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Stockton MA, Mazinyo EW, Mlanjeni L, Sweetland AC, Scharf JY, Nogemane K, Ngcelwane N, Basaraba C, Bezuidenhout C, Sansbury G, Olivier D, Grobler C, Wall MM, Medina-Marino A, Nobatyi P, Wainberg ML. Validation of screening instruments for common mental disorders and suicide risk in south African primary care settings. J Affect Disord 2024; 362:161-168. [PMID: 38908555 PMCID: PMC11316636 DOI: 10.1016/j.jad.2024.06.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 02/15/2024] [Accepted: 06/19/2024] [Indexed: 06/24/2024]
Abstract
INTRODUCTION In South Africa, there is limited mental health infrastructure and resources. Valid screening tools are needed to facilitate identification and linkage to care. We evaluated the performance of Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), Primary Care Post Traumatic Stress Disorder Screen for DSM-5 (PC-PTSD-5), and the Columbia Suicide Severity Rating Scale (C-SSRS) among adults in South Africa against a diagnostic gold standard. METHODS Adults present at healthcare facilities were screened with the PHQ-9, GAD-7, PC-PTSD-5, and the C-SSRS. Nurses used a structured diagnostic interview to identify depression, anxiety, panic disorder, PTSD and elevated suicide risk. We assessed the internal consistency, criterion validity, and the sensitivity and specificity of these tools. RESULTS Of the 1885 participants, the prevalence of common mental disorders and suicide risk was 24.4 % and 14.9 %, respectively. The PHQ-9, GAD-7, and PC-PTSD-5 showed good internal consistency (0.80-0.89). All screeners demonstrated good criterion validity. For depression, a cut-off of ≥5 on the PHQ-9 yielded sensitivity of 84.24 %, while ≥10 yielded sensitivity of 48.77 %. For anxiety, the GAD-7 performed similarly. A cut-off of ≥4 on the PC-PTSD yielded sensitivity of 61.96 %. The C-SSRS yielded lower sensitivity than expected. LIMITATIONS The prevalence data is not generalizable to the larger South African adult population given the use of a targeted, healthcare facility-based sampling and recruitment strategy. CONCLUSIONS The performance of the PHQ-9, GAD-7, and PC-PTSD-5 demonstrated good internal consistency and criterion validity, though sensitivity and specificity trade-offs were enhanced with lower cut-offs. Further research into suicide risk screening is warranted.
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Affiliation(s)
- Melissa A Stockton
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Ernesha Webb Mazinyo
- Research Unit, Foundation for Professional Development, Buffalo City Metro, Eastern Cape Province, South Africa; University of California Global Health Institute, University of California, San Francisco, USA
| | - Lungelwa Mlanjeni
- The Desmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa
| | - Annika C Sweetland
- Columbia University Vagelos College of Physicians and Surgeons, Department of Psychiatry, New York, USA; New York State Psychiatric Institute, New York, USA
| | - Jodi Y Scharf
- Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, USA
| | - Kwanda Nogemane
- Buffalo City Metro Health District, Eastern Cape Provincial Department of Health, Bisho, South Africa
| | - Nondumiso Ngcelwane
- Buffalo City Metro Health District, Eastern Cape Provincial Department of Health, Bisho, South Africa
| | - Cale Basaraba
- Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, USA; Department of Biostatistics, Columbia University Mailman School of Public Health, NY, New York, USA
| | - Charl Bezuidenhout
- Department of Global Health, Boston University School of Public Health, Boston, MA, USA
| | | | - David Olivier
- The Desmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa
| | - Christoffel Grobler
- University of Pretoria, Faculty of Medicine, School of Health Systems and Public Health, Pretoria, South Africa
| | - Melanie M Wall
- Columbia University Vagelos College of Physicians and Surgeons, Department of Psychiatry, New York, USA; New York State Psychiatric Institute, New York, USA
| | - Andrew Medina-Marino
- The Desmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Phumza Nobatyi
- Buffalo City Metro Health District, Eastern Cape Provincial Department of Health, Bisho, South Africa
| | - Milton L Wainberg
- Columbia University Vagelos College of Physicians and Surgeons, Department of Psychiatry, New York, USA; New York State Psychiatric Institute, New York, USA
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Chu W, Tam CC, Harrison S. Associations between perceived discrimination experiences, treatment adherence self-efficacy, and depressive symptoms among people living with HIV in the Southern United States. AIDS Care 2024; 36:1382-1391. [PMID: 38623601 DOI: 10.1080/09540121.2024.2341231] [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: 07/25/2023] [Accepted: 04/05/2024] [Indexed: 04/17/2024]
Abstract
This study examined associations between perceived discrimination, treatment adherence self-efficacy, and depressive symptoms among people living with HIV (PLHIV) in the Southern United States. Cross-sectional survey data were collected from 402 PLHIV who self-reported on interpersonal discrimination experiences based on HIV status, sexuality, gender, income, and living condition. Participants also reported on adherence self-efficacy and depressive symptoms. We employed K-means clustering to identify groups based on discrimination experiences, and logistic regressions to examine group differences on adherence self-efficacy and depressive symptoms. Results suggested three groups: a cluster with high perceived discrimination across all identities/conditions (n = 41; 11%; Cluster 1); a cluster with high perceived discrimination based on HIV status, income, and living condition (n = 49; 13%; Cluster 2); and a cluster with low perceived discrimination across all identities/conditions (n = 288; 76%; Cluster 3). Compared to Cluster 3, Cluster 1 and 2 had 2.22 times (p = .037) and 3.98 times (p<.001) greater odds of reporting depressive symptoms. Compared to Cluster 3, Cluster 2 had 3.40 times (p = .003) greater odds of reporting lower adherence self-efficacy. Findings demonstrate the need for individual-level support for PLHIV with discrimination histories, and broader efforts to end the stigma, discrimination, and marginalization of PLHIV based on HIV status and other characteristics.
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Affiliation(s)
- Wendy Chu
- Department of Psychology, College of Arts and Sciences, University of South Carolina, Columbia, USA
| | - Cheuk Chi Tam
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, USA
| | - Sayward Harrison
- Department of Psychology, College of Arts and Sciences, University of South Carolina, Columbia, USA
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Gebrekidan AY, Lombebo AA, Efa AG, Azeze GA, Kassie GA, Haile KE, Asgedom YS, Woldegeorgis BZ, Dejenie TA. Suicidal ideation and associated factors among people living with HIV/AIDS in Ethiopia: a systematic review and meta-analysis. Front Psychiatry 2024; 15:1361304. [PMID: 39319360 PMCID: PMC11420569 DOI: 10.3389/fpsyt.2024.1361304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Accepted: 08/13/2024] [Indexed: 09/26/2024] Open
Abstract
Background Suicide is one of the main causes of mortality in the world, accounting for more fatalities than homicide, war, human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS), breast cancer, and malaria. Significantly, the biggest risk factors for suicide in the general population are having already attempted suicide and suicidal ideation. Despite the availability of studies on suicidal ideation among people living with HIV/AIDS (PLWHA) in Ethiopia, the results are inconsistent. Thus, a systematic review and meta-analysis was conducted to estimate the pooled prevalence of suicidal ideation among people living with HIV/AIDS. Methods A systematic review and meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. To find papers published in the English language before 20 May 2023, the electronic databases of Medline, Science Direct, Excerpta Medica Database, Cochrane Library, African Journals Online (AJOL), and Google Scholar were searched. The DerSimonian and Laird method for random effects models was used to estimate the pooled prevalence of suicidal ideation with a 95% confidence interval in STATA V.14.0 statistical software. To test for heterogeneity between studies and publication bias, respectively, forest plots and funnel plots were used. Additionally, leave-one-out sensitivity was conducted. Results A total of nine studies with 3,411 study participants were included in this systematic review and meta-analysis. The pooled prevalence of suicidal ideation among PLWHA was 20.55% (95% CI 14.76, 26.33). Being female (Odds ratio (OR) = 4.27, 95% CI = 2.29, 7.97), living alone (OR = 5.02, 95% CI = 2.15, 11.64), poor social support (OR = 3.80, 95% CI = 2.56, 5.65), perceived stigma (OR = 3.50, 95% CI = 1.55, 7.87), depression (OR = 5.08, 95% CI = 2.55, 11.48), undisclosed HIV status (OR = 4.8, 95% CI = 2.10, 10.93), and World Health Organization HIV clinical stages of III or IV (OR = 4.40, 95% CI = 2.95, 6.58) were significantly associated with suicidal ideation. Conclusion Suicidal ideation among PLWHA is high in Ethiopia. Therefore, emphasis should be given to psychiatric assessment and interventions with a special focus on individuals having the associated factors. Systematic Review Registration PROSPERO (CRD42023429613).
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Affiliation(s)
- Amanuel Yosef Gebrekidan
- School of Public Health, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Afework Alemu Lombebo
- School of Medicine, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Amelework Gonfa Efa
- School of Medicine, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Gedion Asnake Azeze
- School of Midwifery, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Gizachew Ambaw Kassie
- School of Public Health, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Kirubel Eshetu Haile
- School of Nursing, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Yordanos Sisay Asgedom
- School of Public Health, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Beshada Zerfu Woldegeorgis
- Department of Internal Medicine, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Tadesse Asmamaw Dejenie
- Department of Medical Biochemistry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Breslow AS, Lopez M, Warren B, Levin J, Sharma A, Watnick D, Sims G, Cavic E, Bassey O, Fisher MR, Bauman LJ. Lessons Learned from a Community-led, Pilot Teletherapy Group for Older Women Living with Depression and HIV. AIDS Behav 2024:10.1007/s10461-024-04468-y. [PMID: 39222185 DOI: 10.1007/s10461-024-04468-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2024] [Indexed: 09/04/2024]
Abstract
Older women with HIV face challenges to their quality of life, including neurocognitive decline, early-onset menopause, and chronic health issues. Chief among these concerns is depression, the most common psychiatric comorbidity among people living with HIV, with rates twice as high among women as men. However, tailored interventions among older women living with HIV and depression are lacking. Following the ADAPT-ITT framework to adapt existing interventions for cultural relevance among groups of people living with HIV, the study team revised an evidence-based intervention, the 'Stress Management and Relaxation Training/Expressive Supportive Therapy Women's Project (SMART/EST),' for online implementation. Working with two community stakeholders, the study team conducted focus groups, theater testing, and manual adaptation. This resulted in the development of e-SMART/EST, an online teletherapy group co-facilitated by a Licensed Psychologist and a credentialed Peer Counselor. The adapted, eight-session weekly intervention was tested with an exploratory pilot sample of eight older women (55 years and older) with HIV and depression. Participants rated the acceptability, feasibility, and appropriateness of the intervention, as well as symptoms of depression and HIV-related quality of life before and after the group. The e-SMART/EST Women's Project demonstrated high acceptability, feasibility, and appropriateness. Engagement was high, as women attended an average of 6.8 sessions. In qualitative interviews, participants reported peer co-facilitation, culturally relevant themes (e.g., HIV-related minority stress, critical consciousness, grief, and sex and pleasure), mindfulness techniques, and cohesion with other women as main favorable elements of the intervention. Barriers to online implementation included technological issues, distractions due to remote participation, and hindered emotional attunement compared with in-person group therapy. Findings support further research to test similar interventions in full-scale trials with older women living with depression and HIV.
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Affiliation(s)
- Aaron S Breslow
- PRIME Center for Health Equity, Psychiatry Research Institute at Montefiore Einstein, Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Bronx, NY, USA.
- Department of Psychiatry & Behavioral Sciences, Montefiore Medical Center, Bronx, NY, USA.
- Einstein-Rockefeller-CUNY Center for AIDS Research, Albert Einstein College of Medicine, Bronx, NY, USA.
- PRIME Center for Health Equity, Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Van Etten 4A-47, Bronx, NY, 10461, USA.
| | - Michelle Lopez
- PRIME Center for Health Equity, Psychiatry Research Institute at Montefiore Einstein, Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Bronx, NY, USA
- Einstein-Rockefeller-CUNY Center for AIDS Research, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Barbara Warren
- LGBT Programs and Policies, Office for Diversity and Inclusion, Mount Sinai Health System, New York, NY, USA
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jules Levin
- PRIME Center for Health Equity, Psychiatry Research Institute at Montefiore Einstein, Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Bronx, NY, USA
- Einstein-Rockefeller-CUNY Center for AIDS Research, Albert Einstein College of Medicine, Bronx, NY, USA
- National AIDS Treatment Advocacy Project, New York, NY, USA
| | - Anjali Sharma
- Einstein-Rockefeller-CUNY Center for AIDS Research, Albert Einstein College of Medicine, Bronx, NY, USA
- Divisions of General Internal Medicine and Infectious Diseases, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Dana Watnick
- Einstein-Rockefeller-CUNY Center for AIDS Research, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Ginette Sims
- PRIME Center for Health Equity, Psychiatry Research Institute at Montefiore Einstein, Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Elizabeth Cavic
- PRIME Center for Health Equity, Psychiatry Research Institute at Montefiore Einstein, Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Obioesio Bassey
- PRIME Center for Health Equity, Psychiatry Research Institute at Montefiore Einstein, Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Bronx, NY, USA
- Department of Psychiatry & Behavioral Sciences, Montefiore Medical Center, Bronx, NY, USA
| | - Marla R Fisher
- PRIME Center for Health Equity, Psychiatry Research Institute at Montefiore Einstein, Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Bronx, NY, USA
- Mount Sinai Morningside/West, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Laurie J Bauman
- Department of Psychiatry & Behavioral Sciences, Montefiore Medical Center, Bronx, NY, USA
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Miller SJ, Weaver KE, Harrison SE. A multi-informant qualitative analysis of desired features for an mHealth tool for youth living with HIV in South Carolina. J Pediatr Psychol 2024; 49:616-627. [PMID: 38976587 DOI: 10.1093/jpepsy/jsae047] [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: 01/25/2024] [Revised: 05/07/2024] [Accepted: 05/27/2024] [Indexed: 07/10/2024] Open
Abstract
OBJECTIVE Youth living with HIV (YLHIV) in the southern United States experience poor outcomes across the HIV care continuum and are at high-risk for virologic failure. This study used a qualitative, community-engaged approach to inform the development of a tailored mobile Health (mHealth) tool for YLHIV in South Carolina (SC). METHODS Semistructured qualitative interviews were conducted with YLHIV in SC (n = 16) and their HIV care providers (n = 15). Focus group discussions (FGDs) were also conducted with HIV-focused community-based organization staff (n = 23). Interviews and FGDs queried desired components for a future mHealth tool tailored for YLHIV. Data were analyzed using a team-based rapid qualitative approach. RESULTS Across informants, key themes emerged related to medical management of HIV, including a desire for connections with medical providers, appointment and medication reminders, and accurate HIV information. In addition, informants voiced a desire for mental health resources to be integrated into the app. Connection with HIV-positive peers also emerged as a key desire from youth informants. In terms of app design, informants emphasized the need for strict privacy practices, a youth-friendly design, compensation for use, and integration with existing healthcare systems. CONCLUSIONS mHealth interventions developed for YLHIV should meet the mental health and social needs of YLHIV in addition to their medical needs. In addition, the highly stigmatized nature of HIV requires careful consideration when designing digital tools-youth want their privacy prioritized, but also express strong desire for social support to help cope with the isolation and stigma of this chronic health condition.
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Affiliation(s)
- Sarah J Miller
- Department of Psychology, College of Arts and Sciences, University of South Carolina, Columbia, SC, United States
- South Carolina SmartState Center for Healthcare Quality, Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Katherine E Weaver
- Department of Psychology, College of Arts and Sciences, University of South Carolina, Columbia, SC, United States
| | - Sayward E Harrison
- Department of Psychology, College of Arts and Sciences, University of South Carolina, Columbia, SC, United States
- South Carolina SmartState Center for Healthcare Quality, Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
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Shi J, Zhang Z, Zhang J, Zhang Y, Qiu J, Liu F, Song D, Ma Y, Zhong L, Wang H, Liu X. Mental health disparities in people living with human immunodeficiency virus: A cross-sectional study on physician-patient concordance and treatment regimens. Chin Med J (Engl) 2024:00029330-990000000-01187. [PMID: 39164815 PMCID: PMC11407812 DOI: 10.1097/cm9.0000000000003202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Indexed: 08/22/2024] Open
Abstract
BACKGROUND Human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) can profoundly affect the mental health of the people living with HIV (PLWH), with higher rates of anxiety, depression, and sleep disturbances. The disparities in neuropsychological problems evaluated by physicians and self-assessed by patients are still unknown. METHODS A total of 5000 PLWH and 500 physicians from 167 hospitals were enrolled in this cross-sectional study from September 2022 to February 2023. 4-Item Patient Health Questionnaire (PHQ-4) was used for the evaluation of depressive issues and anxiety issues by PLWH. Each physician assessed 10 PLWH under their care for the presence of depressive or anxiety issues. The primary outcomes of this study are the concordance rates on the depressive issues and anxiety issues evaluation between physicians and PLWH. The Cohen's kappa test was used to assess the agreement between physicians and PLWH. RESULTS The concordance rate for the evaluation of depressive issues is 73.84% (95% confidence interval [CI]: 72.60-75.04%), and it is significantly different from the expected rate of 80% (P <0.001). Similarly, the concordance rate for the evaluation of anxiety issues is 71.74% (95% CI: 70.47-72.97%), which is significantly different from the expected rate of 80% as per the null hypothesis (P <0.001). The overestimation rate by physicians on depressive issues is 12.20% (95% CI: 11.32-13.14%), and for anxiety issues is 12.76% (95% CI: 11.86-13.71%). The mismatch rate for depressive issues is 26.16% (95% CI: 24.96-27.40%), and for anxiety issues is 28.26% (95% CI: 27.02-29.53%). The underestimation rate by physicians on depressive issues is 13.96% (95% CI: 13.03-14.95%), and for anxiety issues is 15.50% (95% CI: 14.52-16.53%). For the treatment regiments, PLWH sustained on innovative treatment regimen (IR) related to a lower prevalence of depressive issues (odds ratio [OR] = 0.71, 95% CI: 0.59-0.87, P = 0.003) and a lower prevalence of anxiety issues (OR = 0.63, 95% CI: 0.52-0.76, P <0.001). PLWH switch from conventional treatment regimen (CR) to IR also related to a lower prevalence of depressive issues (OR = 0.79, 95% CI: 0.64-0.98) and a lower prevalence of anxiety issues (OR = 0.81, 95% CI: 0.67-0.99). CONCLUSION Nearly one in three PLWH had their condition misjudged by their physicians. The findings underscore the need for improved communication and standardized assessment protocols in the care of PLWH, especially during the acute phase of HIV infection.
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Affiliation(s)
- Jinchuan Shi
- The Second Infectious Disease Department, Hangzhou Xixi Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310023, China
| | - Zhongdong Zhang
- The Second Infectious Disease Department, Hangzhou Xixi Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310023, China
| | - Junyan Zhang
- Department of Clinical Epidemiology and Evidence-based Medicine, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, Shanxi 030032, China
| | - Yishu Zhang
- Department of Neurology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650032, China
| | - Jiating Qiu
- Department of Neurology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650032, China
| | - Fang Liu
- Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650032, China
| | - Daoyuan Song
- Department of Neurology, Affiliated Hospital of Yunnan University, Kunming, Yunnan 650031, China
| | - Yanfang Ma
- Neurology Department, Qian'an People's Hospital, Qian'an, Hebei 064499, China
| | - Lianmei Zhong
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - Hongxing Wang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - Xiaolei Liu
- Department of Neurology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650032, China
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Lee S, Oh JW, Park KM, Ahn JY, Lee S, Lee E. The prevalence and moderating factors of sleep disturbances in people living with HIV: a systematic review and meta-analysis. Sci Rep 2024; 14:14817. [PMID: 38937605 PMCID: PMC11211430 DOI: 10.1038/s41598-024-65713-x] [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: 04/01/2024] [Accepted: 06/24/2024] [Indexed: 06/29/2024] Open
Abstract
This systematic review and meta-analysis aimed to investigate the prevalence of self-reported sleep disturbances in people living with HIV considering the effects of age, depression, anxiety, CD4 cell counts, time since HIV diagnosis, study region, and the instruments used to measure sleep disturbances. We searched PubMed, PsycINFO, and EMBASE to include eligible articles. In this meta-analysis of 43 studies, the pooled prevalence of self-reported sleep disturbances was 52.29% (95% confidence interval 47.69-56.87). The subgroup analyses revealed that variations in the sleep measurements and study region significantly contributed to the observed heterogeneity. In the meta-regression analyses, higher proportions of participants with depression or anxiety and longer times since HIV diagnosis were significantly associated with a higher prevalence of self-reported sleep disturbances after adjusting for mean age. Our findings emphasise the substantial burden of sleep disturbances in people living with HIV and identified comorbid depression and anxiety and the time since HIV diagnosis as significant moderators. These results underscore the importance of considering these factors when designing tailored screening programmes for high-risk patients and implementing early interventions to prevent and mitigate sleep disturbances in people living with HIV.
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Affiliation(s)
- Suonaa Lee
- Department of Psychiatry and the Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Jae Won Oh
- Department of Psychology, The University of Utah Asia Campus, Incheon, Republic of Korea
| | - Kyung Mee Park
- Department of Psychiatry and the Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
- Department of Hospital Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Republic of Korea
| | - Jin Young Ahn
- Division of Infectious Diseases, Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - San Lee
- Department of Psychiatry and the Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
- Department of Psychiatry, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Republic of Korea.
| | - Eun Lee
- Department of Psychiatry and the Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
- Institute for Innovation in Digital Healthcare, Yonsei University, Seoul, Republic of Korea.
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Liu Q, Wang J, Gu Z, Ouyang T, Gao H, Kan H, Yang Y. Comprehensive Exploration of the Neuroprotective Mechanisms of Ginkgo biloba Leaves in Treating Neurological Disorders. THE AMERICAN JOURNAL OF CHINESE MEDICINE 2024; 52:1053-1086. [PMID: 38904550 DOI: 10.1142/s0192415x24500435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/22/2024]
Abstract
Neurological disorders (NDs) are diseases that seriously affect the health of individuals worldwide, potentially leading to a significant reduction in the quality of life for patients and their families. Herbal medicines have been widely used in the treatment of NDs due to their multi-target and multi-pathway features. Ginkgo biloba leaves (GBLs), one of the most popular herbal medicines in the world, have been demonstrated to present therapeutic effects on NDs. However, the pharmacological mechanisms of GBLs in the treatment of neurological disorders have not been systematically summarized. This study aimed to summarize the molecular mechanism of GBLs in treating NDs from the cell models, animal models, and clinical trials of studies. Four databases, i.e., PubMed, Google Scholar, CNKI, and Web of Science were searched using the following keywords: "Ginkgo biloba", "Ginkgo biloba extract", "Ginkgo biloba leaves", "Ginkgo biloba leaves extract", "Neurological disorders", "Neurological diseases", and "Neurodegenerative diseases". All items meeting the inclusion criteria on the treatment of NDs with GBLs were extracted and summarized. Additionally, PRISMA 2020 was performed to independently evaluate the screening methods. Out of 1385 records in the database, 52 were screened in relation to the function of GBLs in the treatment of NDs; of these 52 records, 39 were preclinical trials and 13 were clinical studies. Analysis of pharmacological studies revealed that GBLs can improve memory, cognition, behavior, and psychopathology of NDs and that the most frequently associated GBLs are depression, followed by Alzheimer's disease, stroke, Huntington's disease, and Parkinson's disease. Additionally, the clinical studies of depression, AD, and stroke are the most common, and most of the remaining ND data are available from in vitro or in vivo animal studies. Moreover, the possible mechanisms of GBLs in treating NDs are mainly through free radical scavenging, anti-oxidant activity, anti-inflammatory response, mitochondrial protection, neurotransmitter regulation, and antagonism of PAF. This is the first paper to systematically and comprehensively investigate the pharmacological effects and neuroprotective mechanisms of GBLs in the treatment of NDs thus far. All findings contribute to a better understanding of the efficacy and complexity of GBLs in treating NDs, which is of great significance for the further clinical application of this herbal medicine.
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Affiliation(s)
- Qiwei Liu
- School of Medical Informatics Engineering, Anhui University of Chinese Medicine Hefei, Anhui 230012, P. R. China
| | - Jinghui Wang
- School of Integrated Chinese and Western Medicine, Anhui University of Chinese Medicine Hefei, Anhui 230012, P. R. China
| | - Zongyun Gu
- School of Medical Informatics Engineering, Anhui University of Chinese Medicine Hefei, Anhui 230012, P. R. China
| | - Ting Ouyang
- School of Medical Informatics Engineering, Anhui University of Chinese Medicine Hefei, Anhui 230012, P. R. China
| | - Honglei Gao
- School of Medical Informatics Engineering, Anhui University of Chinese Medicine Hefei, Anhui 230012, P. R. China
| | - Hongxing Kan
- School of Medical Informatics Engineering, Anhui University of Chinese Medicine Hefei, Anhui 230012, P. R. China
- Anhui Computer Application Research Institute of Chinese Medicine, China Academy of Chinese Medical Sciences, Hefei, P. R. China
| | - Yinfeng Yang
- School of Medical Informatics Engineering, Anhui University of Chinese Medicine Hefei, Anhui 230012, P. R. China
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Vance DE, Billings R, Lambert CC, Fazeli PL, Goodin BR, Kempf MC, Rubin LH, Turan B, Wise J, Hellemann G, Lee J. A Systematic Review and Meta-Analysis of Social Cognition Among People Living with HIV: Implications for Non-Social Cognition and Social Everyday Functioning. Neuropsychol Rev 2024:10.1007/s11065-024-09643-5. [PMID: 38869661 DOI: 10.1007/s11065-024-09643-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 05/05/2024] [Indexed: 06/14/2024]
Abstract
Social cognition-the complex mental ability to perceive social stimuli and negotiate the social environment-has emerged as an important cognitive ability needed for social functioning, everyday functioning, and quality of life. Deficits in social cognition have been well documented in those with severe mental illness including schizophrenia and depression, those along the autism spectrum, and those with other brain disorders where such deficits profoundly impact everyday life. Moreover, subtle deficits in social cognition have been observed in other clinical populations, especially those that may have compromised non-social cognition (i.e., fluid intelligence such as memory). Among people living with HIV (PLHIV), 44% experience cognitive impairment; likewise, social cognitive deficits in theory of mind, prosody, empathy, and emotional face recognition/perception are gradually being recognized. This systematic review and meta-analysis aim to summarize the current knowledge of social cognitive ability among PLHIV, identified by 14 studies focused on social cognition among PLHIV, and provides an objective consensus of the findings. In general, the literature suggests that PLHIV may be at-risk of developing subtle social cognitive deficits that may impact their everyday social functioning and quality of life. The causes of such social cognitive deficits remain unclear, but perhaps develop due to (1) HIV-related sequelae that are damaging the same neurological systems in which social cognition and non-social cognition are processed; (2) stress related to coping with HIV disease itself that overwhelms one's social cognitive resources; or (3) may have been present pre-morbidly, possibly contributing to an HIV infection. From this, a theoretical framework is proposed highlighting the relationships between social cognition, non-social cognition, and social everyday functioning.
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Affiliation(s)
- David E Vance
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA.
| | - Rebecca Billings
- UAB Libraries, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Pariya L Fazeli
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Burel R Goodin
- Department of Anesthesiology, Washington University Pain Center, Washington University, St. Louis, MO, USA
| | | | - Leah H Rubin
- Department of Neurology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Bulent Turan
- Department of Psychology, Koc University, Rumelifeneri Caddesi, Turkey
| | - Jenni Wise
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Gerhard Hellemann
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Junghee Lee
- Department of Psychiatry and Behavioral Neurobiology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
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10
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Chen Z, He K, Chen Y, Zhang X, Ye Z, Xie C, Luo T, Fu X, Shi W, Zhang Z, Cao L, Li Y. Sleep quality mediates the effect of medical social support on depression symptoms in patients with HIV/AIDS. BMC Public Health 2024; 24:1429. [PMID: 38807089 PMCID: PMC11134677 DOI: 10.1186/s12889-024-18174-w] [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: 08/09/2023] [Accepted: 02/21/2024] [Indexed: 05/30/2024] Open
Abstract
OBJECTIVES The purpose of our study is to further understanding of the depression symptoms of HIV/AIDS patients in Guilin, Guangxi via exploring whether there is a mediating effect of sleep quality on medical-social support and depression symptoms and therefore provide a theoretical basis for application of medical-social support to alleviate depression symptoms of HIV/AIDS patients. METHODS A convenience sampling method was used to select 200 HIV/AIDS patients for the study. Depression symptoms, sleep quality, and medical-social support of the study participants were investigated using The Center for Epidemiological Studies Depression Scale (CES-D), The Pittsburg Sleep Quality Index (PSQI), and The Medical Outcomes Study Social Support Survey (MOS-SSS), respectively. Predictors of depression symptoms were explored by multiple linear regression, and Pearson correlation was used to analyze the relationship between sleep quality, medical-social support, and depression symptoms. Mediating effect analysis was performed by nonparametric Bootstrap test. RESULTS In this study, the incidence of depression symptoms was 54.4%. Multiple linear regression analysis showed that leanness (β = 0.161, P = 0.008), obesity (β = 0.186, P = 0.002), sleep quality score > 7 (β = 0.331, P < 0.001), and medical-social support score > 56 (β = -0.247, P < 0.001) could influence depression symptoms of HIV and Pearson's correlation analysis demonstrated that there was a two-way correlation between sleep quality, medical social support and depression symptoms (P < 0.05). In addition, Bootstrap tests showed that medical-social support might affect depression symptoms not only directly but also indirectly through the mediating effect of sleep quality with the direct and mediating effects accounting for 77.25% and 22.75% of the total effect, respectively. CONCLUSION The prevalence of depression symptoms is high among HIV/AIDS patients in Guilin City. The depressive symptoms of PLWHs(people living with HIV) are related to their sleep quality and medical-social support, and sleep quality partially mediates the relationship between medical-social support and depression symptoms. Therefore, interventions to improve sleep quality and medical-social support have the potential to allay the depression symptoms of HIV/AIDS patients.
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Affiliation(s)
- Ziqi Chen
- Department of Environmental Health and Occupational Medicine, School of Public Health, Guilin Medical University, Guilin, Guangxi, 541199, People's Republic of China
- Guangxi Health Commission Key Laboratory of Entire Lifecycle Health and Care, Guilin Medical University), Guilin, Guangxi, 541199, People's Republic of China
| | - Kailian He
- Department of Environmental Health and Occupational Medicine, School of Public Health, Guilin Medical University, Guilin, Guangxi, 541199, People's Republic of China
- Health and Wellness Section, Yibin Center for Disease Control and Prevention, Yibin, Sichuan, 644600, People's Republic of China
| | - Yulu Chen
- Department of Environmental Health and Occupational Medicine, School of Public Health, Guilin Medical University, Guilin, Guangxi, 541199, People's Republic of China
- Guangxi Health Commission Key Laboratory of Entire Lifecycle Health and Care, Guilin Medical University), Guilin, Guangxi, 541199, People's Republic of China
| | - Xiashuang Zhang
- Department of Environmental Health and Occupational Medicine, School of Public Health, Guilin Medical University, Guilin, Guangxi, 541199, People's Republic of China
- Guangxi Health Commission Key Laboratory of Entire Lifecycle Health and Care, Guilin Medical University), Guilin, Guangxi, 541199, People's Republic of China
| | - Zeyan Ye
- Department of Environmental Health and Occupational Medicine, School of Public Health, Guilin Medical University, Guilin, Guangxi, 541199, People's Republic of China
- Guangxi Health Commission Key Laboratory of Entire Lifecycle Health and Care, Guilin Medical University), Guilin, Guangxi, 541199, People's Republic of China
| | - Chaofan Xie
- Department of Environmental Health and Occupational Medicine, School of Public Health, Guilin Medical University, Guilin, Guangxi, 541199, People's Republic of China
- Guangxi Health Commission Key Laboratory of Entire Lifecycle Health and Care, Guilin Medical University), Guilin, Guangxi, 541199, People's Republic of China
| | - Tingyu Luo
- Department of Environmental Health and Occupational Medicine, School of Public Health, Guilin Medical University, Guilin, Guangxi, 541199, People's Republic of China
- Guangxi Health Commission Key Laboratory of Entire Lifecycle Health and Care, Guilin Medical University), Guilin, Guangxi, 541199, People's Republic of China
| | - Xiaofeng Fu
- Department of AIDS Control and Prevention, Guilin Center for Disease Control and Prevention, Guilin, Guangxi, 541000, People's Republic of China
| | - Wuxiang Shi
- Health Management Unit, Faculty of Humanities and Management, Guilin Medical University, Guilin, Guangxi, 541199, People's Republic of China
| | - Zhiyong Zhang
- Department of Environmental Health and Occupational Medicine, School of Public Health, Guilin Medical University, Guilin, Guangxi, 541199, People's Republic of China
- Guangxi Health Commission Key Laboratory of Entire Lifecycle Health and Care, Guilin Medical University), Guilin, Guangxi, 541199, People's Republic of China
| | - Liang Cao
- Department of Environmental Health and Occupational Medicine, School of Public Health, Guilin Medical University, Guilin, Guangxi, 541199, People's Republic of China.
- Department of Experimental Teaching Center, School of Public Health, Guilin Medical University, Guilin, Guangxi, 541199, People's Republic of China.
| | - You Li
- Department of Environmental Health and Occupational Medicine, School of Public Health, Guilin Medical University, Guilin, Guangxi, 541199, People's Republic of China.
- Guangxi Health Commission Key Laboratory of Entire Lifecycle Health and Care, Guilin Medical University), Guilin, Guangxi, 541199, People's Republic of China.
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11
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Walker JA, Staab EM, Ridgway JP, Schmitt J, Franco MI, Hunter S, Motley D, Laiteerapong N. Patient Perspectives on Portal-Based Anxiety and Depression Screening in HIV Care: A Qualitative Study Using the Consolidated Framework for Implementation Research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:692. [PMID: 38928937 PMCID: PMC11203430 DOI: 10.3390/ijerph21060692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 05/13/2024] [Accepted: 05/24/2024] [Indexed: 06/28/2024]
Abstract
Electronic patient portals represent a promising means of integrating mental health assessments into HIV care where anxiety and depression are highly prevalent. Patient attitudes toward portal-based mental health screening within HIV clinics have not been well described. The aim of this formative qualitative study is to characterize the patient-perceived facilitators and barriers to portal-based anxiety and depression screening within HIV care in order to inform implementation strategies for mental health screening. Twelve adult HIV clinic patients participated in semi-structured interviews that were audio recorded and transcribed. The transcripts were coded using constructs from the Consolidated Framework for Implementation Research and analyzed thematically to identify the barriers to and facilitators of portal-based anxiety and depression screening. Facilitators included an absence of alternative screening methods, an approachable design, perceived adaptability, high compatibility with HIV care, the potential for linkage to treatment, an increased self-awareness of mental health conditions, the ability to bundle screening with clinic visits, and communicating an action plan for results. The barriers included difficulty navigating the patient portal system, a lack of technical support, stigmatization from the healthcare system, care team response times, and the novelty of using patient portals for communication. The patients in the HIV clinic viewed the use of a portal-based anxiety and depression screening tool as highly compatible with routine HIV care. Technical difficulties, follow-up concerns, and a fear of stigmatization were commonly perceived as barriers to portal use. The results of this study can be used to inform implementation strategies when designing or incorporating portal-based mental health screening into other HIV care settings.
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Affiliation(s)
- Jacob A. Walker
- Department of Medicine, University of Colorado School of Medicine, Aurora, CO 80045, USA
| | - Erin M. Staab
- Department of Medicine, University of Chicago, Chicago, IL 60637, USA (N.L.)
| | - Jessica P. Ridgway
- Department of Medicine, University of Chicago, Chicago, IL 60637, USA (N.L.)
| | - Jessica Schmitt
- Department of Medicine, University of Chicago, Chicago, IL 60637, USA (N.L.)
| | - Melissa I. Franco
- Department of Medicine, University of Chicago, Chicago, IL 60637, USA (N.L.)
| | - Scott Hunter
- Chicago Center for HIV Elimination, Department of Medicine, University of Chicago, Chicago, IL 60637, USA
- WCG Clinical Endpoint Solutions, Hamilton, NJ 08540, USA
| | - Darnell Motley
- Department of Medicine, University of Chicago, Chicago, IL 60637, USA (N.L.)
| | - Neda Laiteerapong
- Department of Medicine, University of Chicago, Chicago, IL 60637, USA (N.L.)
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12
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Ji J, Zhang Y, Ma Y, Jia L, Cai M, Li Z, Zhang T, Guo C. People who living with HIV/AIDS also have a high prevalence of anxiety disorders: a systematic review and meta-analysis. Front Psychiatry 2024; 15:1259290. [PMID: 38380124 PMCID: PMC10877523 DOI: 10.3389/fpsyt.2024.1259290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 01/22/2024] [Indexed: 02/22/2024] Open
Abstract
Background An estimated 301 million people worldwide suffer from anxiety disorders. People living with HIV/AIDS (PLWHA) are particularly prone to anxiety disorders that could interfere with the important developmental process in an individual's development and ultimately result in a wide range of negative mental, physical, and psychosocial consequences, as well as poor quality of life in those population groups. Early intervention for anxiety disorders can reverse some of the physical damage caused by anxiety. However, based on systematic reviews and meta-analyses, the specific prevalence of anxiety disorders in PLWHA remains unknown. Method We conducted a literature search on PubMed, Embase, and Web of Science up to 22 October 2022. A random-effects meta-analysis was used to pool prevalence rates from the included studies. Sensitivity and subgroup analyses were performed to identify the possible sources of heterogeneity and to compare the prevalence estimates across groups. The Joanna Briggs Institute's Quality Assessment Checklist was used to assess the quality of the included studies. Cochran's Q and I2 tests were used to assess the between-study heterogeneity. Results Ten studies with a total of 238,570 cases were included for the final analysis. Results showed that 15.5% of HIV/AIDS patients had anxiety disorders. The prevalence was higher in females (20.8%) than males (20.7%). The mean age of PLWHA with anxiety disorders was 46.58 ± 11.15 years in these included studies. The subgroup analyses showed significant higher prevalence in non-heterosexual (32.1%). Conclusion We attempted to quantify literature that could allow for stronger inferences to be made regarding the significantly higher prevalence of anxiety disorders in PLWHA, a finding that suggests the imperativeness of intervention strategies to alleviate suffering and reduce the probable negative ramifications. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023442219, identifier CRD42023442219.
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Affiliation(s)
- Jiahao Ji
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Yang Zhang
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Sexually Transmitted Disease Prevention and Control, Beijing, China
| | - Yundong Ma
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Lin Jia
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Miaotian Cai
- Department of Respiratory and Critical Care Medicine, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Zhen Li
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Tong Zhang
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Sexually Transmitted Disease Prevention and Control, Beijing, China
| | - Caiping Guo
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
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13
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Yang Y, Chen B, Zhang H, Huang P, Qian J, Lin L, Zhang L, Cai F. Global prevalence of depressive symptoms among people living with HIV/AIDS: a systematic review and meta-analysis of the past five years. AIDS Care 2024; 36:153-164. [PMID: 37995747 DOI: 10.1080/09540121.2023.2285733] [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: 08/27/2022] [Accepted: 11/15/2023] [Indexed: 11/25/2023]
Abstract
A clear and accurate assessment of depressive symptoms among people living with HIV/AIDS (PLWHA) in the past five years is essential to help develop reasonable and sound interventions to improve their depressive symptoms. PubMed, Web of Science, MEDLINE, Cochrane, Embase, CINAHL, and APA were searched from 1 January 2017 to 12 April 2022. The data were analyzed using STATA 15 Software to pool the global prevalence of depressive symptoms in PLWHA. Ultimately, 103785 PLWHA from 81 original studies were included. The pooled analysis showed that the global prevalence of depressive symptoms in PLWHA over the past five years was 0.35 (95% CI: 0.31-0.38), with differences in depressive symptoms in PLWHA by geographic location, gender, assessment instruments, alcohol use, smoking, marriage, co-morbid disease, financial situation, and educational level. Scientific and timely public health interventions should be developed among PLWHA to improve their depressive symptoms and thereby improve mental health and clinical outcomes.
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Affiliation(s)
- Yufan Yang
- School of Nursing, Peking University, Beijing, People's Republic of China
| | - Bei Chen
- Nursing Department, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
- The Second School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Haiyan Zhang
- College of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Pan Huang
- College of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Jieyu Qian
- College of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Lulu Lin
- College of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Liping Zhang
- Nursing Department, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Fuman Cai
- College of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
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14
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Kohli M, Ham L, Saloner R, Dung D, Iudicello J, Ellis RJ, Moore DJ. Latent Profile Analysis of Cognitive Performance and Depressive Symptoms Among People with HIV. AIDS Patient Care STDS 2024; 38:93-106. [PMID: 38381950 PMCID: PMC10890962 DOI: 10.1089/apc.2023.0224] [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: 02/23/2024] Open
Abstract
Depression and cognitive impairment are prevalent conditions among people with HIV (PWH), likely attributable to shared causes and common risk factors. Identifying subtypes of PWH with similar patterns of neurocognitive impairment (NCI) and depressive symptoms may inform development of patient-centered interventions that target-specific profiles. This study aimed to (1) classify PWH based on patterns of domain-specific NCI and depression; and (2) determine the relationship between latent class membership and pertinent clinical characteristics. PWH (N = 580, 86.2% male, 57.1% non-Hispanic White, 69.2% unemployed) completed a comprehensive neuropsychological test battery assessing global and domain-specific cognition. Domain-specific NCI was classified as deficit score >0.5. Participants completed the Beck Depression Inventory-II (BDI-II), and domain-specific BDI-II scores reflecting cognitive, affective, and somatic symptoms were computed. Latent profile analysis (LPA) was used to determine latent subgroups of NCI and depression. The optimal LPA solution consisted of five classes: minimal NCI and minimal depression (Class 1), amnestic and minimal depression (Class 2), severe multi-domain NCI and moderate depression (somatic and affective; Class 3), mild NCI and mild depression (Class 4), and moderate multi-domain NCI and severe depression (Class 5). Despite similar levels of functional impairment, Class 5 had a significant psychiatric profile, whereas Class 3 had a complex medical profile (i.e., higher frailty index, higher medications, greater proportion of AIDS diagnosis). In contrast, Class 1 had the lowest medication use and frailty index, with similar HIV disease characteristics to Classes 3 and 5. Our results suggest there are multiple pathways to cognitive and functional impairment among PWH with co-occurring depression and cognitive impairment, and these groups may respond differently to interventions. Of note, our sample was majority non-Hispanic White and male, which is nonrepresentative of the US population of PWH. Future interventions should consider a more integrated, person-centered approach that addresses cognitive and emotional health to optimize health outcomes in PWH.
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Affiliation(s)
- Maulika Kohli
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California, USA
- HIV Neurobehavioral Research Program, University of California San Diego, San Diego, California, USA
| | - Lillian Ham
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California, USA
- HIV Neurobehavioral Research Program, University of California San Diego, San Diego, California, USA
| | - Rowan Saloner
- Memory and Aging Center, University of California, San Francisco, San Francisco, California, USA
| | - Devin Dung
- HIV Neurobehavioral Research Program, University of California San Diego, San Diego, California, USA
| | - Jennifer Iudicello
- HIV Neurobehavioral Research Program, University of California San Diego, San Diego, California, USA
- Department of Psychiatry and University of California, San Diego, La Jolla, California, USA
| | - Ronald J. Ellis
- HIV Neurobehavioral Research Program, University of California San Diego, San Diego, California, USA
- Department of Psychiatry and University of California, San Diego, La Jolla, California, USA
- Department of Neurosciences, University of California, San Diego, La Jolla, California, USA
| | - David J. Moore
- HIV Neurobehavioral Research Program, University of California San Diego, San Diego, California, USA
- Department of Psychiatry and University of California, San Diego, La Jolla, California, USA
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15
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Wang R, Zheng F, Cao G, Goldsamt LA, Shen Y, Zhang C, Yi M, Peng W, Li X. The relationship between social support and depression among HIV-positive men who have sex with men in China: the chain mediating role of psychological flexibility and hope. Front Public Health 2023; 11:1271915. [PMID: 38026353 PMCID: PMC10665023 DOI: 10.3389/fpubh.2023.1271915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 10/13/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction HIV and mental health problems are a global syndemic. One key issue is that the significant mental health problems among people vulnerable to acquiring or living with HIV have not been fully addressed. Access to social support has been one of the biggest challenges for HIV-positive men who have sex with men (HIV+ MSM). Lower social support has been linked to more severe depression symptoms. However, the mechanisms underlying the association between social support and depression in HIV+ MSM are unclear. Two possible mediators include hope and psychological flexibility. This study aimed to examine the relationship between social support and depression in HIV+ MSM and to explore the single mediating effects of hope and psychological flexibility and the chain mediating effect of these two variables on this relationship. Methods A convenience sample was used to recruit participants from the designated HIV/AIDS hospital in Changsha city, Hunan Province of China. A total of 290 HIV+ MSM completed questionnaires. Results Our findings showed that hope mediated the relationship between social support and depression in HIV+ MSM. Furthermore, the chain mediation model confirmed a direct negative association between social support and depression, but this relationship was largely mediated by the chain effects of hope and psychological flexibility. Conclusions Integrating hope and psychological flexibility into interventions may provide better mental health support for HIV+ MSM and improve their wellbeing and quality of life.
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Affiliation(s)
- Run Wang
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Fang Zheng
- Department of AIDS, The First Hospital of Changsha, Changsha, Hunan, China
| | - Guiying Cao
- Department of AIDS, The First Hospital of Changsha, Changsha, Hunan, China
| | - Lloyd A. Goldsamt
- Rory Meyers College of Nursing, New York University, New York, NY, United States
| | - Yan Shen
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Ci Zhang
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Mengyao Yi
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Wenwen Peng
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Xianhong Li
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
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16
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Shrestha S, Shakya Shrestha U, Priyanka J, Shrestha P. Depressive Symptoms among People Living with HIV Attending ART Centers of Lumbini Province, Nepal: A Cross-Sectional Study. AIDS Res Treat 2023; 2023:3526208. [PMID: 37908331 PMCID: PMC10615575 DOI: 10.1155/2023/3526208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 09/06/2023] [Accepted: 10/17/2023] [Indexed: 11/02/2023] Open
Abstract
Background Depression is a common mental disorder and is a leading cause of disability globally. Depressive symptoms among people living with HIV can be a significant barrier to ART initiation and thus lead to poor ART adherence. Global studies have found the prevalence of depressive symptoms among people living with HIV ranges from 12 to 63%. The real scenario of Nepal still needs to be explored. Thus, this study aimed to identify the prevalence and predictors of depression in individuals with HIV. Methods An institutional-based cross-sectional study was carried out from August to December 2020 among 406 people living with HIV attending ART centers in Lumbini province. Participants were selected using a systematic random sampling technique and surveyed with a structured questionnaire consisting of sociodemographic variables, HIV AIDS-related variables, and 21 items Beck Depression Inventory tool. The odds ratio was used as the ultimate measure of association, with a 95% confidence interval computed to establish statistical significance. A multivariate regression analysis was carried out to identify the final predictors of depressive symptoms. Results The study found that 26.8% of the respondents had depressive symptoms. Those who were literate (AOR = 0.24, 95% CI: 0.10-0.61), in the poorest wealth quintile (AOR = 7.28, 95% CI: 2.22-23.87), initiated ART within 12 months (AOR = 1.88, 95% CI: 1.03-3.42), had CD4 cell counts below 200 (AOR = 2.50, 95% CI: 1.54-4.06), and had a time difference of 3 months or less between HIV diagnosis and ART initiation (AOR = 0.50, 95% CI: 0.29-0.86) were independently associated with depressive symptoms. Conclusion Routine screening for depressive symptoms should be integrated into national HIV prevention and control programs for people living with HIV. An enabling environment should be created to facilitate the rapid enrollment of individuals newly diagnosed with HIV in ART services, thereby reducing the time gap between HIV diagnosis and ART initiation.
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Affiliation(s)
- Saneep Shrestha
- Department of Community Medicine, Universal College of Medical Science and Teaching Hospital, Tribhuvan University, Bhairahawa, Rupandehi, Nepal
| | | | - Jyoti Priyanka
- Department of Community Medicine, Universal College of Medical Science and Teaching Hospital, Tribhuvan University, Bhairahawa, Rupandehi, Nepal
| | - Pragya Shrestha
- School of Nursing and Midwifery, Karnali Academy of Health Sciences, Jumla, Nepal
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17
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Gong K, Lai Y. Development trends of immune activation during HIV infection in recent three decades: a bibliometric analysis based on CiteSpace. Arch Microbiol 2023; 205:283. [PMID: 37432538 DOI: 10.1007/s00203-023-03624-7] [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] [Received: 05/23/2023] [Revised: 06/18/2023] [Accepted: 07/02/2023] [Indexed: 07/12/2023]
Abstract
This study aimed to evaluate and pinpoint the status, hot areas, and frontiers of immune activation during HIV infection utilizing CiteSpace. From 1990 to 2022, we searched for studies on immune activation during HIV infection in the Web of Science Core Collection. CiteSpace was used to visually analyze the publications to identify the research status and pertinent research hotspots and frontiers in terms of the countries, institutions, authors, references, journals, and keywords. The Web of Science Core Collection yielded 5321 articles on immune activation during HIV infection. With 2854 and 364 articles, the United States and the University of California, San Francisco were the leading nation and institution in this domain. Steven G. Deeks has published 95 papers and is the most published author. The top cited articles on microbial translocation as a significant factor during HIV infection were published by Brenchley et al. Research on molecular/biology/genetics is often referenced in publications in the journals of molecular/biology/immunology. Inflammation, risk, mortality, cardiovascular disease, persistence, and biomarkers will be high-frequency words that are hot topics of research. According to the results, there was a strong collaboration between countries and organizations but little collaboration among authors. Molecular biology, immunology, and medicine are the main study subjects. The current hot topics in research are inflammation, risk, mortality, cardiovascular disease, persistence, and biomarkers. Future studies should concentrate on reducing the pathological changes caused by inflammation and altering the mechanisms of immune activation to reduce the size of the viral reservoir.
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Affiliation(s)
- Kang Gong
- School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China
| | - Yu Lai
- School of Basic Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China.
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He K, Zhang X, Yang D, Fu X, Chen Y, Chen Z, Mo J, Zhou L, Xu F, Jiang X, Shi W, Cao L, Li Y. Analysis of Factors Influencing Depression in Elderly People Living with HIV/AIDS Based on Structural Equation Model: A Cross-Sectional Study in Guangxi, China. J Multidiscip Healthc 2023; 16:1491-1501. [PMID: 37274427 PMCID: PMC10238549 DOI: 10.2147/jmdh.s410538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 05/22/2023] [Indexed: 06/06/2023] Open
Abstract
Purpose The purpose of our study is to understand the current status of depression and medical social support in elderly HIV/AIDS, as well as the role of social support on depression, so as to provide a certain reference for reducing the occurrence of depression in the population. Methods A total of 115 participants with PLWHA (people living with HIV/AIDS) aged 50 years or older were collected in Guilin from December 2021 to July 2022. Depression and medical social support were assessed using the Center for Streaming Depression Scale (CES-D) and the Medical Social Support Scale (MOS-SSS). The structural equation model was used to examine the relationship between medical social support and depression. Results Sixty-one of 115 participants developed depressive symptoms with a prevalence of 53.0%. The results of univariate analysis showed that ethnicity, health status, mean monthly income, antiviral treatment status, and medical social support influenced PLWHA depression (P<0.05). Simple linear regression showed that health status (95% CI: -9.901~-2.635), and antiviral treatment status (95% CI: -12.969~-3.394) influent depression (P<0.05). There were associations between total medical social support, practical support dimension, message and emotional support dimension, social interactive cooperation dimension, emotional support dimension and depression (unadjusted and adjusted for contextual factors) (P < 0.05). Using multiple linear regression analyses, we found that medical-social support was negatively associated with depression with a standardized effect value of -0.223. PLWHA with higher medical social support had lower prevalence of depression. Conclusion The results indicate that the prevalence of depression among HIV/AIDS patients in Guilin is high. So the joint efforts of individuals, families, and society are needed to improve the physical and mental health of the PLWHA.
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Affiliation(s)
- Kailian He
- Department of Environmental Health and Occupational Medicine, School of Public Health, Guilin Medical University, Guilin, Guangxi, 541199, People’s Republic of China
- Guangxi Health Commission Key Laboratory of Entire Lifecycle Health and Care (Guilin Medical University), Guilin, Guangxi, 541199, People’s Republic of China
| | - Xiashuang Zhang
- Department of Environmental Health and Occupational Medicine, School of Public Health, Guilin Medical University, Guilin, Guangxi, 541199, People’s Republic of China
- Guangxi Health Commission Key Laboratory of Entire Lifecycle Health and Care (Guilin Medical University), Guilin, Guangxi, 541199, People’s Republic of China
| | - Dong Yang
- Department of AIDS Control and Prevention, Guilin Center for Disease Control and Prevention, Guilin, Guangxi, 541000, People’s Republic of China
| | - Xiaofeng Fu
- Department of AIDS Control and Prevention, Guilin Center for Disease Control and Prevention, Guilin, Guangxi, 541000, People’s Republic of China
| | - Yulu Chen
- Department of Environmental Health and Occupational Medicine, School of Public Health, Guilin Medical University, Guilin, Guangxi, 541199, People’s Republic of China
- Guangxi Health Commission Key Laboratory of Entire Lifecycle Health and Care (Guilin Medical University), Guilin, Guangxi, 541199, People’s Republic of China
| | - Ziqi Chen
- Department of Environmental Health and Occupational Medicine, School of Public Health, Guilin Medical University, Guilin, Guangxi, 541199, People’s Republic of China
- Guangxi Health Commission Key Laboratory of Entire Lifecycle Health and Care (Guilin Medical University), Guilin, Guangxi, 541199, People’s Republic of China
| | - Jinglin Mo
- Department of AIDS Control and Prevention, Guilin Center for Disease Control and Prevention, Guilin, Guangxi, 541000, People’s Republic of China
| | - Lingmi Zhou
- Department of AIDS Control and Prevention, Guilin Center for Disease Control and Prevention, Guilin, Guangxi, 541000, People’s Republic of China
| | - Fang Xu
- Department of AIDS Control and Prevention, Guilin Center for Disease Control and Prevention, Guilin, Guangxi, 541000, People’s Republic of China
| | - Xiuli Jiang
- Department of AIDS Control and Prevention, Guilin Center for Disease Control and Prevention, Guilin, Guangxi, 541000, People’s Republic of China
| | - Wuxiang Shi
- Health Management Unit, Faculty of Humanities and Management, Guilin Medical University, Guilin, Guangxi, 541199, People’s Republic of China
| | - Liang Cao
- Department of Environmental Health and Occupational Medicine, School of Public Health, Guilin Medical University, Guilin, Guangxi, 541199, People’s Republic of China
- Department of Experimental Teaching Center, School of Public Health, Guilin Medical University, Guilin, Guangxi, 541199, People’s Republic of China
| | - You Li
- Department of Environmental Health and Occupational Medicine, School of Public Health, Guilin Medical University, Guilin, Guangxi, 541199, People’s Republic of China
- Guangxi Health Commission Key Laboratory of Entire Lifecycle Health and Care (Guilin Medical University), Guilin, Guangxi, 541199, People’s Republic of China
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Folayan MO, Abeldaño Zuñiga RA, Aly NM, Ellakany P, Idigbe IE, Jafer M, Lawal FB, Khalid Z, Lusher J, Virtanen JI, Nguyen AL. Differences in adoption of COVID-19 pandemic related preventive behaviour by viral load suppression status among people living with HIV during the first wave of the pandemic. BMC Res Notes 2023; 16:90. [PMID: 37231488 PMCID: PMC10212221 DOI: 10.1186/s13104-023-06363-6] [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: 09/13/2022] [Accepted: 05/19/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND Adherence to antiretroviral therapy and COVID-19 preventive behaviours among people living with HIV during the pandemic has received little attention in the literature. To address this gap in knowledge, the present study assessed the associations between viral load, adherence to antiretroviral therapy and the use of COVID-19 prevention strategies during the first wave of the COVID-19 pandemic. This was a secondary analysis of data generated through an online survey recruiting participants from 152 countries. Complete data from 680 respondents living with HIV were extracted for this analysis. RESULTS The findings suggest that detectable viral load was associated with lower odds of wearing facemasks (AOR: 0.44; 95% CI:0.28-0.69; p < 0.01) and washing hands as often as recommended (AOR: 0.64; 95% CI: 0.42-0.97; p = 0.03). Also, adherence to the use of antiretroviral drugs was associated with lower odds of working remotely (AOR: 0.60; 95% CI: 0.38-0.94; p = 0.02). We found a complex relationship between HIV positive status biological parameters and adherence to COVID-19 preventive measures that may be partly explained by risk-taking behaviours. Further studies are needed to understand the reasons for the study findings.
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Affiliation(s)
- Morenike Oluwatoyin Folayan
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife, Nigeria.
- Department of Child Dental Health, Obafemi Awolowo University, Ile-Ife, Nigeria.
| | - Roberto Ariel Abeldaño Zuñiga
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife, Nigeria
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
- Postgraduate Department, University of Sierra Sur, Oaxaca, Mexico
| | - Nourhan M Aly
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife, Nigeria
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Passent Ellakany
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife, Nigeria
- Department of Substitutive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Ifeoma E Idigbe
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife, Nigeria
- Clinical Sciences Department, Nigerian Institute of Medical Research, Lagos, Nigeria
| | - Mohammed Jafer
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife, Nigeria
- Department of Preventive Dental Sciences, Faculty of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Folake B Lawal
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife, Nigeria
- Department of Periodontology and Community Dentistry, University of Ibadan and University College Hospital, Ibadan, Nigeria
| | - Zumama Khalid
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife, Nigeria
- Department of Health Sciences, University of Genova, Genova, GE, 16132, Italy
| | - Joanne Lusher
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife, Nigeria
- Regent's University, London, UK
| | - Jorma I Virtanen
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife, Nigeria
- Faculty of Medicine, University of Turku, Turku, Finland
| | - Annie L Nguyen
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife, Nigeria
- Department of Family Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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20
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Meng J, Xiao X, Wang W, Jiang Y, Jin Y, Wang H. Sleep quality, social rhythms, and depression among people living with HIV: a path analysis based on social zeitgeber theory. Front Psychiatry 2023; 14:1102946. [PMID: 37215662 PMCID: PMC10192574 DOI: 10.3389/fpsyt.2023.1102946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 04/14/2023] [Indexed: 05/24/2023] Open
Abstract
Background People living with HIV frequently report sleep disturbances. The social zeitgeber theory, which proposes that stressful life events can interfere with sleep and even depression by destabilizing daily routines, provides new insights into identifying predictors of sleep disturbances and improving sleep in people living with HIV. Objective To explain the pathways affecting sleep quality in people living with HIV based on social zeitgeber theory. Methods A cross-sectional study was conducted to assess sleep quality, social rhythms, depression, social support, and coping styles from December 2020 to February 2021. The hypothetical model was tested and respecified by performing path analysis and a bias-corrected bootstrapping method using IBM AMOS 24 software. The report of this study followed the STROBE checklist. Results A total of 737 people living with HIV participated in the study. The final model presented a good fit (goodness of fit = 0.999, adjusted goodness of fit index = 0.984, normed fit index = 0.996, comparative fit index = 0.998, Tucker-Lewis index = 0.988, root mean square error of approximation = 0.030, chi-squared/degree of freedom = 1.646), explaining 32.3% of the variance in sleep quality among people living with HIV. Lower social rhythm stability was directly associated with poorer sleep quality, and depression mediated the relationship between social rhythms and sleep quality. Social support and coping styles affected sleep quality through social rhythms and depression. Limitation The cross-sectional study design precludes making assumptions about causality among factors. Conclusion This study validates and extends the applicability of the social zeitgeber theory in the HIV context. Social rhythms have direct and indirect effects on sleep. Social rhythms, sleep, and depression is not simply linked in a cascading sequence but is theoretically linked in a complex way. More studies are needed to explore the predictors of social rhythms, and interventions for stabilizing social rhythms have the potential to alleviate sleep disturbances and depression in people living with HIV.
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Affiliation(s)
- Jingjing Meng
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Xueling Xiao
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Wenru Wang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Ying Jiang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Yanfei Jin
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Honghong Wang
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
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21
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Brown MJ, Gao C, Kaur A, Qiao S, Li X. Social Support, Internalized HIV Stigma, Resilience and Depression Among People Living with HIV: A Moderated Mediation Analysis. AIDS Behav 2023; 27:1106-1115. [PMID: 36094638 PMCID: PMC10115436 DOI: 10.1007/s10461-022-03847-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2022] [Indexed: 11/30/2022]
Abstract
Internalized HIV stigma has been associated with depression among people living with HIV (PLWH). However, it is still unclear whether resilience would mediate the association between internalized HIV stigma and depression and how this indirect effect would be moderated by social support. Data were collected from 402 PLWH in South Carolina using a cross-sectional survey. Data were fitted using a path model that specified the extent to which internalized HIV stigma and depression were related through resilience and how this effect was moderated by social support. Sociodemographic characteristics were included in the model as covariates. The indirect effect of internalized HIV stigma on depression through resilience was statistically significant for high social support but not for low social support. To mitigate negative impacts of internalized HIV stigma on mental health of PLWH, intervention efforts should integrate multilevel components for promoting both resilience and social support.
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Affiliation(s)
- Monique J Brown
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, United States.
- Arnold School of Public Health, South Carolina SmartState Center for Healthcare Quality, University of South Carolina, Columbia, United States.
- Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia, United States.
- Office for the Study on Aging, Arnold School of Public Health, University of South Carolina, Columbia, United States.
| | - Chuanji Gao
- Donders Institute for Brain, Cognition, and Behaviour, Radboud University, Nijmegen, Netherlands
| | - Amandeep Kaur
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, United States
| | - Shan Qiao
- Arnold School of Public Health, South Carolina SmartState Center for Healthcare Quality, University of South Carolina, Columbia, United States
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, United States
| | - Xiaoming Li
- Arnold School of Public Health, South Carolina SmartState Center for Healthcare Quality, University of South Carolina, Columbia, United States
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, United States
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22
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Bayes-Marin I, Egea-Cortés L, Palacio-Vieira J, Bruguera A, Mesías-Gazmuri J, Llibre JM, Fernández E, Imaz A, Forero CG, Agustí C, Arbones-Fernández L, Miró JM, Casabona J, Reyes-Ureña J. Determinants of Depressive Symptoms in People Living with HIV: Findings from a Population-Based Study with a Gender Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3687. [PMID: 36834381 PMCID: PMC9964424 DOI: 10.3390/ijerph20043687] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 02/09/2023] [Accepted: 02/16/2023] [Indexed: 05/26/2023]
Abstract
Depressive symptoms are common among people living with HIV (PLWH). The aim of this study was to identify the determinants of depressive symptoms in PLWH in Spain. A total of 1060 PLWH participated in this cross-sectional study and completed the Patient Health Questionnaire-9. The odds ratios for the presence of depressive symptoms were analyzed in a multivariable logistic regression model, including sociodemographic data, comorbidities, health-related behaviors, and social-environment-related variables. We found an overall prevalence of depressive symptoms of 21.42%; by subgroup, namely men, women, and transgender persons, prevalence was 18.13%, 32.81%, and 37.14%, respectively. Moreover, social isolation (OR = 1.05 [CI, 1.02-1.08]) and poor physical and mental quality of life (OR = 1.06 [CI, 1.02-1.09] and OR = 1.13 [CI, 1.09-1.17], respectively) were associated with depressive symptoms. As protective factors, we identified serodisclosure to more people (vs. none; OR = 0.39 [CI, 0.17-0.87]), satisfaction with social roles (OR = 0.86 [CI, 0.79-0.94]), better cognitive function (OR = 0.92 [CI, 0.89-0.95]), and sexualized drug use once in a lifetime (OR = 0.52 [CI, 0.29-0.93]). This study showed a high prevalence of depressive symptoms in PLWH, especially among women and transgender people. The association between psychosocial variables and depressive symptoms highlights the multidimensionality of the problem and identifies areas for intervention. This study found that the management of mental health issues is an area that needs to be improved and tailored to specific groups, with the aim of enhancing the well-being of PLWH.
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Affiliation(s)
- Ivet Bayes-Marin
- Department of Medicine, School of Medicine and Health Sciences, Universitat Internacional de Catalunya, 08195 Sant Cugat del Vallés, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Laia Egea-Cortés
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, 08916 Barcelona, Spain
- Germans Trias i Pujol Research Institute (IGTP), Campus Can Ruti, 08916 Badalona, Spain
| | - Jorge Palacio-Vieira
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, 08916 Barcelona, Spain
- Germans Trias i Pujol Research Institute (IGTP), Campus Can Ruti, 08916 Badalona, Spain
- Centro de Investigación Biomédica en Epidemiologia y Salud Pública (CIBERESP), 28029 Madrid, Spain
| | - Andreu Bruguera
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, 08916 Barcelona, Spain
- Germans Trias i Pujol Research Institute (IGTP), Campus Can Ruti, 08916 Badalona, Spain
- Centro de Investigación Biomédica en Epidemiologia y Salud Pública (CIBERESP), 28029 Madrid, Spain
- Department of Pediatrics, Obstetrics and Gynecology and Preventive Medicine, Universidad Autónoma de Barcelona, 08193 Barcelona, Spain
| | - Jocelyn Mesías-Gazmuri
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, 08916 Barcelona, Spain
- Germans Trias i Pujol Research Institute (IGTP), Campus Can Ruti, 08916 Badalona, Spain
- Department of Pediatrics, Obstetrics and Gynecology and Preventive Medicine, Universidad Autónoma de Barcelona, 08193 Barcelona, Spain
| | - Josep M. Llibre
- Germans Trias i Pujol Research Institute (IGTP), Campus Can Ruti, 08916 Badalona, Spain
- Fight AIDS and Infectious Diseases Foundation, 08916 Badalona, Spain
| | - Emma Fernández
- Infectious Diseases Service, Hospital Clínic-IDIBAPS, University of Barcelona, 08036 Barcelona, Spain
| | - Arkaitz Imaz
- Hospital Universitari de Bellvitge, Bellvitge Biomedical Research Institute (IDIBELL), University of Barcelona, L’Hospitalet de Llobregat, 08908 Barcelona, Spain
| | - Carlos G. Forero
- Department of Medicine, School of Medicine and Health Sciences, Universitat Internacional de Catalunya, 08195 Sant Cugat del Vallés, Spain
| | - Cristina Agustí
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, 08916 Barcelona, Spain
- Germans Trias i Pujol Research Institute (IGTP), Campus Can Ruti, 08916 Badalona, Spain
- Centro de Investigación Biomédica en Epidemiologia y Salud Pública (CIBERESP), 28029 Madrid, Spain
| | | | - José M. Miró
- Infectious Diseases Service, Hospital Clínic-IDIBAPS, University of Barcelona, 08036 Barcelona, Spain
- Centro de Investigación Biomédica en Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Jordi Casabona
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, 08916 Barcelona, Spain
- Germans Trias i Pujol Research Institute (IGTP), Campus Can Ruti, 08916 Badalona, Spain
- Centro de Investigación Biomédica en Epidemiologia y Salud Pública (CIBERESP), 28029 Madrid, Spain
- Department of Pediatrics, Obstetrics and Gynecology and Preventive Medicine, Universidad Autónoma de Barcelona, 08193 Barcelona, Spain
| | - Juliana Reyes-Ureña
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, 08916 Barcelona, Spain
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Yu X, Giordano TP, Baillargeon J, Westra JR, Berenson AB, Raji MA, Kuo YF. Assessing incident depression among older people with and without HIV in U.S. Soc Psychiatry Psychiatr Epidemiol 2023; 58:299-308. [PMID: 36334100 PMCID: PMC10176598 DOI: 10.1007/s00127-022-02375-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 10/28/2022] [Indexed: 11/06/2022]
Abstract
PURPOSE Despite substantially higher prevalence of depression among people living with HIV/AIDS (PLWHA), few data exist on the incidence and correlates of depression in this population. This study assessed the effect of HIV infection, age, and cohort period on the risk of developing depression by sex among older U.S. Medicare beneficiaries. METHODS We constructed a retrospective matched cohort using a 5% nationally representative sample of Medicare beneficiaries (1996-2015). People with newly diagnosed (n = 1309) and previously diagnosed (n = 1057) HIV were individually matched with up to three beneficiaries without HIV (n = 6805). Fine-Gray models adjusted for baseline covariates were used to assess the effect of HIV status on developing depression by sex strata. RESULTS PLWHA, especially females, had higher risk of developing depression within five years. The relative subdistribution hazards (sHR) for depression among three HIV exposure groups differed between males and females and indicated a marginally significant interaction (p = 0.08). The sHR (95% CI) for newly and previously diagnosed HIV (vs. people without HIV) were 1.6 (1.3, 1.9) and 1.9 (1.5, 2.4) for males, and 1.5 (1.2, 1.8) and 1.2 (0.9, 1.7) for females. The risk of depression increased with age [sHR 1.3 (1.1, 1.5), 80 + vs. 65-69] and cohort period [sHR 1.3 (1.1, 1.5), 2011-2015 vs. 1995-2000]. CONCLUSIONS HIV infection increased the risk of developing depression within 5 years, especially among people with newly diagnosed HIV and females. This risk increased with older age and in recent HIV epidemic periods, suggesting a need for robust mental health treatment in HIV primary care.
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Affiliation(s)
- Xiaoying Yu
- Department of Biostatistics & Data Science, The University of Texas Medical Branch at Galveston, 700 Harborside Drive, Ewing Hall, 1.134, Galveston, TX, USA.
- Center for Interdisciplinary Research in Women's Health, The University of Texas Medical Branch at Galveston, Galveston, TX, USA.
| | - Thomas P Giordano
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
- Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX, USA
| | - Jacques Baillargeon
- Department of Epidemiology, The University of Texas Medical Branch at Galveston, Galveston, TX, USA
| | - Jordan R Westra
- Department of Biostatistics & Data Science, The University of Texas Medical Branch at Galveston, 700 Harborside Drive, Ewing Hall, 1.134, Galveston, TX, USA
| | - Abbey B Berenson
- Center for Interdisciplinary Research in Women's Health, The University of Texas Medical Branch at Galveston, Galveston, TX, USA
- Department of Obstetrics & Gynecology, The University of Texas Medical Branch at Galveston, Galveston, TX, USA
| | - Mukaila A Raji
- Department of Internal Medicine, The University of Texas Medical Branch at Galveston, Galveston, TX, USA
| | - Yong-Fang Kuo
- Department of Biostatistics & Data Science, The University of Texas Medical Branch at Galveston, 700 Harborside Drive, Ewing Hall, 1.134, Galveston, TX, USA
- Center for Interdisciplinary Research in Women's Health, The University of Texas Medical Branch at Galveston, Galveston, TX, USA
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24
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Edwards GG, Miyashita-Ochoa A, Castillo EG, Goodman-Meza D, Kalofonos I, Landovitz RJ, Leibowitz AA, Pulsipher C, El Sayed E, Shoptaw S, Shover CL, Tabajonda M, Yang YS, Harawa NT. Long-Acting Injectable Therapy for People with HIV: Looking Ahead with Lessons from Psychiatry and Addiction Medicine. AIDS Behav 2023; 27:10-24. [PMID: 36063243 PMCID: PMC9443641 DOI: 10.1007/s10461-022-03817-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2022] [Indexed: 01/24/2023]
Abstract
Long-acting injectable antiretroviral medications are new to HIV treatment. People with HIV may benefit from a treatment option that better aligns with their preferences, but could also face new challenges and barriers. Authors from the fields of HIV, substance use treatment, and mental health collaborated on this commentary on the issues surrounding equitable implementation and uptake of LAI ART by drawing lessons from all three fields. We employ a socio-ecological framework beginning at the policy level and moving through the community, organizational, interpersonal, and patient levels. We look at extant literature on the topic as well as draw from the direct experience of our clinician-authors.
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Affiliation(s)
- Gabriel G Edwards
- Division of General Internal Medicine & Health Services Research, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, USA.
- Division of General Internal Medicine & Health Services Research, David Geffen School of Medicine at UCLA, 1100 Glendon Ave., Suite 850, Los Angeles, CA, 90024, USA.
| | - Ayako Miyashita-Ochoa
- Department of Social Welfare, UCLA Luskin School of Public Affairs, Los Angeles, CA, USA
| | - Enrico G Castillo
- Center for Social Medicine and Humanities in the Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - David Goodman-Meza
- Division of Infectious Diseases, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, USA
| | - Ippolytos Kalofonos
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, USA
- Greater Los Angeles Veterans Healthcare Administration, Los Angeles, CA, USA
| | - Raphael J Landovitz
- UCLA Center for Clinical AIDS Research & Education, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, USA
| | - Arleen A Leibowitz
- Department of Social Welfare, UCLA Luskin School of Public Affairs, Los Angeles, CA, USA
| | - Craig Pulsipher
- Department of Government Affairs, APLA Health, Los Angeles, CA, USA
| | - Ed El Sayed
- Department of Pharmacology, Touro College of Medicine, New York, NY, USA
| | - Steven Shoptaw
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, USA
- Department of Family Medicine, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, USA
| | - Chelsea L Shover
- Division of General Internal Medicine & Health Services Research, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, USA
| | - Michelle Tabajonda
- Department of Health Policy and Management, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
| | - Yvonne S Yang
- Greater Los Angeles Veterans Healthcare Administration, Los Angeles, CA, USA
- Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, USA
| | - Nina T Harawa
- Division of General Internal Medicine & Health Services Research, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, USA
- Department of Psychiatry, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
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25
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Han S, Zhang Y, Yang X, Li K, Zhang L, Shao Y, Ma J, Hu Y, Zhu Z, Zhang Y, Wang Z. Exploring core mental health symptoms among persons living with HIV: A network analysis. Front Psychiatry 2023; 14:1081867. [PMID: 36741117 PMCID: PMC9895861 DOI: 10.3389/fpsyt.2023.1081867] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 01/04/2023] [Indexed: 01/21/2023] Open
Abstract
CONTEXT Persons living with HIV (PLWH) commonly experience mental health symptoms. However, little is known about the core mental health symptoms and their relationships. OBJECTIVE This study aimed to evaluate the prevalence of various mental health symptoms and to explore their relationships in symptom networks among PLWH. METHODS From April to July 2022, we recruited 518 participants through convenience sampling in Beijing, China, for this cross-sectional study. Forty mental health symptoms, including six dimensions (somatization symptoms, negative affect, cognitive function, interpersonal communication, cognitive processes, and social adaptation), were assessed through paper-based or online questionnaires. Network analysis was performed in Python 3.6.0 to explore the core mental health symptoms and describe the relationships among symptoms and clusters. RESULTS Of the 40 mental health symptoms, the most common symptoms were fatigue (71.2%), trouble remembering things (65.6%), and uncertainty about the future (64.0%). In the single symptom network, sadness was the most central symptom across the three centrality indices (rS = 0.59, rC = 0.61, rB = 0.06), followed by feeling discouraged about the future (rS = 0.51, rC = 0.57, rB = 0.04) and feelings of worthlessness (rS = 0.54, rC = 0.53, rB = 0.05). In the symptom cluster network, negative affect was the most central symptom cluster across the three centrality indices (rS = 1, rC = 1, rB = 0.43). CONCLUSION Our study provides a new perspective on the role of each mental health symptom among PLWH. To alleviate the mental health symptoms of PLWH to the greatest extent possible and comprehensively improve their mental health, we suggest that psychological professionals pay more attention to pessimistic mood and cognitive processes in PLWH. Interventions that apply positive psychology skills and cognitive behavioral therapy may be necessary components for the mental health care of PLWH.
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Affiliation(s)
- Shuyu Han
- School of Nursing, Peking University, Beijing, China
| | - Yizhu Zhang
- School of Nursing, Peking University, Beijing, China
| | - Xianxia Yang
- School of Public Health, Wuhan University, Wuhan, Hubei, China
| | - Ke Li
- Department of Emergency, Peking University First Hospital, Beijing, China
| | - Lili Zhang
- Department of Nursing, Beijing Youan Hospital Affiliated with Capital Medical University, Beijing, China
| | - Ying Shao
- Department of Infection, Beijing Youan Hospital Affiliated With Capital Medical University, Beijing, China
| | - Jianhong Ma
- Department of Infection, Beijing Youan Hospital Affiliated With Capital Medical University, Beijing, China
| | - Yan Hu
- School of Nursing, Fudan University, Shanghai, China
| | - Zheng Zhu
- School of Nursing, Fudan University, Shanghai, China
| | - Yukun Zhang
- School of Nursing, Fudan University, Shanghai, China
| | - Zhiwen Wang
- School of Nursing, Peking University, Beijing, China
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Age and Mental Health Symptoms Among Chinese Persons With HIV: The Mediating and Moderating Role of Perceived Discrimination. J Assoc Nurses AIDS Care 2023; 34:105-112. [PMID: 36656094 DOI: 10.1097/jnc.0000000000000373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
ABSTRACT The association between age and mental health symptoms among persons with HIV (PWH) is inconsistent, and little is known about the mediators and moderators of this association. This study aimed to examine the association between age and mental health symptoms, as well as the mediators and moderators of perceived discrimination. Data were from 1,304 PWH who completed a cross-sectional survey in five areas of China. Multiple linear regressions showed that younger age was significantly associated with more severe mental health symptoms and that perceived discrimination moderated this relationship. The Sobel test showed that perceived discrimination also mediated the association between age and mental health symptoms. Our study indicates that perceived discrimination shapes the association between age and mental health symptoms among PWH and highlights the importance of designing age-tailored mental health intervention strategies for perceived discrimination among young PWH. Interventions addressing discrimination are necessary to help improve mental health, especially for young PWH.
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Dreyer AJ, Nightingale S, Andersen LS, Lee JS, Gouse H, Safren SA, O'Cleirigh C, Thomas KGF, Joska J. Cognitive performance in a South African cohort of people with HIV and comorbid major depressive disorder. J Neurovirol 2022; 28:537-551. [PMID: 36048403 PMCID: PMC10471884 DOI: 10.1007/s13365-022-01093-0] [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: 05/01/2022] [Revised: 07/22/2022] [Accepted: 08/10/2022] [Indexed: 01/13/2023]
Abstract
Cognitive performance in people with HIV (PWH) may be affected by brain injury attributable to the infection itself, by other medical and psychiatric comorbidities (including major depressive disorder; MDD), and by psychosocial factors (e.g., education, food insecurity). We investigated effects of these variables on cognitive performance in a South African cohort of PWH with comorbid MDD and incomplete adherence to antiretroviral therapy (ART). We also examined (a) associations of depression severity with cognitive performance, and (b) whether improvement in depression led to improved cognitive performance. Participants (N = 105) completed baseline neuropsychological, psychiatric, and sociodemographic assessments. Subsequently, 33 were assigned to a cognitive-behavioural therapy for ART adherence and depression (CBT-AD) and 72 to standard-of-care treatment. Eight months post-baseline, 81 (nCBT-AD = 29) repeated the assessments. We investigated (a) baseline associations between sociodemographic, medical, and psychiatric variables and cognitive performance, (b) whether, from baseline to follow-up, depression and cognitive performance improved significantly more in CBT-AD participants, and (c) associations between post-intervention improvements in depression and cognitive performance. At baseline, less education (β = 0.62) and greater food insecurity (β = -0.20) predicted poorer overall cognitive performance; more severe depression predicted impairment in the attention/working memory domain only (β = -0.25). From baseline to follow-up, depression decreased significantly more in CBT-AD participants (p = .017). Improvement over time in depression and cognitive performance was not significantly associated except in the attention/working memory domain (p = .026). Overall, factors associated with cognitive performance were unrelated to brain injury. We conclude that clinicians examining PWH presenting with cognitive difficulties must assess depression, and that researchers investigating cognitive impairment in PWH must collect information on psychosocial factors.
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Affiliation(s)
- Anna J Dreyer
- Department of Psychiatry and Mental Health, HIV Mental Health Research Unit, Neuroscience Institute, University of Cape Town, Cape Town, South Africa.
| | - Sam Nightingale
- Department of Psychiatry and Mental Health, HIV Mental Health Research Unit, Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Lena S Andersen
- Department of Public Health, Global Health Section, University of Copenhagen, Copenhagen, Denmark
| | - Jasper S Lee
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Hetta Gouse
- Department of Psychiatry and Mental Health, HIV Mental Health Research Unit, Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Steven A Safren
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Conall O'Cleirigh
- Department of Psychology, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Kevin G F Thomas
- Applied Cognitive Science and Experimental Neuropsychology Team (ACSENT), Department of Psychology, University of Cape Town, Cape Town, South Africa
| | - John Joska
- Department of Psychiatry and Mental Health, HIV Mental Health Research Unit, Neuroscience Institute, University of Cape Town, Cape Town, South Africa
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28
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Tan T, Zhou C, Lu R, Chen C, Bai C, Li L, Wu G. Depression and Associated Factors Among Men Living with HIV/AIDS Aged 50 Years and Over in Chongqing, China. J Multidiscip Healthc 2022; 15:2033-2040. [PMID: 36110578 PMCID: PMC9470116 DOI: 10.2147/jmdh.s378956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 09/02/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose This study aimed to assess the proportion of depression and its associated factors among men living with HIV/AIDS and aged 50 and over in Chongqing, China. Methods This cross-sectional study included 774 men diagnosed as HIV/AIDS and aged 50 and over in four regions. Data were collected through face-to-face interviews with a structured questionnaire. Multivariate logistic regression analysis was performed to identify factors associated with depression. A two-tailed P-value less than 0.05 was considered as statistical significance. Results A total of 293 participants (37.9%) reported depressive symptoms. Results from multivariate logistic regression suggested that individuals aged ≥70 (AOR = 1.99, 95% CI: 1.28-3.08) and those living in rural areas (AOR = 2.79, 95% CI: 1.96-3.97) were associated with higher odds of depression, while those being employed (AOR = 0.50, 95% CI: 0.32-0.80) and with monthly income >3000 CNY (AOR = 0.47, 95% CI: 0.30-3.74) had lower odds of depression. Conclusion Our findings indicate a high prevalence of depression among older men living with HIV/AIDS in Chongqing, China. Age, residence, employment, and income have been identified as potential risk factors of depressive symptoms. Mental-health intervention initiatives should be tailored to target adults with a higher risk of depression.
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Affiliation(s)
- Tianyu Tan
- Chongqing Center for Disease Control and Prevention, Chongqing, 400042, People's Republic of China
| | - Chao Zhou
- Chongqing Center for Disease Control and Prevention, Chongqing, 400042, People's Republic of China
| | - Rongrong Lu
- Chongqing Center for Disease Control and Prevention, Chongqing, 400042, People's Republic of China
| | - Cheng Chen
- Chongqing Jiulongpo District Center for Disease Control and Prevention, Chongqing, 400039, People's Republic of China
| | - Chongyang Bai
- Chongqing Center for Disease Control and Prevention, Chongqing, 400042, People's Republic of China
| | - Long Li
- Chongqing Center for Disease Control and Prevention, Chongqing, 400042, People's Republic of China
| | - Guohui Wu
- Chongqing Center for Disease Control and Prevention, Chongqing, 400042, People's Republic of China
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Mudra Rakshasa-Loots A, Whalley HC, Vera JH, Cox SR. Neuroinflammation in HIV-associated depression: evidence and future perspectives. Mol Psychiatry 2022; 27:3619-3632. [PMID: 35618889 PMCID: PMC9708589 DOI: 10.1038/s41380-022-01619-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 05/04/2022] [Accepted: 05/10/2022] [Indexed: 02/08/2023]
Abstract
People living with HIV face a high risk of mental illness, especially depression. We do not yet know the precise neurobiological mechanisms underlying HIV-associated depression. Depression severity in the general population has been linked to acute and chronic markers of systemic inflammation. Given the associations between depression and peripheral inflammation, and since HIV infection in the brain elicits a neuroinflammatory response, it is possible that neuroinflammation contributes to the high prevalence of depression amongst people living with HIV. The purpose of this review was to synthesise existing evidence for associations between inflammation, depression, and HIV. While there is strong evidence for independent associations between these three conditions, few preclinical or clinical studies have attempted to characterise their interrelationship, representing a major gap in the literature. This review identifies key areas of debate in the field and offers perspectives for future investigations of the pathophysiology of HIV-associated depression. Reproducing findings across diverse populations will be crucial in obtaining robust and generalisable results to elucidate the precise role of neuroinflammation in this pathophysiology.
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Affiliation(s)
- Arish Mudra Rakshasa-Loots
- Edinburgh Neuroscience, School of Biomedical Sciences, The University of Edinburgh, Edinburgh, UK.
- Lothian Birth Cohorts Group, Department of Psychology, The University of Edinburgh, Edinburgh, UK.
| | - Heather C Whalley
- Division of Psychiatry, Centre for Clinical Brain Sciences, Royal Edinburgh Hospital, The University of Edinburgh, Edinburgh, UK
| | - Jaime H Vera
- Department of Global Health and Infection, Brighton and Sussex Medical School, University of Sussex, Brighton, UK
| | - Simon R Cox
- Lothian Birth Cohorts Group, Department of Psychology, The University of Edinburgh, Edinburgh, UK
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30
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The power and wisdom of prevention. Cardiovascular risk, new challenge, and approach to PLWH. COR ET VASA 2022. [DOI: 10.33678/cor.2021.132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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31
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Thapinta D, Srithanaviboonchai K, Uthis P, Suktrakul S, Wiwatwongnawa R, Tangmunkongvorakul A, Wannachaiyakul S, Sripan P. Association between Internalized Stigma and Depression among People Living with HIV in Thailand. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084471. [PMID: 35457339 PMCID: PMC9031422 DOI: 10.3390/ijerph19084471] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/04/2022] [Accepted: 04/05/2022] [Indexed: 12/04/2022]
Abstract
Internalized stigma and depression are among the most common mental health problems in people living with HIV (PLHIV). This study aimed to examine the association between depression and overall internalized stigma, as well as different aspects of internalized stigma in PLHIV. The study included 400 PLHIV receiving care in Bangkok and Chiang Mai, Thailand. Data were analyzed using descriptive statistics, Mann-Whitney U test, and Spearman correlation coefficients. The results indicated the PLHIV with mild depression had lower median scores for the social relationship internalized stigma subscale than PLHIV with major depressive disorder (p = 0.009). Total HIV internalized stigma scores were significantly correlated with PHQ-9 scores in the mild depression group (r = 0.327, p = 0.004). Depression and internalized stigma were prevalent and associated, especially in the area of social relationships. Health personnel should be aware of possible depression in PLHIV who have internalized stigma. Intervention to promote understanding and social support for PLHIV is warranted.
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Affiliation(s)
- Darawan Thapinta
- Faculty of Nursing, Chiang Mai University, Chiang Mai 50200, Thailand; (D.T.); (S.W.)
| | - Kriengkrai Srithanaviboonchai
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai 50200, Thailand; (A.T.); (P.S.)
- Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
- Correspondence:
| | - Penpaktr Uthis
- Faculty of Nursing, Chulalongkorn University, Bangkok 10330, Thailand; (P.U.); (S.S.)
| | - Sunisa Suktrakul
- Faculty of Nursing, Chulalongkorn University, Bangkok 10330, Thailand; (P.U.); (S.S.)
| | | | - Arunrat Tangmunkongvorakul
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai 50200, Thailand; (A.T.); (P.S.)
| | | | - Patumrat Sripan
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai 50200, Thailand; (A.T.); (P.S.)
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Łakuta P, Krankowska D, Marcinkiewicz P, Bociąga-Jasik M, Komorska-Błażewicz A. Enhancing well-being and alleviating depressive symptoms in people with HIV/AIDS: An intervention based on if-then plans with self-affirming cognitions. Appl Psychol Health Well Being 2022; 14:899-919. [PMID: 35297176 PMCID: PMC9540674 DOI: 10.1111/aphw.12357] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 03/07/2022] [Indexed: 11/29/2022]
Abstract
Effective antiretroviral treatment has increased the life expectancy of people living with HIV, and currently, the challenges of prominent importance appear to be mental health issues. This preregistered study among adults living with HIV/AIDS investigated the effectiveness of a brief self‐affirmation intervention framed in terms of if–then plans (i.e. self‐affirming implementation intentions [S‐AII]) against both active and non‐active control conditions, forming non‐affirming implementation intentions and mere goal intentions, respectively. The primary outcomes were defined as a reduction of depressive symptoms and enhancement of well‐being, along with secondary outcomes as positive other‐ and self‐directed feelings. A total of 162 individuals were assessed for eligibility, and 130 (aged 18–74 years) were randomized to the study conditions. Intervention effects were estimated through intention‐to‐treat analysis, using linear mixed models. The S‐AII intervention yielded improvements in overall well‐being over 2 weeks (d = .23), primarily driven by positive changes in emotional (d = .24) and social (d = .30) dimensions of well‐being. There were no significant differences in depression or secondary outcomes. Based on a minimal clinically important difference index, the S‐AII intervention resulted in improvement in well‐being in approximately 40 percent of participants. Nevertheless, further systematic research is needed to optimize self‐affirmation‐interventions, before their application in real‐life contexts.
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Affiliation(s)
- Patryk Łakuta
- Institute of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland.,Institute of Psychology, Cardinal Stefan Wyszyński University, Warsaw, Poland
| | - Dagny Krankowska
- Department of Infectious and Tropical Diseases and Hepatology, Medical University of Warsaw, Hospital for Infectious Diseases, Warsaw, Poland
| | - Przemysław Marcinkiewicz
- The Infant Jesus Clinical Hospital, University Clinical Centre, Medical University of Warsaw, Warsaw, Poland
| | - Monika Bociąga-Jasik
- Department of Infectious Diseases, Jagiellonian University Medical College, Kraków, Poland
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Mudra Rakshasa-Loots A, Laughton B. isiXhosa Translation of the Patient Health Questionnaire (PHQ-9): A Pilot Study of Psychometric Properties [Stage 1]. Front Psychiatry 2022; 13:840912. [PMID: 35295783 PMCID: PMC8918580 DOI: 10.3389/fpsyt.2022.840912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 01/21/2022] [Indexed: 11/15/2022] Open
Abstract
Depression is a debilitating illness, and stigma associated with it often prevents people from seeking support. Easy-to-administer and culturally-specific diagnostic tools can allow for early screening for depression in primary care clinics, especially in resource-limited settings. In this pilot study, we will produce the first open-access isiXhosa-language version of the nine-item Patient Health Questionnaire (PHQ-9), a well-validated measure of depression incidence and severity, using a transcultural translation framework. We will validate this isiXhosa PHQ-9 in a small sample of adolescents living with HIV in Cape Town, South Africa who speak isiXhosa at home. Participants have previously completed the ASEBA Youth Self Report (YSR) form, and responses from the YSR will be used as a gold standard to validate the isiXhosa PHQ-9. If validated through this Registered Report, this isiXhosa PHQ-9 may be an invaluable culturally-specific tool for clinicians serving Xhosa people in identifying clinical or sub-clinical depression.
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Affiliation(s)
- Arish Mudra Rakshasa-Loots
- Edinburgh Neuroscience, School of Biomedical Sciences, College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh, United Kingdom
- Department of Paediatrics and Child Health, Family Centre for Research With Ubuntu (FAMCRU), Stellenbosch University, Cape Town, South Africa
| | - Barbara Laughton
- Department of Paediatrics and Child Health, Family Centre for Research With Ubuntu (FAMCRU), Stellenbosch University, Cape Town, South Africa
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Araujo RA, Amaral S, Tolentino A, Zeballos D, Montaño I, Souza LS, Lins-Kusterer L, Brites C. Low Quality of Life, Falls, and Pre-Frailty are Associated with Depressive Symptoms in Virologically Suppressed PLWHIV in Salvador, Brazil. AIDS Behav 2022; 26:397-406. [PMID: 34312738 DOI: 10.1007/s10461-021-03393-8] [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] [Accepted: 07/17/2021] [Indexed: 11/25/2022]
Abstract
Depression is the leading cause of years lived with disability worldwide and PLWHIV present a higher risk of developing depressive symptoms. We aimed to evaluate depressive symptoms and their predictors in virologically suppressed PLWHIV. We conducted a cross-sectional study with 200 PLWHIV. Depressive symptoms were defined as scoring ≥ 14 points in the Beck Depression Inventory II. Most of the participants (58.5%) were men, with a median age of 54 years (IQR: 46.25-59.00). Depressive symptoms' prevalence was 19.5% and they were associated with being divorced/widowed (aOR: 2.93, CI 95%: 1.17-7.37), recurrent falls (aOR: 4.24, CI 95%: 1.07-16.85), pre-frailty (aOR: 3.55, CI 95%: 1.47-8.57), and lower scores in all HRQoL dimensions. Although virologically suppressed PLWHIV presented lower prevalence of depressive symptoms than reported in previous studies in Brazil and South America, they were associated with falls and frailty, highlighting the need for screening.
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Affiliation(s)
- Rafael Antonius Araujo
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Brazil
- Laboratório de Pesquisa em Infectologia (LAPI), Hospital Universitário Prof. Edgard Santos (HUPES), Universidade Federal da Bahia, Dr. Augusto Viana Street, Salvador, BA, 40.110-060, Brazil
| | - Sávio Amaral
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Brazil.
- Programa de Pós-Graduação em Medicina e Saúde (PPgMS), Universidade Federal da Bahia, Salvador, Brazil.
- Laboratório de Pesquisa em Infectologia (LAPI), Hospital Universitário Prof. Edgard Santos (HUPES), Universidade Federal da Bahia, Dr. Augusto Viana Street, Salvador, BA, 40.110-060, Brazil.
| | - Arthur Tolentino
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Brazil
- Laboratório de Pesquisa em Infectologia (LAPI), Hospital Universitário Prof. Edgard Santos (HUPES), Universidade Federal da Bahia, Dr. Augusto Viana Street, Salvador, BA, 40.110-060, Brazil
| | - Diana Zeballos
- Programa de Pós-graduação em Saúde Coletiva (PPgSC), Universidade Federal da Bahia, Salvador, Brazil
| | - Iris Montaño
- Programa de Pós-Graduação em Medicina e Saúde (PPgMS), Universidade Federal da Bahia, Salvador, Brazil
- Laboratório de Pesquisa em Infectologia (LAPI), Hospital Universitário Prof. Edgard Santos (HUPES), Universidade Federal da Bahia, Dr. Augusto Viana Street, Salvador, BA, 40.110-060, Brazil
| | - Lucca S Souza
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Brazil
| | - Liliane Lins-Kusterer
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Brazil
- Programa de Pós-Graduação em Medicina e Saúde (PPgMS), Universidade Federal da Bahia, Salvador, Brazil
- Laboratório de Pesquisa em Infectologia (LAPI), Hospital Universitário Prof. Edgard Santos (HUPES), Universidade Federal da Bahia, Dr. Augusto Viana Street, Salvador, BA, 40.110-060, Brazil
| | - Carlos Brites
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Brazil
- Programa de Pós-Graduação em Medicina e Saúde (PPgMS), Universidade Federal da Bahia, Salvador, Brazil
- Laboratório de Pesquisa em Infectologia (LAPI), Hospital Universitário Prof. Edgard Santos (HUPES), Universidade Federal da Bahia, Dr. Augusto Viana Street, Salvador, BA, 40.110-060, Brazil
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Trang K, Le LX, Brown CA, To MQ, Sullivan PS, Jovanovic T, Worthman CM, Giang LM. Feasibility, Acceptability, and Design of a Mobile Ecological Momentary Assessment for High-Risk Men Who Have Sex With Men in Hanoi, Vietnam: Qualitative Study. JMIR Form Res 2022; 6:e30360. [PMID: 35084340 PMCID: PMC8950985 DOI: 10.2196/30360] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 10/28/2021] [Accepted: 11/21/2021] [Indexed: 12/26/2022] Open
Abstract
Background Men who have sex with men (MSM) are at a disproportionate risk for HIV infection and common mental disorders worldwide. In the context of HIV, common mental disorders are important and are frequent drivers of suboptimal prevention and treatment outcomes. Mobile ecological momentary assessments (EMAs), or the repeated sampling of people’s behaviors and psychological states in their daily lives using mobile phones, can clarify the triggers and HIV-related sequelae of depressive-anxious symptoms and contribute toward the design of ecological momentary interventions (EMIs) that cater to the contextually varying needs of individuals to optimize prevention and treatment outcomes. Objective This study aims to characterize the feasibility and acceptability of mobile EMA among high-risk MSM in Hanoi, Vietnam. It aims to evaluate the perceived relevance, usability, and concerns of this group with regard to the content and delivery of mobile EMA and the potential of leveraging such platforms in the future to deliver EMIs. Methods Between January and April 2018, a total of 46 participants were recruited. The participants completed 6 to 8 mobile EMA surveys daily for 7 days. Surveys occurred once upon waking, 4 to 6 times throughout the day, and once before sleeping. All surveys queried participants’ perceived safety, social interactions, psychological state, and mental health symptoms. The morning survey further queried on sleep and medication use within the past 24 hours, whereas the night survey queried on sexual activity and substance use and allowed participants to share an audio recording of a stressful experience they had that day. At the end of the week, participants were interviewed about their experiences with using the app. Results Participants completed an average of 21.7 (SD 12.7) prompts over the 7-day period. Excluding nonresponders, the average compliance rate was 61.8% (SD 26.6%). A thematic analysis of qualitative interviews suggested an overall positive reception of the app and 5 recurring themes, which were centered on the relevance of psychological and behavioral items to daily experiences (eg, mental health symptoms and audio recording), benefits of using the app (eg, increased self-understanding), worries and concerns (eg, privacy), usability (eg, confusion about the interface), and recommendations for future design (eg, integrating more open-ended questions). Conclusions Mobile EMA is feasible and acceptable among young MSM in Vietnam; however, more research is needed to adapt EMA protocols to this context and enhance compliance. Most participants eagerly provided information about their mental health status and daily activities. As several participants looked toward the app for further mental health and psychosocial support, EMIs have the potential to reduce HIV and mental health comorbidity among MSM.
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Affiliation(s)
- Kathy Trang
- Global TIES for Children, New York University, New York City, NY, United States
| | - Lam X Le
- Vietnam National University, Hanoi, Vietnam
| | | | - Margaret Q To
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Emory University, Atlanta, GA, United States
| | - Patrick S Sullivan
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Neuroscience, School of Medicine, Wayne State University, Detroit, MI, United States
| | - Carol M Worthman
- Department of Anthropology, Emory University, Atlanta, GA, United States
| | - Le Minh Giang
- Department of Epidemiology, Hanoi Medical University, Hanoi, Vietnam
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Hoare J, Sevenoaks T, Mtukushe B, Williams T, Heany S, Phillips N. Global Systematic Review of Common Mental Health Disorders in Adults Living with HIV. Curr HIV/AIDS Rep 2021; 18:569-580. [PMID: 34792706 PMCID: PMC8600343 DOI: 10.1007/s11904-021-00583-w] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2021] [Indexed: 02/01/2023]
Abstract
PURPOSE OF THE REVIEW By reviewing the most recent common mental health disorders (CMHD) studies in people living with HIV (PLWH) (2018-2020), this review discusses the prevalence of CMHD, factors associated with CMHD in PLWH, mental health in PLWH from vulnerable groups, the impact of CMHD on HIV disease progression and adherence to antiretroviral therapy and the efficacy of different treatment approaches. RECENT FINDINGS After screening for eligibility 142 studies were included in the final systematic review. Only 27% of studies were conducted in Sub-Saharan Africa, which carries the highest burn of HIV disease globally. Despite the well-established increased risk of CMHD in PLWH, the current prevalence remains high, with studies reporting 28%-62% of PLWH having mental health symptoms. CONCLUSION Despite the significant challenges that CMHDs present to successful HIV treatment, there are many mental health treatments and interventions which can improve outcomes in PLWH and opportunities to task-shift and integrate mental health care with HIV care.
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Affiliation(s)
- Jacqueline Hoare
- Division of Liaison Psychiatry, Department of Psychiatry and Mental health, University of Cape Town, Anzio Road Observatory, Cape Town, 7925, South Africa.
- Faculty of Health Sciences, Penisula Medical School, University of Plymouth, Plymouth, UK.
| | - Tatum Sevenoaks
- Division of Liaison Psychiatry, Department of Psychiatry and Mental health, University of Cape Town, Anzio Road Observatory, Cape Town, 7925, South Africa
| | - Bulelwa Mtukushe
- Division of Liaison Psychiatry, Department of Psychiatry and Mental health, University of Cape Town, Anzio Road Observatory, Cape Town, 7925, South Africa
| | - Taryn Williams
- Division of Liaison Psychiatry, Department of Psychiatry and Mental health, University of Cape Town, Anzio Road Observatory, Cape Town, 7925, South Africa
| | - Sarah Heany
- Division of Liaison Psychiatry, Department of Psychiatry and Mental health, University of Cape Town, Anzio Road Observatory, Cape Town, 7925, South Africa
| | - Nicole Phillips
- Division of Liaison Psychiatry, Department of Psychiatry and Mental health, University of Cape Town, Anzio Road Observatory, Cape Town, 7925, South Africa
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Mejareh ZN, Abdollahi B, Hoseinipalangi Z, Jeze MS, Hosseinifard H, Rafiei S, Aghajani F, Dehnad A, Ardakani MF, Ahmadi S, Anbarhassani H, Asl MT, Kan FP, Aryankhesal A, Shabaninejad H, Aghalou S, Ghashghaee A. Global, regional, and national prevalence of depression among cancer patients: A systematic review and meta-analysis. Indian J Psychiatry 2021; 63:527-535. [PMID: 35136248 PMCID: PMC8793718 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_77_21] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 08/14/2021] [Accepted: 10/31/2021] [Indexed: 11/09/2022] Open
Abstract
This systematic review and meta-analysis aimed to provide a summary of the existing evidence on the prevalence of depression among cancer patients worldwide to assist health policymakers in adopting appropriate measures to prevent and control depression in these patients. EMBASE, Google Scholar, Scopus, PubMed, and Web of Science databases were searched for original studies published in English from January 2000 to July 2019. The studies were screened on the basis of quality and relevance criteria. The statistical analyses were conducted in the R software. Out of 182,521 cancer patients examined in 183 studies, 49,280 (~27%) had depression (95% confidence interval [CI] = 24%-30%). The highest prevalence of depression was among patients with colorectal cancer with 32% (95% CI = 20%-47%). Among countries, Pakistan with 43% (95% CI = 26%-64%), and among continents, Africa with 36% (95% CI = 29%-43%) had the highest prevalence of reported depression in cancer patients. Adjusting for sample size, the prevalence of depression among female cancer patients, 31% (95% CI = 26%-36%), was higher than men, 26% (95% CI = 21%-31%). The prevalence of depression among cancer patients is increasing by an average of 0.6% per year. The findings show higher prevalence of depression among cancer patients in underdeveloped and developing countries compared to the developed nations and the global average.
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Affiliation(s)
- Zahra Noorani Mejareh
- Medical School, Student Research Committee, Iran University of Medical Sciences, Tehran, Iran
| | - Bahare Abdollahi
- Medical School, Student Research Committee, Iran University of Medical Sciences, Tehran, Iran
| | - Zahra Hoseinipalangi
- Nursing and Midwife School, Student Research Committee, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Melika Shamsian Jeze
- Medical School, Student Research Committee, Iran University of Medical Sciences, Tehran, Iran
| | - Hossein Hosseinifard
- Research Center for Evidence Based Medicine (RCEBM), Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sima Rafiei
- Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Farnaz Aghajani
- Nursing and Midwife School, Student Research Committee, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Afsaneh Dehnad
- Center for Educational Research in Medical Sciences, Director of E learning Center, Iran University of Medical Sciences, Tehran, Iran
| | | | - Saba Ahmadi
- Nursing and Midwife School, Student Research Committee, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Haniyeh Anbarhassani
- Medical School, Student Research Committee, Iran University of Medical Sciences, Tehran, Iran
| | - Mahsa Tohidi Asl
- Nursing and Midwife School, Student Research Committee, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Pashazadeh Kan
- Nursing and Midwife School, Student Research Committee, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Aidin Aryankhesal
- Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Hosein Shabaninejad
- Faculty of Medical Science (FMS), Population Health Sciences Institutes (PHSI), Newcastle University, Newcastle, UK
| | - Sepideh Aghalou
- Psychiatric Research Center, Roozbeh Hospital, Tehran University of Medical Science, Tehran, Iran
| | - Ahmad Ghashghaee
- Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
- Health Management and Economics Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran
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Mughal AY, Stockton MA, Bui Q, Go V, Ha TV, Pence BW, Gaynes BN. Validation of screening tools for common mental health disorders in the methadone maintenance population in Hanoi, Vietnam. BMC Psychiatry 2021; 21:488. [PMID: 34610792 PMCID: PMC8491403 DOI: 10.1186/s12888-021-03493-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 09/22/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Common mental health disorders (CMDs), including depression, anxiety and post-traumatic stress disorder (PTSD) may worsen both HIV and drug use outcomes, yet feasible tools to accurately identify CMDs have received limited study in this population. We aimed to validate the Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder screen (GAD-7) and Primary Care PTSD screen for DSM-5 (PC-PTSD-5) in a methadone maintenance therapy (MMT) patient population in Hanoi, Vietnam. METHODS We conducted a cross-sectional survey. The PHQ-9, GAD-7, and PC-PTSD-5 were administered to MMT patients. A blinded interviewer administered the Mini-International Neuropsychiatric Interview (MINI) as the reference gold standard. Total scores of each tool were compared with the MINI diagnoses using a receiver operating characteristic curves, and we identified the optimal respective cut-off scores using the Youden's Index. RESULTS We enrolled 400 MMT patients. Approximately 99.3% were male (n = 397) and 21.8% (n = 87) were HIV positive. The prevalence of major depressive disorder, generalized anxiety disorder and PTSD, respectively, was 10.5, 4 and 2%. Optimal cut-off scores for the PHQ-9, GAD-7 and PC-PTSD were ≥ 5, ≥3, and ≥ 4 with a sensitivity/specificity of 95.2%/91.9, 93.8%/87.5, and 62.5%/95.2%. CONCLUSIONS The prevalence of CMDs in the MMT population was lower than expected. A lower cut-off score may be considered when screening for CMDs in this population. Further research should investigate the validity of somatic symptom-based screening tools among other drug-using or MMT populations.
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Affiliation(s)
- Anisa Y. Mughal
- grid.21925.3d0000 0004 1936 9000The University of Pittsburgh School of Medicine, 3550 Terrace Street, Pittsburgh, PA 15213 USA
| | - Melissa A. Stockton
- grid.10698.360000000122483208Epidemiology Department, University of North Carolina at Chapel Hill Gillings School of Global Public Health, 135 Dauer Dr, Chapel Hill, NC 27599 USA
| | - Quynh Bui
- The UNC Vietnam Office, Yen Hoa Health Clinic, Lot E2, Duong Dinh Nghe Street, Yen Hoa Ward, Cau Giay District, Hanoi, Vietnam
| | - Vivian Go
- grid.10698.360000000122483208Department of Health Behavior, University of North Carolina at Chapel Hill Gillings School of Global Public Health, 135 Dauer Dr, Chapel Hill, NC 27599 USA
| | - Tran Viet Ha
- The UNC Vietnam Office, Yen Hoa Health Clinic, Lot E2, Duong Dinh Nghe Street, Yen Hoa Ward, Cau Giay District, Hanoi, Vietnam
| | - Brian W. Pence
- grid.10698.360000000122483208Epidemiology Department, University of North Carolina at Chapel Hill Gillings School of Global Public Health, 135 Dauer Dr, Chapel Hill, NC 27599 USA
| | - Bradley N. Gaynes
- grid.10698.360000000122483208Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, 333 S Columbia St, Chapel Hill, NC 27516 USA
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Ahmed A, Saqlain M, Umair MM, Hashmi FK, Saeed H, Amer M, Blebil AQ, Dujaili JA. Stigma, Social Support, Illicit Drug Use, and Other Predictors of Anxiety and Depression Among HIV/AIDS Patients in Pakistan: A Cross-Sectional Study. Front Public Health 2021; 9:745545. [PMID: 34660521 PMCID: PMC8514983 DOI: 10.3389/fpubh.2021.745545] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 08/31/2021] [Indexed: 01/30/2023] Open
Abstract
Introduction: Anxiety and depression in people living with HIV/AIDS (PLWHA) can lead to non-adherence to antiretroviral therapy (ART), morbidity, and mortality. Therefore, assessing the stigma, social support, and other determinants of anxiety and depression in PLWHA are important for developing further interventions. Methods: An institution-based cross-sectional study was conducted in 505 PLWHA, approached through systematic sampling, who paid routine visits to the ART center, Pakistan Institute of Medical Sciences (PIMS), Islamabad. Data was collected by pretested validated hospital anxiety and depression scale (HADS). Version 26 of the SPSS was used to apply Logistic regression analysis to identify determinants, and the 95% confidence interval (CI) adjusted odds ratio (AOR) was calculated to assess the magnitude of the relationships. Results: In PLWHA, the prevalence of co-morbid depression and anxiety was 80%. Separately, 89.9% had depression, and 80.3% had anxiety. Use of illicit drugs [AOR = 1.87, 95% CI (1.01, 3.27)], low social support [AOR = 1.21, 95% CI (1.02, 2.25)], being male [AOR = 2.21, 95% CI (1.11, 5.49)], and HIV related stigma [AOR = 2.48, 95% CI (1.25, 6.02)] were significant predictors of depression. Having detectable viral load [AOR = 3.04, 95% CI (1.04, 8.86)], young age [AOR = 5.31, 95% CI (1.19, 29.39)], no formal education [AOR = 21.78, 95% CI (4.03, 117.62)], low [AOR = 1.70, 95% CI (1.12, 6.93)] or moderate [AOR = 2.20, 95% CI (1.79, 6.09)] social support, illicit drugs addiction [AOR = 1.17, 95% CI (1.03, 2.55)], and HIV stigma [AOR = 54.3, 95% CI (21.20, 139.32)] had a remarkable association with anxiety. Conclusions: Given the high prevalence of anxiety and depression among PLWHA, the Pakistan Ministry of Health should focus more on monitoring mental health, expanding mental health services, and developing interventions based on identified factors to treat depression and anxiety among PLWHA.
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Affiliation(s)
- Ali Ahmed
- School of Pharmacy, Monash University, Subang Jaya, Malaysia
| | - Muhammad Saqlain
- Department of Pharmacy, Quaid i Azam University Islamabad, Islamabad, Pakistan
| | - Malik Muhammad Umair
- National AIDs Control Program, Prime Minister Health Complex, Islamabad, Pakistan
| | - Furqan Khurshid Hashmi
- University College of Pharmacy, University of the Punjab, Allama Iqbal, Lahore, Pakistan
| | - Hamid Saeed
- University College of Pharmacy, University of the Punjab, Allama Iqbal, Lahore, Pakistan
| | - Muhammad Amer
- Department of Pharmacy, The University of Lahore, Islamabad, Pakistan
| | - Ali Qais Blebil
- School of Pharmacy, Monash University, Subang Jaya, Malaysia
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Bronshteyn M, Yang FN, Shattuck KF, Dawson M, Kumar P, Moore DJ, Ellis RJ, Jiang X. Depression is associated with hippocampal volume loss in adults with HIV. Hum Brain Mapp 2021; 42:3750-3759. [PMID: 34089276 PMCID: PMC8288081 DOI: 10.1002/hbm.25451] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 01/15/2021] [Accepted: 04/08/2021] [Indexed: 12/15/2022] Open
Abstract
Depressive symptoms are more prevalent in persons with HIV (PWH) than HIV-uninfected individuals. In HIV-uninfected individuals, depression has been associated with atrophy in the hippocampus and other brain regions. In the present study, we investigated the impact of depression on brain structure in PWH. One hundred PWH participated in a cross-sectional study (56.6 ± 6.4 yrs, range 41-70 yrs, 24 females, 63 African Americans). The Beck's Depression Inventory-II (BDI-II) was used to assess depressive symptoms. Structural MRI images were collected. Both the voxel-based morphometry (VBM) technique and a region of interest (ROI) based approach were used to examine the relationship between hippocampal gray matter volume (GMv) and depressive symptoms. The impact of HIV CD4 nadir and antidepressants was also investigated. Both VBM and ROI approaches revealed that higher BDI-II scores (implicating more severe depressive symptoms) were associated with loss of hippocampal GMv, especially in the right hippocampus and the right entorhinal cortex. Low CD4 nadir predicted additional hippocampal volume loss independent of depressive symptoms. Taking antidepressants did not have a detectable effect on hippocampal volume. In summary, having more depressive symptoms is associated with smaller hippocampal volume in PWH, and a history of severe immunosuppression (i.e., low CD4 nadir) correlates with additional hippocampal volume reduction. However, the impact of depression on hippocampal volume may be independent of HIV-disease severity such as low CD4 nadir.
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Affiliation(s)
- Margarita Bronshteyn
- Department of NeuroscienceGeorgetown University Medical CenterWashingtonDistrict of ColumbiaUSA
| | - Fan Nils Yang
- Department of NeuroscienceGeorgetown University Medical CenterWashingtonDistrict of ColumbiaUSA
| | - Kyle F. Shattuck
- Department of NeuroscienceGeorgetown University Medical CenterWashingtonDistrict of ColumbiaUSA
| | - Matthew Dawson
- Department of PsychiatryUniversity of CaliforniaSan Diego, La JollaCaliforniaUSA
| | - Princy Kumar
- Department of MedicineGeorgetown University Medical CenterWashingtonDistrict of ColumbiaUSA
| | - David J. Moore
- Department of PsychiatryUniversity of CaliforniaSan Diego, La JollaCaliforniaUSA
| | - Ronald J. Ellis
- Department of PsychiatryUniversity of CaliforniaSan Diego, La JollaCaliforniaUSA
- Department of NeurosciencesUniversity of CaliforniaSan Diego, La JollaCaliforniaUSA
| | - Xiong Jiang
- Department of NeuroscienceGeorgetown University Medical CenterWashingtonDistrict of ColumbiaUSA
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Mekonen T, Belete H, Fekadu W. Depressive symptoms among people with HIV/AIDS in Northwest Ethiopia: comparative study. BMJ Open 2021; 11:e048931. [PMID: 34210733 PMCID: PMC8252867 DOI: 10.1136/bmjopen-2021-048931] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 06/16/2021] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES The objective of this study was to compare depressive symptoms among people with HIV/AIDS and the general population sample. We also assessed the factors associated with depressive symptoms. DESIGN A comparative cross-sectional study was conducted. SETTINGS Antiretroviral therapy clinics in three primary healthcare facilities and semi-urban area in Northwest Ethiopia. PARTICIPANTS A total of 1115 participants (558 people with HIV/AIDS and 557 comparison group) aged 18 years and above were recruited. A total of 1026 participants (530 people with HIV/AIDS and 496 comparison group) completed the interview. We excluded people with known HIV-positive status from the comparison group. OUTCOME MEASURE Patient Health Questionnaire (PHQ-9) was used to assess depressive symptoms. The proportion of depressive symptoms was compared between samples of the general population and people with HIV/AIDS using χ2 statistics. Multivariable logistic regression analysis was done to examine the associated factors. RESULTS The overall prevalence of depressive symptoms was 13.3% (11.2%-15.4%). The prevalence was significantly higher in people with HIV/AIDS compared with the community sample (16.6% vs 12.3%), p=0.001. The difference was also significant in the multivariable logistic regression (OR 1.7). For the overall sample, depressive symptoms were significantly associated with older age, being single, divorced/widowed marital status, and poor social support. CONCLUSIONS Depressive symptoms were higher in people with HIV/AIDS compared with the general population. It is necessary to include mental healthcare and screening for depression in routine HIV/AIDS care.
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Affiliation(s)
- Tesfa Mekonen
- Department of Psychiatry, Bahir Dar University, Bahir Dar, Ethiopia
| | - Habte Belete
- Department of Psychiatry, Bahir Dar University, Bahir Dar, Ethiopia
| | - Wubalem Fekadu
- Department of Psychiatry, Bahir Dar University, Bahir Dar, Ethiopia
- Department of Psychiatry, Addis Ababa University, Addis Ababa, Ethiopia
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Nguyen MX, McNaughton Reyes HL, Pence BW, Muessig K, Hutton HE, Latkin CA, Dowdy D, Chander G, Lancaster KE, Frangakis C, Sripaipan T, Ha Tran V, Go VF. The longitudinal association between depression, anxiety symptoms and HIV outcomes, and the modifying effect of alcohol dependence among ART clients with hazardous alcohol use in Vietnam. J Int AIDS Soc 2021; 24 Suppl 2:e25746. [PMID: 34165258 PMCID: PMC8222856 DOI: 10.1002/jia2.25746] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 04/14/2021] [Accepted: 04/28/2021] [Indexed: 01/15/2023] Open
Abstract
INTRODUCTION Mental health disorders may negatively impact HIV outcomes, such as viral suppression (VS) and antiretroviral (ART) adherence among people with HIV (PWH) with hazardous alcohol use. This study evaluates the longitudinal association between depression, anxiety symptoms, VS and complete ART adherence among ART clients with hazardous alcohol use in Vietnam; and examines alcohol dependence as a modifier in this association. METHODS This was a secondary data analysis of a trial for hazardous drinking ART clients in Thai Nguyen, Vietnam. From March 2016 to May 2018, 440 ART clients with an Alcohol Use Disorders Identification Test-Concise (AUDIT-C) score ≥4 for men and ≥3 for women were enrolled. Individuals were randomized to either a combined intervention, a brief intervention or a standard of care. Data on sociodemographics, depression, anxiety symptoms, alcohol use, VS and ART adherence were collected at baseline, three, six, and twelve months. Generalized estimating equation models controlling for intervention exposure were used to estimate time-lagged associations. Risk ratios were estimated using Poisson regression with robust variance estimation. RESULTS The mean age of participants was 40.2. The majority was male (96.8%), had at least some secondary school education (85.0%) and had a history of injection drug use (80.9%). No overall effect of depression and anxiety symptoms on VS was observed. When stratified by time, increased anxiety symptoms at six months were associated with VS at 12 months (adjusted risk ratio (aRR) = 1.09; 95% CI 1.02 to 1.17). An increase in depression or anxiety symptoms was associated with a decreased probability of complete ART adherence (depression symptoms: aRR = 0.95; 95% CI: 0.91 to 0.99; anxiety symptoms: aRR = 0.93; 85% CI: 0.88 to 0.99). The negative effects of anxiety symptoms on ART adherence were stronger among participants with alcohol dependence, compared to those without. CONCLUSIONS Depression and anxiety symptoms had no overall effect on VS, although they were associated with a lower probability of complete ART adherence. Interventions focusing on mental healthcare for PWH with hazardous alcohol use are needed, and integration of mental healthcare and alcohol reduction should be implemented in HIV primary care settings.
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Affiliation(s)
- Minh X Nguyen
- Department of Health BehaviorGillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillNCUSA
| | - H. Luz McNaughton Reyes
- Department of Health BehaviorGillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillNCUSA
| | - Brian W Pence
- Department of EpidemiologyGillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillNCUSA
| | - Kate Muessig
- Department of Health BehaviorGillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillNCUSA
| | - Heidi E Hutton
- Department of Psychiatry and Behavioral SciencesJohns Hopkins University School of MedicineBaltimoreMDUSA
| | - Carl A Latkin
- Department of Health, Behavior and SocietyJohns Hopkins Bloomberg School of Public HealthBaltimoreMDUSA
| | - David Dowdy
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMDUSA
| | | | - Kathryn E Lancaster
- Department of EpidemiologyCollege of Public HealthOhio State UniversityColumbusOHUSA
| | - Constantine Frangakis
- Department of BiostatisticsJohns Hopkins Bloomberg School of Public HealthBaltimoreMDUSA
| | - Teerada Sripaipan
- Department of Health BehaviorGillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillNCUSA
| | - Viet Ha Tran
- Department of Health BehaviorGillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillNCUSA
| | - Vivian F Go
- Department of Health BehaviorGillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillNCUSA
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Meng J, Tang C, Xiao X, Välimäki M, Wang H. Co-occurrence Pattern of Posttraumatic Stress Disorder and Depression in People Living With HIV: A Latent Profile Analysis. Front Psychol 2021; 12:666766. [PMID: 34025528 PMCID: PMC8131520 DOI: 10.3389/fpsyg.2021.666766] [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: 02/11/2021] [Accepted: 04/14/2021] [Indexed: 11/16/2022] Open
Abstract
Background: The comorbidity of posttraumatic stress disorder (PTSD) and depression is common among people living with the HIV (PLWH). Given the high prevalence and serious clinical consequences of the comorbidity of these two disorders, we conducted a latent profile analysis to examine the co-occurrence pattern of PTSD and depression in PLWH. Methods: The data for this cross-sectional study of PLWH were collected from 602 patients with HIV in China. A secondary analysis using latent profile analysis was conducted to examine HIV-related PTSD and depression symptoms. Results: A four-class solution fits the data best, with the four classes characterized as asymptomatic (42.9%), mild symptoms (33.9%), low to moderate symptoms (19.8%), and high to moderate symptoms (3.4%). The severity of PTSD and depression symptoms was comparable in this solution, and no group was dominated by PTSD or depression. Conclusion: The absence of a distinct subcluster of PLWH with only PTSD or depression symptoms supports that PTSD and depression in PLWH are psychopathological manifestations after traumatic exposures. Health care staff should pay more attention to the existence of comorbid symptoms of individuals, develop integrated interventions for the symptoms cluster, and evaluate their effectiveness in clinical practice.
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Affiliation(s)
- Jingjing Meng
- Xiangya Nursing School of Central South University, Changsha, China
| | - Chulei Tang
- Xiangya Nursing School of Central South University, Changsha, China
| | - Xueling Xiao
- Xiangya Nursing School of Central South University, Changsha, China
| | - Maritta Välimäki
- Xiangya Nursing School of Central South University, Changsha, China.,Department of Nursing Science, University of Turku, Turku, Finland
| | - Honghong Wang
- Xiangya Nursing School of Central South University, Changsha, China
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Siewe Fodjo JN, Faria de Moura Villela E, Van Hees S, Vanholder P, Reyntiens P, Colebunders R. Follow-Up Survey of the Impact of COVID-19 on People Living with HIV during the Second Semester of the Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4635. [PMID: 33925506 PMCID: PMC8123847 DOI: 10.3390/ijerph18094635] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 04/12/2021] [Accepted: 04/23/2021] [Indexed: 12/12/2022]
Abstract
COVID-19 affects persons living with HIV (PLWH) both directly (via morbidity/mortality) and indirectly (via disruption of HIV care). From July-November 2020, an online survey was conducted to investigate the psychosocial well-being of PLWH and changes in HIV care during the second semester of the COVID-19 outbreak. Data were collected on the socio-demographic characteristics of PLWH, their psychosocial well-being, impact of COVID-19 preventive measures on their daily routines and HIV follow-up. Of the 247 responses analyzed (mean age: 44.5 ± 13.2 years; 73.7% male), 67 (27.1%) and 69 (27.9%) respondents screened positive for anxiety (GAD-2 score ≥ 3) and depression (PHQ-2 score ≥ 3), respectively. HIV care had returned to pre-COVID-19 state for 48.6% PLWH, and 108 (43.7%) had no HIV follow-up during the past month. Over three quarters (76.1%) of respondents expressed willingness to receive the COVID-19 vaccine. Compared to previous findings in April 2020, substance use increased from 58.6% to 67.2% (p < 0.001). Our findings suggest that the well-being and medical follow-up of PLWH are still affected after almost a year into the COVID-19 outbreak. Remote HIV follow-up (telemedicine) with psychosocial support should be envisaged in the medium to long-term. Given that most PLWH accept COVID-19 vaccination, they may be prioritized for this intervention.
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Affiliation(s)
| | - Edlaine Faria de Moura Villela
- Disease Control Coordination, State Health Department, São Paulo 01246000, Brazil
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia 74605050, Brazil;
| | - Stijn Van Hees
- Global Health Institute, University of Antwerp, 2610 Wilrijk, Belgium; (S.V.H.); (R.C.)
| | | | - Patrick Reyntiens
- Sensoa, Flemish Expertise Centre for Sexual Health, 2060 Antwerp, Belgium;
| | - Robert Colebunders
- Global Health Institute, University of Antwerp, 2610 Wilrijk, Belgium; (S.V.H.); (R.C.)
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Han S, Pei Y, Wang L, Hu Y, Qi X, Zhao R, Zhang L, Sun W, Zhu Z, Wu B. The Development of a Personalized Symptom Management Mobile Health Application for Persons Living with HIV in China. J Pers Med 2021; 11:346. [PMID: 33922984 PMCID: PMC8146530 DOI: 10.3390/jpm11050346] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 04/21/2021] [Accepted: 04/23/2021] [Indexed: 12/31/2022] Open
Abstract
Persons living with HIV (PLWH) continuously experience symptom burdens. Their symptom prevalence and severity are also quite different. Mobile health (mHealth) applications (apps) offer exceptional opportunities for using personalized interventions when and where PLWH are needed. This study aimed to demonstrate the development process of the symptom management (SM) app and the structure and content of it. Our research team systematically searched for evidence-based resources and summarized up-to-date evidence for symptom management and health education. Our multidisciplinary research team that included physicians, nurses, software engineers, and nursing professors, evaluated the structure and content of the drafted app. Both quantitative data and qualitative results were collected at a group discussion meeting. Quantitative data were scores of sufficient evidence, situational suitability, practicability, cost-effectiveness, and understandability (ranged from one to four) for 119 items of the app contents, including the health tracking module, the self-assessment module, coping strategies for 18 symptoms (80 items), medication management, complementary therapy, diet management, exercise, relaxation techniques, and the obtaining support module. The SM app was comprised of eight modules and provided several personalized symptom management functions, including assessing symptoms and receiving different symptom management strategies, tracking health indicators, and communicating with medical staff. The SM app was a promising and flexible tool for HIV symptom management. It provided PLWH with personalized symptom management strategies and facilitated the case management for medical staff. Future studies are needed to further test the app's usability among PLWH users and its effects on symptom management.
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Affiliation(s)
- Shuyu Han
- School of Nursing, Peking University, Beijing 100191, China;
| | - Yaolin Pei
- Rory Meyers College of Nursing, New York University, New York, NY 10010, USA; (Y.P.); (X.Q.)
| | - Lina Wang
- School of Medicine, Huzhou University, Huzhou Central Hospital, Huzhou 313000, China;
| | - Yan Hu
- School of Nursing, Fudan University, Shanghai 200032, China; (R.Z.); (Z.Z.)
- Fudan University Centre for Evidence-based Nursing: A Joanna Briggs Institute Centre of Excellence, Shanghai 200032, China
| | - Xiang Qi
- Rory Meyers College of Nursing, New York University, New York, NY 10010, USA; (Y.P.); (X.Q.)
| | - Rui Zhao
- School of Nursing, Fudan University, Shanghai 200032, China; (R.Z.); (Z.Z.)
- Children’s Hospital of Fudan University, Shanghai 201102, China
| | - Lin Zhang
- Shanghai Public Health Clinical Center Affiliated with Fudan University, Shanghai 201508, China; (L.Z.); (W.S.)
| | - Wenxiu Sun
- Shanghai Public Health Clinical Center Affiliated with Fudan University, Shanghai 201508, China; (L.Z.); (W.S.)
| | - Zheng Zhu
- School of Nursing, Fudan University, Shanghai 200032, China; (R.Z.); (Z.Z.)
- Fudan University Centre for Evidence-based Nursing: A Joanna Briggs Institute Centre of Excellence, Shanghai 200032, China
| | - Bei Wu
- Rory Meyers College of Nursing, New York University, New York, NY 10010, USA; (Y.P.); (X.Q.)
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Mughal AY, Stockton MA, Bui Q, Go V, Pence BW, Ha TV, Gaynes BN. Examining common mental health disorders in people living with HIV on methadone maintenance therapy in Hanoi, Vietnam. Harm Reduct J 2021; 18:45. [PMID: 33892743 PMCID: PMC8063421 DOI: 10.1186/s12954-021-00495-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 04/11/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Injection drug use drives HIV transmission in Southeast Asia, where around a quarter of users are living with HIV. Vietnam developed Methadone Maintenance Therapy (MMT) programs to reduce unsafe drug abuse. Common mental health disorders (CMD), including depression, anxiety and post-traumatic stress disorder (PTSD), can worsen MMT outcomes and are highly prevalent among people living with HIV (PLH). We aimed to characterize HIV and CMD among MMT patients and assess the impact of HIV and CMD on MMT engagement outcomes in Hanoi, Vietnam. METHODS This cross-sectional study was conducted at an urban MMT clinic in Hanoi. Participants were screened for CMD with the relevant sections of the Mini International Neuropsychiatric Interview (MINI). Tabular comparisons and regression models were used to understand the association of HIV and CMD with substance use and methadone compliance. RESULTS Of the 400 MMT participants, 22% were living with HIV, 11% a CMD, 27% reported injection drug use, and 27% reported methadone noncompliance. Around 17% of those with HIV also had a CMD. Reporting non injection and injection drug use were each higher among those with CMD regardless of HIV status. In addition, reporting any drug use was much higher among those with both HIV and CMD than among those with neither (73% vs 31%, p value 0.001). While methadone noncompliance was lower among PLH than among those without HIV (16.3% vs 30.1%, p value 0.010), noncompliance was higher among those with CMD than among those without (40.5% vs 25.6%, p value 0.045). Among those without HIV, noncompliance was higher among those with CMD than among those without, but among those with HIV, the opposite relationship was observed. CONCLUSION There is complex overlap between substance use and methadone noncompliance among MMT patients living with HIV, CMD or both. In this population, we found a high prevalence of CMD and substance use among PLH, and a high prevalence of substance use and methadone noncompliance among those with CMD. Prioritizing provision of mental health care services to MMT patients living with HIV can help improve engagement with substance use disorder treatment and reduce the risk of HIV transmission.
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Affiliation(s)
- Anisa Y Mughal
- School of Medicine, The University of Pittsburgh, 3550 Terrace Street, Pittsburgh, PA, 15213, USA
| | - Melissa Ann Stockton
- Epidemiology Department, University of North Carolina At Chapel Hill Gillings School of Global Public Health, 135 Dauer Dr, Chapel Hill, NC, 27599, USA.
| | - Quynh Bui
- The UNC Vietnam Office, Yen Hoa Health Clinic, Lot E2, Duong Dinh Nghe Street, Yen Hoa Ward, Cau Giay District, Hanoi, Vietnam
| | - Vivian Go
- Department of Health Behavior, University of North Carolina At Chapel Hill Gillings School of Global Public Health, 135 Dauer Dr, Chapel Hill, NC, 27599, USA
| | - Brian W Pence
- Epidemiology Department, University of North Carolina At Chapel Hill Gillings School of Global Public Health, 135 Dauer Dr, Chapel Hill, NC, 27599, USA
| | - Tran Viet Ha
- The UNC Vietnam Office, Yen Hoa Health Clinic, Lot E2, Duong Dinh Nghe Street, Yen Hoa Ward, Cau Giay District, Hanoi, Vietnam
| | - Bradley N Gaynes
- Department of Psychiatry, University of North Carolina At Chapel Hill School of Medicine, 333 S Columbia St, Chapel Hill, NC, 27516, USA
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Factors Affecting Social Support Status of People Living with HIV/AIDS at Selected Hospitals of North Shewa Zone, Amhara Region, Ethiopia. J Trop Med 2021; 2021:6695298. [PMID: 33884002 PMCID: PMC8041550 DOI: 10.1155/2021/6695298] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 03/11/2021] [Accepted: 03/26/2021] [Indexed: 11/18/2022] Open
Abstract
Background Globally, millions of people are affected by human immunodeficiency virus (HIV). Acquired immunodeficiency was linked with psychosocial problems, whereby stigma and discrimination are the most common. Therefore, this study was aimed at assessing the level of the social support problem in people living with human immunodeficiency virus (PLHIV) and factors associated with it at selected hospitals of North Shewa Zone, Amhara Region, Ethiopia. Method An institution-based cross-sectional study design was employed. A total of 422 PLHIV were involved in the study. A multidimensional perceived social support scale (MPSSS) for the measurement of social support problems was implemented. Systematic random sampling was used to recruit the study population after selecting study areas by lottery methods. Multivariate logistic regression analyses were performed via SPSS software. The statistical association was declared at a p value of less than 0.05 in the final model. Result The prevalence of poor social support among study participants was 12.6%. Poor adherence to their antiretrovirus drugs was highly associated with poor social support (AOR = 2.06, 95% CI: 1.36, 3.13). Moreover, psychological distress (AOR = 4.67, 95% CI: 2.02, 10.81) and perceived stigma (AOR = 1.78, 95% CI: 1.18, 2.70) were positively associated. Conclusion The burden of poor social support is increasingly affecting the lives of PLHIV. Poor social support in PLHIV is more magnified by poor adherence, having psychological distress, and perceived stigma.
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Ridgway JP, Uvin A, Schmitt J, Oliwa T, Almirol E, Devlin S, Schneider J. Natural Language Processing of Clinical Notes to Identify Mental Illness and Substance Use Among People Living with HIV: Retrospective Cohort Study. JMIR Med Inform 2021; 9:e23456. [PMID: 33688848 PMCID: PMC7991991 DOI: 10.2196/23456] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 01/30/2021] [Accepted: 01/31/2021] [Indexed: 02/05/2023] Open
Abstract
Background Mental illness and substance use are prevalent among people living with HIV and often lead to poor health outcomes. Electronic medical record (EMR) data are increasingly being utilized for HIV-related clinical research and care, but mental illness and substance use are often underdocumented in structured EMR fields. Natural language processing (NLP) of unstructured text of clinical notes in the EMR may more accurately identify mental illness and substance use among people living with HIV than structured EMR fields alone. Objective The aim of this study was to utilize NLP of clinical notes to detect mental illness and substance use among people living with HIV and to determine how often these factors are documented in structured EMR fields. Methods We collected both structured EMR data (diagnosis codes, social history, Problem List) as well as the unstructured text of clinical HIV care notes for adults living with HIV. We developed NLP algorithms to identify words and phrases associated with mental illness and substance use in the clinical notes. The algorithms were validated based on chart review. We compared numbers of patients with documentation of mental illness or substance use identified by structured EMR fields with those identified by the NLP algorithms. Results The NLP algorithm for detecting mental illness had a positive predictive value (PPV) of 98% and a negative predictive value (NPV) of 98%. The NLP algorithm for detecting substance use had a PPV of 92% and an NPV of 98%. The NLP algorithm for mental illness identified 54.0% (420/778) of patients as having documentation of mental illness in the text of clinical notes. Among the patients with mental illness detected by NLP, 58.6% (246/420) had documentation of mental illness in at least one structured EMR field. Sixty-three patients had documentation of mental illness in structured EMR fields that was not detected by NLP of clinical notes. The NLP algorithm for substance use detected substance use in the text of clinical notes in 18.1% (141/778) of patients. Among patients with substance use detected by NLP, 73.8% (104/141) had documentation of substance use in at least one structured EMR field. Seventy-six patients had documentation of substance use in structured EMR fields that was not detected by NLP of clinical notes. Conclusions Among patients in an urban HIV care clinic, NLP of clinical notes identified high rates of mental illness and substance use that were often not documented in structured EMR fields. This finding has important implications for epidemiologic research and clinical care for people living with HIV.
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Affiliation(s)
- Jessica P Ridgway
- Department of Medicine, University of Chicago, Chicago, IL, United States
| | - Arno Uvin
- Department of Medicine, University of Chicago, Chicago, IL, United States
| | - Jessica Schmitt
- Department of Medicine, University of Chicago, Chicago, IL, United States
| | - Tomasz Oliwa
- Center for Research Informatics, University of Chicago, Chicago, IL, United States
| | - Ellen Almirol
- Department of Medicine, University of Chicago, Chicago, IL, United States
| | - Samantha Devlin
- Department of Medicine, University of Chicago, Chicago, IL, United States
| | - John Schneider
- Department of Medicine, University of Chicago, Chicago, IL, United States
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Gupta K, Shivabalan, Kumar V, Vyas S, Pandey RM, Jagannathan NR, Sinha S. Cognitive Performance and Neuro-Metabolites in HIV Using 3T Magnetic Resonance Spectroscopy: A Cross-Sectional Study from India. Curr HIV Res 2021; 19:147-153. [PMID: 33106144 DOI: 10.2174/1570162x18666201026141729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 09/08/2020] [Accepted: 09/22/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Cognitive impairment in patients with human immunodeficiency virus (HIV) is associated with higher morbidity. The prevalence of the metabolite changes in the brain associated with cognitive impairment in anti-retroviral therapy naïve patients with HIV is unknown. OBJECTIVE To estimate the prevalence of the neurometabolites associated with cognitive impairment in antiretroviral therapy (ART) naïve patients with HIV. METHODS We conducted a cross-sectional study among ART naïve patients with HIV aged 18-50 years in a tertiary care center in India. Cognition was tested using the Post Graduate Institute battery of brain dysfunction across five domains; memory, attention-information processing, abstraction executive, complex perceptual, and simple motor skills. We assessed the total N-acetyl aspartyl (tNAA), creatine (tCr) and glutamate + glutamine (Glx) using 3T magnetic resonance spectroscopy. Cognitive impairment was defined as an impairment in ≥2 domains. RESULTS Among 43 patients eligible for this study, the median age was 32 years (IQR 29, 40) and 30% were women. Median CD4 count and viral load were 317 cells/μL (IQR 157, 456) and 9.3 copies/ μL (IQR 1.4, 38), respectively. Impairment in at least one cognitive domain was present in 32 patients (74.4%). Impairment in simple motor skills and memory was present in 46.5% and 44% of patients, respectively. Cognitive impairment, defined by impairment in ≥2 domains, was found in 22 (51.2%) patients. There was a trend towards higher concentration of tNAA (7.3 vs. 7.0 mmol/kg), tGlx (9.1 vs. 8.2 mmol/kg), and tCr (5.5 vs. 5.2 mmol/kg) in the frontal lobe of patients with cognitive impairment vs. without cognitive impairment but it did not reach statistical significance (p>0.05 for all). There was no difference in the concentration of these metabolites in the two groups in the basal ganglia. CONCLUSION There is a high prevalence of cognitive impairment in ART naïve patients with HIV. There is no difference in metabolites in patients with or without cognitive impairment. Further studies, with longitudinal follow-up are required to understand the underlying pathophysiological mechanisms.
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Affiliation(s)
- K Gupta
- Department of Internal Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Shivabalan
- Department of Nuclear Magnetic Resonance and Magnetic Resonance Imaging Facility, All India Institute of Medical Sciences, New Delhi, India
| | - V Kumar
- Department of Nuclear Magnetic Resonance and Magnetic Resonance Imaging Facility, All India Institute of Medical Sciences, New Delhi, India
| | - S Vyas
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
| | - R M Pandey
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - N R Jagannathan
- Department of Nuclear Magnetic Resonance and Magnetic Resonance Imaging Facility, All India Institute of Medical Sciences, New Delhi, India
| | - S Sinha
- Department of Internal Medicine, All India Institute of Medical Sciences, New Delhi, India
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Mahboobi M, Najafi A, Nakhostin-Ansari A, Kazerooni PA, Bazargani M, Navaiian F, Akbarpour S. Depression, sleep quality and condom use amongst Iranian people living with human immunodeficiency virus. South Afr J HIV Med 2021; 21:1150. [PMID: 33391831 PMCID: PMC7756672 DOI: 10.4102/sajhivmed.v21i1.1150] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 09/26/2020] [Indexed: 11/13/2022] Open
Abstract
Background Depression is a common mood disorder in people living with human immunodeficiency virus (PLWH) and is associated with risk-taking sexual behaviour. Objectives This study examines depression, sleep quality and condom usage amongst PLWH in Tehran, Iran. Method This cross-sectional study was undertaken between October and November 2019 on 298 PLWH referred to voluntary counselling and testing centres (VCTs) in Tehran. Participants provided information as per the following questionnaires: the Depression, Anxiety, Stress Scale (DASS), the Pittsburgh Sleep Quality Index Questionnaire and a demographic questionnaire that evaluated condom use. Results A total of 298 PLWH, of whom 202 (67.8%) were men with a mean age of 39.81 years, were enrolled in the study. The DASS classified 57% with depression. Fewer than 20% of these used condoms regularly. The majority of depressed patients were men (68.6%) and 31.4% were women. The depressed patients were more likely not to use condoms than those who were not depressed (adjusted odds ratio [OR] = 6.5; 95% confidence interval [CI], 3.70–11.42). The adjusted OR for not using a condom amongst the depressed was 7.12 times greater (95% CI, 5.85–10.11) than in those without depression. Conclusion Our findings suggest that depression is common amongst PLWH in Tehran and is associated with risk-taking sexual behaviour. Appropriate interventions are needed to address mental disorders in PLWH. It is recommended that patients be screened regularly for symptoms of depression and, where indicated, counselled and managed.
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Affiliation(s)
- Marzieh Mahboobi
- Department of Epidemiology and Biostatistics, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Arezu Najafi
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Amin Nakhostin-Ansari
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Parvin Afsar Kazerooni
- Center for Communicable Disease Control, Ministry of Health and Medical Education, Tehran, Iran
| | - Matin Bazargani
- HIV Expert of Deputy of Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Navaiian
- HIV Expert of Deputy of Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Samaneh Akbarpour
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
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