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Harsono D, Deng Y, Chung S, Barakat LA, Friedland G, Villanueva M, Yager JE, Justen M, Edelman EJ. Prevalence and Correlates of Physical Inactivity Among Individuals with HIV During the First COVID-19 Wave: A Cross-sectional Survey. AIDS Behav 2024; 28:1531-1545. [PMID: 37824037 DOI: 10.1007/s10461-023-04170-5] [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: 09/08/2023] [Indexed: 10/13/2023]
Abstract
Physical activity is associated with improved health outcomes among people with HIV (PWH). In the recent pandemic context, policies designed to mitigate COVID-19 transmission may result in an increase in sedentary lifestyle and decreased physical activity. In this study, we aimed to characterize self-reported physical activity and factors associated with physical inactivity during the first wave of the COVID-19 pandemic among a sample of PWH engaged in care. We also described whether psychological coping strategies measured by the Brief COPE differed based on physical activity levels. Among 260 surveyed PWH in two HIV clinics in the US Northeast, 28.5% (n = 74) met the criteria for being physically active according to the Centers for Disease Control and Prevention (CDC)'s physical activity guidelines. Receiving care in New Haven, CT, presence of a detectable HIV viral load, every day tobacco use, and unhealthy alcohol use were associated with physical inactivity. Problem-focused coping, emotion-focused coping, and avoidance-focused coping strategies were found to be protective against physical inactivity. In adjusted analysis, only problem-focused coping continued to be significantly associated with lower odds of reporting physical inactivity. Efforts are urgently needed to promote physical activity among PWH, including among those without problem-focused coping strategies.
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Affiliation(s)
- Dini Harsono
- Center for Interdisciplinary Research on AIDS, Yale School of Public Health, 135 College St, Suite 200, New Haven, CT, 06510, USA.
| | - Yanhong Deng
- Yale Center for Analytical Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Sangyun Chung
- Yale Center for Analytical Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Lydia A Barakat
- AIDS Care Program, Section of Infectious Disease, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Gerald Friedland
- Center for Interdisciplinary Research on AIDS, Yale School of Public Health, 135 College St, Suite 200, New Haven, CT, 06510, USA
- AIDS Care Program, Section of Infectious Disease, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
| | - Merceditas Villanueva
- Center for Interdisciplinary Research on AIDS, Yale School of Public Health, 135 College St, Suite 200, New Haven, CT, 06510, USA
- AIDS Care Program, Section of Infectious Disease, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Jessica E Yager
- Center for Interdisciplinary Research on AIDS, Yale School of Public Health, 135 College St, Suite 200, New Haven, CT, 06510, USA
- SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | | | - E Jennifer Edelman
- Center for Interdisciplinary Research on AIDS, Yale School of Public Health, 135 College St, Suite 200, New Haven, CT, 06510, USA
- Section of General Internal Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, 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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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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Nardell MF, Hedt-Gauthier B, Earnshaw VA, Bogart LM, Dietrich JJ, Courtney I, Tshabalala G, Bor J, Orrell C, Gray G, Bangsberg DR, Katz IT. Understanding Repeat Positive HIV Testing in South Africa Under Changing Treatment Guidelines. AIDS Behav 2022; 26:1366-1376. [PMID: 34705150 PMCID: PMC9007825 DOI: 10.1007/s10461-021-03493-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2021] [Indexed: 01/06/2023]
Abstract
Some people with HIV (PWH) test positive multiple times without initiating antiretroviral therapy (ART). We surveyed 496 ART-eligible PWH following routine HIV testing at three clinics in Soweto and Gugulethu, South Africa in 2014-2015. Among repeat positive testers (RPTs) in this cohort, we compared rates of treatment initiation by prior treatment eligibility and assessed psychosocial predictors of treatment initiation in logistic regression models. RPTs represented 33.8% of PWH in this cohort. Less than half of those who reported eligibility for ART on prior testing started treatment upon retesting, in contrast to two thirds of RPTs who were previously ineligible for treatment who started treatment once they learned of their eligibility. Those who reported coping through substance use were more likely to decline treatment versus those not using substances. PWH who test repeatedly represent a vulnerable population at risk for ART non-initiation who may benefit from interventions addressing individualized coping strategies.
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Affiliation(s)
- Maria F Nardell
- Division of Global Health Equity, Brigham and Women's Hospital, Thorn Building 14th Floor, Boston, MA, 02120, USA.
- Harvard Medical School, Boston, USA.
- Department of Medicine, Brigham and Women's Hospital, Boston, USA.
| | - Bethany Hedt-Gauthier
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, USA
- Massachusetts General Hospital Center for Global Health, Boston, USA
| | - Valerie A Earnshaw
- Department of Human Development and Family Sciences, University of Delaware, Newark, USA
| | | | - Janan J Dietrich
- Perinatal HIV Research Unit, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
- Health Systems Research Unit, South African Medical Research Council, Western Cape, South Africa
| | - Ingrid Courtney
- Desmond Tutu Health Foundation, University of Cape Town Medical School, Cape Town, South Africa
| | - Gugulethu Tshabalala
- Perinatal HIV Research Unit, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Jacob Bor
- Department of Global Health, Boston University School of Public Health, Boston, USA
| | - Catherine Orrell
- Desmond Tutu Health Foundation, University of Cape Town Medical School, Cape Town, South Africa
| | - Glenda Gray
- Perinatal HIV Research Unit, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
- Office of the President, South African Medical Research Council, Western Cape, South Africa
| | - David R Bangsberg
- Oregon Health & Science University-Portland State University School of Public Health, Portland, USA
| | - Ingrid T Katz
- Harvard Medical School, Boston, USA
- Department of Medicine, Brigham and Women's Hospital, Boston, USA
- Massachusetts General Hospital Center for Global Health, Boston, USA
- Harvard Global Health Institute, Cambridge, USA
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5
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Toupin I, Engler K, Lessard D, Wong L, Lènàrt A, Spire B, Raffi F, Lebouché B. Developing a patient-reported outcome measure for HIV care on perceived barriers to antiretroviral adherence: assessing the needs of HIV clinicians through qualitative analysis. Qual Life Res 2017; 27:379-388. [PMID: 29027607 DOI: 10.1007/s11136-017-1711-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2017] [Indexed: 12/20/2022]
Abstract
PURPOSE To identify HIV clinicians' needs for the clinical use of a new patient-reported outcome measure (PRO) on barriers to antiretroviral therapy (ART) adherence. METHODS In 2015, five focus groups with 31 clinicians from France were transcribed, coded with Atlas.ti, and submitted to a typological analysis. RESULTS The analysis identified seven patient profiles, each tied to distinct barriers to adherence and to specific needs for the PRO's content, data collection and transmission. Clinicians preferred, for the patient who is: (1) 'passive,' that the PRO collect information on ART knowledge, to ensure that the prescription's instructions are being respected; (2) 'misleading,' that it be able to detect adherence to ART and socially desirable responses; (3) 'stoic,' that questions challenge the patient to recognize treatment-specific side effects; (4) 'hedonistic,' that the PRO contains content on lifestyle and risk-taking; (5) 'obsessive,' that the PRO captures quality of life and stressful life events; (6) 'overburdened,' that the PRO provides information on the person's home environment, socioeconomic status and cultural constraints. For all or most patient profiles, the clinicians wished that the PRO be completed, minimally, prior to the medical consultation and to receive alerts, under varying conditions, when problematic scores were detected. Depending on the profile, there was preference for the inclusion of open-ended questions and transmission of cross-sectional, periodic or longitudinal PRO data. CONCLUSION Overall, this study's findings suggest that to support the clinical management of ART adherence, our PRO must meet the needs of a wide variety of patients and must perform multiple functions.
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Affiliation(s)
- Isabelle Toupin
- Department of Family Medicine, McGill University, Montreal, Canada.
- Centre for Outcomes Research & Evaluation, Research Institute of the McGill University Health Centre, 5252 Boul de Maisonneuve, 3C.35, Montreal, QC, H4A 3S5, Canada.
- Royal Victoria Hospital, Chronic Viral Illness Service, McGill University Health Centre, Montreal, Canada.
- Strategy for Patient-Oriented Research (SPOR) Mentorship Chair in Innovative Clinical Trials (Canadian Institutes of Health Research), Montreal, Canada.
| | - Kim Engler
- Department of Family Medicine, McGill University, Montreal, Canada
- Centre for Outcomes Research & Evaluation, Research Institute of the McGill University Health Centre, 5252 Boul de Maisonneuve, 3C.35, Montreal, QC, H4A 3S5, Canada
- Royal Victoria Hospital, Chronic Viral Illness Service, McGill University Health Centre, Montreal, Canada
- Strategy for Patient-Oriented Research (SPOR) Mentorship Chair in Innovative Clinical Trials (Canadian Institutes of Health Research), Montreal, Canada
| | - David Lessard
- Department of Family Medicine, McGill University, Montreal, Canada
- Centre for Outcomes Research & Evaluation, Research Institute of the McGill University Health Centre, 5252 Boul de Maisonneuve, 3C.35, Montreal, QC, H4A 3S5, Canada
- Royal Victoria Hospital, Chronic Viral Illness Service, McGill University Health Centre, Montreal, Canada
- Strategy for Patient-Oriented Research (SPOR) Mentorship Chair in Innovative Clinical Trials (Canadian Institutes of Health Research), Montreal, Canada
| | - Leo Wong
- Centre for Outcomes Research & Evaluation, Research Institute of the McGill University Health Centre, 5252 Boul de Maisonneuve, 3C.35, Montreal, QC, H4A 3S5, Canada
- Royal Victoria Hospital, Chronic Viral Illness Service, McGill University Health Centre, Montreal, Canada
| | - Andràs Lènàrt
- Department of Family Medicine, McGill University, Montreal, Canada
| | - Bruno Spire
- SESSTIM, Université Aix-Marseille, Marseille, France
| | - François Raffi
- Department of Infectious Diseases, CHU de Nantes and CIC 1413, INSERM, Nantes, France
| | - Bertrand Lebouché
- Department of Family Medicine, McGill University, Montreal, Canada
- Centre for Outcomes Research & Evaluation, Research Institute of the McGill University Health Centre, 5252 Boul de Maisonneuve, 3C.35, Montreal, QC, H4A 3S5, Canada
- Royal Victoria Hospital, Chronic Viral Illness Service, McGill University Health Centre, Montreal, Canada
- Strategy for Patient-Oriented Research (SPOR) Mentorship Chair in Innovative Clinical Trials (Canadian Institutes of Health Research), Montreal, Canada
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Xu Y, Lin X, Chen S, Liu Y, Liu H. Ageism, resilience, coping, family support, and quality of life among older people living with HIV/AIDS in Nanning, China. Glob Public Health 2016; 13:612-625. [PMID: 27756194 DOI: 10.1080/17441692.2016.1240822] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Although the HIV epidemic continues to spread among older adults over 50 years old in China, little empirical research has investigated the interrelationships among ageism, adaptability, family support, and quality of life among older people living with HIV/AIDS (PLWHAs). In this cross-sectional study, among 197 older PLWHAs over 50 years old, path analytic modelling was used to assess the interrelationships among ageism, resilience, coping, family support, and quality of life. Compared with female PLWHAs, male PLWHAs had a higher level of resilience and coping. There were no significant differences in the scores of quality of life, ageism, family support, HIV knowledge, and duration since HIV diagnosis between males and females. The following relationships were statistically significant in the path analysis: (1) family support → resilience [β (standardised coefficient) = 0.18], (2) resilience → ageism (β = -0.29), (3) resilience → coping (β = 0.48), and (4) coping → quality of life (β = 0.24). In addition, male PLWHAs were more resilient than female PLWHAs (β = 0.16). The findings indicate that older PLWHAs do not only negatively accept adversity, but build their adaptability to positively manage the challenges. Family-based interventions need take this adaptability to adversity into consideration.
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Affiliation(s)
- Yongfang Xu
- a Nanning Center for Disease Control and Prevention , Nanning , People's Republic of China
| | - Xinqin Lin
- a Nanning Center for Disease Control and Prevention , Nanning , People's Republic of China
| | - Shiyi Chen
- a Nanning Center for Disease Control and Prevention , Nanning , People's Republic of China
| | - Yanfen Liu
- b Nanning 4th Hospital , Nanning , People's Republic of China
| | - Hongjie Liu
- c School of Public Health, University of Maryland , College Park , MD , USA
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Kato T. Frequently Used Coping Scales: A Meta-Analysis. Stress Health 2015; 31:315-23. [PMID: 24338955 DOI: 10.1002/smi.2557] [Citation(s) in RCA: 119] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2013] [Revised: 10/24/2013] [Accepted: 11/12/2013] [Indexed: 11/10/2022]
Abstract
This article reports the frequency of the use of coping scales in academic journals published from 1998 to 2010. Two thousand empirical journal articles were selected from the EBSCO database. The COPE, Ways of Coping Questionnaire, Coping Strategies Questionnaire, Coping Inventory for Stressful Situations, Religious-COPE and Coping Response Inventory were frequently mentioned. In particular, the COPE (20.2%) and Ways of Coping Questionnaire (13.6%) were used the most frequently. In this literature reviewed, coping scales were most often used to assess coping with health issues (e.g. illness, pain and medical diagnoses) over other types of stressors, and patients were the most frequent participants. Further, alpha coefficients were estimated for the COPE subscales, and correlations between the COPE subscales and coping outcomes were calculated, including depressive symptoms, anxiety, negative affect, psychological distress, physical symptoms and well-being.
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Affiliation(s)
- Tsukasa Kato
- Department of Social Psychology, Toyo University, Tokyo, Japan
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8
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Improving mental health among people living with HIV: a review of intervention trials in low- and middle-income countries. Glob Ment Health (Camb) 2015; 2:e19. [PMID: 26435843 PMCID: PMC4589870 DOI: 10.1017/gmh.2015.17] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
People living with HIV (PLWH) experience greater psychological distress than the general population. Evidence from high-incomes countries suggests that psychological interventions for PLWH can improve mental health symptoms, quality of life, and HIV care engagement. However, little is known about the effectiveness of mental health interventions for PLWH in low and middle-income countries (LMICs), where the large majority of PLWH reside. This systematized review aims to synthesize findings from mental health intervention trials with PLWH in LMICs to inform the delivery of mental health services in these settings. A systematic search strategy was undertaken to identify peer-reviewed published papers of intervention trials addressing negative psychological states or disorders (e.g., depression, anxiety) among PLWH in LMIC settings. Search results were assessed against pre-established inclusion and exclusion criteria. Data from papers meeting criteria were extracted for synthesis. Twenty-six papers, published between 2000 and 2014, describing 22 unique interventions were identified. Trials were implemented in sub-Saharan Africa (n=13), Asia (n=7), and the Middle East (n=2), and addressed mental health using a variety of approaches, including cognitive-behavioral (n=18), family-level (n=2), and pharmacological (n=2) treatments. Four randomized controlled trials reported significant intervention effects in mental health outcomes, and eleven preliminary studies demonstrated promising findings. Among the limited mental health intervention trials with PLWH in LMICs, few demonstrated efficacy. Mental health interventions for PLWH in LMICs must be further developed and adapted for resource-limited settings to improve effectiveness.
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9
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Mulder BC, van Lelyveld MAA, Vervoort SCJM, Lokhorst AM, van Woerkum CMJ, Prins JM, de Bruin M. Communication Between HIV Patients and Their Providers: A Qualitative Preference Match Analysis. HEALTH COMMUNICATION 2014; 31:35-46. [PMID: 25412175 DOI: 10.1080/10410236.2014.933017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Since the introduction of cART (combination antiretroviral therapy), HIV has evolved into a chronic disease such that it requires lifelong medical treatment to which patients must adhere. Communication with health care providers is pivotal in supporting patients to adapt to having HIV and adhering to treatment, in order to maintain health and quality of life. Previous research indicates that communication is optimal when it matches patient preferences for information exchange, relationship establishment, and involvement in treatment decisions. The aim of the present study is to explore HIV patient communication preferences as well as patient experiences with their providers (not) matching their preferences. A second aim is to explore provider beliefs about patient preferences and provider views on optimal communication. Data were collected through interviews with 28 patients and 11 providers from two academic hospitals. Results indicate that patient preferences reflect their cognitive, emotional, and practical needs such that patients look to increase their sense of control over their HIV. Patients aim to further increase their sense of control (by proxy) through their relationship with their providers and through their decisional involvement preferences. Providers are well aware of patient communication preferences but do not explicate underlying control needs. Implications for clinical practice are discussed.
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Affiliation(s)
- Bob C Mulder
- a Strategic Communication , Wageningen University
| | | | - Sigrid C J M Vervoort
- b Department of Internal Medicine & Infectious Diseases , University Medical Center Utrecht
| | | | | | - Jan M Prins
- c Department of Internal Medicine , University of Amsterdam
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Pereira M, Fialho R, Canavarro MC. Prevalence and correlates of emotional distress in HIV/HCV coinfection. AIDS Care 2014; 26 Suppl 1:S56-64. [DOI: 10.1080/09540121.2014.906549] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Marco Pereira
- Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
| | - Renata Fialho
- School of Psychology, University of Sussex, Brighton, UK
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11
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O'Brien KK, Davis AM, Gardner S, Bayoumi AM, Rueda S, Hart TA, Cooper C, Solomon P, Rourke SB, Hanna S. Relationships between dimensions of disability experienced by adults living with HIV: a structural equation model analysis. AIDS Behav 2014; 18:357-67. [PMID: 23132208 DOI: 10.1007/s10461-012-0363-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
As individuals age with HIV it is increasingly important to consider the health-related consequences of HIV and multiple morbidities, known as disability. We assessed relationships between four dimensions of disability among adults living with HIV. We conducted a structural equation modeling analysis using data from 913 participants in the Ontario HIV Treatment Network Cohort Study to determine relationships between four latent variables of disability in the Episodic Disability Framework: physical symptoms and impairments, mental health symptoms and impairments, difficulties with day-to-day activities, and challenges to social inclusion. Results indicated that physical symptoms and impairments, mental health symptoms and impairments and difficulties with day-to-day activities directly or indirectly predicted challenges to social inclusion for adults living with HIV. Challenges to social inclusion were directly predicted by mental health symptoms and indirectly by physical health symptoms via (mediated by) having difficulties carrying out day-to-day activities and mental health symptoms and impairments. These findings provide a basis for conceptualizing disability experienced by people living with HIV.
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Affiliation(s)
- Kelly K O'Brien
- Department of Physical Therapy, University of Toronto, 500 University Avenue, Room 160, Toronto, M5G 1V7, ON, Canada,
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12
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Zhang YX, Golin CE, Bu J, Emrick CB, Zhang N, Li MQ. Coping strategies for HIV-related stigma in Liuzhou, China. AIDS Behav 2014; 18 Suppl 2:S212-20. [PMID: 24337724 PMCID: PMC4096624 DOI: 10.1007/s10461-013-0662-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This study explores the feelings, experiences, and coping strategies of people living with HIV (PLHIV) in Liuzhou, China. In a southwestern Chinese city with high HIV prevalence, we conducted semi-structured in-depth interviews with 47 PLHIV selected to represent individuals who had acquired HIV via different acquisition routes. Many participants felt severely stigmatized; they commonly reported having very low self-esteem and feelings of despair. Based on style of coping and whether it occurred at the interpersonal or intrapersonal level, four types of coping that participants used to deal with HIV-associated stigma were identified: (1) Compassion (Passive/Avoidant-Interpersonal); (2) Hiding HIV status (Passive/Avoidant-Intrapersonal); (3) Social support (Active/Problem-focused-Interpersonal; and (4) Self-care (Active/Problem-focused-Intrapersonal). Educational and stigma-reduction interventions targeting potential social support networks for PLHIV (e.g., family, close friends, and peers) could strengthen active interpersonal PLHIV coping strategies. Interventions teaching self-care to PLHIV would encourage active intrapersonal coping, both of which may enhance PLHIV quality of life in Liuzhou, China.
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Affiliation(s)
- Ying-Xia Zhang
- Liuzhou Center for Disease Prevention and Control, Liuzhou, China
| | - Carol E. Golin
- Division of General Medicine and Epidemiology, University of North Carolina at Chapel Hill
- Department of Health Behavior, University of North Carolina at Chapel Hill
- Center For AIDS Research (CFAR), University of North Carolina at Chapel Hill
| | - Jin Bu
- Editorial Department, Journal of Nanjing Medical University, Nanjing, China
| | | | - Nan Zhang
- Department of Sociology and Institute of Sexuality and Gender, Renmin University of China, Beijing
| | - Ming-Qiang Li
- Liuzhou Center for Disease Prevention and Control, Liuzhou, China
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13
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Complementary therapy provision in a London community clinic for people living with HIV/AIDS: a case study. Complement Ther Clin Pract 2013; 20:65-9. [PMID: 24439648 DOI: 10.1016/j.ctcp.2013.10.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Revised: 09/06/2013] [Accepted: 10/03/2013] [Indexed: 11/22/2022]
Abstract
AIM To present a case study of complementary therapy (CT) provision within a community HIV multi-agency service in a Northwest London deprived area. METHODS Anonymised routine service data were provided for all clients (n = 1030) August 2010 to October 2012. Face-to-face meetings provided feedback from volunteers (9 CT-using clients and 9 staff). RESULTS CT-users were demographically similar to other clients. Support for coping with HIV was commonly cited as a service benefit. Over 26 months 1416 CT sessions were provided; 875 aromatherapy and 471 shiatsu. CT-users' most common concerns were pain (48%), stress (15%) and insomnia (13%), few had heard of or used CT before. Perceived mental and emotional benefits included relaxation,stress relief, relieving musculoskeletal aches and pains. Service challenges included time and funding, though staff felt CT may be cost-effective. CONCLUSIONS CT may provide important support and treatment options for HIV disease, but cost effectiveness requires further evaluation.
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Sublette VA, Douglas MW, McCaffery K, George J, Perry KN. Psychological, lifestyle and social predictors of hepatitis C treatment response: a systematic review. Liver Int 2013; 33:894-903. [PMID: 23581550 DOI: 10.1111/liv.12138] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2012] [Accepted: 02/13/2013] [Indexed: 12/16/2022]
Abstract
BACKGROUND To increase cure rates for Hepatitis C, barriers to treatment adherence and completion must be identified and overcome. AIMS This study systematically reviewed evidence on the psychological, lifestyle and social determinants of achieving viral eradication with antiviral therapy. METHODS An electronic search strategy was used to identify relevant studies that examined psychological, lifestyle and social factors related to achieving a sustained virological response (SVR). RESULTS Thirty-four studies that matched our criteria were identified. Of the factors that predict response to treatment, Asian ethnicity was an independent predictor of SVR. We found an indirect relationship between diet and SVR, with non-responders to treatment consuming more polyunsaturated fatty acids, fats and carbohydrates than those who attained SVR. The effect of alcohol consumption relied on the amount consumed; fewer than 30 grams daily had no effect on SVR, whereas >70 grams daily had an adverse impact on a patient's ability to achieve SVR, with termination rates up to 44% in those who drank >2 drinks a day. Patients with psychiatric illnesses had comparable SVR rates to controls if they continued psychological therapy (average 42%), although discontinuation rates were high with 11 studies reporting rates from 14 to 48%. CONCLUSIONS There are major gaps in current knowledge of the impact of variables such as diet, exercise, attitudes and coping skills on cure rates in chronic Hepatitis C. Those who drink limited amounts of alcohol or have psychiatric disorders should be offered treatment for their disease, with adjunctive education and support to improve treatment completion.
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15
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Seedat S. Interventions to improve psychological functioning and health outcomes of HIV-infected individuals with a history of trauma or PTSD. Curr HIV/AIDS Rep 2013; 9:344-50. [PMID: 23007792 DOI: 10.1007/s11904-012-0139-3] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The experience of early or later life trauma in HIV-positive adults can have devastating mental and physical health consequences. Women bear the brunt of this double burden. Depression, posttraumatic stress disorder, and alcohol and drug use disorders are among the most common psychiatric disorders documented, both in infected women and men, in high-, middle-, and low-income countries. Traumatized individuals, particularly those with childhood sexual abuse characterized by repeated traumatization, are at high risk of engaging in risky behaviors, including substance abuse and sexual promiscuity. These issues are further compounded by stigma, discrimination, poverty, and low social support. While there is a significant need to pay more attention to psychiatric and psychological outcomes in the context of HIV-trauma and improve screening for traumatic stress in HIV care settings, there are currently few treatment and secondary prevention studies. Group cognitive-behavioral strategies, including prolonged exposure, coping skills training, and stress management have, to date, shown some evidence for efficacy in HIV-positive individuals with childhood trauma and in those with PTSD.
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Affiliation(s)
- Soraya Seedat
- Department of Psychiatry, Faculty of Health Sciences, Stellenbosch University, PO Box 19063, Tygerberg, 7505, Cape Town, South Africa.
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Do changes in coping style explain the effectiveness of interventions for psychological morbidity in family carers of people with dementia? A systematic review and meta-analysis. Int Psychogeriatr 2013; 25:204-14. [PMID: 23088896 DOI: 10.1017/s1041610212001755] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Observational studies find that family carers of people with dementia who use more emotional support and acceptance-based coping, and less dysfunctional coping, are less depressed and anxious. We hypothesized that interventions effective in reducing psychological symptoms would increase emotional support and acceptance-based coping, or decrease dysfunctional coping. METHODS We systematically reviewed randomized controlled trials published up to July 2011, of interventions for carers of people with dementia measuring coping and psychological morbidity. We rated study validity and reported findings. We conducted fixed-effect meta-analyses for interventions where possible. RESULTS Eight of 433 papers identified by the search met inclusion criteria. All measured coping immediately after intervention. Two interventions significantly decreased depressive or anxiety symptoms: the smaller study found no change in dysfunctional coping. Neither measured emotional support and acceptance-based coping. Meta-analysis found that both group coping skills interventions alone (SMD = -0.39, 95% CI = -0.75 to -0.03, p = 0.04) and with behavioral activation (SMD = -0.26, 95% CI = -0.48 to -0.04, p = 0.02) significantly increased dysfunctional coping, while significantly reducing depressive symptoms. Positive coping (a mix of emotional and solution-focused strategies) increased (SMD = 0.28, 95% CI = 0.05-0.51, p = 0.02) with group coping skills interventions and behavioral activation. CONCLUSIONS Contrary to our hypothesis, dysfunctional coping increased when carer depressive symptoms improved. There was preliminary evidence that emotional support and acceptance-based coping increased, as positive coping increased although solution-focused coping alone did not. More research is needed to elucidate whether successful interventions work through changing coping strategies immediately and in the longer term.
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Slomka J, Lim JW, Gripshover B, Daly B. How have long-term survivors coped with living with HIV? J Assoc Nurses AIDS Care 2012; 24:449-59. [PMID: 23253776 DOI: 10.1016/j.jana.2012.09.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2012] [Accepted: 09/18/2012] [Indexed: 10/27/2022]
Abstract
With advances in HIV treatment, more individuals have grown older with the disease. Little is known about factors that have helped these survivors manage everyday life with HIV. In this exploratory, qualitative study, we asked, "What has helped survivors cope with challenges of living long term with HIV?" Participants were recruited from a convenience sample of persons living with HIV who obtained treatment at a specialty HIV clinic; 16 long-term survivors of HIV were interviewed. Mean age was 50.13 (SD = 8.30) years; mean time from diagnosis was 16.75 (SD = 5.98) years. Results were broadly dichotomized as coping mechanisms and social supports. Three themes characterized coping mechanisms: disease coping, practical coping, and emotional coping. Social supports included themes of family, friends, professionals, peer groups, and pets. In particular, the power of patient-professional relationships and meanings derived from religion/spirituality were considered by a majority of participants to be influential factors.
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Affiliation(s)
- Jacquelyn Slomka
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio, USA
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Pain anxiety, acceptance, and outcomes among individuals with HIV and chronic pain: A preliminary investigation. Behav Res Ther 2012; 50:72-8. [DOI: 10.1016/j.brat.2011.10.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2010] [Revised: 09/06/2011] [Accepted: 10/21/2011] [Indexed: 11/21/2022]
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White W, Grant JS, Pryor ER, Keltner NL, Vance DE, Raper JL. Do Social Support, Stigma, and Social Problem-Solving Skills Predict Depressive Symptoms in People Living With HIV? A Mediation Analysis. Res Theory Nurs Pract 2012; 26:182-204. [DOI: 10.1891/1541-6577.26.3.182] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Social support, stigma, and social problem solving may be mediators of the relationship between sign and symptom severity and depressive symptoms in people living with HIV (PLWH). However, no published studies have examined these individual variables as mediators in PLWH. This cross-sectional, correlational study of 150 PLWH examined whether social support, stigma, and social problem solving were mediators of the relationship between HIV-related sign and symptom severity and depressive symptoms. Participants completed self-report questionnaires during their visits at two HIV outpatient clinics in the Southeastern United States. Using multiple regression analyses as a part of mediation testing, social support, stigma, and social problem solving were found to be partial mediators of the relationship between sign and symptom severity and depressive symptoms, considered individually and as a set.
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