Common mental disorders and psychological adjustment among individuals seeking HIV testing: a study protocol to explore implications for mental health care systems

The factor structure of the Hopkins Symptom Checklist 25 among persons seeking HIV testing

Rates of anxiety and depression are high among individuals living with HIV. The Hopkins Symptom Checklist (HSCL) is a screening tool to identify symptoms of depression and anxiety. The objective of this study was to determine the factor structure of the 25-item HSCL in a population-based sample of individuals seeking HIV testing in the Western Cape in South Africa. Participants volunteered for HIV testing at two non-medical HIV testing sites in the Western Cape. We used convenience sampling to administer the scale prior to their undergoing HIV testing. Data were analysed using exploratory factor analysis, using an extraction method of principal components with Promax (oblique) rotation. The Cronbach's alpha reliability indices were calculated for each of the independent factors to determine internal consistency. Factor analysis revealed a three-factor structure that explained 56.86% of the total variance. These factors included depression (14 items), anxiety (7 items) and somatic symptoms (4 items). Alpha levels ranged from 0.67 to 0.94. We found that the HSCL is a reliable measure for depression and anxiety, and consists of 3 distinguishable factors depression, anxiety, and somatic symptoms.

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

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.

Resilience in Relation to Adherence to Antiretroviral Therapy in People Living With HIV: A Qualitative Study

Antiretroviral therapy (ART) adherence significantly impacts the survival and quality of life of people living with HIV (PLWH). Despite the challenges faced by PLWH, adherence remains crucial. Thus, cultivating resilience in ART is essential for optimal treatment outcomes. This qualitative study explored the experience of resilience in relation to ART adherence among PLWH. Semi-structured interviews with 10 participants were conducted and inductively analyzed. Participants' resilience in ART adherence was reflected in their achievements related to cultivating the habit of taking medication and in their convictions that the medication was a daily necessity. PLWH developed resilience through strategies encompassing finding purpose through faith and motivation, fostering wellness by obtaining adequate information, enjoying life, managing disease therapy, and adopting a healthy lifestyle, and building connections by finding adequate support and involving in the community. Nurses are crucial in HIV management, fostering resilience for successful ART adherence and ensuring effective treatment outcomes.

Psychosocial interventions and their effectiveness on quality of life among elderly persons living with HIV in Africa South of the Sahara: Systematic review and meta -analysis protocol

BACKGROUND

The number of elderly people living with HIV (EPLHIV) has increased significantly as a result of antiretroviral treatment (ART) and this has brought about a variety of psychosocial challenges that have an impact on their quality of life (QoL). Various psychosocial interventions have been tried or implemented in Sub-Saharan Africa (SSA) to improve QoL of EPLHIV. However, there is paucity of data on the types and effectiveness of these interventions. This systematic review, therefore, aims to explore available psychosocial interventions in SSA and their effectiveness in improving the QoL of EPLHIV.

METHODS

We will search PubMed, PsycINFO, LILACS, Cochrane Library, Google Scholar, HINARI, Africa Journals Online, Scopus and Web of Science to retrieve publications on psychosocial interventions implemented to improve QoL of EPLHIV from inception of the identified databases to 31st December 2023 without language restrictions. Also, supplementary sources such as conference proceedings, preprint repositories, databases of dissertations, as well as WHO and governmental databases can be explored for additional studies. For unpublished studies, trial registries and experts would be contacted, and reference lists of retrieved papers will be manually searched. Retrieved studies will be deduplicated using Mendeley and exported to Rayyan. At least two reviewers will independently select studies, extract data and assess the quality of the included studies using validated tools. Dichotomous outcomes data will be assessed and reported as odds ratio (OR) or risk ratio (RR) and for continuous outcomes, mean difference (MD) will be used; all reported with their 95% confidence interval (CI). Heterogeneity will be explored graphically by inspecting the overlapping of CIs and assessed quantitatively using the I2 statistic.

EXPECTED OUTCOMES

This systematic review will be the first to rigorously identify psychosocial intervention on QoL of EPLHIV in SSA and assess their effectiveness with the aim to provide regional and country- specific data that will inform the selection and implementation of appropriate and socially acceptable policies across countries in SSA. Key findings of the review are expected to contribute critical evidence on availability, types and effectiveness of psychosocial interventions for improving quality of life of vulnerable elderly persons in SSA living with HIV. Furthermore, the review will explore any variation and possible correlates of psychosocial interventions by age, sex, CD4 count (if available), setting and geographic location within SSA that will provide healthcare professionals with reliable evidence, with the ultimate goal of inspiring countries in SSA to adopt innovative interventions to improve HIV care.

TRIAL REGISTRATION

Systematic review registration: The systematic review protocol has been registered in the International Prospective Register for Systematic Reviews (PROSPERO), with registration ID CRD42021278218.

Student adjustment during Covid-19 pandemic: Exploring the moderating role of university support

The study investigates the moderating effect of university support on the association between fear of Cov19 and student adjustment including (a) academic; (b) psychological; and (c) social adjustment. A total of 592 students took part in the research by completing self-reported questionnaire. The respondents were chosen using a multi-stage sampling technique. The data was processed and analyzed using IBM SPSS version 24 and SEM-PLS, respectively. Results reveal fear of Cov19 negatively predict student's academic, psychological, and social adjustment. University support positively predicts student's academic, psychological, and social adjustment and further mitigate the impact of fear of Cov19 on students' academic, psychological, and social adjustment. This is the first study to examine university support as a moderator between fear of Cov19 and three dimensions of students' adjustment.

Social media use for coping with stress and psychological adjustment: A transactional model of stress and coping perspective

Introduction

The psychological well-being of individuals has become an essential issue during the global pandemic. As a pervasive activity for individuals to pull through COVID-19, social media use may play a role in psychological well-being. Drawing on the transactional model of stress and coping, the current study investigated the relationships between COVID-19-related stressors and the use of social media to facilitate specific coping strategies. We further investigated how social media coping strategies impact users' psychological adjustment.

Methods

We collected the data from 641 quarantined residents through a two-wave survey that was conducted in two cities in China during government-mandated lockdowns.

Results

The results showed that perceived COVID-19 stress was related to the intensity of social media use for problem-focused coping, socioemotional coping, and mental disengagement. In addition, individuals' psychological adjustment was positively associated with social media use for socioemotional coping and mental disengagement while negatively related to problem-focused coping. Age was also found to be a moderator of the relationship between socioemotional coping and psychological adjustment.

Discussion

To relieve pandemic-related stress, individuals can actively utilize social media to implement various coping strategies. However, coping activities with social media may not always induce psychological benefits. By revealing the different levels of psychological adjustment among social media users with specific coping strategies, the current research enriched the literature on the effects of social media use on mental health. Findings from this study suggest the need for the prudent use of social media to cope with public health crises.

Coronavirus Anxiety and Psychological Adjustment in College Students: Exploring the Role of College Belongingness and Social Media Addiction

The psychological health of people all around the world is severely affected due to the COVID-19 outbreak. This study examined a moderated mediation model in which college belongingness mediated the relationship between coronavirus anxiety and psychological adjustment, and this mediation effect was moderated by social media addiction. A total of 315 undergraduate students (M = 21.65±3.68 years and 67% females) participated in this study. The results demonstrated that college belongingness partially mediated the association between coronavirus anxiety and psychological adjustment. The mediating part from coronavirus anxiety to college belongingness was moderated by social media addiction. In comparison with the high level of social media addiction, coronavirus anxiety had a stronger predictive effect on college belongingness under the low and moderate levels of social media addiction condition. Our findings highlight that college belongingness is a potential mechanism explaining how coronavirus anxiety is related to psychological adjustment and that this relation may depend on the levels of social media addiction.

The Utility of the Hopkins Symptom Checklist as a Trans-Diagnostic Screening Instrument for Common Mental Disorders Among Persons Seeking HIV Testing

There is a need for effective psychiatric screening of HIV test seekers, given the high rates of psychopathology in this population. We used receiver operating characteristic curve analysis to establish the utility of the short version of the Hopkins Symptom Checklist (HSCL-25) to correctly identify common mental disorders (CMDs) among persons seeking HIV testing. The HSCL-25 is moderately accurate in identifying CMDs (sensitivity = 69%, specificity = 71%). The HSCL-25 performed better than the Beck Depression Inventory at detecting depressive disorders, and was comparable to the Beck Anxiety Inventory and Posttraumatic Stress Scale-Self-report at detecting cases of generalised anxiety disorder and posttraumatic stress disorder, respectively. However, the instrument generates a high number of false positives and is poor at detecting cases of alcohol use disorder, which limits its utility as a trans-diagnostic screening tool in HIV testing sites.

Tailoring Cognitive Behavioral Therapy for Trauma-Exposed Persons Living With HIV

This Treatment Development Report describes the need for evidence-based psychosocial trauma-focused treatment for people living with comorbid posttraumatic stress disorder (PTSD) and HIV. Individuals with HIV have higher rates of exposure to traumatic events and PTSD than the general public, and they also experience additional consequences of PTSD on the management of their chronic disease (e.g., established link between PTSD symptoms and lack of adherence to antiretroviral therapy [ART]). We used the empirically-supported ADAPT-ITT approach to consider the initial steps in adapting evidence-based Cognitive Processing Therapy (CPT) for individuals with PTSD and HIV. This paper reviews a case example that involved various clinical issues that may arise when providing trauma-focused treatment for people living with HIV including HIV-stigma, disease management, and the need for making multicultural adaptations to psychotherapy. This case example illustrates how trauma-focused treatment may benefit from enhancement to address additional barriers that may arise over the course of PTSD treatment in this population. Feasibility of engaging and delivering a "full dose" of evidence-based PTSD treatment among individuals living with HIV is discussed. While evidence-based treatments can reduce PTSD symptom severity, issues related to chronic disease coping and HIV-related stigma management could be integrated to augment the efficacy of treatment for individuals with HIV. Adaptive intervention research targeting PTSD in persons living with HIV warrants further attention, especially given the association between PTSD and adherence to ART.