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Brady VJ, Willig AL, Christopoulos KA, Grelotti DJ, Yendewa GA, O'Cleirigh C, Moore RD, Napravnik S, Webel A, Crane HM, Saag MS, Ruderman SA. Impact of Depression and HIV Symptoms on Glycemic Outcomes among Patients with HIV and Type 2 Diabetes: A Clinical Cohort Study. AIDS Behav 2025; 29:1851-1858. [PMID: 39961951 DOI: 10.1007/s10461-025-04653-7] [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: 02/01/2025] [Indexed: 04/02/2025]
Abstract
Type 2 diabetes (T2DM) and depressive symptoms frequently co-occur among people with HIV (PWH). Depression may impact diabetes management in PWH. This study evaluated the prevalence of concurrent T2DM and depression among PWH and the impact of depression and HIV symptoms on glycemic outcomes (hemoglobin A1c [A1c], blood glucose [BG]) among people with both HIV and T2DM. We conducted a secondary analysis in the CFAR Network of Integrated Clinical Systems, a multisite clinical cohort including a diverse population of PWH in care from July 2005 through July 2023. Linear regression and linear mixed models were used to estimate the association between depression, HIV symptoms, and glycemic outcomes (A1C, BG) at baseline and over time. Of the 18,562 PWH, 2,945 (16%) also had T2DM. PWH with T2DM were older (56 vs. 49 years) and more often non-Hispanic Black and cis-gender men. The prevalence of depression was not significantly different between PWH with or without T2DM (20% vs. 21%) although more PWH with T2DM received antidepressant medications. Among people with both HIV and T2DM, HIV baseline symptoms and depression were not associated with a change in A1c. Increases in time-updated HIV symptom scores were associated with random (non-fasting) BG levels, with each additional HIV symptom resulting in 0.8 mg/dL increase in random BG level (95% CI: 0.04-1.60, p = 0.04). The prevalence of T2DM was higher among PWH than in the general population. Although depression appears to be well managed, other factors impacting glycemic outcomes among people with both HIV and T2DM require further study.
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Affiliation(s)
- Veronica Joyce Brady
- Department of Research, Cizik School of Nursing, The University of Texas Health Houston, Houston, TX, USA.
- Cizik School of Nursing, The University of Texas Health Houston, 6901 Bertner Ave., Suite 567E, Houston, TX, 77030, USA.
| | - Amanda L Willig
- Division of Infectious Diseases, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Katerina A Christopoulos
- Division of HIV, ID and Global Medicine, San Francisco General Hospital, University of California San Francisco, San Francisco, USA
| | - David J Grelotti
- HIV Neurobehavioral Research Program, Department of Psychiatry, University of California San Diego School of Medicine, San Diego, CA, USA
| | - George A Yendewa
- Department of Medicine, Division of Infectious Diseases and HIV Medicine, Case Western Reserve University School of Medicine, Cleveland, USA
| | - Conall O'Cleirigh
- Fenway Institute, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Richard D Moore
- Divisions of Infectious Diseases and General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Sonia Napravnik
- Division of Infectious Diseases, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Allison Webel
- School of Nursing, University of Washington, Seattle, WA, USA
| | - Heidi M Crane
- Division of Infectious Diseases, School of Medicine, University of Washington, Seattle, WA, USA
| | - Michael S Saag
- Division of Infectious Diseases, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
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da Cunha GH, Fontenele MSM, Galvão MTG, Dantas MB, Gomes MEC, Fechine FV, de Sousa Paiva S. Factors Associated With Symptoms of Anxiety and Depression in People Living With HIV in Northeast Brazil. J Acquir Immune Defic Syndr 2024; 97:87-98. [PMID: 39116335 DOI: 10.1097/qai.0000000000003468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 05/21/2024] [Indexed: 08/10/2024]
Abstract
BACKGROUND The diagnosis of HIV infection can cause mental disorders or exacerbate existing symptoms because of the stigma, psychological stress, and need for the self-management of the illness. The aim of this study was to determine the prevalence of anxiety and depression symptoms in people with HIV and to identify the associated factors. METHODS This is a cross-sectional study. A sample of 385 people living with HIV (PLWH) was interviewed using the Sociodemographic, Epidemiological, and Clinical Form; the Beck Anxiety Inventory; the Beck Depression Inventory; and Pittsburgh Sleep Quality Index. Univariate and multivariate logistic regression analysis were performed. The odds ratio and 95% confidence interval were calculated. RESULTS The prevalence of anxiety was 27.1% and depression was 39.8%. Being female (P = 0.0227), antiretroviral therapy (ART) for 8 years or less (P = 0.0042), and having depression (P < 0.0001) were associated with the occurrence of anxiety. Having a detectable viral load (P = 0.0476), not exercising regularly (P = 0.0070), and having sleep disorders (P = 0.0001) and anxiety (P < 0.0001) were associated with depression. Retired and on leave or sick pay were, respectively, 2.67 and 3.90 times more likely to have depression than those who were employed. CONCLUSIONS A considerable percentage of PLWH have anxiety and depression symptoms. Being female, less than 8 years of ART, and depression are associated with anxiety, while detectable viral load, not practicing physical exercise, having sleep disorders, anxiety, and being retired or on leave or sick pay are associated with depression. The study showed important data for health interventions by members of the multidisciplinary team for PLWH.
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Oladejo TS, Myezwa H, Ajidahun AT, Ibeneme S. Prevalence and predictors of HIV-related disability among people living with HIV in Nigeria. SOUTH AFRICAN JOURNAL OF PHYSIOTHERAPY 2024; 80:2001. [PMID: 39114422 PMCID: PMC11304381 DOI: 10.4102/sajp.v80i1.2001] [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: 10/15/2023] [Accepted: 02/15/2024] [Indexed: 08/10/2024] Open
Abstract
Background People living with human immunodeficiency virus (PLWH) live longer, but experience human immunodeficiency virus (HIV)-related comorbidities and disabilities that lower their quality of life. Understanding the prevalence, risk factors, and disability patterns is crucial for tailored interventions. Objectives To explore the prevalence and predictors of HIV-related disability among PLWH in Nigeria. Method This cross-sectional survey involved 385 PLWH, exploring demographic data, HIV history, recent symptoms, disability (measured by the WHO Disability Assessment Schedule-WHODAS 2.0). Descriptive statistics summarised the data, all variables were entered into univariate and multivariate regression models. IBM SPSS 25® was used for all analyses at a 95% confidence level. Results The prevalence of disability among PLWH was 39.5%, the mean age was 42.2 ± 10.43 years, and 73% of the participants were females. Factors significantly associated with disability were marital status (p = 0.009) and level of education (p = 0.001). Conclusion The study reveals a prevalence of disability (39.5%) among PLWH on antiretroviral therapy (ART), emphasising the need for tailored interventions considering socio-demographic factors. Continuous screening, risk identification, and effective management strategies are imperative, recognising disability as an indicator of health and quality of life. Clinical implications With PLWH experiencing increased life expectancy, the study underscores the need for an informed patient-centred approach to care, recognising the specific challenges faced by PLWH in Nigeria and guiding the development of targeted interventions to enhance both functional outcomes and overall well-being.
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Affiliation(s)
- Temitope S Oladejo
- Department of Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Hellen Myezwa
- School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Adedayo T Ajidahun
- Department of Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Sam Ibeneme
- Department of Medical Rehabilitation, Faculty of Health Sciences, University of Nigeria, Enugu, Nigeria
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Xie M, Wang A, Zhang Z, Wang K, Yu Y, Ma X, Lin Z, Yu Z, Ke J. Development and validation of the perceived symptom manageability scale among people living with the human immunodeficiency virus. BMC Psychol 2024; 12:172. [PMID: 38528643 DOI: 10.1186/s40359-024-01658-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 03/13/2024] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND "Perceived Symptom Manageability (PSM)" is essential in symptom management among people living with HIV. As a standardized assessment instrument was lacking, we developed a PSM scale for people living with human immunodeficiency virus (PSM-HIV). METHODS Data analysis was performed using the sample from HIV-designated medical institutions (N = 540). Psychometric testing, namely reliability and validity, is assessed by unidimensionality, internal consistency, exploratory and confirmatory factor analysis, and structural equation modeling. RESULTS The final version of the PSM- HIV scale contained 15 items. This scale was submitted to a principal components analysis with varimax rotation, and three factors were obtained, explained by a total variance of 63.10%. The three factors were named Cognitive-Behavioral, Affective Interaction, and Self-Attitude. The results show that the scale had high reliability, Cronbach's α of the scale ranged from 0.71 to 0.92, and the Intraclass Correlation Coefficient was 0.88. The structural equation model supports a factor model with the acceptable fit (χ2/df (CMIN/DF) = 2.50, Root Mean square Residual (RMR) = 0.03, Goodness-of-Fit Index (GFI) = 0.93, Adjusted Goodness of Fit Index (AGFI) = 0.90, Normed Fit Index (NFI) = 0.93, Incremental Fit Index (IFI) = 0.96, Comparative Fit Index (CFI) = 0.96). The average variance extracted was 0.38 ∼ 0.59, and the composite reliability was 0.70 ∼ 0.91, indicating that the convergent validity of the scale is acceptable. Subjects with different stages of the disease reached significance(χ2 = 9.02; df = 2, P<0.05), meaning moderate Known-Groups Comparison Validation. CONCLUSIONS The PSM-HIV scale is a valid instrument that measures overall attitude and belief about controlling or coping with HIV-relevant symptoms.
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Affiliation(s)
- Meilian Xie
- Department of Nursing, Beijing Ditan Hospital Capital Medical University, Beijing, China
| | - Aiping Wang
- Department of Public Service, The First Hospital of China Medical University, Shenyang, Liaoning Province, China.
| | - Zhiyun Zhang
- Department of Nursing, Beijing Ditan Hospital Capital Medical University, Beijing, China
| | - Kerong Wang
- Beijing Home of Red Ribbon, Beijing Ditan Hospital Capital Medical University, Beijing, China
| | - Yanping Yu
- Beijing Home of Red Ribbon, Beijing Ditan Hospital Capital Medical University, Beijing, China
| | - Xiaojing Ma
- Department of Infectious Disease, Beijing Ditan Hospital Capital Medical University, Beijing, China
| | - Zhaoxia Lin
- Department of Quality Control, Beijing Ditan Hospital Capital Medical University, Beijing, China
| | - Zhengli Yu
- Department of Infectious Disease, Beijing Ditan Hospital Capital Medical University, Beijing, China
| | - Jianxue Ke
- Department of Infectious Disease, Beijing Ditan Hospital Capital Medical University, Beijing, China
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Mendoza-Quispe D, Perez-Leon S, Alarcon-Ruiz CA, Gaspar A, Cuba-Fuentes MS, Zunt JR, Montori VM, Bazo-Alvarez JC, Miranda JJ. Scoping review of measures of treatment burden in patients with multimorbidity: advancements and current gaps. J Clin Epidemiol 2023; 159:92-105. [PMID: 37217106 PMCID: PMC10529536 DOI: 10.1016/j.jclinepi.2023.05.013] [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] [Received: 11/26/2022] [Revised: 05/03/2023] [Accepted: 05/16/2023] [Indexed: 05/24/2023]
Abstract
OBJECTIVES To identify, assess, and summarize the measures to assess burden of treatment in patients with multimorbidity (BoT-MMs) and their measurement properties. STUDY DESIGN AND SETTING MEDLINE via PubMed was searched from inception until May 2021. Independent reviewers extracted data from studies in which BoT-MMs were developed, validated, or reported as used, including an assessment of their measurement properties (e.g., validity and reliability) using the COnsensus-based Standards for the selection of health Measurement INstruments. RESULTS Eight BoT-MMs were identified across 72 studies. Most studies were performed in English (68%), in high-income countries (90%), without noting urban-rural settings (90%). No BoT-MMs had both sufficient content validity and internal consistency; some measurement properties were either insufficient or uncertain (e.g., responsiveness). Other frequent limitations of BoT-MMs included absent recall time, presence of floor effects, and unclear rationale for categorizing and interpreting raw scores. CONCLUSION The evidence needed for use of extant BoT-MMs in patients with multimorbidity remains insufficiently developed, including that of suitability for their development, measurement properties, interpretability of scores, and use in low-resource settings. This review summarizes this evidence and identifies issues needing attention for using BoT-MMs in research and clinical practice.
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Affiliation(s)
- Daniel Mendoza-Quispe
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru.
| | - Silvana Perez-Leon
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Christoper A Alarcon-Ruiz
- Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, Peru
| | - Andrea Gaspar
- School of Medicine, University of Washington, Washington, DC, USA
| | | | - Joseph R Zunt
- Departments of Neurology, Global Health, Medicine (Infectious Diseases), and Epidemiology, University of Washington, Seattle, WA, USA
| | - Victor M Montori
- Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN 55905, USA
| | - Juan Carlos Bazo-Alvarez
- Research Department of Primary Care and Population Health, University College London, London, UK
| | - J Jaime Miranda
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru; School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru; The George Institute for Global Health, UNSW, Sydney, Australia
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Identifying subtypes of HIV/AIDS-related symptoms in China using latent profile analysis and symptom networks. Sci Rep 2022; 12:13271. [PMID: 35918513 PMCID: PMC9345945 DOI: 10.1038/s41598-022-17720-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 07/29/2022] [Indexed: 11/09/2022] Open
Abstract
The identification of subgroups of people living with HIV in China based on the severity of symptom clusters and individual symptoms is crucial to determine group-specific symptom management strategies. Participants reported 27 highly prevalent HIV/AIDS-related symptoms. Latent profile analysis based on symptom severity was used to identify person-centered subtypes of HIV/AIDS-related symptoms. Symptom networks were compared among subgroups identified by latent profile analysis. A total of 2927 eligible people living with HIV (PWH) were included in the analysis. Five profiles were identified: "Profile 1: all low symptom severity" (n2 = 2094, 71.54%), "Profile 2: medium symptom severity with syndemic conditions" (n3 = 109, 3.72%), "Profile 3: medium symptom severity with low functional status" (n1 = 165, 5.64%), "Profile 4: medium symptom severity in transitional period" (n4 = 448, 15.31%), and "Profile 5: all high symptom severity" (n5 = 111, 3.79%). Except for Profile 1 and Profile 5, the symptom severity was similar among the other three profiles. Profiles 1 (2.09 ± 0.52) and 4 (2.44 ± 0.66) had the smallest ∑s values, and Profiles 2 (4.38 ± 1.40) and 5 (4.39 ± 1.22) had the largest ∑s values. Our study demonstrates the need for health care professionals to provide PWH with group-specific symptom management interventions based on five profiles to improve their physical and psychological well-being. Future studies should be conducted in different contexts using different symptom checklists to further validate our results.
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Oliveira VHF, Erlandson KM, Cook PF, Jankowski C, MaWhinney S, Dirajlal-Fargo S, Knaub L, Hsiao CP, Horvat Davey C, Webel AR. The High-Intensity Exercise Study to Attenuate Limitations and Train Habits in Older Adults With HIV (HEALTH): A Research Protocol. J Assoc Nurses AIDS Care 2022; 33:178-188. [PMID: 34039876 PMCID: PMC8613312 DOI: 10.1097/jnc.0000000000000276] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT The High-Intensity Exercise Study to Attenuate Limitations and Train Habits in Older Adults With HIV (HEALTH), which incorporates an exercise and biobehavioral coaching intervention, has the following overall goals: (a) to determine whether high-intensity interval training (HIIT) mitigates physical function impairments, fatigue, and impairments in mitochondrial bioenergetics of older people living with HIV (PLWH) to a greater extent than continuous moderate exercise (CME); and (b) to determine whether a biobehavioral coaching and mobile health text messaging intervention after HIIT or CME can promote long-term adherence to physical activity. The HEALTH study is a randomized trial of 100 older PLWH (≥50 years of age) who self-report fatigue and have a sedentary lifestyle. Enrolled participants will be randomized to 16 weeks of supervised HIIT or CME training, followed by a 12-week maintenance phase, involving a mobile health coaching intervention. Outcomes of the HEALTH study will inform the development of scalable, effective exercise recommendations tailored to the unique needs of aging PLWH.
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Affiliation(s)
- Vitor H F Oliveira
- Vitor H. F. Oliveira, PhD, is an Acting Instructor, University of Washington, School of Nursing, Seattle, Washington, USA. Kristine M. Erlandson, MD, MS, is an Associate Professor, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA. Paul F. Cook, PhD, is an Associate Professor, University of Colorado College of Nursing, Anschutz Medical Campus, Aurora, Colorado, USA. Catherine Jankowski, PhD, is an Associate Professor, University of Colorado College of Nursing, Anschutz Medical Campus, Aurora, Colorado, USA. Samantha MaWhinney, ScD, is a Professor, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA. Sahera Dirajlal-Fargo, DO, MS, is an Assistant Professor, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, Ohio, USA. Leslie Knaub, MS, is a Senior Professional Research Assistant, University of Colorado Anschutz Medical Campus, Rocky Mountain Regional VA Medical Center, Aurora, Colorado, USA. Chao-Pin Hsiao, RN, PhD, FAAN, is an Assistant Professor, Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio, USA. Christine Horvat Davey, RN, PhD, is a Research Associate and Postdoctoral Fellow, Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio, USA. Allison R. Webel, RN, PhD, FAAN, is a Professor and Associate Dean for Research, University of Washington, School of Nursing, Seattle, Washington, USA
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Tan QY, Cox NJ, Lim SER, Coutts L, Fraser SDS, Roberts HC, Ibrahim K. The Experiences of Treatment Burden in People with Parkinson's Disease and Their Caregivers: A Systematic Review of Qualitative Studies. JOURNAL OF PARKINSONS DISEASE 2021; 11:1597-1617. [PMID: 34334419 DOI: 10.3233/jpd-212612] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BackgroundHigh treatment burden is associated with poor adherence, wasted resources, poor quality of life and poor health outcomes. Identifying factors that impact treatment burden in Parkinson's disease can offer insights into strategies to mitigate them.ObjectiveTo explore the experiences of treatment burden among people with Parkinson's disease (PwP) and their caregivers.MethodsA systematic review of studies published from year 2006 was conducted. Qualitative and mixed-method studies with a qualitative component that relate to usual care in Parkinson's disease were included. Quantitative studies and grey literature were excluded. Data synthesis was conducted using framework synthesis.Results1757 articles were screened, and 39 articles included. Understanding treatment burden in PwP and caregivers was not the primary aim in any of the included studies. The main issues of treatment burden in Parkinson's disease are: 1) work and challenges of taking medication; 2) healthcare provider obstacles including lack of patient-centered care, poor patient-provider relationships, lack of care coordination, inflexible organizational structures, lack of access to services and issues in care home or hospital settings; and 3) learning about health and challenges with information provision. The treatment burden led to physical and mental exhaustion of self-care and limitations on the role and social activities of PwP and caregivers.Conclusion:There are potential strategies to improve the treatment burden in Parkinson's disease at an individual level such as patient-centered approach to care, and at system level by improving access and care coordination between services. Future research is needed to determine the modifiable factors of treatment burden in Parkinson's disease.
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Affiliation(s)
- Qian Yue Tan
- Academic Geriatric Medicine, Faculty of Medicine, University of Southampton, Southampton, UK.,National Institute for Health Research Applied Research Collaboration Wessex, University of Southampton, Southampton, UK
| | - Natalie J Cox
- Academic Geriatric Medicine, Faculty of Medicine, University of Southampton, Southampton, UK.,National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Trust, Southampton, UK
| | - Stephen E R Lim
- Academic Geriatric Medicine, Faculty of Medicine, University of Southampton, Southampton, UK.,National Institute for Health Research Applied Research Collaboration Wessex, University of Southampton, Southampton, UK
| | - Laura Coutts
- Academic Geriatric Medicine, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Simon D S Fraser
- National Institute for Health Research Applied Research Collaboration Wessex, University of Southampton, Southampton, UK.,School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Helen C Roberts
- Academic Geriatric Medicine, Faculty of Medicine, University of Southampton, Southampton, UK.,National Institute for Health Research Applied Research Collaboration Wessex, University of Southampton, Southampton, UK.,National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Trust, Southampton, UK
| | - Kinda Ibrahim
- Academic Geriatric Medicine, Faculty of Medicine, University of Southampton, Southampton, UK.,National Institute for Health Research Applied Research Collaboration Wessex, University of Southampton, Southampton, UK
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Zhu Z, Wen H, Yang Z, Han S, Fu Y, Zhang L, Hu Y, Wu B. Evolving symptom networks in relation to HIV-positive duration among people living with HIV: A network analysis. Int J Infect Dis 2021; 108:503-509. [PMID: 34098098 DOI: 10.1016/j.ijid.2021.05.084] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 05/27/2021] [Accepted: 05/31/2021] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES To explore and visualize the relationships among multiple symptoms in people living with HIV (PLWH) and compare centrality indices and the density of symptom networks among groups of individuals with different HIV-positive durations. METHODS We conducted a secondary analysis of data from the HIV-related Symptoms Monitoring Survey conducted in China. Networks were constructed among 27 symptoms. Centrality properties, including strength and closeness, and network density were used to describe relationships among symptoms in 5 different HIV-positive duration groups. RESULTS The findings showed that PLWH with longer HIV-positive durations did not have more severe symptoms; instead, their symptom networks were denser than those of their newly HIV-diagnosed counterparts (F = 27.073, P < 0.001). Fatigue was the most severe and central symptom in PLWH with an HIV-positive duration <10 years (rS = 7.79-10.09, rB = 18-44, rC = 0.01). Confusion was the most central symptom across the 3 centrality indices (rS = 11.81, rB = 14.00, rC = 0.02) in PLWH who had HIV-positive durations >10 years. CONCLUSION This study demonstrates a need to include an assessment of PLWH symptom networks as an essential component of HIV care. We recommended evaluating cognitive function and cognitive training as essential components of HIV care for long-term survivors, even in younger populations (aged ≤50 years).
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Affiliation(s)
- Zheng Zhu
- Fudan University School of Nursing, Shanghai, China; Fudan University Centre for Evidence-based Nursing: A Joanna Briggs Institute Centre of Excellence, Shanghai, China
| | - Huan Wen
- Fudan University School of Public Health, Shanghai, China
| | - Zhongfang Yang
- Fudan University School of Nursing, Shanghai, China; Fudan University Centre for Evidence-based Nursing: A Joanna Briggs Institute Centre of Excellence, Shanghai, China
| | - Shuyu Han
- Fudan University School of Nursing, Shanghai, China
| | - Yanfen Fu
- Dali University School of Nursing, Dali, Yunnan Province, China
| | - Lin Zhang
- Shanghai Public Health Clinical Center, Shanghai, China
| | - Yan Hu
- Fudan University School of Nursing, Shanghai, China; Fudan University Centre for Evidence-based Nursing: A Joanna Briggs Institute Centre of Excellence, Shanghai, China.
| | - Bei Wu
- NYU Rory Meyers College of Nursing, New York City, NY, USA
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