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Zeleke TA, Alemu K, Ayele TA, Denu ZA, Mwanri L, Azale T. Coping strategies for depression among HIV-positive women in Gondar town health facilities, Northwest, Ethiopia: A cross-sectional study. Int J Ment Health Syst 2025; 19:7. [PMID: 40025571 PMCID: PMC11874830 DOI: 10.1186/s13033-025-00665-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2024] [Accepted: 02/21/2025] [Indexed: 03/04/2025] Open
Abstract
BACKGROUND Most women living with HIV in low- and middle-income countries remain undiagnosed and untreated for depression. Even though depression has an adverse effect on treatment outcome and disease progression, less attention is given. The progression of depression is influenced by coping mechanism. The aim of this study was to identify the coping strategies used by depressed women living with HIV in Gondar town health facilities, north west, Ethiopia. METHODS Health institution based cross-sectional study was conducted in Gondar town health facilities, in north-western Ethiopia. All women living with HIV (n = 1043) were screened for depression symptoms using the validated Patient Health Questionnaire, 9 item version (PHQ-9). Those who scored ten or more, "moderate depression among women living with HIV," (n = 435) were included in this study. The BRIEF Coping with Problem Experienced (COPE-28) scale was used to assess coping strategies. Construct validity of the brief COPE was evaluated using confirmatory factor analysis with AMOS 23 software. Linear regression model was fitted and beta coefficients were used to interpret the significant factors for coping strategies at p- values < 0.05 with 95% confidence interval. RESULTS Dysfunctional coping strategy was more widely practiced than emotional focused or problem focused coping strategies. From the emotional coping strategy, spiritual believes and praying coping were the most frequently used coping strategies in the study group. Time taken to initiate antiretroviral therapy (ART) less than 5 years and the increment of viral load were significantly associated with dysfunctional coping strategy. Having 1-2 children and fear of COVID-19 were the significant factors for problem focused coping strategy. An increment in emotion focused coping was associated with food insecurity. Social support and distance from health institutions 5 km or more were found to have a positive association with problem and emotion-focused coping strategies. Conversely, time taken to initiate antiretroviral therapy (ART) 5 years and more negatively correlated with both problem and emotion-focused coping mechanisms. CONCLUSION The study revealed that all coping strategies were utilized by depressed women living with HIV (WLWHIV). Strengthening spiritual coping styles proved beneficial in reducing depression among these individuals. It is recommended that depressed WLWHIV practice problem and emotion-focused coping strategies. Additionally, social support enhances both problem and emotion-focused coping approaches. Factors contributing to dysfunctional coping included having started ART less than five years ago and high viral load levels. Therefore, providing holistic support for depressed WLWHIV is essential to improve their mental health.
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Affiliation(s)
- Tadele Amare Zeleke
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia.
| | - Kassahun Alemu
- Department of Epidemiology and Biostatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tadesse Awoke Ayele
- Department of Epidemiology and Biostatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Zewditu Abdissa Denu
- Department of Anesthesia, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Lillian Mwanri
- Research Centre for Public Health, Equity and Human Flourishing, Torrens University, Adelaide Campus, Adelaide, SA, 5000, Australia
| | - Telake Azale
- Department of Health Promotion and Behavioral Sciences, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Lin C, Diep NB, Nguyen L, Trang NT, Li L, Le MG. Navigating cultural and gender aspects of stigma among women living with HIV in Vietnam. CULTURE, HEALTH & SEXUALITY 2024; 26:1333-1349. [PMID: 38478464 PMCID: PMC11393182 DOI: 10.1080/13691058.2024.2318428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 02/09/2024] [Indexed: 04/21/2024]
Abstract
Women living with HIV often face intersecting challenges of stigma and gender inequality. In Vietnam, this issue is potentially exacerbated by the patriarchal culture. From December 2021 to March 2022, we conducted in-depth interviews with 30 women living with HIV in Hanoi to better understand their experiences and the coping mechanisms to navigate HIV stigma, cultural beliefs and gender norms. The interviews explored various topics including women's social and family roles in Vietnam, HIV-related beliefs, stigma and its impact on one's health and coping strategies. Participants reported stereotypes that assumed that women living with HIV had either engaged in sex work or behaved promiscuously. These stereotypes render them vulnerable to judgement and discrimination owing to widespread expectations of female virtue. As a result, women living with HIV often enacted non-disclosure and self-isolation to avoid stigma. This self-stigmatisation negatively impacted their healthcare-seeking, employment opportunities and ability to fulfil traditional family-caring roles. Conversely, many participants exhibited resilience with the support of family and peers. Overall, the complex interplay between gender, culture and HIV stigma underscores the importance of developing culturally appropriate, multifaceted approaches to engaging family and peers, modifying gender-based discriminatory social practices and enhancing women's self-efficacy and empowerment in Vietnam.
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Affiliation(s)
- Chunqing Lin
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior University of California, Center for Community Health, Los Angeles, CA, USA
| | - Nguyen Bich Diep
- Center for Training and Research on Substance Use & HIV, Hanoi Medical University, Hanoi, Vietnam
| | - Lynn Nguyen
- David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Nguyen Thu Trang
- David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Li Li
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior University of California, Center for Community Health, Los Angeles, CA, USA
| | - Minh Giang Le
- David Geffen School of Medicine, University of California, Los Angeles, CA, USA
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3
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Roh HW, Cho EJ, Son SJ, Hong CH. The moderating effect of cognitive function on the association between social support and depressive symptoms among community-dwelling older adults: Cross-sectional and longitudinal analyses. J Affect Disord 2022; 318:185-190. [PMID: 36057289 DOI: 10.1016/j.jad.2022.08.117] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 08/08/2022] [Accepted: 08/26/2022] [Indexed: 01/22/2023]
Abstract
BACKGROUND The moderating effect of cognitive function on the association between social support and late-life depressive symptoms has not been thoroughly investigated. Identifying cognitive function as a possible moderator of this association might help plan community-based interventions for late-life depressive symptoms. METHODS Participants were community-dwelling older adults who visited a community-based mental health center. The ENRICHD Social Support Instrument and the Montgomery-Asberg Depression Rating Scale were used to evaluate social support and depressive symptoms, respectively. Cognitive function was assessed using the Korean version of the Mini-Mental State Examination. Data from 1088 and 506 participants were included in the cross-sectional and longitudinal analyses, respectively. Multiple linear regression analysis was performed to assess the effects of social support on depressive symptoms and the possible moderating effect of cognition. RESULTS After adjusting for possible confounders, greater social support at baseline was associated with fewer depressive symptoms in both cross-sectional (estimate = -0.25 standard error [SE] = 0.03, P < 0.001) and longitudinal analyses (estimate = -0.11, SE = 0.05, P = 0.014). Moreover, the association between social support and depressive symptoms was significantly moderated by cognitive function (P for interaction < 0.001 for cross-sectional analysis, and P for interaction = 0.011 for longitudinal analysis). LIMITATIONS The tool for assessing social support was self-reported. There may have been a selection bias in the study sample. CONCLUSIONS Greater social support was associated with fewer late-life depressive symptoms in both analyses. However, social support may have less benefits for alleviating depressive symptoms in older adults with cognitive decline.
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Affiliation(s)
- Hyun Woong Roh
- Department of Psychiatry, Ajou University School of Medicine, Suwon, Republic of Korea; Suwon Geriatric Mental Health Center, Suwon, Republic of Korea
| | - Eun Ji Cho
- Department of Psychology, University of California, Berkeley, California, United States of America
| | - Sang Joon Son
- Department of Psychiatry, Ajou University School of Medicine, Suwon, Republic of Korea; Suwon Geriatric Mental Health Center, Suwon, Republic of Korea.
| | - Chang Hyung Hong
- Department of Psychiatry, Ajou University School of Medicine, Suwon, Republic of Korea.
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Wang Q, Fong VWI, Qin Q, Yao H, Zheng J, Wang X, Wang A, Gao Q, Mo PKH. Trends in the psychosocial and mental health of HIV-positive women in China from 2015 to 2020: Results from two cross-sectional surveys. Health Expect 2022; 25:1555-1562. [PMID: 35726358 PMCID: PMC9327813 DOI: 10.1111/hex.13498] [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: 08/31/2021] [Revised: 03/28/2022] [Accepted: 03/30/2022] [Indexed: 11/05/2022] Open
Abstract
Background The human immunodeficiency virus (HIV) continues to be one of the major public health challenges in the world. Despite the advancement in medication and changes in views towards HIV in Chinese society, little is known about the changes in the psychosocial and mental health of HIV‐positive women in recent years. Objectives The present study examined the change in depression, anxiety, stigma, relationship with the child, intimacy with a partner, and social support from family, friends, and health professionals, for HIV‐positive women in China from 2015 to 2020. Methods Two cross‐sectional surveys were conducted in 2015 and 2020, and 429 and 382 HIV‐positive women were recruited from the Women's Health Department in Yunnan and Guangxi, China between November 2015 to May 2016, and November 2019 to January 2020, respectively. Results After controlling for significant sociodemographic variables, participants recruited in 2019–2020 had significantly lower levels of depression and anxiety and higher scores on emotional and tangible support from friends. On the other hand, they had lower scores in intimacy with partners and emotional and tangible support from family. No significant changes were found in stigma, relationship with the child, and support from health professionals. Conclusion Results provide important information on the changes in psychosocial and mental health, which offer insights into the design of interventions to promote psychosocial and mental health among HIV‐positive women in China. Patient or Public Contribution HIV‐positive women contributed to the data of this study. Health care professionals were involved in the discussion of the methods and results.
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Affiliation(s)
- Qian Wang
- Antenatal Health Care Department, National Center for Women and Children's Health, China CDC, Beijing, China
| | - Vivian W I Fong
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - Qinghua Qin
- Antenatal Health Care Department, Maternal and Child Health Hospital of Guangxi, Zhuang Autonomous Region, Nanning, China
| | - Hui Yao
- Antenatal Health Care Department, Maternal and Child Health Hospital of Guangxi, Zhuang Autonomous Region, Nanning, China
| | - Jiarui Zheng
- Antenatal Health Care Department, Yunnan Maternal and Child Health Care Hospital, Kunming, China
| | - Xiaoyan Wang
- Antenatal Health Care Department, National Center for Women and Children's Health, China CDC, Beijing, China
| | - Ailing Wang
- Antenatal Health Care Department, National Center for Women and Children's Health, China CDC, Beijing, China
| | - Qun Gao
- Antenatal Health Care Department, National Center for Women and Children's Health, China CDC, Beijing, China
| | - Phoenix K H Mo
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Sha Tin, Hong Kong.,The Chinese University of Hong Kong Shenzhen Research Institute, Shenzhen, China
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Relationship between spiritual well-being and Health-Related Quality of Life and some related factors in patients with AIDS/HIV. FRONTIERS OF NURSING 2022. [DOI: 10.2478/fon-2022-0007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Objective
The study of effective factors on the quality of life (QoL), as an important criterion, in the outcome of new therapeutic and preventive strategies in human immunodeficiency virus (HIV) has been considered by researchers. To study the relationship between spiritual well-being and Health-Related Quality of Life (HRQoL) and some related factors in patients with Acquired Immunodeficiency Syndrome ([AIDS]/HIV).
Methods
In this cross-sectional study, 224 people were selected as the study population (112 were male and 112 were female) from patients with AIDS/HIV at the Behavioral Counseling Center of Shiraz with available sampling method. The research tool was Palutzian & Ellison well-being scale and QoL Questionnaire (SF-36). Data were analyzed using Pearson correlation test.
Results
There was a significant direct relationship between physical function dimensions (P = 0.003). There was a significant relationship between general well-being, mental well-being, and total spiritual well-being (P < 0.001). There was a statistically significant relationship between the dimensions of QoL and spiritual well-being with some age section of the patients, and their occupation and education (P < 0.001).
Conclusions
Spirituality has an impact on the QoL dimensions. Therefore, HIV positive people's quality of life could be improved by the possibility of the spiritual well-being promotion as a method of adaptation with the disease.
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6
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Gendered Experiences of Living with HIV in Australia. SEXES 2021. [DOI: 10.3390/sexes2030020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Globally, women represent more than half the people living with HIV. This proportion varies by country, with an over-representation of HIV among men who have sex with men (MSM) in some regions. For example, in Australia, MSM account for over 60% of transmissions, with heterosexual sex accounting for almost a quarter of transmissions. Irrespective of geographic region, there is evidence that women can have a different lived experience of HIV due to their unequal social and economic status in society, while MSM can have a different lived experience depending on the laws and customs of their geographic location. Gender differences related to risk factors, stigma, access to services, mental health, health-related quality of life and economic consequences have been consistently reported globally. This paper explores the subjective lived experience of gender and sexuality disparities among three individuals living with HIV in Australia: a male who identified as gay, and a male and female who each identified as heterosexual. Analysis of themes from these three case reports indicated discernible differences by gender and sexuality in four areas: access to medical services, social support, stigma and mental health. It is argued that knowledge and understanding of potential gender and sexuality disparities must be factored into supportive interventions for people living with HIV in Australia.
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Choi S, Toyama J, Brecht ML. Effect of Disclosure on Receiving Spousal Support in Korean Immigrants With Type 2 Diabetes. DIABETES EDUCATOR 2020; 46:559-568. [PMID: 33063629 DOI: 10.1177/0145721720964580] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE The purpose of this study was to investigate factors associated with receiving diabetes spousal support in a sample of Korean immigrants with type 2 diabetes (T2DM) and to test whether disclosure (culture-specific factor) is a significant predictor of spousal support receipt in this group. METHODS A cross-sectional survey was conducted with a convenience sample of 136 US community-dwelling Korean immigrants with T2DM ages 46 to 89 years old. Potential predictors were sociodemographic factors (age, gender, education, years in US), personal characteristics (quality of marriage and depression), diabetes severity (duration of diabetes, A1C, insulin use), diabetes self-management, diabetes worries/concerns (psychological factor), and disclosure of worries (cultural factor). The study used validated survey instruments including Diabetes Care Profile for spousal support received, Summary of Diabetes Self-Care Activities, Problem Area in Diabetes, and Diabetes Distress Disclosure Index. Descriptive statistics, correlations, and hierarchical multivariable linear regression models were conducted. RESULTS Six predictors (education level, years spent in the US, glucose control status, diabetes self-management level, diabetes worries/concerns, and disclosure of diabetes worries) were significantly related to receiving spousal support. At least some college education, less time in the US, better glucose control (lower A1C), poor self-management, more diabetes worries, and more disclosure of diabetes worries/distress were associated with receiving higher level of spousal support. Disclosure was the strongest predictor. CONCLUSION Receiving spousal support for diabetes self-management among Korean immigrants is influenced by 6 factors identified in this study. Disclosing diabetes worries (cultural factor) is most impactful.
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Affiliation(s)
- Sarah Choi
- UCLA School of Nursing, University of California at Los Angeles, Los Angeles, California
| | - Joy Toyama
- Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California
| | - Mary-Lynn Brecht
- UCLA School of Nursing, University of California at Los Angeles, Los Angeles, California
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8
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Gruszczyńska E, Rzeszutek M. Trajectories of Health-Related Quality of Life and Perceived Social Support Among People Living With HIV Undergoing Antiretroviral Treatment: Does Gender Matter? Front Psychol 2019; 10:1664. [PMID: 31396129 PMCID: PMC6664262 DOI: 10.3389/fpsyg.2019.01664] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Accepted: 07/02/2019] [Indexed: 12/22/2022] Open
Abstract
The study examined the trajectories of health-related quality of life (HRQoL) and perceived social support (PSS) among people living with HIV (PLWH), with a special focus on gender differences. The participants included 252 PLWH (18% female) undergoing antiretroviral therapy. HRQoL (WHO Quality of Life-BREF; WHOQOL Group, 1998) and PSS (Berlin Social Support Scales; Schulz and Schwarzer, 2003) were measured three times at six-month intervals. Using a univariate approach, three trajectories of HRQoL and four trajectories of PSS were identified. Gender and relationship status were significant covariates for PSS only, with overrepresentation of single women in the increasing trajectory. The dual trajectory approach revealed a match in the decrease of HRQoL and PSS, but only for 31% of the sample. In fact, decreasing PSS co-occurred with increasing as well as stable HRQoL. There was no significant gender effect in this regard. Although a clear correspondence for decreasing trajectories exists, the findings also highlight a discrepancy between HRQoL and PSS changes that are unrelated to gender.
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Affiliation(s)
- Ewa Gruszczyńska
- Faculty of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland
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Huang J, Lin D, Yu NX. Variations in Dyadic Adjustment Among Heterosexual HIV-Discordant Couples in Rural China: A Latent Profile Analysis. AIDS Patient Care STDS 2019; 33:323-335. [PMID: 31194573 DOI: 10.1089/apc.2019.0026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The systemic framework of resilience and dyadic perspective of couple coping suggests that HIV-discordant couples may show heterogeneous profiles of dyadic adjustment, shaped by contextual risks and resources. This study aimed to identify heterogeneous profiles of dyadic adjustment and thus investigate the expression of resilience among 159 heterosexual HIV-discordant couples in rural China. We hypothesized that the couples could be grouped into distinct profiles: both members showing poor well-being, both members showing good well-being, and discrepant well-being across the two members. A latent profile analysis classified the couples into three subgroups based on well-being, which was measured using the World Health Organization Well-Being Index. As expected, one subgroup, labeled Maladapted Couples (n = 58, 36.5%), reported poor well-being in both people living with HIV/AIDS (PLWHA) and the seronegative spouse. The second subgroup, labeled Resilient Couples (n = 50, 31.4%), was characterized by relatively good well-being in both partners. In the third subgroup, labeled Maladapted PLWHA and Resilient Spouses (n = 51, 32.1%), the PLWHA showed poor well-being, while the seronegative spouses demonstrated good well-being. The identified subgroups were validated against external well-being measures, including depression and self-rated health measures. Exploratory analyses identified distinct patterns of contextual risks (including HIV stigma and financial difficulties) and resource factors (including individual resources and relational resources) across the subgroups. These findings underscore the heterogeneity of adjustment among heterosexual HIV-discordant couples in rural China and suggest the potential usefulness of services tailored to specific subgroups.
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Affiliation(s)
- Jiasheng Huang
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong, China
| | - Danhua Lin
- Institute of Developmental Psychology, Beijing Normal University, Beijing, China
| | - Nancy Xiaonan Yu
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong, China
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Mabweazara SZ, Ley C, Leach LL. Physical activity, social support and socio-economic status amongst persons living with HIV and AIDS: a review. AJAR-AFRICAN JOURNAL OF AIDS RESEARCH 2019; 17:203-212. [PMID: 30003848 DOI: 10.2989/16085906.2018.1475400] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Physical activity can be used for the effective and comprehensive management of HIV and AIDS. Social support and socio-economic status (SES) are two factors that shape physical activity behaviours. Individuals of low SES carry a disproportionate burden of the HIV and AIDS epidemic. In addition, limited resources constitute socio-ecological barriers predisposing such individuals to physical inactivity. The purpose of this narrative review is to examine the available literature on physical activity, social support and SES and to generate recommendations for designing and implementing physical activity interventions targeting people living with HIV and AIDS (PLWHA) of low SES. The review used literature from Google, Google Scholar and PubMed on physical activity of PLWHA, social support for physical activity, and SES and physical activity. Qualitative and quantitative studies in English were included from 1970 to 2016. The results show that social support plays a major role in promoting physical activity and counteracting the barriers to PA in PLWHA of low SES. The results on the role of social support and the influence of SES are integrated to help design appropriate physical activity interventions for PLWHA of low SES. Well-designed interventions should utilise social support and be contextualised for PLWHA of low SES, whose living conditions present multiple barriers to physical activity.
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Affiliation(s)
- Smart Z Mabweazara
- a Department of Sport Recreation and Exercise Science , University of the Western Cape , Bellville , South Africa
| | - Clemens Ley
- b Institute of Sport Science , University of Vienna , Vienna , Austria
| | - Lloyd L Leach
- a Department of Sport Recreation and Exercise Science , University of the Western Cape , Bellville , South Africa
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Nakimuli-Mpungu E, Musisi S, Wamala K, Okello J, Ndyanabangi S, Birungi J, Nanfuka M, Etukoit M, Mojtabai R, Nachega J, Harari O, Mills E. Recruitment and Baseline Characteristics of Participants in the Social, Emotional, and Economic Empowerment Through Knowledge of Group Support Psychotherapy Study (SEEK-GSP): Cluster Randomized Controlled Trial. JMIR Res Protoc 2019; 8:e11560. [PMID: 30609989 PMCID: PMC6682267 DOI: 10.2196/11560] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 10/25/2018] [Accepted: 11/01/2018] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Psychosocial characteristics, including self-esteem, perceived social support, coping skills, stigma, discrimination, and poverty, are strongly correlated with depression symptoms. However, data on the extent of these correlations among persons living with HIV and the associations between psychosocial characteristics and HIV treatment outcomes are limited in sub-Saharan Africa. OBJECTIVE This paper aims to describe the recruitment process and baseline characteristics associated with depression in a sample of HIV-positive people in a cluster randomized trial of group support psychotherapy (GSP) for depression delivered by trained lay health workers (LHWs). METHODS Thirty eligible primary care health centers across three districts in Uganda were randomly allocated to have their LHWs trained to deliver GSP (intervention arm) or group HIV education and treatment as usual (control arm) to persons living with HIV comorbid with depression. Baseline demographic, socioeconomic, and psychosocial characteristics were collected via interviewer-administered questionnaires. Among eligible participants, differences between those enrolled versus those who refused enrollment were assessed using chi square for categorical variables and t tests for continuous variables. Spearman rank order correlation analyses were conducted to determine associations between baseline depression symptoms and adherence to antiretroviral therapy (ART), viral load suppression, and other psychosocial variables. RESULTS The study screened 1473 people and 1140 were found to be eligible and enrolled over 14 weeks. Participants recruited comprised 95% of the target sample size of 1200. The sample's mean age was 38.5 (SD 10.9) years and both genders were well represented (males: 46.32%, 528/1140). Most participants met the diagnostic criteria for major depressive disorder (96.92%, 1105/1140), had significant posttraumatic stress symptoms (72.46%, 826/1140), reported moderate suicide risk (52.54%, 599/1140), had primary or no formal education (86.22%, 983/1140), and reported no income-generating activity (72.63%, 828/1140) and no food insecurity (81.67%, 931/1140). Among eligible participants, 48 of 1140 (4.21%) refused to participate in the interventions; these participants were more likely to be males (χ21=4.0, P=.045) and have significantly lower depression symptoms scores (t2=2.36, P=.01) than those who participated in the interventions. There was a significant positive correlation between viral load and number of traumatic experiences (ρ=.12, P=.05). Adherence to ART was positively correlated with perceived social support (ρ=.15, P<.001), but negatively correlated with depression symptoms (ρ=-.11, P=.05) and stigma (ρ=-.14, P<.001). CONCLUSIONS Men and women with HIV and depression experience multiple social and economic vulnerabilities and disadvantages. Culturally tailored psychological interventions aimed at these individuals should address these socioeconomic disadvantages in addition to addressing their mental health care needs. TRIAL REGISTRATION Pan African Clinical Trials Registry PACTR201608001738234; https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=1738 (Archived by WebCite at http://www.webcitation.org/74NtMphom).
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Affiliation(s)
| | - Seggane Musisi
- Department of Psychiatry, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Kizito Wamala
- Center for Victims of Torture, Department of Psychology, Gulu, Uganda
| | - James Okello
- Department of Mental Health, Faculty of Medicine, Gulu University, Gulu, Uganda
| | | | | | | | | | - Ramin Mojtabai
- Department of Mental Health, Bloomberg's School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Jean Nachega
- Department of Epidemiology, Pittsburg Graduate School of Public Health, University of Pittsburg, Pittsburgh, PA, United States.,Stellenbosch Center for Infectious Disease, Department of Medicine, Stellenbosch University, Cape Town, South Africa.,Department of Epidemiology, Bloomberg's School of Public Health, Johns Hopkins University, Baltimore, MD, United States.,Department of International Health, Bloomberg's School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | | | - Edward Mills
- Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, ON, Canada
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12
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Siregar ML, Abdullah V, Mamfaluti T. Correlation of depression and quality of life in HIV/AIDS patients. ACTA ACUST UNITED AC 2018. [DOI: 10.1088/1755-1315/125/1/012009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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13
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Li L, Liang LJ, Lin C, Ji G, Xiao Y. Gender Differences in Depressive Symptoms Among HIV-Positive Concordant and Discordant Heterosexual Couples in China. PSYCHOLOGY OF WOMEN QUARTERLY 2017; 41:89-99. [PMID: 28490832 PMCID: PMC5421639 DOI: 10.1177/0361684316671302] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
HIV seropositive individuals and their heterosexual partners/spouses, either seropositive or seronegative, are facing several mental health challenges. The objective of this study was to examine gender differences in depressive symptoms among HIV-positive concordant and HIV-discordant couples. We identified heterosexual couples from participants of a randomized controlled trial conducted in Anhui province, China. A total of 265 couples, comprising 129 HIV+ male/HIV- female couples, 98 HIV- male/HIV+ female couples, and 38 HIV-positive concordant couples, were included in the analyses. We collected data using the computer-assisted personal interview method. We used a linear mixed-effects regression model to assess whether gender differences in depressive symptoms varied across couple types. HIV-positive women reported a significantly higher level of depressive symptoms than their partners/spouses. HIV-positive women with HIV-positive partners had higher depressive symptoms than those with HIV-negative partners, whereas HIV-positive men reported similar levels of depressive symptoms regardless of their partners' serostatus. Among the concordant couples, those with the highest annual family income showed the greatest gender differences in depressive symptoms. We suggest that family interventions should be gender- and couple-type specific and that mental health counseling is warranted not only for HIV-positive women but also for HIV-negative women in an HIV-affected relationship.
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Affiliation(s)
- Li Li
- Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles, Los Angeles, CA, USA
| | - Li-Jung Liang
- Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles, Los Angeles, CA, USA
| | - Chunqing Lin
- Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles, Los Angeles, CA, USA
| | - Guoping Ji
- Anhui Provincial Center for Disease Control and Prevention, Hefei, Anhui, China
| | - Yongkang Xiao
- Anhui Provincial Center for Disease Control and Prevention, Hefei, Anhui, China
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