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Gómez W, Schustack A, Carrico AW, Ramirez-Forcier J, Batchelder A. In the Interest of Time: Assessing the Role of Resilience Across an Intergenerational Sample of People Living with HIV. Int J Behav Med 2024; 31:315-324. [PMID: 37438561 DOI: 10.1007/s12529-023-10198-7] [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] [Accepted: 06/29/2023] [Indexed: 07/14/2023]
Abstract
BACKGROUND Biomedical advances have improved the quality of life of people living with HIV (PLWH); however, barriers to optimal well-being remain. A key feature in understanding the lived experiences of PLWH is resilience. The concept of resilience is quite complex in terms of its antecedents and expressions, suggesting the need for more nuanced understandings of how it could be harnessed to better support this population. METHOD The concept of resilience was explored in a qualitative study involving 22 PLWH, selectively sampled by era of diagnosis. Through interviews focused on context and experiences of living with HIV, the sample highlighted resilience processes corresponding to Positive reappraisal of life events, Positive reappraisal of self, and Community as resilience. RESULTS Participants who have lived with HIV longer more commonly described engaging in psychological processes of resilience, whereas those who were more recently diagnosed reported engaging in more social processes. However, these processes were not mutually exclusive and the ability to perform resilience through community seems to be key to optimizing outcomes, irrespective of era of diagnosis. CONCLUSION PLWH are a heterogeneous population where engagement in distinct processes of resilience may have important implications for optimal social and health outcomes. Better understanding of the distinct and diverse pathways through which PLWH engage in resilience may inform interventions promoting optimal well-being.
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Affiliation(s)
- Walter Gómez
- Jane Addams College of Social Work, University of Illinois Chicago, 1040 West Harrison Street (MC309), Chicago, IL, 60607-7134, USA.
| | | | - Adam W Carrico
- Department of Public Health Sciences, University of Miami, Miami, FL, USA
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Mwangala PN, Wagner RG, Newton CR, Abubakar A. Strategies for improving mental health and wellbeing used by adults ageing with HIV from the Kenyan coast: a qualitative exploration. Wellcome Open Res 2023; 7:221. [PMID: 37415804 PMCID: PMC10320323 DOI: 10.12688/wellcomeopenres.18212.2] [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: 06/20/2023] [Indexed: 07/08/2023] Open
Abstract
Background: Physical and mental health problems are common among older adults living with HIV (OALWH). Adaptive coping strategies play a vital role in improving these adults' mental health and well-being despite the deleterious effects of HIV and ageing. However, in sub-Saharan Africa, limited evidence exists on the commonly utilized coping strategies in this population. We explore the coping strategies used by Kenyan OALWH to improve their mental health and wellbeing. Methods: Semi-structured in-depth interviews were conducted between October and December 2019 with 56 participants: 34 OALWH (53% female), 11 healthcare providers (63% female) and 11 primary caregivers (73% female) in Kilifi County. All interviews were audio-recorded and transcribed verbatim. We used the framework approach to synthesize the qualitative data. Results: Five major themes emerged from the analysis of participants' narratives, including self-care practices, religion and spirituality, relational living (social connectedness), generativity, identity, and mastery. Our study further revealed maladaptive coping strategies, including reliance on over-the-counter medications, self-isolation, waiting to see if symptoms would subside despite doing nothing, and HIV treatment interruptions during prolonged periods of prayer and fasting. Conclusions: Our findings provide an initial understanding of the coping strategies used by OALWH to confront HIV and ageing challenges in a low-literacy, low socio-economic Kenyan setting. Our results suggest that interventions designed to enhance personal capacity, social support, positive religiosity and spirituality, and intergenerational connections may be beneficial in improving the mental health and well-being of OALWH.
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Affiliation(s)
- Patrick N. Mwangala
- Centre for Geographic Medicine Research Coast, Kenya Medical Research Institute (KEMRI), Kilifi, P O Box 230-80108, Kenya
- School of Public Health, University of the Witwatersrand, Johannesburg, 27 St Andrews Road, Parktown 2193, South Africa
- Institute for Human Development, Aga Khan University, Nairobi, P.O. BOX 30270-00100, Kenya
| | - Ryan G. Wagner
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), University of the Witwatersrand, Faculty of Health Sciences, Johannesburg, South Africa
| | - Charles R. Newton
- Centre for Geographic Medicine Research Coast, Kenya Medical Research Institute (KEMRI), Kilifi, P O Box 230-80108, Kenya
- Institute for Human Development, Aga Khan University, Nairobi, P.O. BOX 30270-00100, Kenya
- Department of Psychiatry, University of Oxford, Warneford Hospital, Warneford Ln, Oxford, OX3 7JX, UK
- Department of Public Health, Pwani University, Kilifi, P.O. BOX 195-80108, Kenya
| | - Amina Abubakar
- Centre for Geographic Medicine Research Coast, Kenya Medical Research Institute (KEMRI), Kilifi, P O Box 230-80108, Kenya
- Institute for Human Development, Aga Khan University, Nairobi, P.O. BOX 30270-00100, Kenya
- Department of Psychiatry, University of Oxford, Warneford Hospital, Warneford Ln, Oxford, OX3 7JX, UK
- Department of Public Health, Pwani University, Kilifi, P.O. BOX 195-80108, Kenya
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Mitchell BD, Utterback L, Hibbeler P, Logsdon AR, Smith PF, Harris LM, Castle B, Kerr J, Crawford TN. Patient-Identified Markers of Quality Care: Improving HIV Service Delivery for Older African Americans. J Racial Ethn Health Disparities 2023; 10:475-486. [PMID: 35064521 PMCID: PMC8781691 DOI: 10.1007/s40615-022-01237-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 01/11/2022] [Accepted: 01/12/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND Over 50% of new AIDS/HIV diagnoses are older adults and disproportionately African American people. Longstanding health inequities, driven by the enduring nature of systemic racism, pose challenges to obtaining optimal HIV services. Patient experiences and identities shape the health care experience, yet patient voices are often minimized, including their assessment of quality HIV care. Understanding these markers of care, including facilitators of and barriers to care and engagement, may help enhance the patient voice, potentially improving service delivery and eradicating HIV healthcare disparities. METHOD Using a convergent mixed method design, our study identifies patient-identified markers of quality care among older African Americans (N = 35). Measurements of global stress, HIV stigma, and engagement in care were collected, and in-depth qualitative interviews explored the symbols of quality care as well as facilitators of and barriers to care. RESULTS We identified widespread participant awareness and recognition of quality care, the detection of facilitators and barriers across individual, clinic, and community levels. Facilitators of care include diet, health, relationships, community support, and compassionate HIV care. Barriers to care include health comorbidities, economic, food, and housing insecurity, lack of transportation, and structural racism. CONCLUSION Our findings illuminate how the prominence of barriers to care often uproot facilitators of care, creating impediments to HIV service delivery as patients transition through the HIV care continuum. We offer implications for practice and policy, as well as recommendations for reducing structural barriers to care by enhancing the patient voice and for aligning services toward compassionate and inclusive care.
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Affiliation(s)
- Brandon D. Mitchell
- grid.266623.50000 0001 2113 1622Kent School of Social Work, University of Louisville, Louisville, KY USA
| | - Liz Utterback
- grid.266623.50000 0001 2113 1622Kent School of Social Work, University of Louisville, Louisville, KY USA
| | - Paul Hibbeler
- grid.266623.50000 0001 2113 1622Kent School of Social Work, University of Louisville, Louisville, KY USA
| | - Ashley R. Logsdon
- grid.266623.50000 0001 2113 1622Kent School of Social Work, University of Louisville, Louisville, KY USA
| | - Patricia F. Smith
- grid.266623.50000 0001 2113 1622Kent School of Social Work, University of Louisville, Louisville, KY USA
| | - Lesley M. Harris
- grid.266623.50000 0001 2113 1622Kent School of Social Work, University of Louisville, Louisville, KY USA
| | - Billie Castle
- grid.266623.50000 0001 2113 1622School of Public Health and Information Sciences, University of Louisville, Louisville, KY USA
| | - Jelani Kerr
- grid.266623.50000 0001 2113 1622School of Public Health and Information Sciences, University of Louisville, Louisville, KY USA
| | - Timothy N. Crawford
- grid.268333.f0000 0004 1936 7937Family Medicine and Population and Public Health Sciences, Wright State University, Dayton, OH USA
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The Development and Validation of Multi-dimensional Resilience Scale for People Living with HIV in China. AIDS Behav 2023; 27:832-841. [PMID: 36029424 PMCID: PMC9419641 DOI: 10.1007/s10461-022-03818-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2022] [Indexed: 11/11/2022]
Abstract
The study aimed to provide a measurement tool for the assessment of resilience among people living with HIV (PLHIV) in China. The study period was from April 2019 to October 2020: first, 14 PLHIV were interviewed to build an item pool; 15 experts were invited to evaluate the scale items. The test-retest reliability of the scale was carried out with 29 PLHIV. Online and field investigation were used, and convenience sampling was conducted in Luzhou and Zigong. A pool of 31 items was formed and the Scale-Level Content Validity Index average was 0.96, while the that intra-class correlation coefficient for test-retest reliability was 0.816. From the exploratory factor analysis, four factors (Acceptance; Disease Management; Emotion Regulation; and Reconstruction) with 19 items were extracted. The Cronbach's alpha value of the Resilience Scale was 0.88. This scale could prove useful as a measuring tool for evaluating the level of resilience for PLHIV.
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Lavie-Ajayi M. The Social Construction of Cannabis in Social Work. SOCIAL WORK 2022; 67:331-340. [PMID: 35869948 DOI: 10.1093/sw/swac030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 02/01/2021] [Accepted: 06/20/2022] [Indexed: 06/15/2023]
Abstract
The social construction of cannabis has important implications for policy, research, practice, and education in social work. The objective of this article is to chart the construction of cannabis in articles published in social work journals across the past half century. The author critically reviews empirical articles with references to cannabis published in 15 key social work journals between 1970 and 2018. Systematic searches resulted in a combined set of 510 articles, of which 244 matched the inclusion criteria for this study. A content and thematic analysis of the corpus identified the dominant construction of cannabis in social work research literature as a harmful substance undifferentiated from other drugs. This construction was challenged by a minority of the articles in three ways: (1) by differentiating between use and abuse and between cannabis as a soft drug and a hard drug; (2) by highlighting social inequality as an important component of any consideration of social work policy and practice with regard to cannabis use; and (3) by considering the possible positive effects of cannabis use. This article calls for a revision of the construction of cannabis use in social work.
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Murzin K, Racz E, Behrens DM, Conway T, Da Silva G, Fitzpatrick E, Lindsay JD, Walmsley SL. "We can hardly even do it nowadays. So, what's going to happen in 5 years from now, 10 years from now?" The health and community care and support needs and preferences of older people living with HIV in Ontario, Canada: a qualitative study. J Int AIDS Soc 2022; 25 Suppl 4:e25978. [PMID: 36176028 PMCID: PMC9522634 DOI: 10.1002/jia2.25978] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 07/31/2022] [Indexed: 11/10/2022] Open
Abstract
Introduction The population of people living with HIV (PLWH) is ageing consequent to effective treatment and a steady stream of new diagnoses among older adults. PLWH experience a greater burden of age‐related comorbidities and poorer social determinants of health compared to their HIV‐negative peers, yet comprehensive requisites for care and support as PLWH age remain poorly understood. Preferences And Needs for Ageing Care among HIV‐positive Elderly people in Ontario, Canada (PANACHE ON), explored the health and community care and social support needs and preferences of a diverse group of older PLWH (age 60+) and described life course experiences among older PLWH that shape these needs and preferences and whether they are met. Methods PANACHE ON was a qualitative community‐based participatory research study. In‐person focus groups using a semi‐structured interview guide were co‐facilitated by pairs of trained older PLWH from July to October 2019. Purposive sampling bolstered the inclusion of communities disproportionately affected by HIV in Ontario. Descriptive analysis was used to summarize demographic data; participatory data analysis was conducted by a subset of the research team, with transcripts double‐coded and analysed using NVIVO 12 Plus. Results A total of 73 PLWH participated, 66% identified as men. The mean age was 64 years (range 55–77) and median time living with HIV was 23 years (range 2–37). The current and anticipated needs of older PLWH, many of which were only partially met, included necessities such as food and housing, mobility and sensory aids, in‐home support, social and emotional support, transportation and information. Three experiences—trauma, stigma and uncertainty—intersected in the lives of many of our participants, shaping their needs for care and support, and impacting the ease with which these needs were met. Conclusions Unmet health and social needs and limited control over the availability and accessibility of ageing‐related care and support due to resource constraints or reduced capacity for self‐advocacy results in anxiety about the future among older PLWH, despite their well‐developed coping strategies and experience navigating systems of care. These study findings will inform the development of the first national needs assessment of older PLWH in Canada.
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Affiliation(s)
| | | | | | | | | | - Eimear Fitzpatrick
- Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Joanne D Lindsay
- Realize, Toronto, Ontario, Canada.,MAP Centre for Urban Health Solutions, Unity Health Toronto, Toronto, Ontario, Canada
| | - Sharon L Walmsley
- Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada.,Department of Medicine, University of Toronto, Toronto, Ontario, Canada
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Mwangala PN, Wagner RG, Newton CR, Abubakar A. Strategies for improving mental health and wellbeing used by adults ageing with HIV: a qualitative exploration. Wellcome Open Res 2022. [DOI: 10.12688/wellcomeopenres.18212.1] [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
Background: Physical and mental health problems are common among older adults living with HIV (OALWH). Adaptive coping strategies play a vital role in improving these adults' mental health and well-being despite the deleterious effects of HIV and ageing. However, in sub-Saharan Africa, limited evidence exists on the commonly utilized coping strategies in this population. We explore the coping strategies used by Kenyan OALWH to improve their mental health and wellbeing. Methods: Semi-structured in-depth interviews were conducted between October and December 2019 with 56 participants: 34 OALWH (53% female), 11 healthcare providers (63% female) and 11 primary caregivers (73% female) in Kilifi County. All interviews were audio-recorded and transcribed verbatim. We used the framework approach to synthesize the qualitative data. Results: Five major themes emerged from the analysis of participants’ narratives, including self-care practices, religion and spirituality, relational living (social connectedness), generativity, identity, and mastery. Our study further revealed maladaptive coping strategies, including reliance on over-the-counter medications, self-isolation, waiting to see if symptoms would subside despite doing nothing, and HIV treatment interruptions during prolonged periods of prayer and fasting. Conclusions: Our findings provide an initial understanding of the coping strategies used by OALWH to confront HIV and ageing challenges in a low-literacy, low socio-economic Kenyan setting. Our results suggest that interventions designed to enhance personal capacity, social support, positive religiosity and spirituality, and intergenerational connections may be beneficial in improving the mental health and well-being of OALWH.
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8
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Batchelder AW, Burgess C, Perlson J, O’Cleirigh C. Age and Year of HIV Diagnosis are Associated with Perceptions of Discrimination and Internalized Stigma Among Sexual Minority Men Who Use Substances. AIDS Behav 2022; 26:125-137. [PMID: 34117966 PMCID: PMC8665940 DOI: 10.1007/s10461-021-03333-6] [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] [Accepted: 06/04/2021] [Indexed: 01/03/2023]
Abstract
Discrimination and internalized stigma are barriers to engagement in HIV self-care among men who have sex with men (MSM) living with HIV. However, differences in perceptions of discrimination and internalized stigmas by age, year of HIV-diagnosis, and race are poorly understood. We assessed differences in reported discrimination related to HIV, race, sexual orientation, and substance use and internalized stigmas among 202 MSM living with HIV who use substances. Younger participants reported higher levels of all types of discrimination and internalized stigmas (p-values < 0.001-0.030). Those diagnosed after the advent of antiretrovirals reported higher levels of discrimination related to HIV, sexual orientation, and substance use, as well as internalized stigma related to HIV and substance use (p-values 0.001-0.049). We explored perceived community HIV stigma, which accounted for associations involving age and year of diagnosis. Age, year of diagnosis, and race should be considered when assessing and intervening with stigma.
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Affiliation(s)
- Abigail W. Batchelder
- Department of Psychiatry, Massachusetts General Hospital, Behavioral Medicine, Boston, MA,Department of Psychiatry, Harvard Medical School, Boston, MA,The Fenway Health Institute, Fenway Health, Boston, MA,Corresponding Author: Abigail Batchelder, Ph.D., M.P.H., One Bowdoin Square, 7th Floor, Boston, MA 02114; Phone: 617-643-0387; Fax: 617-536-8602;
| | - Claire Burgess
- Department of Psychiatry, Harvard Medical School, Boston, MA,VA Boston Healthcare System, Boston, MA
| | - Jacob Perlson
- The Fenway Health Institute, Fenway Health, Boston, MA,Geisel School of Medicine at Dartmouth College, Hanover, NH
| | - Conall O’Cleirigh
- Department of Psychiatry, Massachusetts General Hospital, Behavioral Medicine, Boston, MA,Department of Psychiatry, Harvard Medical School, Boston, MA,The Fenway Health Institute, Fenway Health, Boston, MA
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Knettel BA, Corrigan KL, Cherenack EM, Ho N, Carr S, Cahill J, Chino JP, Ubel P, Watt MH, Suneja G. HIV, cancer, and coping: The cumulative burden of a cancer diagnosis among people living with HIV. J Psychosoc Oncol 2021; 39:734-748. [PMID: 33407058 PMCID: PMC8397369 DOI: 10.1080/07347332.2020.1867691] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES People living with HIV (PLWH) have increased risk for cancer and worse cancer-specific survival. We explored the emotional burden of cancer and HIV as a potential driver of cancer mortality. RESEARCH APPROACH Semi-structured qualitative interviews with PLWH and cancer. PARTICIPANTS 27 PLWH who had either completed cancer treatment, were currently undergoing treatment, or experienced challenges in completing treatment. METHODOLOGICAL APPROACH An inductive qualitative approach using the constant comparative method. FINDINGS Participants drew strong parallels between being diagnosed with HIV and cancer. Many described HIV-related stigma that hindered social support. Cancer treatment side effects were a major challenge, impacting treatment adherence for both cancer and HIV. IMPLICATIONS FOR PSYCHOSOCIAL PROVIDERS There is a need for convenient, affordable, and visible services to support PLHIV as they navigate cancer care. Services should be tailored to the unique needs of this population by addressing HIV-related stigma, building social support, and fostering resilience.
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Affiliation(s)
- Brandon A. Knettel
- Duke University School of Nursing, Durham, NC
- Duke Global Health Institute, Durham, NC
| | | | - Emily M. Cherenack
- Duke Global Health Institute, Durham, NC
- Department of Psychology and Neuroscience, Duke University, Durham, NC
| | - Noelani Ho
- Margolis Center for Health Policy, Duke University, Durham, NC
| | - Stuart Carr
- Department of Pediatrics Infectious Disease, Duke University Medical Center, Durham, NC
| | - Joan Cahill
- Department of Radiation Oncology, Duke Cancer Institute, Durham, NC
| | - Junzo P. Chino
- Duke University School of Medicine, Durham, NC
- Department of Radiation Oncology, Duke Cancer Institute, Durham, NC
| | - Peter Ubel
- Margolis Center for Health Policy, Duke University, Durham, NC
| | - Melissa H. Watt
- Department of Population Health Sciences, University of Utah School of Medicine, Salt Lake City, UT
| | - Gita Suneja
- Department of Radiation Oncology, University of Utah School of Medicine, Salt Lake City, UT
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Brown MJ, Trask JS, Zhang J, Haider MR, Li X. Sociodemographic and psychosocial correlates of resilience among older adults living with HIV in the Deep South. J Health Psychol 2020; 26:2010-2019. [PMID: 31912745 DOI: 10.1177/1359105319897783] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This cross-sectional study assessed the psychosocial and sociodemographic correlates of resilience among older adults living with HIV. Data were obtained from 103 men and 53 women aged 50 years and older in South Carolina. Multivariable linear regression models showed that employment (any) (B: 3.52; 95% confidence interval : 1.04, 5.99), education (B: -3.56; 95% confidence interval : -6.15, -0.98), time since diagnosis (B: 0.18; 95% confidence interval : 0.04, 0.31), and social support (B: 0.27; 95% confidence interval : 0.20, 0.34) were associated with resilience. Interventions tailored for older adults living with HIV to support resilience could facilitate social support, particularly for those who are newly diagnosed, unemployed, and have lower educational attainment.
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Alencar RA, Parenti ABH, Lopes CDC, Ramos FT, Ciosak SI. Aspects that influence the self-care of patients living with human immunodeficiency virus. Rev Lat Am Enfermagem 2019; 27:e3112. [PMID: 30916226 PMCID: PMC6432987 DOI: 10.1590/1518-8345.2746.3112] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 10/12/2018] [Indexed: 11/22/2022] Open
Abstract
Objective: to analyze aspects related to the increase or decrease of self-care in patients living with human immunodeficiency virus treated in a specialized outpatient service. Method: analytical cross-sectional study with 135 patients aged 18 and over, of both sexes, who are followed up on the service. The independent variables and outcomes were collected from the nursing consultation instrument, whose theoretical reference is the Orem’s Theory. The data were analyzed by parametric approach. Relationships or differences were considered significant if p <0.05. The analysis was done with SPSS v21.0 software. Results: most participants were male (56.3%), with a mean age of 42.1 years. Patients who needed to conceal the diagnosis had less self-care (β = -0.72 (-1.38, -0.06), p <0.031). The chance of performing self-care decreased with increasing age (OR = 0.93 (0.89, 0.97), p <0.003). On the other hand, patients with a permanent partner had a higher chance of performing self-care (OR = 3.46 (1.27, 9.46), p <0.015). Conclusion: aspects related to the increase or decrease of self-care in patients living with human immunodeficiency virus were evidenced. However, further studies are necessary to emphasize the analytical character of the self-care of these patients.
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Affiliation(s)
- Rúbia Aguiar Alencar
- Universidade Estadual Paulista, Faculdade de Medicina de Botucatu, Botucatu, SP, Brazil
| | | | | | - Fabiana Tomé Ramos
- Universidade Estadual Paulista, Faculdade de Medicina de Botucatu, Botucatu, SP, Brazil
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Vance DE, Blake BJ, Brennan-Ing M, DeMarco RF, Fazeli PL, Relf MV. Revisiting Successful Aging With HIV Through a Revised Biopsychosocial Model: An Update of the Literature. J Assoc Nurses AIDS Care 2019; 30:5-14. [PMID: 30586079 DOI: 10.1097/jnc.0000000000000029] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The concept of successful aging was recognized only recently by HIV researchers because people living with HIV (PLWH) in the early epidemic were not expected to survive. With the introduction of antiretrovirals that block viral replication, PLWH are now aging with HIV. Given the complex nature of HIV within the social, economic, and political climates in which it occurs, a holistic model of successful aging is needed to guide researchers and clinicians. Several overarching models exist, but must be updated for rapidly advancing HIV and aging research agendas. We provide an updated, adapted, and integrated biopsychosocial model of successful aging with HIV based on the principles of Baltes and Baltes (1998) on 8 essential components of successful aging: (a) length of life, (b) biological health, (c) mental health, (d) cognitive efficiency, (e) social competence, (f) productivity, (g) personal control, and (h) life satisfaction. Clinical practice and research implications are highlighted.
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