Perceived Social Support and Associated Factors Among Adults Living with HIV/AIDS Attending ART Clinic at Public Hospitals in Gamo Zone, Southern Ethiopia 2021

Background

HIV/AIDS remains one of the world’s serious public health challenges. Patients with limited support from their family and community often experience social damage, poor adherence, compliance and are prone to additional psychosocial problems. This study aimed to assess the level of perceived social support and factors among adults living with HIV/AIDS.

Methods

Facility-based mixed study (sequential explanatory) design was conducted among 423 adults living with HIV/AIDS attending chronic care follow-up at public hospitals in Gamo zone, southern Ethiopia. Respondents were selected by systematic sampling technique. The bivariable and multivariable ordinal logistic regression was used to determine associated factors. All assumptions applied to ordinal logistic regression including multicollinearity, proportional odds, model fitness and pseudo R² were checked. Level of significance was declared at p-values <0.05 and 95% CI.

Results

Proportion of perceived social support of participants was 128 (30.7%), 197 (47.2%) and 92 (22.1%) with low, moderate and high levels of perceived social support, respectively. Females [(APOR = 2.42, 95% CI:(1.63–3.58), P < 0.001)], no formal education [(AOR = 0.49, 95% CI: (0.30–0.789), P = 0.004)], fair adherence [(APOR = 2.07, 95% CI: (1.17–3.49), P = 0.006)], no comprehensive knowledge about HIV [(APOR = 0.40, 95% CI: (0.26–0.62), P < 0.001)], and no disclosure status [(APOR = 0.64, 95% CI: (0.43–0.95), P = 0.028] were significantly associated with perceived social support. Qualitative findings revealed that disclosure and adherences involving income generation activities are beneficial to perceived social support.

Conclusion

This study showed that one from three of the participants had low perceived social support. Low perceived social support was associated with adherence, disclosure status of individual, educational status and knowledge about HIV/AIDS. Family, friends, health care providers and significant others should provide necessary support and inform people living with HIV/AIDS (PLWHA) about social support.

Experience and management of stigma among persons living with HIV in Bali, Indonesia: A descriptive study

AIM

This study aimed to describe the level of HIV stigma experience and the HIV stigma management strategies used by persons living with HIV (PLWH) in Bali, Indonesia.

METHODS

A cross-sectional descriptive study was conducted from March to May 2019. In total, 215 respondents were recruited using purposive sampling from hospitals and HIV private clinic. The research tools consisted of the demographic characteristics form, the 28-Item Internalized HIV Stigma Scale, and the Stigma Management Strategies Checklist. This study used descriptive statistics and non-parametric statistics to analyze the data.

RESULTS

Overall, the transformed mean score of HIV stigma experience was at a low level (mean = 42.88, SD ± 17.59). There was no statistically significant difference between demographic characteristics and HIV stigma (p > .05). Of the 38 stigma management strategies, prayer (70.7%) was reported as the most common, whereas forgiving one's spouse (4.1%) was the least utilized strategy of the respondents. The most often reported reason to manage stigma was to alleviate and/or avoid stress (68.8%). In addition, the most effective stigma management strategy was prayer (28.8%). Conversely, the least effective was staying alone (21.9%).

CONCLUSIONS

HIV stigma is present in Bali, Indonesia, and PLWH struggle to accept their HIV status. Furthermore, they use prayer as a stigma management strategy to get closer to God. The findings of this study could serve as evidence to inform HIV stigma reduction programs in the community. In addition, the development of faith-based stigma management interventions is recommended.

Internalized Stigmatization, Social Support, and Individual Mental Health Problems in the Public Health Crisis

This study investigates the relationship between internalized stigmatization brought on by epicenter travel experiences and mental health problems (including anxiety, depression, and shame) during the period of the novel coronavirus disease emergency in China. The cross-sectional data were collected using the time-lag design to avoid the common method bias as much as possible. Regression results using structural equation modeling show that the internalized stigmatization of epicenter travel experiences may have positive relationships with mental health problems (i.e., anxiety, depression, and shame), and such relationships can be moderated by social support. Specifically, the positive relationships between internalized stigmatization and mental health problems are buffered/strengthened when social support is at a high/low level. The findings of this study suggest that, in this epidemic, people who have epicenter travel experience could be affected by internalized stigmatization, no matter whether they have ever got infected.

Social Determinants of Depression Among Older Black Women Living With HIV

BACKGROUND: The prevalence of depression spans age-groups, but it can be particularly destructive for older people with chronic illness. Among older Black women living with HIV (OBWLH), multiple social determinants have been associated with the prevalence and severity of depression. A greater understanding of the impact of the social determinants at the individual, interpersonal, and community levels is needed. AIMS: To explore social determinants of depression among OBWLH at the intrapersonal, interpersonal, and community levels. METHOD: Cross-sectional descriptive design. RESULTS: A total of 118 OBWLH were analyzed in the study. Depression was prevalent among the participants. Approximately 89.8% of the participants had moderate to severe depressive symptoms. Health status, exercise, and social support were significant predictors of depression in the sample. CONCLUSION: Social determinants at multiple levels play a significant role in the occurrence and management of depression among OBWLH. Implications for practice, education, and research can be drawn from these findings.

Burden of HIV-Related Stigma and Post-Partum Depression: A Cross-Sectional Study of Patients Attending Prevention of Mother-to-Child Transmission Clinic at Kenyatta National Hospital in Nairobi

Background: We look at how various HIV-related stigma subtypes, especially internalizing types, interact with postpartum depression (PPD) among women living with HIV. Additionally, we identify key psychosocial risk factors that influence stigma and PPD among women attending Prevention of Mother-to-Child Transmission (PMTCT) clinics. Methods: In this cross-sectional design, 123 women living with HIV were recruited. Participants ages between 18 and 50, who were at least 8 weeks postpartum seeking PMTCT services at Kenyatta National Hospital (KNH), between June and September 2014 participated in the study. HIV/AIDS Stigma Instrument-PLWHA (HASI-P) was used to assesses stigma and Postpartum depression was assessed by Edinburgh Postnatal Depression Scale (EPDS). Bivariate and multivariate regression models were used to determine the individual characteristics associated with the HIV-related stigma Scale. Post survey a few in-depth-interviews were conducted to explore individuals' stigma and depression experiences. Results: The mean age was 31.2 years (SD = 5.2). Fifty-nine (48%) women screened positive for significant depressive symptoms. Post-partum depression was a significant predictor of internalized stigma, enacted, and total stigma (P < 0.05). Older age was associated with less internalized stigma. Living with a partner was associated with more internalized stigma. Having an income above 100 USD per month was protective against stigma. Having good family social support was protective against internalized stigma. A higher educational level was protective against enacted stigma. Being treated for STIs was a risk factor for both enacted and overall stigma. Conclusions: HIV-related stigma needs to be addressed through integrated mental health care programs in PMTCT. Postpartum depression requires comprehensive management to improve short- and long-term outcomes of women living with HIV.

Depression, Anxiety and Their Correlates Among Patients With HIV in South Ethiopia: An Institution-Based Cross-Sectional Study

Background: Depressive and anxious symptoms are more regularly seen in HIV-infected people than in the general population. This investigation planned to evaluate the magnitude and factors related to depressive and anxiety symptoms among HIV patients in South Ethiopia, 2018. Methods: This was an institution-based cross-sectional study directed among 363 HIV-infected individuals who had a customary visit at Hawassa University Comprehensive Specialized Hospital and Yirgalem Hospital, Ethiopia, who were incorporated into the study through systematic sampling techniques. The hospital anxiety and depression scale (HADS) was utilized to take a look at anxious and depressive symptoms. Results: The mean age of the respondents was 37.66 years (SD ±10.03). The prevalence of depression and anxiety were 32.0% and 34.4%, respectively. Patients who were living alone [AOR = 1.94, (95% CI: 1.06, 3.56)], had poor social support [AOR = 5.57, (95% CI: 1.20, 10.84)] or had HIV-related perceived stigma [AOR = 2.35, (95% CI: 1.44, 3.84)] were more likely to have depression as compared to their counterparts. Those with a previous history of mental illness [AOR = 3.36, (95% CI: 1.31, 8.61)] and poor social support [AOR = 6.67, (95% CI: 1.47, 10.33)] were more likely to have anxiety symptoms. Conclusion: The prevalence of anxiety and depression in the current study was high. Concerned health departments of the country should create guidelines to screen and treat depression and anxiety among HIV patients. Further research on hazard factors of depression and anxiety ought to be examined to strengthen and expand these findings.

Stigmas, symptom severity and perceived social support predict quality of life for PLHIV in urban Indian context

Background

Multiple variables have been studied in relation to health-related quality of life (HRQoL), but research has not integrated the contributions of different variables in a single model that allows to compare them. This study, carried out with people living with HIV/AIDS in India, sought to develop a prediction model considering various predictors previously found to be related to HRQoL, namely sociodemographic factors, HIV symptoms, social support, stigmas and avoidant coping.

Methods

A sample of 961 HIV-positive persons from Bengaluru and Mumbai participated in this cross-sectional study, completing a sociodemographic questionnaire along with HRQoL, HIV symptoms, disclosure expectations, disclosure avoidance, social support and internalized, felt, vicarious and enacted stigma scales. Bivariate associations were obtained (correlations, ANOVAs and t tests) and a multiple regression analysis was performed.

Results

Results show that, when all variables are considered together, being married, widowed or deserted, symptom intensity, internalized stigma, disclosure avoidance and enacted stigma contribute negatively to predict HRQoL. On the other hand, being employed, good disclosure expectations and good social support contribute positively to predict HRQoL. Almost half of the variance in HRQoL was explained by this model.

Conclusions

Interventions seeking to increase HRQoL in people living with HIV/AIDS in India would benefit from addressing these aspects.

Prevalence and correlates of depression and anxiety among patients with HIV on-follow up at Alert Hospital, Addis Ababa, Ethiopia

BACKGROUND

Depression and anxiety disorders are common among people living with Human Immunodeficiency Virus than the non-infected individuals. The co-existence of these disorders are associated with barriers to treatment and worsening medical outcomes, including treatment resistance, increased risk for suicide, greater chance for recurrence and utilization of medical resources and/or increase morbidity and mortality. Therefore, assessing depression and anxiety among HIV patients has a pivotal role for further interventions.

METHODS

Institution based cross-sectional study was conducted at ALERT hospital May, 2015. Data were collected using a pretested, structured and standardized questionnaire. Systematic sampling technique was used to select the study participants. Binary logistic regression analysis was used to identify associated factors. Odds ratio with 95 % CI was computed to assess the strength of associations.

RESULTS

The prevalence of co-morbid depression and anxiety among HIV patients was 24.5 % and prevalence of depression and anxiety among HIV patients was 41.2 % (172) and 32.4 % (135) respectively. Multivariate analysis showed that individual who had perceived HIV stigma (AOR = 3.60, 95 % CI (2.23, 5.80), poor social support (AOR = 2.02, 95 % CI (1.25, 3.27), HIV stage III (AOR = 2.80, 95 % CI (1.50, 5.21) and poor medication adherence (AOR = 1.61, 95 % CI (1.02, 2.55) were significantly associated with depression. Being female (AOR = 3.13, 95 % CI (1.80, 5.44), being divorced (AOR = 2.51, 95 % CI (1.26, 5.00), having co morbid TB (AOR = 2.74, 95 % CI (1.37, 5.47) and perceived HIV stigma (AOR = 4.00, 95 % CI (2.40, 6.69) were also significantly associated with anxiety.

CONCLUSION

Prevalence of depression and anxiety was high. Having perceived HIV stigma, HIV Stage III, poor social support and poor medication adherence were associated with depression. Whereas being female, being divorced and having co morbid TB and perceived HIV stigma were associated with anxiety. Ministry of health should give training on how to screen anxiety and depression among HIV patients and should develop guidelines to screen and treat depression and anxiety among HIV patients.