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de Oliveira Gomes M, Castro R, Corrêa da Mota J, De Boni RB. Association of syndemic conditions and quality of life among people living with HIV/AIDS. AIDS Care 2023; 35:1508-1517. [PMID: 35621316 DOI: 10.1080/09540121.2022.2080801] [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: 07/14/2021] [Accepted: 05/17/2022] [Indexed: 10/18/2022]
Abstract
The syndemics theory seeks to understand the effect of multiple synergic problems in promoting poor health outcomes. To disentangle which and how syndemic conditions affect the quality of life (QoL) may be important to improve well-being of people living with HIV/AIDS (PLWHA). This study evaluates the association between syndemic conditions and QoL among PLWHA. We performed a secondary analysis using data obtained between 2014 and 2017 among PLWHA under care in Rio de Janeiro, Brazil. The outcomes were the six QoL domains (physical, psychological, level of independence, social relationships, environmental, and spirituality) measured through the World Health Organization Quality of Life in HIV infection scale, abbreviated version (WHOQOL-HIV-BREF). The independent variables were demographic and clinical characteristics, syndemic conditions (binge drinking, compulsive sexual behavior, polysubstance use, intimate partner violence, and depression), and syndemics (two or more syndemic conditions simultaneously). Bivariate analysis (t-test and ANOVA) and linear regressions were performed for each quality-of-life domain. The analytical sample comprised 1530 participants, mostly male at birth (64%) and with median age of 43 years. The syndemic conditions most frequently observed were binge drinking (56%), IPV (13%), and depression (9%). Both individual syndemic conditions and syndemics were associated with worse QoL. In the multivariate analysis, positive screening for depression was associated with worse QoL in all domains. Polysubstance users presented worse QoL at social and environmental domains. Intimate partner violence was associated with worse QoL at environment domain while binge drinking was associated with worse scores in the physical domain. The presence of syndemics increased the likelihood of worse scores in the psychological, social, and environment domains. Our study expands the understanding of QoL in PLWHA, as it considers a holistic/integral, multifactorial, and synergistic approach to the determinants of QoL. Seeking strategies that target syndemics may be important to improve patient-centered outcomes in health.Abbreviations: HIV/AIDS: human immunodeficiency virus/acquired immunodeficiency syndromeWHO: World Health OrganizationQoL: quality of lifeHRQoL: health-related quality of lifePLWHA: people living with HIV/AIDScART: combined antiretroviral therapyIPV: intimate partner violenceINI/FIOCRUZ: Evandro Chagas National Institute of Infectious DiseasesOswaldo Cruz FoundationSRH: self-rated healthVL: viral loadCD4: CD4 cell countNIAAA: National Institute on Alcohol Abuse and AlcoholismCSBcompulsive sexual behaviorWHO-ASSIST: alcoholsmoking and substance involvement screening test developed by the World Health OrganizationPHQ-2: Patient Health Questionnaire-2.
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Affiliation(s)
| | - Rodolfo Castro
- Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil
- Evandro Chagas National Institute of Infectious Diseases/Oswaldo Cruzs Foundation, Rio de Janeiro, Brazil
- Sergio Arouca National School of Public Health/Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Jurema Corrêa da Mota
- Institute of Technological Communication and Information in Health, Laboratory of Health Information/Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Raquel B De Boni
- Evandro Chagas National Institute of Infectious Diseases/Oswaldo Cruzs Foundation, Rio de Janeiro, Brazil
- Institute of Technological Communication and Information in Health, Laboratory of Health Information/Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
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Mesías-Gazmuri J, Folch C, Palacio-Vieira J, Bruguera A, Egea-Cortés L, Forero CG, Hernández J, Miró JM, Navarro J, Riera M, Peraire J, Alonso-García L, Díaz Y, Casabona J, Reyes-Urueña J. Syndemic conditions and quality of life in the PISCIS Cohort of people living with HIV in Catalonia and the Balearic Islands: a cross sectional study. Health Qual Life Outcomes 2023; 21:42. [PMID: 37165368 PMCID: PMC10173626 DOI: 10.1186/s12955-023-02120-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 04/24/2023] [Indexed: 05/12/2023] Open
Abstract
BACKGROUND People living with HIV (PLWH) face structural and psychosocial factors that affect health-related quality of life (HRQoL). We aimed to evaluate how syndemic conditions affected HRQoL in PLWH. METHODS A cross-sectional survey was conducted among 861 PLWH, to determine whether syndemic conditions (monthly income; sexual satisfaction; depressive symptoms; social role satisfaction; social isolation; cognitive function; nicotine dependence; perception of stigma) have an effect on HRQoL. A linear regression model and measures of Additive Interaction (AI) were used to determine the effects of syndemic conditions on HRQoL, controlling for other risk factors. RESULTS Overall, the most frequently observed were stigma perception (56.9%), poor cognitive function (50.6%) and the perception of social isolation (51.6%). The presence of depressive symptoms was the risk factor most associated with worse Physical Health (PH) (B 3.93, 2.71-5.15) and Mental Health (MH) (B 5.08, 3.81-6.34) in linear regression model. Specifically, an interaction was observed between poor cognitive function and poor satisfaction with social role on worse PH and MH (AI 2.08, 0.14-4.02; AI 2.69, 0.15-5.22, respectively); and low income and perception of stigma (AI 2.98, 0.26-5.71), low income and perception of social isolation (AI 2.79, 0.27-5.32), and low income and poor satisfaction with social role (AI 3.45, 0.99-5.91) on MH. CONCLUSION These findings provide evidence that syndemic factors impact HRQoL. HIV prevention programs should screen and address co-occurring health problems to improve patient-centered health care and outcomes.
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Affiliation(s)
- Jocelyn Mesías-Gazmuri
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain
- Germans Trias I Pujol Research Institute (IGTP), Campus Can Ruti, Badalona, Spain
- PhD in Methodology of Biomedical Research and Public Health, Department of Pediatrics, Obstetrics and Gynecology, Preventive Medicine and Public Health, Universidad Autonoma de Barcelona, Badalona, Spain
| | - Cinta Folch
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain.
- Germans Trias I Pujol Research Institute (IGTP), Campus Can Ruti, Badalona, Spain.
- CIBER Epidemiología Y Salud Pública (CIBERESP), Madrid, Spain.
| | - Jorge Palacio-Vieira
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain
- Germans Trias I Pujol Research Institute (IGTP), Campus Can Ruti, Badalona, Spain
- CIBER Epidemiología Y Salud Pública (CIBERESP), Madrid, Spain
| | - Andreu Bruguera
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain
- Germans Trias I Pujol Research Institute (IGTP), Campus Can Ruti, Badalona, Spain
- PhD in Methodology of Biomedical Research and Public Health, Department of Pediatrics, Obstetrics and Gynecology, Preventive Medicine and Public Health, Universidad Autonoma de Barcelona, Badalona, Spain
- CIBER Epidemiología Y Salud Pública (CIBERESP), Madrid, Spain
| | - Laia Egea-Cortés
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain
| | - Carlos G Forero
- Department of Medicine. School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Sant Cugat, Spain
| | - Juan Hernández
- Grupo de Trabajo Sobre Tratamientos del VIH (gTt), Barcelona, Spain
| | - José M Miró
- Infectious Diseases Service. Hospital Clínic-IDIBAPS. University of Barcelona, Barcelona, Spain
- CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
| | - Jordi Navarro
- Infectious Diseases Department. Hospital, Universitari Vall d'Hebron, Barcelona, Spain
- Institut de Recerca Vall d'Hebron, Barcelona, Spain
| | | | - Joaquim Peraire
- Infectious Diseases Department. Hospital, Universitari Vall d'Hebron, Barcelona, Spain
- Hospital Joan XXIII, IISPV, Universitat Rovira I Virgili, Tarragona, Spain
| | - Lucía Alonso-García
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain
| | - Yesika Díaz
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain
- Germans Trias I Pujol Research Institute (IGTP), Campus Can Ruti, Badalona, Spain
- CIBER Epidemiología Y Salud Pública (CIBERESP), Madrid, Spain
| | - Jordi Casabona
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain
- Germans Trias I Pujol Research Institute (IGTP), Campus Can Ruti, Badalona, Spain
- CIBER Epidemiología Y Salud Pública (CIBERESP), Madrid, Spain
- Department of Pediatrics, Obstetrics and Gynecology and Preventive Medicine, Univ Autonoma de Barcelona, Badalona, Spain
| | - Juliana Reyes-Urueña
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain
- Germans Trias I Pujol Research Institute (IGTP), Campus Can Ruti, Badalona, Spain
- CIBER Epidemiología Y Salud Pública (CIBERESP), Madrid, Spain
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Mvilongo PTN, Vanhamel J, Siegel M, Nöstlinger C. The '4th 90' target as a strategy to improve health-related quality of life of people living with HIV in sub-Saharan Africa. Trop Med Int Health 2022; 27:1026-1043. [PMID: 36268604 DOI: 10.1111/tmi.13825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVES Next to monitoring the clinical health of people living with HIV through the triple 90 targets, a 4th 90 target was proposed in 2016 to improve HIV health-related quality of life (HrQoL) by addressing comorbidities and other psychosocial challenges. This scoping review aimed at understanding related psychosocial determinants, including strategies to improve HrQoL for people living with HIV in sub-Saharan Africa (SSA), as an initiative to ameliorate the continuum of care. METHODS This scoping review followed PRISMA guidelines. We searched PubMed and Wiley databases from 01 January 2011 to 19 April 2021 for articles on HrQoL, including determinants and related interventions in SSA. We also conducted a manual search to retrieve grey literature on the '4th 90' target. The six domains of HrQoL defined in the most widely used instrument (i.e., WHOQOL-HIV-BREF tool) served as a guiding framework. RESULTS Thirty-three articles were included for analysis. Seven articles illustrated the ongoing debate on the 4th 90 target, highlighting challenges with measuring indicators. Nine articles discussed HrQoL domains, reporting the highest scores in the spirituality and physical domains and lowest scores in the social and environmental domains. The presence of stigma and depressive symptoms was associated with low HrQoL. Seventeen articles discussed HrQoL interventions, highlighting that improved HrQoL enhanced health-seeking behaviour. Only two interventions addressed the environmental domain highlighting the fact that selection of intervention aims were not evidence led. CONCLUSION Introducing the 4th 90 target in SSA as a strategy to enhance HrQoL amongst people living with HIV could improve the HIV continuum of care; however, efforts are required to effectively address environmental and structural determinants.
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Affiliation(s)
- Prudence Tatiana Nti Mvilongo
- Global Health Systems Solutions, Douala, Cameroon.,Department of Public Health, Sexual and Reproductive Health Research Group, Institute of Tropical Medicine, Antwerp, Belgium
| | - Jef Vanhamel
- Department of Public Health, Sexual and Reproductive Health Research Group, Institute of Tropical Medicine, Antwerp, Belgium
| | - Magdalena Siegel
- Department of Public Health, Sexual and Reproductive Health Research Group, Institute of Tropical Medicine, Antwerp, Belgium.,Department of Clinical and Health Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Christiana Nöstlinger
- Department of Public Health, Sexual and Reproductive Health Research Group, Institute of Tropical Medicine, Antwerp, Belgium
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Nebhinani N, Mattoo S, Wanchu A. Quality of life, social support, coping strategies, and their association with psychological morbidity among people living with HIV. J Neurosci Rural Pract 2022; 13:725-729. [PMID: 36743764 PMCID: PMC9893948 DOI: 10.25259/jnrp-2022-6-15] [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: 06/08/2022] [Accepted: 09/20/2022] [Indexed: 11/19/2022] Open
Abstract
Objectives Enhancement of quality of life and social support havebecome important therapeutic goals among people living with HIV. However, research from developing countries is sparse in this area. Index study was aimed to assess association of social support, coping, and quality of life with psychological morbidity among people living with HIV. Materials and Methods In this cross-sectional study, 100 people with HIV were recruited through purposive sampling who were not receiving antiretroviral therapy. To assess social support, coping, and quality of life social support questionnaire, coping strategy check list and World Health Organization quality of life-HIV BREF were administered, respectively. Results Quality of life domain scores fell in the moderate category and spirituality, religion, and personal belief domain had maximum score. Educated, married, employed, and male subjects reported better quality of life. Females reported greater use of internalization and emotional outlet coping strategies. Low social support, lower quality of life (in all domains and total score), and greater use of internalization coping strategy were significantly associated with psychiatric morbidity. Conclusion Internalization coping, low social support, and lower quality of life were associated with greater psychiatric morbidity. Therefore, to improve their mental health and overall course of HIV, multipronged interventions should be implemented for promoting the adaptive coping, social support and quality of life.
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Affiliation(s)
- Naresh Nebhinani
- Department of Psychiatry, All India Institute of Medical Science, Jodhpur, Rajasthan, India
| | - Surendra Mattoo
- Consultant Psychiatrist, Newcastle North East Community Treatment Team, Cumbria, Northumberland, United Kingdom
| | - Ajay Wanchu
- Consultant Rheumatologist, Adventist Medical Center, Portland, Oregon, United States
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Patil V, Salunkhe R, Khot P, Ainapur K. Study of the severity of depression and quality of life in adults with HIV/Acquired Immunodeficiency Syndrome at antiretroviral therapy center in western Maharashtra. ANNALS OF INDIAN PSYCHIATRY 2022. [DOI: 10.4103/aip.aip_138_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
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Li Y, Guo Y, Hong YA, Zeng C, Zeng Y, Zhang H, Zhu M, Qiao J, Cai W, Li L, Liu C. Mediating Effects of Stigma and Depressive Symptoms in a Social Media-Based Intervention to Improve Long-term Quality of Life Among People Living With HIV: Secondary Analysis of a Randomized Controlled Trial. J Med Internet Res 2021; 23:e27897. [PMID: 34751654 PMCID: PMC8663519 DOI: 10.2196/27897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 06/09/2021] [Accepted: 09/22/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Mobile health (mHealth) interventions have been shown to effectively improve the quality of life (QOL) among people living with HIV. However, little is known about the long-term effects of mHealth interventions. OBJECTIVE This study aims to explore the intervention mechanisms of a social media-based intervention, Run4Love, on the QOL of people with HIV over across a 9-month follow-up period. METHODS We recruited people living with HIV who were concurrently experiencing elevated depressive symptoms from an HIV outpatient clinic in South China. A total of 300 eligible participants were randomized either to the intervention group or the control group in a 1:1 ratio after they provided informed consent and completed a baseline survey. The intervention group received a 3-month WeChat-based intervention, comprising cognitive-behavioral stress management (CBSM) courses and physical activity promotion. The control group received a printed brochure on nutrition guidelines in addition to the usual care for HIV treatment. Neither participants nor the research staff were blinded to group assignment. All patients were followed at 3, 6, and 9 months. The primary outcome was depressive symptoms. Structural equation model (SEM) with longitudinal data was conducted to examine the sequential mediating effects of HIV-related stigma and depressive symptoms on the long-term intervention effects on participants' QOL. RESULTS About 91.3% (274/300), 88.3% (265/300), and 86.7% (260/300) of all participants completed follow-up surveys at 3, 6, and 9 months, respectively. Results showed that the intervention had significantly improved participants' QOL at 9 months, via complete mediating effects of reduced HIV-related stigma at 3 months and decreased depressive symptoms at 6 months. No adverse events were reported. CONCLUSIONS These findings underscore the critical roles of HIV-related stigma and depressive symptoms in an mHealth intervention with long-term effects on QOL improvements. We call for targeted mHealth interventions to improve QOL among people living with HIV, especially social media-based interventions that can address HIV-related stigma and alleviate depressive symptoms. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR-IPR-17012606; https://www.chictr.org.cn/showproj.aspx?proj=21019.
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Affiliation(s)
- Yiran Li
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yan Guo
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Sun Yat-sen Center for Global Health, Guangzhou, China
| | - Y Alicia Hong
- Department of Health Administration and Policy, College of Health and Human Services, George Mason University, Fairfax, VA, United States
| | - Chengbo Zeng
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States.,Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Yu Zeng
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Hanxi Zhang
- National Center of AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Mengting Zhu
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Jiaying Qiao
- Department of Vital Statistics, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Weiping Cai
- Department of Infectious Diseases, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Linghua Li
- Department of Infectious Diseases, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Cong Liu
- Department of Infectious Diseases, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
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Desai KT, Patel PB, Verma A, Bansal RK. Environment and psychosocial factors are more important than clinical factors in determining quality of life of HIV-positive patients on antiretroviral therapy. Trop Doct 2020; 50:180-186. [PMID: 32138621 DOI: 10.1177/0049475520908180] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Assessing quality of life (QOL) outcome helps to show the effect of antiretroviral therapy (ART) on the subjective perception of its benefits among patients with HIV. A cross-sectional assessment of QOL, using the World Health Organization WHOQOL-HIV, on 204 HIV patients taking ART in western India showed patients with HIV on ART as having the best QOL score in the spiritual domain and the worst in the environment domain. Patients who are single, highly educated, of higher occupational status, with no HIV-positive children, not undergoing frequent hospital admissions, with access to a counsellor for support, who are not stigmatised or discriminated against due to HIV status, who do not have guilt or suicidal ideas, and who are theist, tend to have a better QOL, irrespective of their clinical condition or ART regimen. Patients' personal perceptions and feelings, societal support or stigma, and sociodemographic status have a more significant influence on QOL than clinical variables.
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Affiliation(s)
- Kanan T Desai
- Postgraduate Resident, Department of Community Medicine, Surat Municipal Institute of Medical Education & Research (SMIMER), Surat, Gujarat, India
| | - Prakash B Patel
- Assistant Professor, Department of Community Medicine, Surat Municipal Institute of Medical Education & Research (SMIMER), Surat, Gujarat, India
| | - Anupam Verma
- Associate Professor, Department of Community Medicine, Surat Municipal Institute of Medical Education & Research (SMIMER), Surat, Gujarat, India
| | - R K Bansal
- Professor & Head, Department of Community Medicine, Surat Municipal Institute of Medical Education & Research (SMIMER), Surat, Gujarat, India
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Shriharsha C, Rentala S. Quality of life among people living with HIV/AIDS and its predictors: A cross-sectional study at ART center, Bagalkot, Karnataka. J Family Med Prim Care 2019; 8:1011-1016. [PMID: 31041243 PMCID: PMC6482744 DOI: 10.4103/jfmpc.jfmpc_411_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Background: Human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) emerged as one of the most important public health issues of the late twentieth and early twenty- first centuries. Quality of life (QoL) of people living with HIV/AIDS (PLHIV) is affected by multiple variables including depression as a major predictor of QoL. Aims: To assess the QoL of PLHIV and its predictors. Settings and Design: This cross-sectional study included a sample of 450 PLHIV attending the ART center, District Government Hospital, Bagalkot. Methods and Materials: Data were collected using self-report method and Hospital's records. Tools used for data collection included sociodemographic questionnaire, WHOQOLHIV-BREF scale, and Centre for Epidemiologic Studies Depression Scale (CES-D Scale). Bivariate associations were observed through Pearson's correlations, analysis of variance (ANOVA), and t-tests. Multiple linear regression analysis was performed to find the significant predictors of QoL. Results: Findings revealed a significant negative correlation between the QoL and depression (r = –0.751, P < 0.001). A significant regression equation was found (F14, 435= 57.76, P < 0.001, adjusted R2 = 0.64) when all the variables are considered together for finding the significant predictors of the QoL. Male gender, being graduated, not knowing the mode of transmission have positively predicted the QoL. On the other hand, having primary education, being in nuclear family, having HIV-positive wife, having HIV-positive children, HIV infection through homosexual relationships, history of suicidal attempts, and history of alcohol intake negatively predicted the QoL of PLHIV. Depression was the strongest negative predictor of the QoL of PLHIV (β = –0.672, P < 0.001). Conclusions: Interventions aimed at management of depression among PLHIV attending the ART centers would result in enhancing their QoL.
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Affiliation(s)
- C Shriharsha
- Department of Psychiatric Nursing, BVVS Sajjalashree Institute of Nursing Sciences, Navanagar, Bagalkot, Karnataka, India
| | - Sreevani Rentala
- Department of Psychiatric Nursing, Dharwad Institute of Mental Health and Neurosciences (DIMHANS), Dharwad, Karnataka, India
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Health-Related Quality of Life and Associated Factors among Women on Antiretroviral Therapy in Health Facilities of Jimma Town, Southwest Ethiopia. ADVANCES IN PUBLIC HEALTH 2018. [DOI: 10.1155/2018/5965343] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background. This study examined health-related quality of life and associated factors among HIV positive women receiving antiretroviral therapy in health facilities of Jimma town. Methods. A cross-sectional study was conducted, and consecutive sampling technique was employed to select 377 HIV positive women who were on antiretroviral therapy. Quality of life was measured using WHOQOL-BREF tool. Descriptive statistics, bivariate, and multivariable logistic regression analyses were performed. P values < 0.05 and adjusted odds ratio with 95% of confidence interval were used to determine statistical significance and report associations between the quality of life and independent variables. Results. Among the sampled participants, 344 were interviewed, yielding 91% of response rate. The mean ± standard deviation age of the respondents was 34.07 ± 8.76 years and 80.5% of them were urban dwellers. The proportion of women reporting good health-related quality of life was found to be 46.5%. Specific to each domain, the mean ± standard deviation of level of independence domain was the highest (14.08 ± 3.07) followed by physical (13.46 ± 2.95), social relationships (13.27 ± 3.91), psychological (12.97 ± 2.47), environmental (12.94 ± 3.25), and spiritual (12.39 ± 2.84) domains. Good social support (AOR: 4.99; 95% CI: [2.88, 8.34]), higher wealth status (AOR: 1.85; 95% CI: [1.02, 3.39]), and being on antiretroviral therapy for shorter duration (AOR: 1.85; 95% CI [1.14, 3.03]) were independently associated with better overall health-related quality of life among the participants. Conclusions. The study demonstrated high proportion of HIV positive women on ART had poor health-related quality of life which was affected by wealth index, social support, and duration on antiretroviral therapy.
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Dasgupta P, Bhattacherjee S, Das DK. Food Security in Households of People Living With Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome: A Cross-sectional Study in a Subdivision of Darjeeling District, West Bengal. J Prev Med Public Health 2017; 49:240-8. [PMID: 27499166 PMCID: PMC4977769 DOI: 10.3961/jpmph.16.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Accepted: 07/19/2016] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES Human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) adversely impacts food security in households of people living with HIV/AIDS (PLWHA). Little research has focused on food insecurity among PLWHA in India. The purpose of this study was to identify the prevalence of and factors relating to food security in households of PLWHA in the Siliguri subdivision of Darjeeling, West Bengal, India. METHODS A cross-sectional community-based study was carried out among 173 PLWHA residing in Siliguri and registered at the Anti-retroviral Therapy Centre of North Bengal Medical College & Hospital. Data was collected at the household level with interviews of PLWHA using a food security survey instrument. We analyzed the associations using logistic regression. RESULTS The prevalence of household food security among the participants was 50.9% (88/173). Five years or more of schooling, higher socioeconomic class and males were found to be significantly associated with a higher likelihood of food security. A later stage of the disease and the presence of other family members with HIV/AIDS were significantly associated with a lower likelihood of food security. The major coping strategies to deal with food insecurity in the acute phase HIV infection included borrowing money (56.1%), followed by spousal support, loans from microfinance institutions, banks, or money lenders, borrowing food, or selling agricultural products. CONCLUSIONS The present study revealed that only about half of households with PLWHA were food secure. Prior interventions relating to periods of food and economic crisis as well as strategies for sustaining food security and economic status are needed in this area.
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Affiliation(s)
- Pallabi Dasgupta
- Department of Community Medicine, North Bengal Medical College & Hospital, Siliguri, India
| | | | - Dilip Kumar Das
- Department of Community Medicine, North Bengal Medical College & Hospital, Siliguri, India
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Nyamathi AM, Ekstrand M, Yadav K, Ramakrishna P, Heylen E, Carpenter C, Wall S, Oleskowicz T, Arab L, Sinha S. Quality of Life Among Women Living With HIV in Rural India. J Assoc Nurses AIDS Care 2017; 28:575-586. [PMID: 28473182 DOI: 10.1016/j.jana.2017.03.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Accepted: 03/15/2017] [Indexed: 01/20/2023]
Abstract
A cross-sectional examination was conducted on quality of life (QOL) among women living with HIV (WLWH) in rural Andhra Pradesh, India. Baseline data were collected from 400 WLWH and their children. QOL was measured with 10 items from the Quality of Life Enjoyment and Satisfaction Questionnaire. Findings revealed low QOL scores; on a scale from 0 to 3, the mean QOL score was 0.38 (SD = 0.30). Depression symptoms were reported by 25.5%, internalized stigma was high, and most reported little to no social support. Multivariable analysis revealed positive associations between QOL and CD4+ T cells (b = .0011, p = .021) and social support (b = .260, p < .0001), and a negative relationship between QOL and internalized stigma (b = -.232, p < .0001). Interventions focused on improving QOL for WLWH should incorporate strategies to improve social support and adherence to antiretroviral therapy, while mitigating internalized stigma.
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Garrido-Hernansaiz H, Heylen E, Bharat S, Ramakrishna J, Ekstrand ML. Stigmas, symptom severity and perceived social support predict quality of life for PLHIV in urban Indian context. Health Qual Life Outcomes 2016; 14:152. [PMID: 27809839 PMCID: PMC5094021 DOI: 10.1186/s12955-016-0556-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Accepted: 10/18/2016] [Indexed: 11/22/2022] Open
Abstract
Background Multiple variables have been studied in relation to health-related quality of life (HRQoL), but research has not integrated the contributions of different variables in a single model that allows to compare them. This study, carried out with people living with HIV/AIDS in India, sought to develop a prediction model considering various predictors previously found to be related to HRQoL, namely sociodemographic factors, HIV symptoms, social support, stigmas and avoidant coping. Methods A sample of 961 HIV-positive persons from Bengaluru and Mumbai participated in this cross-sectional study, completing a sociodemographic questionnaire along with HRQoL, HIV symptoms, disclosure expectations, disclosure avoidance, social support and internalized, felt, vicarious and enacted stigma scales. Bivariate associations were obtained (correlations, ANOVAs and t tests) and a multiple regression analysis was performed. Results Results show that, when all variables are considered together, being married, widowed or deserted, symptom intensity, internalized stigma, disclosure avoidance and enacted stigma contribute negatively to predict HRQoL. On the other hand, being employed, good disclosure expectations and good social support contribute positively to predict HRQoL. Almost half of the variance in HRQoL was explained by this model. Conclusions Interventions seeking to increase HRQoL in people living with HIV/AIDS in India would benefit from addressing these aspects.
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Affiliation(s)
- Helena Garrido-Hernansaiz
- Department of Biological and Health Psychology, Psychology Faculty, Universidad Autónoma de Madrid, C/Ivan Pavlov, 6, 28049, Madrid, Spain
| | - Elsa Heylen
- Center for AIDS Prevention Studies, Department of Medicine, University of California San Francisco, 550 16th St, 3rd floor, San Francisco, CA, 94158, USA
| | - Shalini Bharat
- Centre for Health and Social Sciences, School of Health Systems Studies, Tata Institute of Social Sciences, V.N. Purav Marg, Chembur, Mumbai, Maharashtra, 400085, India
| | - Jayashree Ramakrishna
- Department of Mental Health Education, National Institute of Mental Health and Neurosciences, Post Bag 2900, Hosur Road, Bengaluru, 560 029, Karnataka, India
| | - Maria L Ekstrand
- Center for AIDS Prevention Studies, Department of Medicine, University of California San Francisco, 550 16th St, 3rd floor, San Francisco, CA, 94158, USA. .,St John's Research Institute, St John's National Academy of Health Sciences, 100 Feet Rd, Bengaluru, Karnataka, 560034, India.
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Reynolds NR, Satyanarayana V, Duggal M, Varghese M, Liberti L, Singh P, Ranganathan M, Jeon S, Chandra PS. MAHILA: a protocol for evaluating a nurse-delivered mHealth intervention for women with HIV and psychosocial risk factors in India. BMC Health Serv Res 2016; 16:352. [PMID: 27491288 PMCID: PMC4973541 DOI: 10.1186/s12913-016-1605-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Accepted: 07/29/2016] [Indexed: 01/12/2023] Open
Abstract
Background Women living with HIV are vulnerable to a variety of psychosocial barriers that limit access and adherence to treatment. There is little evidence supporting interventions for improving access and treatment adherence among vulnerable groups of women in low- and middle-income countries. The Mobile Phone-BasedApproach forHealthImprovement,Literacy andAdherence (MAHILA) trial is assessing the feasibility, acceptability and preliminary efficacy of a novel, theory-guided mobile health intervention delivered by nurses for enhancing self-care and treatment adherence among HIV-infected women in India. Methods/Design Women (n = 120) with HIV infection who screen positive for depressive symptoms and/or other psychosocial vulnerabilities are randomly assigned in equal numbers to one of two treatment arms: treatment as usual plus the mobile phone intervention (experimental group) or treatment as usual (control group). In addition to treatment as usual, the experimental group receives nurse-delivered self-care counselling via mobile phone at fixed intervals over 16 weeks. Outcome measures are collected at baseline and at 4, 12, 24 and 36 weeks post-baseline. Outcomes include antiretroviral treatment adherence, HIV-1 RNA, depressive symptoms, illness perceptions, internalized stigma and quality of life. Discussion The MAHILA trial will provide information about how a mobile health counselling intervention delivered by non specialist nurses may improve access to care and support the adherence and clinical outcomes of women with HIV infection living in low- and middle-income countries such as India. Trial registration NCT02319330 (First received: July 30, 2014; Last verified: January 2016)
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Affiliation(s)
- Nancy R Reynolds
- Division of Acute Care/Health Systems, School of Nursing, Yale University, 400 West Campus Drive, West Haven, CT, 06516, USA.
| | - Veena Satyanarayana
- Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences, Bengaluru, 560029, India
| | - Mona Duggal
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Meiya Varghese
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Hosur Road, Bengaluru, 560029, India
| | - Lauren Liberti
- Division of Acute Care/Health Systems, School of Nursing, Yale University, 400 West Campus Drive, West Haven, CT, 06516, USA
| | - Pushpendra Singh
- Indraprastha Institute of Information Technology (IIIT-D), B-304, Academic Block, Okhla Phase III, New Delhi, 110020, India
| | - Mohini Ranganathan
- Department of Psychiatry, Yale University, School of Medicine, 300 George Street, New Haven, CT, 06511, USA
| | - Sangchoon Jeon
- Division of Acute Care/Health Systems, School of Nursing, Yale University, 400 West Campus Drive, West Haven, CT, 06516, USA
| | - Prabha S Chandra
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Hosur Road, Bengaluru, 560029, India.
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Teoh Bing Fei J, Yee A, Habil MHB, Danaee M. Effectiveness of Methadone Maintenance Therapy and Improvement in Quality of Life Following a Decade of Implementation. J Subst Abuse Treat 2016; 69:50-6. [PMID: 27568510 DOI: 10.1016/j.jsat.2016.07.006] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Revised: 05/24/2016] [Accepted: 07/13/2016] [Indexed: 11/18/2022]
Abstract
Methadone maintenance therapy has been found to be an effective harm reduction treatment for opioid use disorder. However evidence of its benefits over a longer duration of treatment is limited as most studies focus on its short term benefits. As methadone maintenance therapy reaches a decade since its implementation in Malaysia, this study sought to examine the effectiveness of methadone treatment, change in quality of life among patients since entry to methadone treatment, as well as factors predicting the magnitude of change in quality of life. This study found that methadone maintenance therapy was effective in reducing heroin use, injecting practices and crime, and in improving in social functioning and physical symptoms, but not in reducing sex-related HIV risk-taking behavior. Though patients had a significantly better quality of life at follow-up than at entry to methadone maintenance therapy, the improvement in quality of life was not significantly greater as the duration of treatment increased. Age above 50 years old, human immunodeficiency virus (HIV) positive status and physical symptoms predicted a poorer improvement in quality of life between baseline and follow-up. On the other hand, patients with hepatitis B showed a greater improvement in quality of life in the social relationships domain compared to patients without hepatitis B. In conclusion, methadone maintenance therapy is an effective treatment for opioid use disorder and improves quality of life but its benefits in further improving quality of life beyond a decade of treatment need further evaluation.
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Affiliation(s)
- Joni Teoh Bing Fei
- Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
| | - Anne Yee
- University Malaya Centre for Addiction Sciences, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Mahmoud Danaee
- Unit for the Enhancement of Academic Performance, University of Malaya, Kuala Lumpur, Malaysia
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Bhatnagar S, Noble S, Chaturvedi SK, Gielen J. Development and Psychometric Assessment of a Spirituality Questionnaire for Indian Palliative Care Patients. Indian J Palliat Care 2016; 22:9-18. [PMID: 26962275 PMCID: PMC4768456 DOI: 10.4103/0973-1075.173939] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introduction: There are only a few studies on spirituality among palliative care patients in India. This gap in research may be caused by the absence of relevant questionnaires and scales specifically designed for Indian palliative care populations. In this study, we describe the development of such a questionnaire and explain its psychometric characteristics. Methods: We designed a questionnaire on the basis of a systematic review of the literature. After a review of the questionnaire by specialists and a subsequent pilot study, the questionnaire was amended. The final questionnaire consisted of a list of 36 spirituality items. It was administered to a sample of 300 cancer patients attending the pain clinic of a tertiary hospital in New Delhi. Results: A factor analysis led to four factors explaining 54.6% of variance: Shifting moral and religious values (Factor 1), support from religious relationship (Factor 2), existential blame (Factor 3), and spiritual trust (Factor 4). The skewness and kurtosis for Factors 1, 3, and 4 were within a tolerable range for assuming a normal distribution, but Factor 2 was skewed. The alphas showed that the four factors have an acceptable internal consistency. Statistically significant associations were observed for age and Factor 3 (P = 0.004), gender and Factor 4 (P = 0.014), marital status and Factors 3 (P = 0.002) and 4 (P = 0.001), educational level and Factors 3 (P < 0.001) and 4 (P < 0.001), and pain scores and Factors 1 (P < 0.001), 2 (P < 0.001), and 3 (P = 0.001). Conclusion: The questionnaire offers promising prospects for the study of spirituality among palliative care patients in India.
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Affiliation(s)
- Sushma Bhatnagar
- Unit of Anesthesiology, Pain, and Palliative Care, Dr. B.R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Simon Noble
- Institute of Cancer and Genetics, Cardiff University School of Medicine, Heath Park, Cardiff CF14 4YS, UK
| | - Santosh K Chaturvedi
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Joris Gielen
- Center for Healthcare Ethics, 301A Fisher Hall, 600 Forbes Avenue, Pittsburgh, Pennsylvania 15282, USA
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Mawar N, Katendra T, Bagul R, Bembalkar S, Vedamurthachar A, Tripathy S, Srinivas K, Mandar K, Kumar N, Gupte N, Paranjape RS. Sudarshan Kriya yoga improves quality of life in healthy people living with HIV (PLHIV): results from an open label randomized clinical trial. Indian J Med Res 2016; 141:90-9. [PMID: 25857500 PMCID: PMC4405947 DOI: 10.4103/0971-5916.154509] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background & objectives: Improving quality of life (QOL) of healthy people living with HIV (PLHIV) is critical needing home-based, long-term strategy. Sudarshan Kriya yoga (SKY) intervention is acknowledged for its positive impact on health. It is hypothesised that SKY would improve PLHIV's QOL, justifying an evaluation. Methods: In this open label randomized controlled pilot trial, 61 adult PLHIV with CD4 count more than 400 cells/µl and Karnofsky scale score above 70 were enrolled. Those with cardiac disease, jaundice, tuberculosis, or on antiretroviral therapy/yoga intervention were excluded. All were given standard care, randomized to SKY intervention (31: I-SKY) and only standard of care in control (30: O-SOC) arms. The I-SKY participants were trained for six days to prepare for daily practice of SKY at home for 30 min. A validated 31-item WHOQOL-HIVBREF questionnaire was used to document effect in both arms from baseline to three visits at 4 wk interval. Results: Baseline QOL scores, hypertension and CD4 count were similar in both arms. An overall 6 per cent improvement of QOL scores was observed in I-SKY group as compared to O-SOC group, after controlling for baseline variables like age, gender, education and occupation (P =0.016); 12 per cent for physical (P =0.004), 11 per cent psychological (P =0.023) and 9 per cent level of independence (P =0.001) domains. Improvement in I-SKY observed at post-training and in the SKY adherence group showed increase in these two domains. Conclusions: A significant improvement in QOL scores was observed for the three health related QOL domains in SKY intervention arm. This low cost strategy improved physical and psychological state of PLHIV calling for upscaling with effective monitoring for sustainability of quality of life.
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Affiliation(s)
- N Mawar
- National AIDS Research Institute (ICMR), Pune, India
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Spirituality as an ethical challenge in Indian palliative care: A systematic review. Palliat Support Care 2015; 14:561-82. [DOI: 10.1017/s147895151500125x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjective:Spiritual care is recognized as an essential component of palliative care (PC). However, patients' experience of spirituality is heavily context dependent. In addition, Western definitions and findings regarding spirituality may not be applicable to patients of non-Western origin, such as Indian PC patients. Given the particular sociocultural, religious, and economic conditions in which PC programs in India operate, we decided to undertake a systematic review of the literature on spirituality among Indian PC patients. We intended to assess how spirituality has been interpreted and operationalized in studies of this population, to determine which dimensions of spirituality are important for patients, and to analyze its ethical implications.Method:In January of 2015, we searched five databases (ATLA, CINAHL, EMBASE, PsycINFO, and PubMed) using a combination of controlled and noncontrolled vocabulary. A content analysis of all selected reports was undertaken to assess the interpretation and dimensions of spirituality. Data extraction from empirical studies was done using a data-extraction sheet.Results:A total of 39 empirical studies (12 qualitative, 21 quantitative, and 6 mixed-methods) and 18 others (10 reviews, 4 opinion articles, and 4 case studies) were retrieved. To date, no systematic review on spirituality in Indian PC has been published. Spirituality was the main focus of only six empirical studies. The content analysis revealed three dimensions of spirituality: (1) the relational dimension, (2) the existential dimension, and (3) the values dimension. Religion is prominent in all these dimensions. Patients' experiences of spirituality are determined by the specifically Indian context, which leads to particular ethical issues.Significance of results:Since spiritual well-being greatly impacts quality of life, and because of the substantial presence of people of Indian origin living outside the subcontinent, the findings of our review have international relevance. Moreover, our review illustrates that spirituality can be an ethical challenge and that more ethical reflection on provision of spiritual care is needed.
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Arjun BY, Unnikrishnan B, Ramapuram JT, Thapar R, Mithra P, Kumar N, Madi D, Kulkarni V, Holla R, Darshan B. Factors Influencing Quality of Life among People Living with HIV in Coastal South India. J Int Assoc Provid AIDS Care 2015; 16:247-253. [PMID: 26251226 DOI: 10.1177/2325957415599213] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Antiretroviral therapy (ART) has increased life expectancy of HIV/AIDS patients, but the quality of life (QOL) still remains the same. METHODS In this cross-sectional study, 356 people living with HIV (PLHIV) were interviewed to assess their QOL using WHOQOL-HIV BREF questionnaire. The association between QOL with sociodemographic, clinical and cohabitation status of the participants was tested using ANOVA and Student t-test, and p value < .05 was considered statistically significant. RESULTS Physical domain of QOL showed maximum score of 16.4, while a minimum score of 12.2 was seen in social relationship domain. Participants with higher socioeconomic status (SES) and self-motivated to take ART had shown better scores across all the domains of QOL ( p < .05). CONCLUSION In our study, quality of life was high among males, younger patients, married participants, higher socioeconomic status, longer duration of ART, self-motivation to take ART, absence of opportunistic infection, and with higher CD4 count.
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Affiliation(s)
- Banagi Yathiraj Arjun
- 1 Department of Community Medicine, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India
| | - Bhaskaran Unnikrishnan
- 2 Department of Internal Medicine, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India
| | - John T Ramapuram
- 2 Department of Internal Medicine, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India
| | - Rekha Thapar
- 1 Department of Community Medicine, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India
| | - Prasanna Mithra
- 1 Department of Community Medicine, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India
| | - Nithin Kumar
- 1 Department of Community Medicine, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India
| | - Deepak Madi
- 2 Department of Internal Medicine, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India
| | - Vaman Kulkarni
- 1 Department of Community Medicine, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India
| | - Ramesh Holla
- 1 Department of Community Medicine, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India
| | - Bhagawan Darshan
- 1 Department of Community Medicine, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India
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Food Insecurity and Its Relation to Psychological Well-Being Among South Indian People Living with HIV. AIDS Behav 2015; 19:1548-58. [PMID: 25488171 DOI: 10.1007/s10461-014-0966-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Food insecurity (FI) and its link with depression and quality of life (QOL) among people living with HIV (PLHIV) in India are not well-documented. We analyzed cohort data from 243 male and 129 female PLHIV from Bengaluru, and found 19 % of men and 26 % of women reported moderate or severe FI over a 6-month period. Women reported higher mean depression than men, and lower mean QOL. In multivariate analyses adjusting for HIV stigma and demographic covariates, both male and female PLHIV with moderate to severe FI showed lower mean QOL than those reporting mild to no FI. Male but not female food insecure participants also had higher depression scores in adjusted regression analyses. As ART has improved the physical health of PLHIV, more effort is being invested in improving their psychological well-being. Our results suggest such interventions could benefit from including nutritional support to reduce FI among PLHIV.
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Nomoto SH, Longhi RMP, de Barros BP, Croda J, Ziff EB, Castelon Konkiewitz E. Socioeconomic disadvantage increasing risk for depression among recently diagnosed HIV patients in an urban area in Brazil: cross-sectional study. AIDS Care 2015; 27:979-85. [PMID: 25741909 DOI: 10.1080/09540121.2015.1017442] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Depression is the most common psychiatric co-morbidity among people living with HIV (PLHIV), with prevalence rates ranging from 25% to 36%. Depression impacts negatively upon adherence and response to combined antiretroviral therapy (CART) and the transmission of HIV infection through increased sexually risky behavior. This cross-sectional study presents data from a reference HIV-outpatient service in Dourados (Brazil) that evaluated the association between depressive symptoms, health-related quality of life, and clinical, socioeconomic, and demographic factors in newly diagnosed HIV/AIDS patients. Using the Beck Depression Inventory (BDI), the prevalence of depressive symptoms was 61% with a predominance of self-deprecating and cognitive-affective factors. Depressive symptoms were associated with lower income (p=0.019) and disadvantaged social class (p=0.005). Poorer quality of life was related to depressive symptoms (p<0.0001), low educational level (p=0.05), and lower income (p=0.03). These data suggest that socioeconomic factors, including level of income and education, are mediating the risk of depression and poor quality of life of PLHIV. Possible explanations for this effect are discussed, including the possible role of stigma.
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Affiliation(s)
- Silmara Harumi Nomoto
- a Department of Medicine , University Hospital, Federal University of Grande , Dourados , Brazil
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Peter E, Kamath R, Andrews T, Hegde BM. Psychosocial Determinants of Health-Related Quality of Life of People Living with HIV/AIDS on Antiretroviral Therapy at Udupi District, Southern India. Int J Prev Med 2014; 5:203-9. [PMID: 24627748 PMCID: PMC3950744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2012] [Accepted: 01/02/2013] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Life expectancy of people living with HIV/AIDS (PLHA) on antiretroviral therapy has appreciably increased. However, psychosocial challenges pose a great threat to their health-related quality of life (HRQOL). The aim of this study was to determine psychosocial factors influencing health-related quality of life of PLHA on antiretroviral therapy. METHODS A cross-sectional study was conducted using convenience sampling to select 226 PLHA at District hospital. Demographic information was collected using a semistructured questionnaire. HRQOL was assessed using WHOQOL-HIV Bref. The Hospital Anxiety and Depression Scale, CAGE scale, and Multidimensional Scale of Perceived Social Support were used. One-way ANOVA was applied. RESULTS There was a significant difference in mean quality of life score with respect to level of anxiety in the physical (P < 0.001), psychological (P < 0.001), level of independence (P < 0.001), social relationships (P = 0.047), environment (P < 0.001), and spirituality domain (P < 0.001). Significant difference in mean quality of life score was observed with respect to level of depression in physical (P = 0.003), psychological (P = 0.036), level of independence (P = 0.017), social relationships (P = 0.019), and spirituality (P = 0.001). Friend support was positively associated with HRQOL in physical (P < 0.001), psychological (P < 0.001), level of independence (P = 0.013), social relationships (P < 0.001), environment (0.001), and spirituality domain (0.026). Family support was positively associated with HRQOL in physical (P = 0.001), psychological (P = 0.001), level of independence (P = 0.040), social relationships (P = 0.008), environment (0.001), and spirituality domain (0.026). A significant difference was observed with respect to affiliation to social organization in social relationships domain (P = 0.044). CONCLUSIONS Psychosocial challenges including anxiety, depression, and social support impact upon all domains of HRQOL of PLHA.
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Affiliation(s)
- Emanuel Peter
- Department of Public Health, Manipal University, Manipal, Karnataka, India
| | - Ramachandra Kamath
- Department of Public Health, Manipal University, Manipal, Karnataka, India
| | - Teddy Andrews
- Department of Public Health, Manipal University, Manipal, Karnataka, India
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Reychler G, Caty G, Vincent A, Billo S, Yombi JC. Validation of the French version of the World Health Organization quality of life HIV instrument. PLoS One 2013; 8:e73180. [PMID: 24019904 PMCID: PMC3760883 DOI: 10.1371/journal.pone.0073180] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Accepted: 07/17/2013] [Indexed: 12/29/2022] Open
Abstract
PURPOSE Quality of life is a key element in the follow-up of people living with HIV/AIDS. The main purpose of this study was to validate the French version of the WHOQOL-HIV instrument by comparing this instrument to a generic questionnaire. The second objective was to test the reproducibility of this questionnaire. METHOD The WHOQOL-HIV and SF-36 questionnaires were filled out by 50 patients on two separate occasions with a time interval of 2 weeks. The internal consistency, validity and reliability of the WHOQOL-HIV were evaluated. RESULTS The internal consistency was acceptable for the different domains, with Cronbach's alpha ranging from 0.937 to 0.944. The facet-domain correlations were all statistically significant (p<0.001). There was a correlation between the domains from the WHOQOL-HIV and SF-36 questionnaires, with coefficients ranging from 0.349 to 0.763 (p<0.05 for all), except for the Spirituality domain. The test-retest reliability was suitable for all domains and facets, with statistically significant intra-class coefficients between 0.615 and 0.931. CONCLUSION This study demonstrated that the French translation of the WHOQOL-HIV instrument is a valid and reproducible tool for the evaluation of the quality of life for HIV-infected patients.
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Affiliation(s)
- Gregory Reychler
- Institut de Recherche Expérimentale et Clinique (IREC), Pôle de Pneumologie, ENT & Dermatologie, Université Catholique de Louvain, Brussels, Belgium
- Service de Pneumologie, Cliniques universitaires Saint-Luc, Brussels, Belgium
- Département de Médecine Physique et Réadaptation, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - Gilles Caty
- Département de Médecine Physique et Réadaptation, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - Anne Vincent
- Centre de prise en charge VIH, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - Simon Billo
- Département de Médecine Physique et Réadaptation, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - Jean-Cyr Yombi
- Centre de prise en charge VIH, Cliniques universitaires Saint-Luc, Brussels, Belgium
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Nazik E, Arslan S, Nazik H, Kurtaran B, Nazik S, Ulu A, Taşova Y. Determination of Quality of Life and Their Perceived Social Support from Family of Patients with HIV/AIDS. SEXUALITY AND DISABILITY 2013. [DOI: 10.1007/s11195-013-9304-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Cook R, Jones DL, Nehra R, Kumar AM, Prabhakar S, Waldrop-Valverde D, Sharma S, Kumar M. HIV Clade-C Infection and Cognitive Impairment, Fatigue, Depression, and Quality of Life in Early-Stage Infection in Northern Indians. J Int Assoc Provid AIDS Care 2013; 15:332-7. [PMID: 23722088 DOI: 10.1177/2325957413488193] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
HIV disease progression is associated with declining quality of life and overall health status, although most research in this domain has been conducted among Western populations where B is the infecting clade. This study sought to determine the effects of early-stage clade-C HIV infection (CD4 count ≥400 cells/mm(3)) on neurocognitive functioning, cognitive depression, and fatigue by comparing a matched sample of HIV-positive and HIV-negative Northern Indians. This study also examined the impact of these factors on quality of life within the HIV-positive individuals. HIV-positive participants demonstrated reduced cognitive functioning, increased fatigue, and lower quality of life. Fatigue and cognitive impairment interacted to negatively impact quality of life. Results suggest that early-stage HIV clade-C-infected individuals may experience subclinical symptoms, and further research is needed to explore the benefit of therapeutic interventions to ensure optimal clinical outcomes and maintain quality of life in this vulnerable population.
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Affiliation(s)
- R Cook
- Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - D L Jones
- Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - R Nehra
- Postgraduate Institute of Medical Education and Research, Chandigarh, Punjab, India
| | - A M Kumar
- Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - S Prabhakar
- Postgraduate Institute of Medical Education and Research, Chandigarh, Punjab, India
| | - D Waldrop-Valverde
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| | - S Sharma
- Postgraduate Institute of Medical Education and Research, Chandigarh, Punjab, India
| | - M Kumar
- Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
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Shenoy A, Ramapuram JT, Unnikrishan B, Achappa B, Madi D, Rao S, Mahalingam S. Effect of Lipodystrophy on the Quality of Life among People Living with HIV (PLHIV) on Highly Active Antiretroviral Therapy. ACTA ACUST UNITED AC 2013; 13:471-5. [DOI: 10.1177/2325957413488205] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Lipodystrophy is a known adverse effect of highly active antiretroviral therapy (HAART). Lipodystrophy resulting in body dysmorphism can lower the quality of life (QoL) among HAART recipients. The main aim of our study was to find the effect of lipodystrophy on QoL among people living with HIV (PLHIV) on HAART. Methods: This cross-sectional study was conducted in a tertiary care hospital in south India. The participants were assessed for the presence of lipodystrophy. Their QoL was assessed using HIV-AIDS-targeted QoL questionnaire (HAT-QoL). Statistical analysis was carried out using SPSS version 11.5. Results: Lipodystrophy was present in 21 participants (42%). The QoL among individuals with lipodystrophy was found to be significantly lower in terms of disclosure worries ( P = .023) and financial worries ( P = .049). Conclusions: Lipodystrophy adversely affects QoL among PLHIV. There is a need for studies analyzing factors that can potentially improve the QoL in such individuals.
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Affiliation(s)
- Archana Shenoy
- Kasturba Medical College, Manipal University, Mangalore, India
| | - John T. Ramapuram
- Department of Internal Medicine, Kasturba Medical College, Manipal University, Mangalore, India
| | - Bhaskaran Unnikrishan
- Department of Community Medicine, Kasturba Medical College, Manipal University, Mangalore, India
| | - Basavaprabhu Achappa
- Department of Internal Medicine, Kasturba Medical College, Manipal University, Mangalore, India
| | - Deepak Madi
- Department of Internal Medicine, Kasturba Medical College, Manipal University, Mangalore, India
| | - Satish Rao
- Department of Internal Medicine, Kasturba Medical College, Manipal University, Mangalore, India
| | - Soundarya Mahalingam
- Department of Paediatrics, Kasturba Medical College, Manipal University, Mangalore, India
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Vigneshwaran E, Padmanabhareddy Y, Devanna N, Alvarez-Uria G. Gender Differences in Health Related Quality of Life of People Living with HIV/AIDS in the Era of Highly Active Antiretroviral Therapy. NORTH AMERICAN JOURNAL OF MEDICAL SCIENCES 2013; 5:102-7. [PMID: 23641370 PMCID: PMC3624709 DOI: 10.4103/1947-2714.107526] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Background: Data about the health-related quality of life (HR-QOL) of people living with HIV/AIDS (PLHA) after the implementation of free antiretroviral treatment in India are scarce. Aim: The study was to describe the HR-QOL and gender differences of PLHA in rural India. Materials and Methods: Cross sectional study of 120 PLHA who came to the outpatient department in a rural district hospital. Assessment of the HR-QOL was performed through interviews using a validated structured questionnaire from the Medical Outcome Study HIV Health Survey. Linear regression with robust standard errors was used for multivariable analysis. Results: Domains related to social and daily activities such as cognitive, role and social functioning had lower HR-QOL scores than domains related to physical health. Men had higher scores of HR-QOL in health transition, perceived HR-QOL, health distress, social functioning and role functioning. In multivariable analysis, factors associated with poorer HR-QOL were female sex, lower levels of education and being widowed or separated in women. Conclusions: HR-QOL of PLHA in rural India is poor, especially in widowed or separated women and people with lower levels of education. There is an urgent need of implementing programmes for improving the HR-QOL of HIV infected women in rural India.
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Affiliation(s)
- Easwaran Vigneshwaran
- Department of Pharmacy Practice, Raghavendra Institute of Pharmaceutical Education and Research, Anantapur, India
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Charles B, Jeyaseelan L, Pandian AK, Sam AE, Thenmozhi M, Jayaseelan V. Association between stigma, depression and quality of life of people living with HIV/AIDS (PLHA) in South India - a community based cross sectional study. BMC Public Health 2012; 12:463. [PMID: 22720691 PMCID: PMC3444349 DOI: 10.1186/1471-2458-12-463] [Citation(s) in RCA: 117] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2011] [Accepted: 06/21/2012] [Indexed: 12/02/2022] Open
Abstract
Background India has around 2.27 million adults living with HIV/AIDS who face several challenges in the medical management of their disease. Stigma, discrimination and psychosocial issues are prevalent. The objective of the study was to determine the prevalence of severe stigma and to study the association between this, depression and the quality of life (QOL) of people living with HIV/AIDS (PLHA) in Tamil Nadu. Methods This was a community based cross sectional study carried out in seven districts of Tamil Nadu, India, among 400 PLHA in the year 2009. The following scales were used for stigma, depression and quality of life, Berger scale, Major Depression Inventory (MDI) scale and the WHO BREF scale. Both Stigma and QOL were classified as none, moderate or severe/poor based on the tertile cut off values of the scale scores. Depression was classified as none, mild, moderate and severe. Logistic regression analyses were performed to study the risk factors. Results Twenty seven per cent of PLHA had experienced severe forms of stigma. These were severe forms of personalized stigma (28.8%), negative self-image (30.3%), perceived public attitude (18.2%) and disclosure concerns (26%). PLHA experiencing severe depression were 12% and those experiencing poor quality of life were 34%. Poor QOL reported in the physical, psychological, social and environmental domains was 42.5%, 40%, 51.2% and 34% respectively. PLHA who had severe personalized stigma and negative self-image had 3.4 (1.6-7.0) and 2.1 (1.0-4.1) times higher risk of severe depression respectively (p < .001). PLHA who had severe depression had experienced 2.7(1.1-7.7) times significantly poorer QOL. Conclusions Severe forms of stigma were equivalently prevalent among all the categories of PLHA. However, PLHA who had experienced severe depression had only developed poor QOL. A high level of social support was associated with a high level of QOL.
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Affiliation(s)
- Bimal Charles
- AIDS Prevention and Control Project, Voluntary Health Services, Adyar, Chennai, 600 113, India
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