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Haase SR, Billings R, Vance DE, Fazeli PL. The Association Between Intrapersonal Resilience Resources and Quality of Life Among Older Persons Living With HIV: A Systematic Review. J Assoc Nurses AIDS Care 2023; 34:502-526. [PMID: 37815846 PMCID: PMC10593503 DOI: 10.1097/jnc.0000000000000432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/11/2023]
Abstract
ABSTRACT Despite positive improvements in health care, older persons living with HIV (PWH) still face psychosocial challenges and medical issues that affect their overall quality of life (QoL). Intrapersonal resilience resources may serve as a protective factor allowing PWH to better cope with adversity, thereby improving their well-being. In our systematic review, we examined intrapersonal resilience resources and their association with QoL outcomes among middle-aged and older PWH (≥40 years). Four databases (CINAHL, PubMed, PsycINFO, and Embase) were searched, and 1,400 articles were yielded. Following screening and full-text review, 19 studies met full criteria and were included. Based on our findings from these studies, trait resilience, spirituality, and self-efficacy were the most common resilience resources investigated. Resilience resources were positively associated with QoL outcomes and mediated the association between various psychosocial factors (e.g., stigma) and QoL. Future studies should explore resilience resources and QoL over time among diverse populations of PWH.
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Affiliation(s)
- Shakaye R. Haase
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Rebecca Billings
- UAB Libraries, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - David E. Vance
- School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Pariya L. Fazeli
- School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
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Sarma P, Cassidy R, Corlett S, Katusiime B. Ageing with HIV: Medicine Optimisation Challenges and Support Needs for Older People Living with HIV: A Systematic Review. Drugs Aging 2023; 40:179-240. [PMID: 36670321 PMCID: PMC9857901 DOI: 10.1007/s40266-022-01003-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2022] [Indexed: 01/22/2023]
Abstract
BACKGROUND Older people living with HIV (PLWH) are at increased risks of co-morbidities and polypharmacy. However, little is known about factors affecting their needs and concerns about medicines. This systematic review aims to describe these and to identify interventions to improve medicine optimisation outcomes in older PLWH. METHODS AND DATA SOURCES Multiple databases and grey literature were searched from inception to February 2022 including MEDLINE, CINAHL, PsycInfo, PsychArticles, the Cochrane Database of Systematic Reviews and the Cochrane Controlled Register of Trials, Abstracts in Social Gerontology, and Academic Search Complete. ELIGIBILITY CRITERIA Studies reporting interventions/issues affecting older PLWH (sample populations with mean/median age ≥ 50 years; any aspect of medicine optimisation, or concerns). Quality assessments were completed by means of critical appraisal checklists for each study design. Title and abstract screening was led by one reviewer and a sample reviewed independently by two reviewers. Full-paper reviews were completed by one author and a 20% sample was reviewed independently by two reviewers. SYNTHESIS Data were extracted by three independent reviewers using standardised data extraction forms and synthesised according to outcomes or interventions reported. Data were summarised to include key themes, outcomes or concerns, and summary of intervention. RESULTS Seventy-nine (n = 79) studies met the eligibility criteria, most of which originated from the USA (n = 36). A few studies originated from Australia (n = 5), Canada (n = 5), Spain (n = 9), and the UK (n = 5). Ten studies originated from Sub-Saharan Africa (Kenya n = 1, South Africa n = 6, Tanzania n = 1, Uganda n = 1, Zimbabwe n = 1). The rest of the studies were from China (n = 1), France (n = 1), Germany (n = 1), Italy (n = 1), the Netherlands (n = 1), Pakistan (n = 1), Switzerland (n = 1), Saudi Arabia (n = 1) and Ukraine (n = 1). Publication dates ranged from 2002 to 2022. Sample sizes ranged from 10 to 15,602 across studies. The factors affecting older PLWH's experience of and issues with medicines were co-morbidities, health-related quality of life, polypharmacy, drug interactions, adverse drug reactions, adherence, medicine burden, treatment burden, stigma, social support, and patient-healthcare provider relationships. Nine interventions were identified to target older persons, five aimed at improving medication adherence, two to reduce drug interactions, and two for medicine self-management initiatives. CONCLUSION Further in-depth research is needed to understand older PLWH's experiences of medicines and their priority issues. Adherence-focused interventions are predominant, but there is a scarcity of interventions aimed at improving medicine experiences for this population. Multi-faceted interventions are needed to achieve medicine optimisation outcomes for PLWH. TRIAL REGISTRATION This study is registered with PROSPERO registration number: CRD42020188448.
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Affiliation(s)
- Priya Sarma
- Medway School of Pharmacy, The Universities of Kent and Greenwich, Chatham, Kent, UK.
| | - Rebecca Cassidy
- Centre for Health Service Studies, University of Kent, Canterbury, Kent, UK
| | - Sarah Corlett
- Medway School of Pharmacy, The Universities of Kent and Greenwich, Chatham, Kent, UK
| | - Barbra Katusiime
- Medway School of Pharmacy, The Universities of Kent and Greenwich, Chatham, Kent, UK
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Health related quality of life of HIV-positive women on ART follow-up in north Shewa zone public hospitals, central Ethiopia: Evidence from a cross-sectional study. Heliyon 2023; 9:e13318. [PMID: 36747523 PMCID: PMC9898445 DOI: 10.1016/j.heliyon.2023.e13318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 01/24/2023] [Accepted: 01/27/2023] [Indexed: 01/30/2023] Open
Abstract
Background Evidence revealed that there is a statistically significant gender difference in Health-related quality of life (HRQoL) among HIV-positive people on Antiretroviral therapy (ART). Consequently, HIV-positive women have low scores in all HRQoL domains than men. Despite this fact, previous studies in Ethiopia focused on general HIV-positive people and paid less attention to HIV-positive women. Therefore, this study was intended to measure HRQoL and associated factors among HIV-positive women on ART follow-up in north Shewa zone public hospitals, central Ethiopia. Methods An institution-based cross-sectional study was conducted from February 01-April 30, 2022. Four hundred twenty-six women on ART were included using a systematic random sampling technique. Face-to-face interviews and medical record reviews were used to collect data. Both bivariable and multiple linear regressions were computed to identify the factors associated with HRQoL. A p-value <0.05 was used to assert statistically significant variables in multiple linear regression analysis. Results The overall mean (SD) score of the HRQoL was 11.84 (2.44). And, 44.7% [95% CI: 40.3, 49.5] of the women have poor HRQoL. In multiple linear regression analysis, factors like depression (β = -0.35), Post-Traumatic Stress Disorder (PTSD) (β = -0.16), age (β = -0.07), rural residence (β = -0.52), and bedridden functional status (β = -1.02) were inversely associated with HRQoL. Oppositely, good treatment adherence (β = 0.46) was positively associated with overall HRQoL, keeping other factors constant. Conclusion This study reveals a high magnitude of poor HRQoL among HIV-positive women. Therefore, as HRQoL domains are comprehensive indicators of living status, healthcare service providers should be dedicated to screening and supporting HIV-positive women with poor HRQoL. Additionally, healthcare providers should also pay special attention to routine PTSD screening and management for HIV-positive women due to its detrimental effect on HRQoL.
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How older people living with HIV narrate their quality of life: Tensions with quantitative approaches to quality-of-life research. SSM - QUALITATIVE RESEARCH IN HEALTH 2021; 1:None. [PMID: 34977852 PMCID: PMC8688149 DOI: 10.1016/j.ssmqr.2021.100018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 10/08/2021] [Accepted: 10/15/2021] [Indexed: 11/24/2022]
Abstract
This article draws on life-history interviews with older (aged 50+) people living with HIV in England to uncover the interpretive practices in which they engaged as they evaluated their own quality of life (QoL). Our paper highlights the distinctive insights that biographical and narrative approaches can bring to QoL research. While accounts of subjectively ‘poor’ QoL were relatively straightforward and unequivocally phrased, accounts of subjectively ‘good’ and ‘OK’ QoL were produced using complex interpretive and evaluative practices. These practices involved biographical reflection and contextualization, with participants weighing up and comparing their current lives' ‘pros’ and ‘cons’, their own lives with the lives of others, and their present lives with lives they had imagined having at the time of interview. Thus, ‘good’ and ‘OK’ QoL were constructed using practical, relational, and interpretive work – features of QoL analytically unavailable in quantitative data gathered through standardised measures (including our own survey data collected from these same participants). Our findings underscore the uneasy fit between QoL's quantitative measurement and its subjective understandings and evaluations, on the one hand, and the interpretive work that goes into achieving these understandings and evaluations, on the other.
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Kteily-Hawa R, Warren L, Kazemi M, Logie CH, Islam S, Kaida A, Conway T, Persad Y, de Pokomandy A, Loutfy M. Examining Multilevel Factors Associated with the Process of Resilience among Women Living with HIV in a Large Canadian Cohort Study: A Structural Equation Modeling Approach. J Int Assoc Provid AIDS Care 2020; 18:2325958219871289. [PMID: 31552790 PMCID: PMC6900626 DOI: 10.1177/2325958219871289] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Objectives: We examined how multiple, nested, and interacting systems impact the protective process
of resilience for women living with HIV (WLWH). Methods: Using data from a Cohort Study, we conducted univariate analyses, multivariable
logistic regression, and a 2-step structural equation modeling for the outcome, high
resilience (N = 1422). Results: Participants reported high overall resilience scores with a mean of 62.2 (standard
deviation = 8.1) and median of 64 (interquartile range = 59-69). The odds of having high
resilience were greater for those residing in Quebec compared to Ontario (adjusted odds
ratio [aOR] = 2.1 [1.6, 2.9]) and British Columbia (aOR = 1.8 [1.3, 2.5]). Transgender
women had increased odds of high resilience than cisgender women (aOR = 1.9 [1.0, 3.6]).
There were higher odds of resilience for those without mental health diagnoses (aOR =
2.4 [1.9, 3.0]), non-binge drinkers (aOR=1.5 [1.1, 2.1]), and not currently versus
previously injecting drugs (aOR = 3.6 [2.1, 5.9]). Structural equation modeling
confirmed that factors influencing resilience lie at multiple levels: micro, meso, exo,
and macro systems of influence. Conclusion: There is a need to consider resilience as the interaction between the person and their
environments, informing the development of multilevel interventions to support
resilience among WLWH.
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Affiliation(s)
- Roula Kteily-Hawa
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.,Faculty of Education, Queen's University, Kingston, Ontario, Canada
| | - Laura Warren
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Mina Kazemi
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
| | - Carmen H Logie
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.,Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Shazia Islam
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.,Alliance for South Asian AIDS Prevention, Toronto, Ontario, Canada
| | - Angela Kaida
- Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia, Canada
| | - Tracey Conway
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
| | - Yasmeen Persad
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
| | - Alexandra de Pokomandy
- Department of Family Medicine, McGill University, Montreal, Quebec, Canada.,Chronic Viral Illness Service, McGill University Health Centre, Montreal, Quebec, Canada
| | - Mona Loutfy
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Department of Medicine, University of Toronto, Toronto, Ontario, Canada
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Marg LZ, Ruiz G, Chagolla F, Cabral A, Taylor J, Christensen C, Martin M, Picou B, Brown B. "We are becoming older women and then we have two stigmas": voicing women's biopsychosocial health issues as they age with HIV. J Women Aging 2020; 32:365-388. [PMID: 32310730 DOI: 10.1080/08952841.2020.1751566] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
In April 2019, nine older women (age 50+) living with HIV in Palm Springs, California, participated in a 90-minute focus group to identify their major health issues, strengths, and HIV and aging-related health priorities. Using the rigorous and accelerated data reduction (RADaR) technique, we identified four major themes: (1) mental health, (2) HIV comorbidities, (3) social determinants of health, and (4) resiliencies. These results reinforce the need to conduct additional research focused on women aging with HIV, an understudied population that requires more effective, tailored interventions to promote better quality of life and healthy aging.
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Affiliation(s)
- Logan Z Marg
- Department of Sociology, University of California, Riverside , Riverside, California, USA
| | - Griselda Ruiz
- Department of Public Health, University of California, San Diego , San Diego, California, USA
| | - Fidel Chagolla
- Department of Sociology, University of California, Riverside , Riverside, California, USA
| | - Alejandra Cabral
- Department of Community Health Sciences, UCLA Fielding School of Public Health , Los Angeles, California, USA
| | - Jeff Taylor
- HIV and Aging Research Project-Palm Springs , Palm Springs, California, USA
| | - Chris Christensen
- HIV and Aging Research Project-Palm Springs , Palm Springs, California, USA
| | - Marjorie Martin
- HIV and Aging Research Project-Palm Springs , Palm Springs, California, USA
| | - Bridgette Picou
- HIV and Aging Research Project-Palm Springs , Palm Springs, California, USA.,Desert AIDS Project , Palm Springs, California, USA
| | - Brandon Brown
- Center for Healthy Communities, School of Medicine, University of California, Riverside , Riverside, California, USA
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