How newly diagnosed HIV-positive men who have sex with men look at HIV/AIDS - validation of the Chinese version of the revised illness perception questionnaire

Interaction of social support and depressive symptoms on antiretroviral therapy adherence among people living with HIV in South Africa

Background

Depression consistently emerges as a significant predictor of poor antiretroviral therapy (ART) adherence among adult people living with human immunodeficiency virus (PLHIV). However, a gap exists regarding how social support and depressive symptoms can interact to influence ART adherence among adult PLHIV in South Africa (SA).

Aim

To investigate the interaction between social support and depressive symptoms on ART adherence among adult PLHIV.

Setting

A tertiary hospital in Durban, KwaZulu-Natal province of SA.

Methods

Utilising a quantitative cross-sectional research design along with time location sampling technique (TLS); the study recruited 201 adult patients enrolled in an ART programme.

Results

The results indicated that depressive symptoms were significantly associated with ART adherence with and without the interaction (B = -0.105; odds ratios [OR] 0.901; 95% confidence intervals [CI] = 0.827, 0.981; p = 0.016), while social support was not significantly associated with ART adherence (B = 0.007; OR 1.007; 95%CI = 0.989, 1.025; p = 0.475). However, a statistically significant interaction was found between social support and depressive symptoms (B = -0.006; OR 0.994; 95%CI = 0.989, 1.000; p = 0.037) on ART adherence.

Conclusion

Based on the results, depressive symptoms significantly influenced ART adherence. However, social support did not buffer the adverse effects of clinical depression associated with poor ART adherence.

Contribution

This study provides an evidence-based approach to address gaps in the mental health and social well-being of PLHIV in the context of ART adherence.

HIV-related stress predicts depression over five years among people living with HIV

Introduction

Extant literature has demonstrated significant associations between HIV-related stress, social support, and depression among PLWH. However, little research has been conducted on the changes in such associations over time. Our study aims to explore the longitudinal relationship between HIV-related stress, social support, and depression among PLWH over five years.

Methods

320 PLWH were recruited from Changsha Center for Disease Control and Prevention (CDC), Hunan Province, China. They were assessed for depressive symptoms, HIV-related stress, and social support within 1 month of HIV diagnosis, 1 year after diagnosis, and five years after diagnosis, respectively. Relationships between these variables were examined using a fixed effect model.

Result

The prevalence of depressive symptoms within the first month, first year, and fifth years of HIV diagnosis was 35, 12.2, and 14.7%, respectively. Emotional stress (β: 0.730, 95% CI: 0.648, 0.811), social stress (β: 0.066, 95% CI: 0.010, 0.123), instrumental stress (β: 0.133, 95% CI:0.046, 0.221) positively predicted depression, while social support utilization (β: -0.176, 95% CI: -0.303, -0.049) negatively predicted depression.

Conclusion

Our study suggests that HIV-related stress and social support predict depressive symptoms over time among PLWH and that reducing HIV-related stress and improving social support in the early stages of diagnosis is extremely important in preventing depressive symptoms among PLWH.

Resilience among women with breast cancer surviving longer than five years: The relationship with illness perception and body image

PURPOSE

This study aimed to investigate the correlations and identify the relationships between the resilience, perception of illness and body image of women with breast cancer in the 5-year-or-above survivorship.

METHODS

We used convenient sampling to recruit from an outpatient department 106 women with breast cancer. The inclusion criteria were participants aged >20 years currently in a stable condition and were able to understand the Chinese language. Those women with mental health illness were excluded. All participants completed questionnaires on the following: demographic information, revision of illness perception (IPQ-R), body image scale (BIS), Eysenck personality questionnaire (EPQ), and resilience scale (RS). We conducted the structural equation modeling (SEM) to explore the factor structure.

RESULTS

SEM results showed a good fit to the data (comparative fit index = 0.97, Tucker-Lewis index = 0.94). Findings F indicated the existence of significant relationships between resilience and either illness perception or body image. Personality had a direct association with illness perception (β = 0.73, P < 0.05). Body image had an indirect effect on the relationship between resilience and illness perception (coefficient = -2.52; 95% bootstrapping CI = -31.36, -0.62).

CONCLUSIONS

Results indicated that illness perception is a crucial predictor for better resilience as mediated through body image. To provide adequate information to women with breast cancer can improve their perception of breast cancer more positively. Hence, their body image and their way of coping with survival life turn better.

New Insight into HIV-Related Psychological Distress: A Concept Analysis

Psychological distress is a frequently reported outcome measure in HIV research. However, because of its poor conceptualization, many studies only partially capture it because they focus solely on depression or anxiety based on symptoms. This study undertook a concept analysis of HIV-related psychological distress (HRPD) using Walker and Avant's method. The findings include HRPD's (a) attributes, including changes to emotional status, symptom burden, HIV disclosure distress and HIV-related stigma; (b) antecedents, including HIV-related stressors, cognitive appraisal of stressors and difficulty coping with the disease or treatment; and (c) consequences, including poor health outcomes and posttraumatic growth. Lazarus and Folkman's theory and the conservation of resources theory were adapted to further understand HRPD. This article provides insight into HRPD and increases the awareness of how to screen and assess HRPD at an early stage. The findings indicate the need to develop specific and rigorous measures and to provide appropriate interventions.

A qualitative inquiry into the patient-related barriers to linkage and retention in HIV care within the community setting

Background

People with the Human Immunodeficiency Virus (PWH) experience barriers to care within the community that impedes their progress from when they discover that they are HIV positive to becoming virally suppressed. For individuals with HIV to achieve sustained viral suppression, they must be linked to care to start receiving anti-retroviral therapy and remain retained in care for continuous treatment. However, HIV surveillance data shows that many PWH are not linked to care and become lost to continuous follow-up care. Although pharmacists, PWH, and social workers interact with one another and are aware of their roles in HIV care, their perspectives on barriers to linkage and retention in care have not been investigated collectively.

Objectives

Explore the perspectives of PWH, pharmacists, and social workers on barriers to linkage and retention of HIV care within the community setting.

Methods

Convenience sampling was used to recruit 15 stakeholders (five PWH, five community pharmacists, and five social workers) who participated in 1-h, semi-structured interviews based on three domains of the Patient-centered Medical Home Model including (1) experiences (individual and system-level barriers to care experienced by PWH), (2) activities (social workers and pharmacists initiatives that impact adherence to care)and (3) interventions (critical issues pharmacists can address in the community to engage PWH in their HIV care). We conducted a directed content analysis based on deductive coding. To establish rigor, we focused on Lincoln and Guba's criteria of rigorous qualitative methodology: credibility, dependability, confirmability, and transferability. Similarities and divergences of themes were discussed during data analysis and agreement was reached before interpretation.

Results

Emergent themes uncovered barriers to linkage and retention in HIV care as HIV-related stigma, having mental health illnesses including a history of substance abuse and social determinants of health such as homelessness, food insecurity, and insurance issues.

Conclusion

The perspectives of pharmacists, social workers, and PWH can provide insight into barriers that should be identified and addressed in people living with HIV to enhance their linkage and retention in care.

Community-engaged Intervention Mapping for CVD-prevention in Black and Latinx Sexual Minority Men with HIV in New York City: Protocol for A Web-based Mixed Method Study

Background

Approximately every 37 seconds, someone in the United States dies of cardiovascular disease (CVD). It has emerged as an important contributor to morbidity among persons with HIV. Black and Latinx sexual minority men are at higher risk of both HIV and CVD when compared to heterosexual, nonethnic or minority men. Persons with HIV have a 1.5 to 2-times risk of having CVD than do HIV-negative persons. Data suggest that by the year 2030, an estimated 78% of persons with HIV will have CVD. The relationship between HIV and CVD in marginalized populations is not well understood because overall awareness of HIV and CVD as comorbid conditions is low, which further heightens risk. This has created a critically pressing issue affecting underrepresented ethnic and racial populations with HIV and requires immediate efforts to mitigate risk.

Objective

The purpose of this formative, mixed methods study is to use a community-engaged approach to map a behavioral intervention for CVD prevention in Black and Latinx sexual minority men with HIV in New York City.

Methods

Literature reviews focused on behavioral prevention studies using intervention mapping. In Aim 1, we will use qualitative interviews with HIV program managers and community members to understand facilitators and barriers to CVD prevention, chronic illnesses of concern, and early design elements needed for a web-based CVD prevention intervention. In Aim 2, we will conduct qualitative interviews and administer cross-sectional validated surveys with 30 Black and Latinx sexual minority men with HIV. We will assess illness perceptions of chronic conditions, such as HIV, hypertension, and diabetes. A total of 40 participants (program managers and community members) for Aims 1 and 2 will be enrolled to participate. To develop the protocol, we will follow steps 1 through 3 (needs assessment, change objectives, implementation strategy) of intervention mapping, using mixed methods.

Results

The study was approved by New York University Institutional Review Board in February 2021 (IRB-FY2021-4772) and also by the Yale University Institutional Review Board in June 2022 (#2000031577). We anticipate completing data collection on or before December 2022. Early analyses suggested concerns about illnesses outside of HIV and associated comorbid conditions, such as COVID-19 and monkeypox. Additionally, we noted a strong interest in using a web-based platform for CVD prevention education.

Conclusions

Web-based, behavioral, CVD prevention interventions may be promising modalities to closing the cardiovascular health disparities gap in Black and Latinx sexual minority men with HIV by extending the reach of prevention interventions using community-informed approaches and technological modalities that have been underused in this population.

International Registered Report Identifier (IRRID)

RR1-10.2196/41602

The Impact of Pandemic-Related Life Stress on Internet Gaming: Social Cynicism and Gaming Motivation as Serial Mediators

A heightened interest in online gaming has emerged during COVID-19, and people have become increasingly vulnerable to internet gaming disorder (IGD). However, playing video games can also have a positive effect; gaming has been recognized as an efficient coping strategy. Currently, relatively little is understood about how online gaming can turn from an efficient coping strategy into an addiction disorder. This study investigated the mediating roles of social cynicism, escape and coping motives on the association between daily disruption during COVID-19 and IGD, seeking to reveal the underlying mechanism that influences the effects of gaming. A total of 203 participants in Hong Kong who reported having played electronic games during COVID-19 were surveyed. We conducted three hierarchical multiple regressions, then tested a serial mediation model using path analysis with structural equation modeling. The results revealed that escape motives significantly mediated the relationship between daily disruption related to COVID-19 and IGD, but no such effect was found for coping motives. Social cynicism alone was not a significant mediator, but social cynicism and escape motives in series mediated the relationship between daily disruption and IGD. These difference outcomes suggested different underlying mechanisms of escape and coping motives.

Relationships of Illness Perceptions with Depression and Anxiety in People Who Live with HIV/AIDS in a High-prevalence Ethnic Autonomous Region of Sichuan, China

Poor mental health challenges outcomes and treatment of people living with HIV/AIDS (PLWHA) and may be related to illness perceptions. To investigate if depression and anxiety were associated with illness perceptions, we drew a random sample of 729 PLWHA from 13 administrative units in Liangshan Prefecture, Sichuan, China. Among the PLWHA surveyed, 222 and 175 had probable anxiety or depression. In mixed-effects logistic regression, negative illness perceptions were associated with increased odds of anxiety/depression. In linear mixed-effects quantile regression, the relationship of more negative illness perceptions with more severe and frequent symptoms of anxiety/depression grew stronger in the upper quantiles of the GAD-7 and PHQ-9 distributions, well beyond scale cut-offs for probable clinical relevance. We hypothesize that negative illness perceptions of HIV/AIDS and severity of depression and anxiety symptoms may mutually reinforce each other. Illness perceptions are a promising intervention target for improving the mental health of PLWHA.

Awareness of HIV functional cure and willingness in participating in related clinical trials: comparison between antiretroviral naïve and experienced men who have sex with men living with HIV

Background

Human immunodeficiency virus (HIV) functional cure is a novel biomedical strategy characterized by sustained viral suppression without the need for life-long medications. The attitude of people living with HIV (PLHIV) towards functional cure and clinical trials are understudied. We aimed to examine the awareness and levels of anticipation for HIV functional cure among men who have sex with men (MSM) living with HIV, and their willingness to join trials as differentiated by their antiretroviral treatment status.

Methods

MSM living with HIV with and those without treatment history were recruited from Hong Kong’s HIV specialist clinics. Self-administered questionnaires covering behavioral profile, perceived impact of HIV cure, attitude towards HIV functional cure and related clinical trials were collected. Clinical data were separately transcribed. Determinants of perceptions and attitudes were identified by logistic regression models.

Results

Of 356 MSM living with HIV recruited, less than half (42%) were aware of HIV functional cure, but they had a high level of anticipation for it. Treatment-experienced participants were more likely to be aware of HIV functional cure. Awareness was associated with continued engagement in sexual activities after HIV diagnosis and sexually transmitted infection (STI) diagnosis. Higher anticipation was observed among older MSM living with HIV but it was negatively associated with one’s awareness. Over 90% were willing to join functional cure trials, especially those who had previously been diagnosed with STI and had engaged in chemsex in the past year. Advice from healthcare professional was an important factor considered by those willing to join clinical trials. Younger, better educated MSM, and those with lower CD4 counts were more concerned about potential risk of AIDS and potential complications upon trial participation.

Conclusions

MSM living with HIV, especially those sexually active, showed positive attitude towards functional cure and willingness to join related clinical trials despite low awareness. To enhance preparedness for HIV functional cure trials, community education, updated information and appropriate medical advice would be needed. Safety is a major concern for potential enrollees in HIV functional cure trials.

Illness perceptions, social support and antiretroviral medication adherence in people living with HIV in the greater Accra region, Ghana

AIM

To assess how illness perceptions and social support influence antiretroviral medication adherence in a HIV patient population in Ghana.

DESIGN

This study used a correlational research design with cross-sectional data.

METHOD

A total of 235 people living with HIV at two general hospitals in the Greater Accra Region of Ghana provided data on illness perceptions, social support and medication adherence. Hierarchical multiple regression test was used to analyse the data.

RESULTS

Illness perceptions' facets of timeline, personal control and treatment control were negatively associated with medication adherence, whereas emotional response was positively associated with adherence. Further, significant other support was negatively associated with adherence. Family and friend support were not associated with adherence. The findings offer preliminary evidence that illness perceptions may have utility for medication adherence in a HIV patient population in Ghana.

The psychometric properties of the Revised Illness Perception Questionnaire (IPQ-R) regarding Internet gaming disorder in a general population of Chinese adults

BACKGROUND AND AIMS

Internet gaming disorder (IGD) has been recognized as a mental illness. Cognitive and emotional illness representations affect coping and health outcomes. Very little is known about such perceptions related to IGD, in both general and diseased populations. This study examined the psychometric properties of the Revised Illness Perception Questionnaire (IPQ-R) for IGD in a general population that included mostly non-cases while a small proportion of the sample was IGD cases.

METHODS

An anonymous cross-sectional telephone survey was conducted in a random sample of 1,501 Chinese community-dwelling adults (41.3% male; mean age = 40.42, SD = 16.85) in Macao, China.

RESULTS

The confirmatory factor analysis identified a modified 6-factor model (i.e., timeline cyclical, consequences, personal control, treatment control, illness coherence, and emotional representations) of 26 items that showed satisfactory model fit and internal consistency. Criterion-related validity was supported by the constructs' significant correlations with stigma (positive correlations: timeline cyclical, consequence, emotional representations; negative correlations: illness coherence). Ever-gamers, compared to never-gamers, reported higher mean scores in the subscales of personal control and illness coherence, and lower mean scores in time cyclical, consequence, and emotional representations. Among the sampled gamers, probable IGD cases were more likely than non-IGD cases to perceive IGD as cyclical and involved more negative emotions.

CONCLUSIONS

This study shows that the revised 26-item version of IPQ-R is a valid instrument for assessing illness representation regarding IGD in a general population of Chinese adults. It can be used in future research that examines factors of incidence and prevention related to IGD.

Adaptation and psychometric testing of the Chinese version of the Revised Illness Perception Questionnaire for cervical cancer patients

PURPOSE

Illness perception is an important factor that influences psychological distress, coping behaviors, and illness outcomes, and this factor is often assessed by the Revised Illness Perception Questionnaire (IPQ-R). Data regarding illness perception among cervical cancer patients are limited, especially in China. The study aimed to adapt and psychometrically test the Chinese version of the IPQ-R for Cervical Cancer (CIPQ-R-CC).

METHODS

This was a methodological study. Before the survey, the identity and causal subscales (originally 14 and 18 items, respectively) were adapted. Data were collected from 220 cervical cancer patients (N = 220) from June 2018 to February 2019. Psychometric properties were assessed using explanatory factor analysis, confirmatory factor analysis, Pearson correlation coefficients, one-way analysis of variance, t-tests and Cronbach's alpha coefficients.

RESULTS

Eight identity items and twenty-six causal items were included in the CIPQ-R-CC, which showed acceptable content validity (I-CVI = 0.78-1.00, S-CVI = 0.97-0.99). A five-factor solution was obtained from the cause subscale by explanatory factor analysis, and these factors explained 60.19% of the total variance. For Part III of the CIPQ-R-CC, after deleting nine items and respecifying five error covariances, the proposed seven-factor model was confirmed. There were low to moderate correlations between the latent factors (r＜0.52). Known-group validity was demonstrated in some groups with different demographic characteristics. The Cronbach's alpha coefficients were also acceptable (0.60-0.88).

CONCLUSION

The CIPQ-R-CC is a reliable and valid tool for assessing illness perception among Chinese cervical cancer patients. Future studies are needed to verify its factor structure and to confirm its theoretical connotation.

Revista Digital Internacional de Psicología y Ciencia Social | Volumen 6 | Número 2 | Julio-Diciembre 2020 | Desafíos contemporáneos en educación y salud

El actual número se titula “Desafíos contemporáneos en educación y salud” y nos permite conocer acerca de los temas de interés para algunos investigadores y la manera en que se han abordado para su estudio. De manera coincidente este número ha sido trabajado en tiempos de pandemia, donde también nos hemos enfrentado a retos ante las nuevas condiciones para adaptarnos a nuevas formas de trabajo, mayoritariamente a distancia y por ahora a lo que parece ser “la nueva normalidad”, y con ello, en algunos meses, estaremos leyendo trabajos que surjan de estos momentos históricos mundiales, sus implicaciones, problemas, alcances y tal vez sus repercusiones.

Propiedades psicométricas del Cuestionario Revisado de Percepción de Enfermedad (IPQ-R) en adultos mexicanos con asma

El objetivo del presente trabajo fue evaluar las propiedades psicométricas de la versión en español del Illness Perception Questionnaire-Revised (IPQ-R) en pacientes mexicanos con asma. Se obtuvo una muestra por conveniencia de 315 adultos quienes respondieron una batería de evaluación. Los resultados muestran que el IPQ-R cuenta con una escala de identidad con 16 síntomas, escala de causas con 21 opciones y un grupo de subescalas en las que se agrupan cuatro factores y tres indicadores con αlfas que van de 0.591 a 0.874, con un KMO= 0.809 y una varianza total explicada del 51.611%, Se incluyen evidencias de validez convergente y divergente con variables de adherencia, creencias sobre medicamentos y control del asma. Se concluye que el IPQ-R es un instrumento confiable y valido para la evaluación de creencias sobre la enfermedad en adultos mexicanos con asma.

Translation and psychometric properties for the Demoralization Scale in Chinese breast cancer patients

PURPOSE

To translate and validate the Chinese version of the Demoralization Scale among breast cancer patients.

METHOD

A cross-sectional, descriptive correlational design was employed. From September 2016 to May 2017, 203 breast cancer survivors completed the survey. Content, construct, concurrent and divergent validity and internal consistency of the Chinese version of the Demoralization Scale were evaluated.

RESULTS

The proposed factor structures of the Demoralization Scale in previous studies cannot be confirmed using confirmatory factor analysis in the present study. Moreover, four factors were extracted by exploratory factor analysis, which accounted for 58.66% of the variance. Each subscale yielded satisfactory internal consistency with coefficient alphas ranging from 0.720 to 0.894. Relationships/differences between demoralization, quality of life, despair and depression provide initial support for the concurrent/divergent validity. Given these results, the Chinese version of the Demoralization Scale appears to be both valid and reliable.

CONCLUSIONS

Our results preliminary supported that the Chinese version of the Demoralization Scale is a reliable and valid instrument for assessing demoralization among mainland Chinese breast cancer patients, and the factor structure of this measurement needs to be further addressed in future studies.

Psychometric Properties and Factor Structure of the Chinese Version of the Hospital Anxiety and Depression Scale in People Living With HIV

The population of people living with HIV (PLWH) is growing in number and usually results in mental health problems that impact their quality of life. Therefore, valid instruments and screening methods for psychological disorders are of great significance. The Hospital Anxiety and Depression Scale (HADS) reveals good psychometric properties, but shows ambiguous results in factor structure. This study aims to evaluate psychometric properties in terms of the internal reliability and structure validity of the Chinese version of the HADS (C-HADS) in a large sample of PLWH in China. The C-HADS was administered to 4,102 HIV-infected adults at an HIV clinic in China. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed to examine the factor structure. Measurement invariance was assessed across gender and course of infection. Internal reliability was also assessed. A bifactor model with anomalous loadings of items 7, 8, and 10 fits the data best and holds measurement invariance across gender and course of infection. Internal reliability was good with all Cronbach's alphas > 0.70 and Spearman's ρ between 0.30 and 0.70. The C-HADS has good psychometric properties in terms of internal reliability and structure validity of a bifactor model. The C-HADS is recommended to be used as a total scale that measures general psychological distress, instead of anxiety and depression separately, when applied to PLWH. Further studies are needed to evaluate criterion validity, the cutoff score, and the effect of wording and scoring of the HADS.