Trauma-informed models of HIV care that holistically address co-occurring factors are warranted to cater to communities with HIV health disparities and keep them from falling off the HIV care continuum.
Collapse
Affiliation(s)
- Tiffany R Glynn
- Department of Psychology, University of Miami Miller School of Medicine, Clinical Research Building, 1120 NW 14th St., Miami, FL, 33136, USA
| | - Noelle A Mendez
- Department of Psychology, University of Miami Miller School of Medicine, Clinical Research Building, 1120 NW 14th St., Miami, FL, 33136, USA
| | - Deborah L Jones
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Sannisha K Dale
- Department of Psychology, University of Miami Miller School of Medicine, Clinical Research Building, 1120 NW 14th St., Miami, FL, 33136, USA
| | - Adam W Carrico
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Daniel J Feaster
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Allan E Rodriguez
- Division of Infectious Disease, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Steven A Safren
- Department of Psychology, University of Miami Miller School of Medicine, Clinical Research Building, 1120 NW 14th St., Miami, FL, 33136, USA.
| |
Collapse
|
33
|
Hou J, Fu J, Meng S, Jiang T, Guo C, Wu H, Su B, Zhang T. Posttraumatic Stress Disorder and Nonadherence to Treatment in People Living With HIV: A Systematic Review and Meta-analysis. Front Psychiatry 2020; 11:834. [PMID: 32973579 PMCID: PMC7466667 DOI: 10.3389/fpsyt.2020.00834] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Accepted: 07/31/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) is a commonly reported and serious complication among people living with HIV (PLWH). PTSD may significantly increase unintentional non-adherence to antiretroviral therapy. In this systematic review and meta-analysis, we aimed to pool the observational studies exploring the association between PTSD and medication adherence among PLWH. METHODS Comprehensive searches were conducted in PubMed/Medline, Web of Science, PsycINFO, Google Scholar, and ProQuest to identify relevant articles and dissertations. A random effects meta-analysis with inverse variance weighting was used to summarize the odds ratio (OR) across studies. Meta-regression and subgroup analyses were also carried out to assess the moderation effects for potential factors. RESULTS By synthesizing 12 studies comprising 2489 participants, the pooled odd ratio of non-adherence to antiretroviral therapy was 1.19 (95% confidential interval (CI), 1.03-1.37, p = 0.02). No significant publication bias was detected by Egger's test (Intercept = 0.842, p = 0.284). Factors moderating the association were mean age of participants, depression adjustment, and depression (all p < 0.05). CONCLUSIONS This meta-analysis supports that PTSD is related to adherence in PLWH. The hypothesized mechanisms (avoidant behavior and cognitive impairment) underlying this association need further investigation. Overall, this study highlights that clinicians should thoughtfully integrate timely mental health intervention into routine care.
Collapse
Affiliation(s)
- Jianhua Hou
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory for HIV/AIDS Research, Beijing, China
| | - Jiangning Fu
- Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Siyan Meng
- School of Public Health, Yale University, New Haven, CT, United States
| | - Taiyi Jiang
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory for HIV/AIDS Research, Beijing, China
| | - Caiping Guo
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Hao Wu
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory for HIV/AIDS Research, Beijing, China
| | - Bin Su
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory for HIV/AIDS Research, Beijing, China
| | - Tong Zhang
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory for HIV/AIDS Research, Beijing, China
| |
Collapse
|