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Lin C, Nguyen BD, Nguyen TT, Dang HT, Li L, Giang LM. Empowering Women Living with HIV/AIDS in Vietnam: A Hybrid Online-Offline Intervention to Combat Stigma. AIDS Behav 2024:10.1007/s10461-024-04439-3. [PMID: 38992226 DOI: 10.1007/s10461-024-04439-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2024] [Indexed: 07/13/2024]
Abstract
Women living with HIV/AIDS (WLHA) encounter numerous challenges, such as stigma and gender disparities, that hinder their access to care, especially in patriarchal societies like Vietnam. We developed a hybrid intervention with online and offline (in-person) components to empower WLHA in Vietnam. The intervention was pilot tested with 91 WLHA in Hanoi. During baseline and 4-month, study investigators delivered two in-person sessions, one Zoom session, and 15 weeks of Zalo (social media platform) discussions to enhance positive coping strategies, treatment utilization and adherence, and engagement of support from family and peers. The participants continued their Zalo discussions from 4-month to 6-month without investigators' involvement. Intervention outcomes, including active coping and perceived barriers to care, were evaluated at baseline, 4-, and 6-month surveys. Mixed-effects regression models showed that the participants' active coping significantly increased from baseline (50.5 ± 9.4) to 4-month (53.8 ± 6.2; p = 0.0001), although there was a slight decrease at 6-month (52.8 ± 7.2), the change from 4-month to 6-month was not significantly significant (p = 0.3256). There was a significant reduction in participants' perceived barriers to care, from 19.8 ± 5.2 at baseline to 17.4 ± 5.2 at 4-month (p < 0.0001), which remained stable at 17.8 ± 4.3 at 6-month (p < 0.0001 compared to baseline). This intervention presents a promising model to empower WLHA in Vietnam and potentially in similar global contexts. Future interventions could benefit from leveraging natural peer leaders and adopting a more person-centered approach to meet WLHA's varying needs.
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Affiliation(s)
- Chunqing Lin
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, Center for Community Health, University of California, Los Angeles, 760 Westwood Plaza, 17-369E, Los Angeles, CA, 90024, USA.
| | - Bich Diep Nguyen
- Center for Training and Research on Substance Use & HIV, Hanoi Medical University, Đống Đa, Vietnam
| | - Thu Trang Nguyen
- Center for Training and Research on Substance Use & HIV, Hanoi Medical University, Đống Đa, Vietnam
| | - Huong Thi Dang
- Center for Training and Research on Substance Use & HIV, Hanoi Medical University, Đống Đa, Vietnam
| | - Li Li
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, Center for Community Health, University of California, Los Angeles, 760 Westwood Plaza, 17-369E, Los Angeles, CA, 90024, USA
| | - Le Minh Giang
- Center for Training and Research on Substance Use & HIV, Hanoi Medical University, Đống Đa, Vietnam
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Nuño N, Martínez A, Martínez S, Cobos M, Hernández JS, Polo R. Sex differences in health-related quality of life and poverty risk among older people living with HIV in Spain: A cross-sectional study. PLoS One 2024; 19:e0301335. [PMID: 38713682 DOI: 10.1371/journal.pone.0301335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 03/14/2024] [Indexed: 05/09/2024] Open
Abstract
BACKGROUND Current antiretroviral therapies have increased the life expectancy of people living with HIV (PLHIV). There is, however, limited evidence regarding the health-related quality of life (HRQoL) and living conditions of older people living with HIV (OPLHIV) in Spain. METHODS We implemented a self-administered online questionnaire to identify sex differences in HRQoL and poverty risk among Spanish OPLHIV (PLHIV ≥50 years). Participants were contacted through non-governmental organisations. We used the standardised WHOQoL-HIV BREF questionnaire and the Europe 2020 guidelines to estimate HRQoL and poverty risk respectively. The statistical analysis included multivariable generalised linear models with potential confounding variables and robust estimates. RESULTS The study included 247 OPLHIV (192 men and 55 women). On the WHOQoL-HIV BREF questionnaire, men scored higher on 84% of items and in all six domains. Women had significantly lower HRQoL in five domains: physical health (β: -1.5; 95% CI: -2.5, -0.5; p: 0.002), psychological health (β: -1.0; 95% CI: -1.9, -0.1; p: 0.036), level of independence (β: -1.1; 95% CI: -1.9, -0.2; p: 0.019), environmental health (β: -1.1; 95% CI: -1.8, -0.3; p: 0.008), and spirituality/personal beliefs (β: -1.4; 95% CI: -2.5, -0.3; p: 0.012). No statistical differences were found in the domain of social relations. Poverty risk was considerable for both men (30%) and women (53%), but women were significantly more likely to experience it (OR: 2.9; 95% CI: 1.3, 6.5; p: 0.009). CONCLUSION The aging of PLHIV is a public health concern. Our findings indicate that HRQoL and poverty risk among Spanish OPLHIV differ significantly by sex. Spain should, therefore, implement specific policies and interventions to address OPLHIV needs. The strategies must place a high priority on the reduction of sex inequalities in HRQoL and the enhancement of the structural conditions in which OPLHIV live.
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Affiliation(s)
- Néstor Nuño
- Division for Control of HIV, STIs, Viral Hepatitis and Tuberculosis, Spanish Ministry of Health, Madrid, Spain
| | - Alberto Martínez
- Division for Control of HIV, STIs, Viral Hepatitis and Tuberculosis, Spanish Ministry of Health, Madrid, Spain
| | - Susana Martínez
- Division for Control of HIV, STIs, Viral Hepatitis and Tuberculosis, Spanish Ministry of Health, Madrid, Spain
| | - Marta Cobos
- Division for Control of HIV, STIs, Viral Hepatitis and Tuberculosis, Spanish Ministry of Health, Madrid, Spain
| | | | - Rosa Polo
- Division for Control of HIV, STIs, Viral Hepatitis and Tuberculosis, Spanish Ministry of Health, Madrid, Spain
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Boakye DS, Setordzi M, Dzansi G, Adjorlolo S. Mental health burden among females living with HIV and AIDS in sub-Saharan Africa: A systematic review. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002767. [PMID: 38300927 PMCID: PMC10833589 DOI: 10.1371/journal.pgph.0002767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 12/06/2023] [Indexed: 02/03/2024]
Abstract
Mental health problems, particularly depression and anxiety, are common in women and young girls living with HIV/ AIDS particularly in low- and middle-income (LMICs) countries where women's vulnerability to psychiatric symptoms is heightened due to the prevalent intersectional stressors such as stigma and intimate partner violence. However, no synthesized evidence exists on the mental health burden of females living with HIV/AIDS (FLWHA) in Africa. This systematic review aimed to synthesize the current evidence on the mental health burden among FLWHA in sub-Saharan Africa. A systematic literature review of articles published from 2013-2023 was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA). Five electronic databases; PubMed, MEDLINE with full text, Scopus, Academic Search Complete, and Health Source: Nursing Academic Edition were searched for articles published in English. Nineteen articles (15 quantitative, 3 qualitative, and 1 case study) from over 7 African countries met the inclusion criteria. The majority of the studies' quality was determined to be moderate. The prevalence of depression ranged from 5.9 to 61% and anxiety from 28.9 to 61%. Mental health burden was a logical outcome of HIV diagnosis. Predictors of mental health outcomes in the context of HIV/AIDS were identified as intimate partner violence (IPV), stigma, childhood traumas, sexual abuse, poverty, unemployment, and social isolation. Social support and resilience were identified as protective factors against mental illness in FLWHA. Mental illness had a deleterious effect on viral suppression rates among FLWHA, resulting in delayed initiation of antiretroviral therapy treatment and increased mortality but had no impact on immune reconstitution in the face of ART adherence. Given the high prevalence rates of depression and anxiety and their relationship with HIV progression, it is crucial that mental health care services are integrated into routine HIV care.
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Affiliation(s)
- Dorothy Serwaa Boakye
- Department of Health Administration and Education, University of Education, Winneba, Ghana
- School of Nursing and Midwifery, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | - Mawuko Setordzi
- School of Nursing and Midwifery, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
- Department of Nursing, Presbyterian Nursing, and Midwifery Training College, Dormaa Ahenkro, Bono Region, Ghana
| | - Gladys Dzansi
- School of Nursing and Midwifery, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | - Samuel Adjorlolo
- School of Nursing and Midwifery, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
- Research and Grant Institute of Ghana, Legon, Ghana
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Kohli M, Ham L, Saloner R, Dung D, Iudicello J, Ellis RJ, Moore DJ. Latent Profile Analysis of Cognitive Performance and Depressive Symptoms Among People with HIV. AIDS Patient Care STDS 2024; 38:93-106. [PMID: 38381950 PMCID: PMC10890962 DOI: 10.1089/apc.2023.0224] [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: 02/23/2024] Open
Abstract
Depression and cognitive impairment are prevalent conditions among people with HIV (PWH), likely attributable to shared causes and common risk factors. Identifying subtypes of PWH with similar patterns of neurocognitive impairment (NCI) and depressive symptoms may inform development of patient-centered interventions that target-specific profiles. This study aimed to (1) classify PWH based on patterns of domain-specific NCI and depression; and (2) determine the relationship between latent class membership and pertinent clinical characteristics. PWH (N = 580, 86.2% male, 57.1% non-Hispanic White, 69.2% unemployed) completed a comprehensive neuropsychological test battery assessing global and domain-specific cognition. Domain-specific NCI was classified as deficit score >0.5. Participants completed the Beck Depression Inventory-II (BDI-II), and domain-specific BDI-II scores reflecting cognitive, affective, and somatic symptoms were computed. Latent profile analysis (LPA) was used to determine latent subgroups of NCI and depression. The optimal LPA solution consisted of five classes: minimal NCI and minimal depression (Class 1), amnestic and minimal depression (Class 2), severe multi-domain NCI and moderate depression (somatic and affective; Class 3), mild NCI and mild depression (Class 4), and moderate multi-domain NCI and severe depression (Class 5). Despite similar levels of functional impairment, Class 5 had a significant psychiatric profile, whereas Class 3 had a complex medical profile (i.e., higher frailty index, higher medications, greater proportion of AIDS diagnosis). In contrast, Class 1 had the lowest medication use and frailty index, with similar HIV disease characteristics to Classes 3 and 5. Our results suggest there are multiple pathways to cognitive and functional impairment among PWH with co-occurring depression and cognitive impairment, and these groups may respond differently to interventions. Of note, our sample was majority non-Hispanic White and male, which is nonrepresentative of the US population of PWH. Future interventions should consider a more integrated, person-centered approach that addresses cognitive and emotional health to optimize health outcomes in PWH.
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Affiliation(s)
- Maulika Kohli
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California, USA
- HIV Neurobehavioral Research Program, University of California San Diego, San Diego, California, USA
| | - Lillian Ham
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California, USA
- HIV Neurobehavioral Research Program, University of California San Diego, San Diego, California, USA
| | - Rowan Saloner
- Memory and Aging Center, University of California, San Francisco, San Francisco, California, USA
| | - Devin Dung
- HIV Neurobehavioral Research Program, University of California San Diego, San Diego, California, USA
| | - Jennifer Iudicello
- HIV Neurobehavioral Research Program, University of California San Diego, San Diego, California, USA
- Department of Psychiatry and University of California, San Diego, La Jolla, California, USA
| | - Ronald J. Ellis
- HIV Neurobehavioral Research Program, University of California San Diego, San Diego, California, USA
- Department of Psychiatry and University of California, San Diego, La Jolla, California, USA
- Department of Neurosciences, University of California, San Diego, La Jolla, California, USA
| | - David J. Moore
- HIV Neurobehavioral Research Program, University of California San Diego, San Diego, California, USA
- Department of Psychiatry and University of California, San Diego, La Jolla, California, USA
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Akinsolu FT, Abodunrin OR, Lawale AA, Bankole SA, Adegbite ZO, Adewole IE, Olagunju MT, Ola OM, Dabar AM, Sanni-Adeniyi RA, Gambari AO, Njuguna DW, Salako AO, Ezechi OC. Depression and perceived stress among perinatal women living with HIV in Nigeria. Front Public Health 2023; 11:1259830. [PMID: 38054071 PMCID: PMC10694505 DOI: 10.3389/fpubh.2023.1259830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 10/18/2023] [Indexed: 12/07/2023] Open
Abstract
Background Pregnancy and postpartum periods are crucial stages for women's mental health, and women living with HIV are particularly susceptible to depression and psychological stress due to various factors. This study investigated the prevalence and associated factors of depression and perceived stress among women living with HIV during their perinatal period in Ibadan, Nigeria. Methods A cross-sectional survey was conducted in three HIV treatment centers in Ibadan, Nigeria, among women living with HIV between the ages of 19 and 49 who were either pregnant or had given birth within the last 2 years. The study was conducted from September 2022 to December 2022. An interviewer-administered questionnaire was used to collect the data from the participants. Ethical approval and informed consent were obtained, and data were analyzed using the Statistical Package for Social Science version 26. Results The study included 402 participants, of whom 69.0 and 78.0% reported symptoms of depression and perceived stress, respectively. However, 15.2% of the participants have comorbid depression and stress. Positive partner status was significantly associated with lower perceived depression, while gestational age between 29 and 40 weeks was significantly associated with lower perceived stress. The co-occurrence of depression and perceived stress was associated with partner status, income level, family support, gestational age, and years on antiretroviral therapy. Conclusion The high prevalence of depression, perceived stress, and their co-occurrence among women living with HIV during the perinatal period call for incorporating mental health care into routine maternal healthcare for all women, particularly those living with HIV. This finding emphasizes the need for public health efforts to prioritize perinatal mental health and improve access to care and support for women and their partners.
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Affiliation(s)
- Folahanmi T. Akinsolu
- Department of Public Health, Lead City University, Ibadan, Nigeria
- Nigerian Institute of Medical Research, Lagos, Nigeria
| | - Olunike R. Abodunrin
- Department of Public Health, Lead City University, Ibadan, Nigeria
- Lagos State Health Management Agency, Ministry of Health, Lagos, Nigeria
- Department of Epidemiology and Health Statistics, School of Public Health, Nanjing Medical University, Jiangning, Jiangsu, China
| | | | | | | | | | - Mobolaji T. Olagunju
- Department of Epidemiology and Health Statistics, School of Public Health, Nanjing Medical University, Jiangning, Jiangsu, China
| | | | - Anita M. Dabar
- Department of Public Health, Lead City University, Ibadan, Nigeria
| | | | - Aisha O. Gambari
- Department of Public Health, Lead City University, Ibadan, Nigeria
- Nigerian Institute of Medical Research, Lagos, Nigeria
| | - Diana Wangeshi Njuguna
- School of Nursing, Department of Medical-Surgical Nursing, Dedan Kimathi University of Technology, Nairobi, Kenya
| | - Abideen O. Salako
- Department of Public Health, Lead City University, Ibadan, Nigeria
- Nigerian Institute of Medical Research, Lagos, Nigeria
| | - Oliver C. Ezechi
- Department of Public Health, Lead City University, Ibadan, Nigeria
- Nigerian Institute of Medical Research, Lagos, Nigeria
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Mohamed NA, Eraslan A, Kose S. The impact of anxiety and depression on the quality of life of hemodialysis patients in a sample from Somalia. BMC Psychiatry 2023; 23:825. [PMID: 37950178 PMCID: PMC10636891 DOI: 10.1186/s12888-023-05312-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 10/26/2023] [Indexed: 11/12/2023] Open
Abstract
OBJECTIVE The main objective of the present study was to determine the quality of life (QoL), depression, and anxiety levels in kidney failure patients undergoing hemodialysis (HD) treatment and examine the impact of depression and anxiety on the QoL of these patients in a sample from Somalia. METHODS A sample of 200 patients with kidney failure who were undergoing HD treatment approximately two to three times a week was included. All participants were administered a sociodemographic data form, the Patient Health Questionnaire-9 (PHQ-9), the Hospital Anxiety and Depression Scale (HADS), and the World Health Organization Quality of Life (WHO-QOL-BREF). Subjects on HD for less than 3 months prior to the study date were excluded. RESULTS Of the kidney failure patients, 200 patients, aged 18-86 years (median: 50.0; IQR: 25.0), consented and participated in the study. 58.5% of the participants were men; 64% had a kidney failure duration of 1-5 years, and 52.6% had a HD duration of 1-5 years. Mild symptoms of depression were found in 48%, while moderate-to-severe depressive symptoms were found in 13.5% of HD patients. Depression and anxiety were found to be significantly correlated with overall QoL, physical health, psychological health, social relationships, and environmental well-being. There were similar predictors of overall QoL, physical health, psychological well-being, social relationships, and environmental well-being relating to socio-demographic factors such as age, gender, family income, anxiety, and depression. CONCLUSIONS This study emphasizes the important role that anxiety, depression, and family income have in HD patients' QoL in Somalia. It highlights the significance of regular emotional assessment and efficient management in order to increase patient satisfaction. Future studies with larger samples are necessary for more accurate statistical analysis. To optimize patient care, a multidisciplinary healthcare team is recommended.
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Affiliation(s)
- Nur Adam Mohamed
- Department of Psychiatry and Behavioral Sciences, Mogadishu Somalia Türkiye Recep Tayyip Erdogan Research and Training Hospital, Mogadishu, Somalia.
| | - Asir Eraslan
- Department of Urology, Mogadishu Somalia Türkiye Recep Tayyip Erdogan Research and Training Hospital, Mogadishu, Somalia
| | - Samet Kose
- Department of Psychiatry and Behavioral Sciences, Mogadishu Somalia Türkiye Recep Tayyip Erdogan Research and Training Hospital, Mogadishu, Somalia
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Nguyen MX, Zimmer C, Latkin CA, Lancaster KE, Dowdy DW, Hutton H, Chander G, Frangakis C, Gaynes BN, Sripaipan T, Tran HV, Go VF. Validation of the combined Patient Health Questionnaire Anxiety and Depression Scale among people with HIV in Vietnam. Int J STD AIDS 2023; 34:832-840. [PMID: 37287254 DOI: 10.1177/09564624231180782] [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: 06/09/2023]
Abstract
BACKGROUND Our study aims to examine the factor structure, validity, and reliability of the combined scale Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS) among people with HIV (PWH) in Vietnam. METHODS Baseline data from an alcohol-reduction intervention trial among ART clients in Thai Nguyen, Vietnam were used for this analysis (n = 1547). A score ≥10 on the PHQ-9, GAD-7 and PHQ-ADS scale was considered having clinically meaningful depression, anxiety and distress symptoms. Factor structure of the combined PHQ-ADS scale was validated using confirmatory factor analysis, and three models were tested: a one-factor, a two-factor, and a bi-factor model. Reliability and construct validity were examined. RESULTS The prevalence of clinically meaningful depression and anxiety symptoms was 7% and 2%, respectively, while 19% had distress symptoms. A bi-factor model had the best fit to the data (RMSEA = 0.048; CFI = 0.99; TLI = 0.98). The Omega index of the bi-factor model was 0.97. The scale showed good construct validity through negative associations between depression, anxiety, distress symptoms and quality of life. CONCLUSIONS Our study supports the use of a combined scale to measure general distress for PWH, which has good validity, reliability and is unidimensional enough to justify the use of a composite depression and anxiety score.
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Affiliation(s)
- Minh X Nguyen
- Department of Epidemiology, Hanoi Medical University, Hanoi, Vietnam
| | - Catherine Zimmer
- Department of Sociology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Carl A Latkin
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Kathryn E Lancaster
- Department of Epidemiology, College of Public Health, Ohio State University, Columbus, OH, USA
| | - David W Dowdy
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Heidi Hutton
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Constantine Frangakis
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Bradley N Gaynes
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Teerada Sripaipan
- Department of Epidemiology, Hanoi Medical University, Hanoi, Vietnam
| | - Ha V Tran
- Department of Epidemiology, Hanoi Medical University, Hanoi, Vietnam
| | - Vivian F Go
- Department of Epidemiology, Hanoi Medical University, Hanoi, Vietnam
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Povshedna T, Swann SA, Levy SLA, Campbell AR, Choinière M, Durand M, Price C, Gill P, Murray MCM, Côté HCF. Global Prevalence of Chronic Pain in Women with HIV: A Systematic Review and Meta-analysis. Open Forum Infect Dis 2023; 10:ofad350. [PMID: 37547855 PMCID: PMC10404009 DOI: 10.1093/ofid/ofad350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 07/13/2023] [Indexed: 08/08/2023] Open
Abstract
Chronic pain is common among people with human immunodeficiency virus (HIV) and detrimental to quality of life and overall health. It is often underdiagnosed, undertreated, and frankly dismissed in women with HIV, despite growing evidence that it is highly prevalent in this population. Thus, we conducted a systematic review and meta-analysis to estimate the global prevalence of chronic pain in women with HIV. The full protocol can be found on PROSPERO (identifier CRD42022301145). Of the 2984 references identified in our search, 36 were included in the systematic review and 35 in the meta-analysis. The prevalence of chronic pain was 31.2% (95% confidence interval [CI], 24.6%-38.7%; I2 = 98% [95% CI, 97%-99%]; P < .0001). In this global assessment, we found a high prevalence of chronic pain among women with HIV, underscoring the importance of understanding the etiology of chronic pain, identifying effective treatments, and conducting regular assessments in clinical practice.
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Affiliation(s)
- Tetiana Povshedna
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Blood Research, University of British Columbia, Vancouver, British Columbia, Canada
- Edwin S. H. Leong Healthy Aging Program, University of British Columbia, Vancouver, British Columbia, Canada
| | - Shayda A Swann
- Edwin S. H. Leong Healthy Aging Program, University of British Columbia, Vancouver, British Columbia, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Women's Health Research Institute, British Columbia Women’s Hospital and Health Centre, Vancouver, British Columbia, Canada
| | - Sofia L A Levy
- Faculty of Science, University of British Columbia, Vancouver, British Columbia, Canada
| | - Amber R Campbell
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Women's Health Research Institute, British Columbia Women’s Hospital and Health Centre, Vancouver, British Columbia, Canada
- Oak Tree Clinic, British Columbia Women’s Hospital and Health Centre, Vancouver, British Columbia, Canada
| | - Manon Choinière
- Department of Anesthesiology and Pain Medicine, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Madeleine Durand
- Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Colleen Price
- Canadian HIV/AIDS and Chronic Pain Society, Global Pain and HIV Task Force, Ottawa, Ontario, Canada
| | - Prubjot Gill
- Woodward Library, University of British Columbia, Vancouver, British Columbia, Canada
| | - Melanie C M Murray
- Edwin S. H. Leong Healthy Aging Program, University of British Columbia, Vancouver, British Columbia, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Women's Health Research Institute, British Columbia Women’s Hospital and Health Centre, Vancouver, British Columbia, Canada
- Oak Tree Clinic, British Columbia Women’s Hospital and Health Centre, Vancouver, British Columbia, Canada
| | - Hélène C F Côté
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Blood Research, University of British Columbia, Vancouver, British Columbia, Canada
- Edwin S. H. Leong Healthy Aging Program, University of British Columbia, Vancouver, British Columbia, Canada
- Women's Health Research Institute, British Columbia Women’s Hospital and Health Centre, Vancouver, British Columbia, Canada
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Deaterly CD, Varma DS, Li Y, Manavalan P, Cook RL. Mental health, substance use, and risky sexual behaviors among women living with HIV. J Nurs Scholarsh 2023; 55:751-760. [PMID: 37132071 PMCID: PMC10626942 DOI: 10.1111/jnu.12900] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 04/06/2023] [Accepted: 04/07/2023] [Indexed: 05/04/2023]
Abstract
INTRODUCTION Risky sexual behavior has been explored in women living with HIV (WLHIV) internationally but is not well studied in WLHIV in the United States (U.S.). This merits further investigation due to the negative reproductive and HIV health outcomes associated with risky sexual behavior, such as the increased risk for HIV transmission and infertility from sexually transmitted infections (STIs). The aims of this study are to (1) describe sexual behaviors in a cohort of WLHIV in Florida, (2) determine whether demographic characteristics, substance use, and mental health symptoms are associated with risky sexual behavior in a cohort of WLHIV in Florida, and (3) explore whether the relationship between substance use and mental health symptoms and risky sexual behavior differs in reproductive-age (age 18-49), compared to non-reproductive-age WLHIV (age 50+). DESIGN This was a cross-sectional analysis of data from a multisite cohort study done in Florida. METHODS Data were collected from a sample of 304 participants who were recruited into the Florida Cohort Study from 9 clinical and community sites in Florida between 2014 to 2017. The predictor variables of interest were mental health symptoms, substance use, and demographic variables. The outcome variable of interest was risky sexual behavior which was defined as reporting ≥1 of the following: (1) at least one STI diagnosis in the past 12 months, (2) two or more sexual partners in the past 12 months, or (3) any inconsistent condom use in the past 12 months. Descriptive statistics, bivariate analysis, and logistic regression (p < 0.1) were conducted on the variables of interest. RESULTS The mean age of the sample was 47.8 years, and approximately half (51.6%) of the sample was of reproductive-age. Reporting ≥1 risky sexual behavior was reported in over half (51.6%) of the reproductive-age WLHIV in the sample and 32% of the non-reproductive-age WLHIV in the sample. Binge drinking, alcohol-related problems, marijuana use, and age were all significantly associated with self-reporting ≥1 risky sexual behaviors in all WLHIV. Self-reporting binge drinking, marijuana use, and a high alcohol-related problems score respectively were associated with increased odds of self-reporting ≥1 risky sexual behavior in all WLHIV. Neither mental health symptoms nor race/ethnicity or education were significantly associated with self-reporting ≥1 risky sexual behavior in all WLHIV. Self-reporting severe anxiety symptoms and high alcohol-related problems scores respectively were associated with increased odds of self-reporting ≥1 risky sexual behavior only in reproductive-age WLHIV from the sample. CONCLUSION Marijuana use, binge drinking, and alcohol-related problems appear to have a relationship with risky sexual behavior in WLHIV regardless of age. Reproductive-age also appears to influence risky sexual behavior in WLHIV, and specific reporting severe anxiety symptoms and high alcohol-related problems in reproductive-age WLHIV increases the odds of engaging in risky sexual behavior. CLINICAL SIGNIFICANCE This study holds clinical significance for nurses and other clinicians working in reproductive health settings and clinics with WLHIV. Results indicate that it could be beneficial to do more screening for mental health symptoms (particularly anxiety) and alcohol use in younger reproductive-age WLHIV.
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Affiliation(s)
| | - Deepthi S. Varma
- Department of Epidemiology, University of Florida, Gainesville, Florida, USA
| | - Yancheng Li
- Department of Epidemiology, University of Florida, Gainesville, Florida, USA
| | - Preeti Manavalan
- Department of Medicine, University of Florida, Gainesville, Florida, USA
| | - Robert L. Cook
- Department of Epidemiology, University of Florida, Gainesville, Florida, USA
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Fauk NK, Gesesew HA, Mwanri L, Hawke K, Merry MS, Asa GA, Ward PR. Understanding coping strategies of mothers living with HIV who care for children living with HIV: a qualitative study in Indonesia. BMC Womens Health 2023; 23:172. [PMID: 37041572 PMCID: PMC10091524 DOI: 10.1186/s12905-023-02299-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 03/22/2023] [Indexed: 04/13/2023] Open
Abstract
HIV infection and its sequelae continue to be a significant challenge among women and their families in developing countries despite the progress that has been made in the prevention and treatment of HIV. This paper describes the strategies employed by mothers with HIV to cope with the various challenges experienced following their own and their children's HIV diagnosis. This paper uses previously unpublished data collected for a study that sought to explore the mental health challenges and coping strategies of mothers living with HIV (MLHIV) (n = 23) who have children living with HIV (CLHIV). Data collection was conducted using in-depth interviews, and participants were recruited using the snowball sampling technique. The concept of meaning-making was used to guide the conceptualisation, analysis, and discussion of the findings. Our analysis showed that meaning-making such as the awareness of how important mothers were to their children/CLHIV and families and religious meaning were used by participants to cope with HIV-related and mental health challenges they faced. The meaning of mother-child relationship which was supported and maintained through the provision of time, attention and fulfillment of CLHIV's needs were also coping strategies employed by these women. Additional coping strategies used were to link their CLHIV to groups and activities of CLHIV. The connections made through these links enabled their children to know other CLHIV, build relationships, and share experiences. These findings are useful evidence that can inform policies and practices and indicate the need for the development of intervention programs that address the needs of MLHIV and their families to cope with HIV-related challenges of their children. Future large-scale studies involving MLHIV who have CLHIV are recommended to have a comprehensive understanding of strategies they employ to cope with HIV-related challenging circumstances and mental health issues that they continue to face.
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Affiliation(s)
- Nelsensius Klau Fauk
- Research Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, Adelaide, South Australia, Australia
- Institute of Resource Governance and Social Change, Kupang, Indonesia
| | - Hailay Abrha Gesesew
- Research Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, Adelaide, South Australia, Australia.
- College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia.
| | - Lillian Mwanri
- Research Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, Adelaide, South Australia, Australia
| | - Karen Hawke
- Women and Kids theme, Aboriginal Health, South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Maria Silvia Merry
- Medicine Faculty, Duta Wacana Christian University, Yogyakarta, Indonesia
| | - Gregorius Abanit Asa
- Research Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, Adelaide, South Australia, Australia
| | - Paul Russell Ward
- Research Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, Adelaide, South Australia, Australia
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11
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Jones MC, Byun JY, Billings R, Shorten A, Kempf MC, Vance DE, Puga F. Tools for Screening and Measuring Anxiety Among Women Living with HIV of Reproductive Age: A Scoping Review. AIDS Behav 2023:10.1007/s10461-023-03990-9. [PMID: 36757556 DOI: 10.1007/s10461-023-03990-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2023] [Indexed: 02/10/2023]
Abstract
Emerging evidence suggests that women living with HIV (WLWH) may experience higher rates of anxiety than men living with HIV and women living without HIV. To date, relatively little knowledge exists on valid anxiety screening and diagnostic tools and how they are used among WLWH, specifically WLWH of reproductive age. Thus, the purpose of this scoping review was to describe what is known in the published literature about anxiety among WLWH and the tools used to measure and screen for anxiety in clinical and research contexts. The Arksey and O'Malley methodological framework was used to guide a scoping review of published articles in PsycINFO, Scopus, Sociological Abstracts, and PubMed databases. Twenty-one measures of anxiety were used across the 52 articles identified in the search. Most measures used were self-report. Inconsistencies in standardized screening tools and cutoff scores were observed across studies. Further, measures to assess anxiety varied among studies focused on WLWH. Based on the results from this review, there is a need for consistent, valid measures of anxiety to advance research and clinical practice to support the well-being of WLWH.
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Affiliation(s)
- Meghan C Jones
- School of Nursing, University of Alabama at Birmingham, 1701 University Blvd, 35294-1210, Birmingham, AL, USA.
| | - Jun Y Byun
- School of Nursing, University of Alabama at Birmingham, 1701 University Blvd, 35294-1210, Birmingham, AL, USA
| | - Rebecca Billings
- UAB Libraries, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Allison Shorten
- School of Nursing, University of Alabama at Birmingham, 1701 University Blvd, 35294-1210, Birmingham, AL, USA
| | - Mirjam-Colette Kempf
- School of Nursing, University of Alabama at Birmingham, 1701 University Blvd, 35294-1210, Birmingham, AL, USA
| | - David E Vance
- School of Nursing, University of Alabama at Birmingham, 1701 University Blvd, 35294-1210, Birmingham, AL, USA
| | - Frank Puga
- School of Nursing, University of Alabama at Birmingham, 1701 University Blvd, 35294-1210, Birmingham, AL, USA
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12
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Madundo K, Knettel BA, Knippler E, Mbwambo J. Prevalence, severity, and associated factors of depression in newly diagnosed people living with HIV in Kilimanjaro, Tanzania: a cross-sectional study. BMC Psychiatry 2023; 23:83. [PMID: 36726113 PMCID: PMC9890688 DOI: 10.1186/s12888-022-04496-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 12/23/2022] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Depression is particularly common among people living with Human Immunodeficiency Virus (HIV), with some studies showing a prevalence of depression three times higher among people living with HIV as compared to the general public. The stress associated with being diagnosed with HIV can be quite impactful, including concerns about one's long-term health, stigma, and the burden of long-term treatment. Therefore, it is common for a new HIV diagnosis to contribute to the onset of depressive symptoms. The objective of this study was to determine the prevalence and severity of depression, and its associated factors in people diagnosed with HIV within the past 12 months. METHODS We conducted a cross-sectional survey with patients newly diagnosed with HIV at three hospitals in the Kilimanjaro region of Tanzania utilizing a locally validated version of the Patient Health Questionnaire-9 (PHQ-9) as a screener for depression, the Demographic Health Survey (SES-DHS8) for socio-demographic characteristics, and the Duke-UNC Functional Social Support Questionnaire (FSSQ) to assess perceived social support. We enrolled 272 participants between September and December 2020, diagnosed with HIV within the past 12 months. Analysis of Co-variance (ANCOVA) and Bonferroni post-hoc analysis were used to determine associations of sociodemographic variables with the dependent variable of depression. RESULTS Overall prevalence of depression in our sample was 41%, including 54 participants (20%) with moderate symptoms, 42 (15%) with moderately severe symptoms, and 16 (6%) with severe symptoms. Severity was highest in participants diagnosed with HIV less than 1 month ago. An ANCOVA model (overall F = 4.72, p < 0.001) assessing factors associated with greater depression severity revealed significant effects of study site (F = 7.6, p < 0.001), female gender (F = 5.11, p = 0.02), and less time since HIV diagnosis (F = 12.3, p < 0.001). CONCLUSION The study demonstrates very high prevalence of depression among people living with HIV in this setting, particularly among those newly diagnosed, female participants, and those seen at the larger regional referral hospital. Integration of mental health screening and interventions into CTC care is vital in the first visits following a positive test result and may be tailored to meet the needs of patients at highest risk for developing symptoms of depression.
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Affiliation(s)
- Kim Madundo
- Department of Mental Health and Psychiatry, Kilimanjaro Christian Medical Centre, Moshi, Tanzania.
| | - Brandon A Knettel
- Duke University School of Nursing and Duke Global Health Institute, Durham, NC, USA
| | - Elizabeth Knippler
- Duke Centre for AIDS Research, Duke University School of Nursing, Durham, NC, USA
| | - Jessie Mbwambo
- Department of Psychiatry and Mental Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
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13
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King EM, Swann SA, Prior JC, Berger C, Mayer U, Pick N, Campbell AR, Côté HCF, Murray MCM. Vitamin D intakes among women living with and without HIV in Canada. HIV Med 2023; 24:628-639. [PMID: 36597960 DOI: 10.1111/hiv.13454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 12/06/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND Patterns of vitamin D intake are relatively unexplored among women living with HIV, despite its importance for women's health. We compared vitamin D dietary and supplement intakes in women with HIV and population-based national controls and investigated barriers to intake. METHODS In this case-control study, women with HIV in the Children and Women: AntiRetrovirals and Markers of Aging (CARMA) cohort were matched with Canadian Multicentre Osteoporosis Study (CaMos) controls. Participants were queried for vitamin D in dairy consumption, supplementation/dosage, and sociodemographic variables. We assessed barriers to supplementation and factors associated with dietary intake by regression modelling. RESULTS Ninety-five women living with HIV were age-matched to 284 controls. Women with HIV had lower income and bone mineral density and were more likely to smoke, take multiple medications and be non-white. Vitamin D dietary intake was lower in women living with HIV versus controls [0.76 vs. 1.79 μg/day; adjusted odds ratio (aOR) for greater than or equal to median intake 0.29 (0.12-0.61), p = 0.002], but any supplementation was higher [62.2% vs. 44.7%; aOR = 3.44 (95% CI: 1.16-11.00), p = 0.03]. Total vitamin D intake was similar between groups. Smoking was associated with no supplementation; non-white ethnicity and low income were related to lower dietary intake. CONCLUSIONS Women living with HIV showed lower dietary vitamin D intake but higher supplementation rates, suggesting that care providers are promoting supplementation. Women living with HIV who smoke, have low incomes and are non-white may particularly benefit from targeted efforts to improve vitamin D intake.
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Affiliation(s)
- Elizabeth M King
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada.,Women's Health Research Institute, Vancouver, British Columbia, Canada
| | - Shayda A Swann
- Women's Health Research Institute, Vancouver, British Columbia, Canada.,Experimental Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jerilynn C Prior
- Women's Health Research Institute, Vancouver, British Columbia, Canada.,Centre for Menstrual Cycle and Ovulation Research, Endocrinology and Metabolism, University of British Columbia, Vancouver, British Columbia, Canada.,School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Claudie Berger
- Research Institute of the McGill University Health Centre, McGill University, Montreal, Quebec, Canada
| | - Ulrike Mayer
- Women's Health Research Institute, Vancouver, British Columbia, Canada
| | - Neora Pick
- Women's Health Research Institute, Vancouver, British Columbia, Canada.,Oak Tree Clinic, BC Women's Hospital and Health Centre, Vancouver, British Columbia, Canada
| | - Amber R Campbell
- Women's Health Research Institute, Vancouver, British Columbia, Canada.,Oak Tree Clinic, BC Women's Hospital and Health Centre, Vancouver, British Columbia, Canada.,Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Hélène C F Côté
- Women's Health Research Institute, Vancouver, British Columbia, Canada.,Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada.,Centre for Blood Research, University of British Columbia, Vancouver, British Columbia, Canada
| | - Melanie C M Murray
- Women's Health Research Institute, Vancouver, British Columbia, Canada.,Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.,Oak Tree Clinic, BC Women's Hospital and Health Centre, Vancouver, British Columbia, Canada
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Tadesse A, Huang J. Women's Participation in a Savings Group and Depression: a Community-Based Financial Capability Intervention in Mozambique. GLOBAL SOCIAL WELFARE : RESEARCH, POLICY & PRACTICE 2022; 10:49-59. [PMID: 36337380 PMCID: PMC9628344 DOI: 10.1007/s40609-022-00251-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/15/2022] [Indexed: 05/05/2023]
Abstract
Background As one of the fastest growing community-based financial capability approaches, village savings and loan group (VSLG) is an organized group and formal entity that creates opportunities for participants to save and access financial assets. VSLG has potentially positive impacts on increasing women's financial resources and social support and further improves their mental health. Participation in a VSLG not only increases women's opportunities for asset-building and income generation, but also facilitates trust and promotes social capital development. However, few studies have examined the association between the VSLG participation and women's depression status. To fill the knowledge gap, we examined the association between the VSLG participation and depressive symptoms among low-income women in Mozambique. Methods The data was collected as part of the VSLG program evaluation. The study applied a posttest-only comparison group quasi-experimental design and sampled female VSLG participants and non-participants from three sub-villages in the Sofala province, Mozambique. A multi-stage sampling technique was employed, and a total of 205 women were randomly selected, including 105 VSLG participants and 100 non-participants. Depressive symptoms were measured using the short version of the Edinburgh Depression Scale (EDS) with a summative score ranging from 7 to 28. Using the cutoff value at a score of 14, we created a dichotomous depression indicator. Linear and logit models were used to examine the associations of the VSLG participation and the participation duration with the depression score and the presence of depression controlling for demographic variables. Results The VSLG participants had a statistically lower mean depression score of 12.2 (SD = 4.4) compared to non-participants (15.0, SD = 4.0, p < .001). The regression analysis suggested that the VSLG participants had a mean depression score of 2.7 lower than the non-participants (p < .001). Nearly 60% of the non-participants reported the presence of depression; however, this percentage is 31% for participants (p < .001). The multivariate logit model indicated the odds of the presence of depression for participants are .34 of that for non-participants. Similar results were obtained when the VSLG program duration was used as an independent variable. Conclusions Study findings showed a positive association between the VSLG participation and women's mental health. Future research should further explore the intervention mechanisms and assess how the VSLG participation affects women's mental health. Findings also provided important insights into developing community-based financial capability interventions to improve low-income women's mental health.
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Affiliation(s)
- Aweke Tadesse
- Saint Louis University, 3550 Lindell Blvd., Tegeler Hall 309, St. Louis, MO 63103 USA
| | - Jin Huang
- Saint Louis University, 3550 Lindell Blvd., Tegeler Hall 309, St. Louis, MO 63103 USA
- Center for Social Development, Washington University in St. Louis, St. Louis, MO 63112 USA
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15
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Opoku Agyemang S, Ninonni J, Bennin L, Agyare E, Gyimah L, Senya K, Birikorang E, Quarshie EN, Baddoo NA, Addo SA, Obiri‐Yeboah D. Prevalence and associations of depression, anxiety, and stress among people living with HIV: A hospital‐based analytical cross‐sectional study. Health Sci Rep 2022; 5:e754. [PMID: 35949667 PMCID: PMC9358537 DOI: 10.1002/hsr2.754] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 06/25/2022] [Accepted: 06/26/2022] [Indexed: 11/07/2022] Open
Affiliation(s)
- Sampson Opoku Agyemang
- Department of Mental Health, School of Nursing and MidwiferyUniversity of Cape CoastCape CoastGhana
| | - Jerry Ninonni
- Department of Mental Health, School of Nursing and MidwiferyUniversity of Cape CoastCape CoastGhana
| | - Lydia Bennin
- Department of Mental Health, School of Nursing and MidwiferyUniversity of Cape CoastCape CoastGhana
| | | | - Leveana Gyimah
- Communicable and Non‐Communicable Diseases ClusterWorld Health Organisation Country OfficeAccraGhana
| | - Kafui Senya
- Communicable and Non‐Communicable Diseases ClusterWorld Health Organisation Country OfficeAccraGhana
| | - Emmanuel Birikorang
- Department of Laboratory Technology, School of Physical SciencesUniversity of Cape CoastCape CoastGhana
| | | | | | | | - Dorcas Obiri‐Yeboah
- Public Health Unit, Cape Coast Teaching HospitalCape CoastGhana
- Department of Microbiology and Immunology, School of Medical SciencesUniversity of Cape CoastCape CoastGhana
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16
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Omuojine JP, Nguah SB, Ayisi-Boateng NK, Sarfo FS, Ovbiagele B. Contemporary prevalence and predictors of anxiety among patients living with HIV/AIDS in Ghana. Ghana Med J 2022; 56:169-175. [PMID: 37448991 PMCID: PMC10336633 DOI: 10.4314/gmj.v56i3.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2023] Open
Abstract
Objectives To identify the prevalence and associated factors of anxiety in people living with HIV/AIDS in a tertiary centre in Ghana. Design The study employed a cross-sectional design. Setting The study was conducted in the outpatient HIV clinic of a tertiary hospital. Participants Participants were adult PLWHA receiving OPD care, including those established on combined antiretroviral therapy (cART) and newer patients who were not on cART. Four hundred ninety-five participants aged ≥30 years were consecutively enrolled on the study. Interventions Demographic and clinical data were collected using standard questionnaires and patient files. Anxiety was assessed using the Hospital Anxiety and Depression Scale (HADS). Multivariate logistic regression analysis was done to identify associated factors. Main outcome measure Proportion of PLWHA who had HADS score of ≥8. Results Overall prevalence of anxiety was 61.0% (95%CI: 56.6 - 65.3), with no significant difference between recently diagnosed (≤ 6 months, 64.3%) and those with established diagnoses (>6 months, 59.1%). Urban residence (aOR: 1.67, 95%CI: 1.12 - 2.51), alcohol use (aOR: 1.64, 95%CI: 1.13 - 2.38) and depression (aOR: 13.62, 95%CI: 7.91 - 23.45) were independently associated with anxiety. Conclusion In this sample, 6 in 10 Ghanaian PLWHA had evidence of anxiety. Liaison with the national mental health service for more comprehensive and integrated care and further research into the mental health of PLWHA is recommended to reduce this high burden of anxiety. Funding This study was funded by a grant from the National Institutes of Health Fogarty International Center (R21 TW010479).
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Affiliation(s)
- John-Paul Omuojine
- Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Samuel B Nguah
- Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | | | - Fred S Sarfo
- Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Bruce Ovbiagele
- Department of Neurology, University of California, San Francisco, USA
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17
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Devlin SA, Johnson AK, McNulty MC, Joseph OL, Hall A, Ridgway JP. "Even if I'm undetectable, I just feel like I would die": a qualitative study to understand the psychological and socioeconomic impacts of the COVID-19 pandemic on women living with HIV (WLWH) in Chicago, IL. BMC Womens Health 2022; 22:218. [PMID: 35689277 PMCID: PMC9185710 DOI: 10.1186/s12905-022-01812-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 05/31/2022] [Indexed: 11/10/2022] Open
Abstract
Background The COVID-19 pandemic has affected the health and well-being of people worldwide, yet few studies have qualitatively examined its cumulative effects on ciswomen living with HIV (WLWH). We aimed to explore how the pandemic has impacted WLWH, including challenges related to HIV care, employment, finances, and childcare. We also investigated how HIV status and different psychosocial stressors affected their mental health. Methods We performed 25 semi-structured qualitative interviews with WLWH regarding the ways in which COVID-19 impacted their social determinants of health and physical well-being during the pandemic. 19 WLWH who received care at the University of Chicago Medicine (UCM) and 6 women who received care at Howard Brown Health, a federally qualified health center (FQHC) in Chicago, were interviewed remotely from June 2020 to April 2021. All interviews were audio recorded and transcribed. Interviews were thematically analyzed for commonalities regarding HIV-specific and general experiences of WLWH during the pandemic. Results The majority of participants reported COVID-19 impacted their HIV care, such as appointment cancellations and difficulties adhering to antiretroviral therapy. In addition to HIV care obstacles, almost all participants described perceived heightened vulnerability to or fear of COVID-19. The pandemic also affected the socioeconomic well-being of participants, with reported financial strains and employment disruptions. Some mothers took on additional childcare responsibilities, such as homeschooling. Increased mental health concerns and negative psychological effects from the social isolation associated with the pandemic were also experienced by most participants. Conclusions We gained invaluable insight into how WLWH were challenged by and adapted to the COVID-19 pandemic, including its destabilizing effects on their HIV care and mental health. Women described how they undertook additional childcare responsibilities during the pandemic and how their HIV status compounded their concerns (e.g., perceived heightened vulnerability to COVID-19). Strategies to better support WLWH in maintaining their overall health throughout the pandemic include childcare assistance, access to affordable mental health services, support groups, and education from HIV care providers. These findings have significant implications for examining future health crises through the perspective of potential gender inequalities.
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Affiliation(s)
- Samantha A Devlin
- Department of Medicine, University of Chicago, 5837 S. Maryland Avenue, L-038, Chicago, IL, 60637, USA.
| | - Amy K Johnson
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.,Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Moira C McNulty
- Department of Medicine, University of Chicago, 5837 S. Maryland Avenue, L-038, Chicago, IL, 60637, USA
| | - Olivier L Joseph
- Department of Medicine, University of Chicago, 5837 S. Maryland Avenue, L-038, Chicago, IL, 60637, USA
| | - André Hall
- Department of Medicine, University of Chicago, 5837 S. Maryland Avenue, L-038, Chicago, IL, 60637, USA
| | - Jessica P Ridgway
- Department of Medicine, University of Chicago, 5837 S. Maryland Avenue, L-038, Chicago, IL, 60637, USA
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18
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Mental Health Challenges and the Associated Factors in Women Living with HIV Who Have Children Living with HIV in Indonesia: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116879. [PMID: 35682460 PMCID: PMC9180562 DOI: 10.3390/ijerph19116879] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 06/01/2022] [Accepted: 06/03/2022] [Indexed: 11/17/2022]
Abstract
Women living with HIV (WLHIV) are vulnerable to various mental health challenges. However, there is a paucity of studies globally and in the Indonesian context that have specifically explored mental health challenges among mothers living with HIV who also have children living with HIV (CLHIV). This qualitative study explored mental health challenges and the associated factors in mothers living with HIV who have CLHIV in Yogyakarta, Indonesia. In-depth interviews were employed to collect data from the participants (N = 23) who were recruited using the snowball sampling technique. A qualitative data analysis framework was used to guide the analysis of the findings. The findings showed that the mothers experienced a range of mental health issues due to their own, and their child’s diagnoses of stress, depression, anxiety, fear, sadness, and guilt. Lack of knowledge about HIV, fear of death, shame, not knowing whom to talk with and what to do after their own HIV diagnosis, and the HIV diagnosis of their children were factors that challenged their mental health. Difficulties in dealing with daily life or social activities of their CLHIV, dilemmas in addressing questions and complaints of their CLHIV about HIV treatment, and concerns about the health condition of their CLHIV and how their children cope with any potential negative social impacts also impacted the mothers’ mental health. Social factors such as unsympathetic expressions from friends towards them and their CLHIV and negatively worded religious-related advice from parents and relatives also contributed to their poor mental health. Our findings indicate the need for intervention programs that support mothers living with HIV and their CLHIV. Future large-scale studies involving mothers living with HIV who have CLHIV in Indonesia and other settings globally are needed to obtain a comprehensive understanding of mental health challenges and the associated factors they face.
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19
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Mercadal-Orfila G, Font J, Pons M, Blasco Mascaró I, Piqué N. HIV-positive women have higher prevalence of comorbidities and anticholinergic burden: assessment of the HIV-positive population from Menorca (Balearic Islands). AIDS Care 2022; 35:800-809. [PMID: 35473442 DOI: 10.1080/09540121.2022.2067518] [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: 10/18/2022]
Abstract
Currently, the management of comorbidities and polypharmacy in HIV-infected patients requires a coordinated action, with special focus on gender differences. Observational, cross-sectional study was conducted to study the HIV population from Menorca (Illes Balears). Adult HIV-positive individuals on antiretroviral treatment attending the pharmacy service from Hospital Mateu Orfila (Menorca) were included. In a single visit, demographical and clinical characteristics, comorbidities and cotreatments were collected. Anticholinergic burden (Drug Burden Index, DBI), drug-to-drug interactions (BOT PLUS database) and symptoms associated with HIV treatment (HIV-SI index) were assessed. A total of 223 patients were included, 68.2% men, with a median age of 53.00 (44.50-58.00) years, median BMI of 24.07, 47.73% smokers and 9.90% drug consumers. Women had more advanced stages of the disease and significantly more symptoms (cough and anxiety) versus men (p = .033 and p = .048, respectively). Moreover higher exposures to anticholinergic drugs (DBI 0.51 vs. 0.27) were reported, together with more frequency of drug-to-drug interactions (57.7% vs. 37.5%; p = .005) that increased with age. Red interactions were more frequently reported in PI (2.69%), NNRTIs (1.92%) and booster drugs (1.92%). These results support the need to implement specific measures for the management of HIV-infected women and tools to assess polypharmacy and risk of drug-to-drug interactions.
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Affiliation(s)
- Gabriel Mercadal-Orfila
- Pharmacy Department, Hospital Mateu Orfila, Menorca, Spain.,Department of Biochemistry and Molecular Biology, Universitat de les Illes Balears (UIB), Palma de Mallorca, Spain
| | - Julia Font
- Pharmacy Department, Hospital Mateu Orfila, Menorca, Spain
| | - Marta Pons
- Pharmacy Department, Hospital Mateu Orfila, Menorca, Spain
| | | | - Núria Piqué
- Microbiology Section, Department of Biology, Healthcare and Environment, Faculty of Pharmacy and Food Sciences, Universitat de Barcelona (UB), Barcelona, Spain.,Research Institute of Nutrition and Food Safety, Universitat de Barcelona (INSA-UB), Barcelona, Spain
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20
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Ade-Ojo IP, Dada MU, Adeyanju TB. Comparison of Anxiety and Depression Among HIV-Positive and HIV-Negative Pregnant Women During COVID-19 Pandemic in Ekiti State, Southwest Nigeria. Int J Gen Med 2022; 15:4123-4130. [PMID: 35465305 PMCID: PMC9020505 DOI: 10.2147/ijgm.s362225] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 04/06/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Idowu Pius Ade-Ojo
- Department of Obstetrics & Gynecology, Ekiti State University, Ado-Ekiti, Ekiti State, Nigeria
- Correspondence: Idowu Pius Ade-Ojo, Department of Obstetrics & Gynecology, Ekiti State University, PMB 5363, Ado-Ekiti, Ekiti State, Nigeria, Tel +234 8033886173, Email
| | - Mobolaji Usman Dada
- Department of Psychiatry, Ekiti State University, Ado-Ekiti, Ekiti State, Nigeria
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Osborn L, Ronen K, Larsen AM, Richardson B, Khasimwa B, Chohan B, Matemo D, Unger J, Drake AL, Kinuthia J, John-Stewart G. Antenatal depressive symptoms in Kenyan women living with HIV: contributions of recent HIV diagnosis, stigma, and partner violence. AIDS Care 2022; 34:69-77. [PMID: 34579601 PMCID: PMC8758509 DOI: 10.1080/09540121.2021.1981216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Depression among pregnant women living with HIV (WLWH) in sub-Saharan Africa leads to poor pregnancy and HIV outcomes. This cross-sectional analysis utilized enrollment data from a randomized trial (Mobile WAChX, NCT02400671) in six Kenyan public maternal and child health clinics. Depressive symptoms were assessed with the Patient Health Questionnaire-9 (PHQ-9), stigma with the Stigma Scale for Chronic Illness, and intimate partner violence (IPV) with the Abuse Assessment Screen. Correlates of moderate-to-severe depressive symptoms ("depression", PHQ-9 score ≥10) were assessed using generalized estimating equation models clustered by facility. Among 824 pregnant WLWH, 9% had depression; these women had more recent HIV diagnosis than those without depression (median 0.4 vs. 2.0 years since diagnosis, p = .008). Depression was associated with HIV-related stigma (adjusted Prevalence Ratio [aPR]:2.36, p = .025), IPV (aPR:2.93, p = .002), and lower social support score (aPR:0.99, p = .023). Using population-attributable risk percent to estimate contributors to maternal depression, 81% were attributable to stigma (27%), recent diagnosis (24%), and IPV (20%). Integrating depression screening and treatment in prevention of mother-to-child HIV transmission programs may be beneficial, particularly in women recently diagnosed or reporting stigma and IPV.
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Affiliation(s)
| | | | | | | | | | - Bhavna Chohan
- University of Washington, Seattle, WA, USA,Kenya Medical Research Institute, Nairobi, Kenya
| | | | | | | | - John Kinuthia
- Kenyatta National Hospital, Nairobi, Kenya,University of Nairobi, Nairobi, Kenya
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Neuropsychiatric Disorders, Emotional Disturbances, and Their Associations with HIV-Associated Neurocognitive Disorder. Curr Top Behav Neurosci 2021; 50:347-366. [PMID: 34081306 DOI: 10.1007/7854_2021_233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The current chapter provides a critical and narrative review of recent research on the neuropsychiatric disorders, emotional disturbances, and their associations with neurocognitive functioning in people living with HIV infection. We review a range of neuropsychiatric disorders including depression and anxiety disorders, but also emotional disturbances, which can be partly distinguished from depression and anxiety (apathy, alexithymia, and emotional processing impairment). While reviewing the research into the neuropsychiatric disorders and HIV-associated neurocognitive disorders, we also cover the questions of self-reported cognitive symptoms evaluation and interpretation. The chapter includes research on the role of coping skills, perceived stress and response to stressful life events, and connections to neurocognitive impairment in people living with HIV. Promising non-pharmacological interventions are highlighted. The chapter concludes with the clinical implications on how to best consider neuropsychiatric disorders and cognitive symptoms for the diagnosis of HIV-associated neurocognitive disorders, as well as future research directions.
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