The Impact of Psychosocial Factors on Health and Retention Outcomes for People Living With HIV: Implications for Rehabilitation Counselors and Educators

2018 ◽  
Vol 62 (2) ◽  
pp. 94-107
Author(s):  
Yung-Chen Jen Chiu ◽  
K. B. Boomer ◽  
Liza M. Conyers
Keyword(s):  
Mental Health ◽  
Immune System ◽  
Case Management ◽  
Health Outcomes ◽  
Retention In Care ◽  
Rehabilitation Counselors ◽  
People Living With Hiv ◽  
Management Service ◽  
Living With Hiv ◽  
The Impact

Despite medical advancements that have significantly improved the health outcomes of people living with HIV (PLWH), many do not achieve optimal health outcomes due to psychosocial barriers. This 5-year retrospective longitudinal study draws upon the International Classification of Functioning, Disability, and Health (ICF) framework to conceptualize the relationships between personal and environmental factors and health and retention outcomes among a sample of 704 PLWH in Pennsylvania. A generalized estimated equations (GEE) model was used to model retention in care outcomes (at least one medical visit every 6 months) and a general linear mixed (GLM) model was used to analyze immune system health outcomes (CD4%). This exploratory study reveals that gender, age, race, use of antiretroviral (ARV) medications, use of case management service, mental health diagnosis, and alcohol use were significantly associated with retention in care, whereas race, ethnicity, gender, mental health treatment, use of ARV medications, use of case management services, and retention in care status were significantly associated with the immune system health outcome of CD4%. The results suggest a need for rehabilitation interventions to address key psychosocial issues, as rehabilitation counselors have a unique skill set to address the medical case management needs of individuals with HIV. Implications for rehabilitation counselors and educators are discussed.

scholarly journals Mental health, coping, and social support among people living with HIV in the Americas: A comparative study between Argentina and the USA during the SARS-CoV-2 pandemic

2020 ◽  
Author(s):  
Deborah L. Jones ◽  
Jamile Ballivian ◽  
Violeta J. Rodriguez ◽  
Claudia Uribe ◽  
Diego Cecchini ◽  
...  
Keyword(s):  
Mental Health ◽  
Social Support ◽  
Depressive Symptoms ◽  
Significant Risk ◽  
Ordinary Least Squares ◽  
People Living With Hiv ◽  
Least Squares Regression ◽  
Coping With Stress ◽  
Living With Hiv ◽  
The Impact

Abstract Background: The COVID-19 pandemic pose significant risk to mental health and may disproportionately affect people living with HIV (PLWH). This study examined the interaction of social support and resilient coping in predicting depressive symptoms among PLWH.Methods: PLWH residing in Buenos Aires, Argentina and in Miami, Florida (US) were asked to complete an anonymous survey on the impact of COVID-19. Statistical analysis included ordinary least squares regression.Results: A total of 1,554 participants were included. Mean age was 47.30 years; 63.7 % were men. A test of three-way interaction of social support resilient coping study site indicated differences by site (b = -0.63.862, p = .043010, 95% CI [-1.24, -0.02.205, 1.52]). In Argentina, at higher social support and resilient coping, depressive symptoms were lowest. At lower social support and resilient coping, depressive symptoms were highest.Discussion: The impact of COVID-19 on mental health illustrates the need to develop innovative strategies to support resilience and to enhance coping with stress and adversity among PLWH.

scholarly journals Undetectable equals untransmittable (U = U): awareness and associations with health outcomes among people living with HIV in 25 countries

2020 ◽  
pp. sextrans-2020-054551 ◽  
Author(s):  
Chinyere Okoli ◽  
Nicolas Van de Velde ◽  
Bruce Richman ◽  
Brent Allan ◽  
Erika Castellanos ◽  
...  
Keyword(s):  
Health Outcomes ◽  
Standard Of Care ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Hiv Status ◽  
Missed Opportunities ◽  
Suboptimal Adherence ◽  
Health Related ◽  
Living With Hiv ◽  
The Impact

Objectives‘Undetectable equals Untransmittable’ (U=U) is an empowering message that may enable people living with HIV (PLHIV) to reach and maintain undetectability. We estimated the percentage of PLHIV who ever discussed U=U with their main HIV care provider, and measured associations with health-related outcomes. Secondarily, we evaluated whether the impact of the U=U message varied between those who heard it from their healthcare provider (HCP) vs from elsewhere.MethodsData were from the 25-country 2019 Positive Perspectives Survey of PLHIV on treatment (n=2389). PLHIV were classified as having discussed U=U with their HCP if they indicated that their HCP had ever told them about U=U. Those who had not discussed U=U with their HCP but were nonetheless aware that ‘My HIV medication prevents me from passing on HIV to others’ were classified as being made aware of U=U from non-HCP sources. Multivariable logistic regression was used to measure associations between exposure to U=U messages and health outcomes.ResultsOverall, 66.5% reported ever discussing U=U with their HCP, from 38.0% (South Korea) to 87.3% (Switzerland). Prevalence was lowest among heterosexual men (57.6%) and PLHIV in Asia (51.3%). Compared with those unaware of U=U, those reporting U=U discussions with their HCP had lower odds of suboptimal adherence (AOR=0.59, 95% CI 0.44 to 0.78) and higher odds of self-reported viral suppression (AOR=2.34, 95% CI 1.72 to 3.20), optimal sexual health (AOR=1.48, 95% CI 1.14 to 1.92) and reporting they ‘always shared’ their HIV status (AOR=2.99, 95% CI 1.42 to 6.28). While exposure to U=U information from non-HCP sources was beneficial too, the observed associations were attenuated relative to those seen with reported discussions with HCPs.ConclusionHCP discussion of U=U with PLHIV was associated with favourable health outcomes. However, missed opportunities exist since a third of PLHIV reported not having any U=U discussion with their HCP. U=U discussions with PLHIV should be considered as a standard of care in clinical guidelines.

scholarly journals A-077 Relationship Between Mental Health and Physical Health and Neurocognitive Function among Latinx People Living With HIV

2020 ◽  
Vol 35 (6) ◽  
pp. 869-869
Author(s):  
Breen E ◽  
Aghvinian M ◽  
Stiver J ◽  
Savin M ◽  
Summers A ◽  
...  
Keyword(s):  
Mental Health ◽  
Working Memory ◽  
Physical Health ◽  
Processing Speed ◽  
Cognitive Outcomes ◽  
People Living With Hiv ◽  
Living With Hiv ◽  
The Impact ◽  
The Relationship ◽  
Domain Scores

Abstract Objective The relationship between self-reported mental health (MH), physical health (PH), and neurocognition (NC) is vastly understudied among Latinx people living with HIV (PLWH). Evidence of increased somatization in this group suggests that self-reported MH and PH may contextualize cognitive outcomes among Latinx PLWH. Thus, this study examines the relationship between self-reported MH/PH and NC in a sample of Latinx PLWH. Method This study included 76 Latinx PLWH (33% female; M age = 46.0, SD = 7.08) who completed the Medical Outcomes Study HIV Health Survey (MOS-HIV) and a comprehensive neurocognitive battery. MH and PH were defined by the MOS-HIV, where higher MH and PH summary scores indicate better perceived health. Demographically-corrected T-scores were used to compute average global NC and domain scores. Results Within Latinx PLWH, partial correlations controlling for age and education found PH was associated with better processing speed (r = .28, p = .03), and MH was related to better global NC, fluency, learning, and processing speed (ps < .05). A series of multiple regressions (Step 1: age, education, Step 2: MH, PH summary scores) were used to predict NC domain scores. MH (R2 = .11–.15) significantly predicted better attention/working memory (β = .26, p = .03) and global NC at the trend level (β = .19, p = .07). PH did not predict any NC domains. Conclusions Findings indicate that MH and PH correlated with global and domain-specific NC within Latinx PLWH. Better self-reported MH may improve attention/working memory and global NC in Latinx PLWH. Somatization is important when considering MH/PH and cognition within Latinx PLWH; physicians should consider the impact of patients’ self-reported MH/PH on NC in Latinx PLWH.

scholarly journals The impact of caring for persons living with HIV and AIDS on the mental health of nurses in the Limpopo Province

Curationis ◽  
2008 ◽  
Vol 31 (2) ◽  
Author(s):  
M Davhana-Maselesele
Keyword(s):  
Mental Health ◽  
Depression Scale ◽  
Maslach Burnout Inventory ◽  
Hiv And Aids ◽  
Limpopo Province ◽  
People Living With Hiv ◽  
Persons Living With Hiv ◽  
Support Programmes ◽  
Living With Hiv ◽  
The Impact

This study assessed the impact of caring for AIDS sufferers on the mental health of nurses. This assessment was measured against the level of burnout, stress and depression among 174 nurses caring for people living with HIV and AIDS in Limpopo Province, South Africa. A structured questionnaire was used for data collection. The questionnaire incorporated the AIDS Impact Scale (AIS), Maslach Burnout Inventory (MBI), Beck Depression Inventory (BDI) and the participants’ demographic and professional profiles. Participants were conveniently selected from five selected hospitals in Limpopo Province. The study participants’ valuation using the AIS showed that nurses tended to develop strong bonds and relationships with the patients; felt frustrated by their inability to help the terminally ill AIDS sufferers and were subsequently affected by the death of their patients. Personal accomplishments of the nurses remained high and the levels of emotional exhaustion and depersonalization levels were low. The BDI showed that over 3 out of 4 nurses were experiencing between mild mood disturbance and extreme depression. Higher average scores were noted for items of the depression scale like sadness, dissatisfaction, fatigue and low level of energy. The findings highlight the need to develop psychological support programmes for nurses caring for AIDS patients and promote the provision of social incentives and recognition of the role of nurses in AIDS care.

scholarly journals The impact of social capital and mental health on medication adherence among older people living with HIV (PLWH)

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lei He ◽  
Bin Yu ◽  
Jun Yu ◽  
Jun Xiong ◽  
Yuling Huang ◽  
...  
Keyword(s):  
Mental Health ◽  
Social Capital ◽  
Medication Adherence ◽  
Older People ◽  
Penalized Regression ◽  
People Living With Hiv ◽  
Hiv Medication ◽  
The Individual ◽  
Living With Hiv ◽  
The Impact

Abstract Background The number of older people living with HIV (PLWH) is increasing. Although there are many studies affecting medication adherence, research on the impact of social capital and mental health on medication adherence in this particular population is limited. Method Data were collected from an ongoing observational prospective cohort study, starting from November 2018, among older PLWH in Sichuan province, China. Five hundred twenty-one participants were interviewed. Social capital consists of the individual and family (IF) scale, and the community and society (CS) scale. The presence of probable depression and probable anxiety were assessed using the CES-D-10 and GAD-7 scales. Adherence was defined as taking ≥80% of prescribed HIV medication in 4 days prior to the interview. Two sets of Firth’ penalized regression analyses were used to estimate the association between social capital, mental health, and medication adherence. Results The prevalence of non-adherence was 18.2% (95/521) among older PLWH in this study. After adjusting for significant factors, the CS social capital (OR: 0.92, 95%CI:0.85–0.99, p < 0.05) and probable anxiety (OR:1.73, 95%CI:1.07–2.80, p < 0.05) were associated with non-adherence. Conclusion This study highlighted that the effects of social capital and mental health on older PLWH’s adherence, which implied that the need to develop interventions to concern for mental health and enhance CS social capital to help the older PLWH better manage HIV medication adherence.

scholarly journals Measuring and explaining inequality of continuous care for people living with HIV receiving antiretroviral therapy in Kunming, China

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0251252
Author(s):  
Yongmei Jin ◽  
Sawitri Assanangkornchai ◽  
Yingrong Du ◽  
Jun Liu ◽  
Jingsong Bai ◽  
...  
Keyword(s):  
Mental Health ◽  
Antiretroviral Therapy ◽  
Health Assessment ◽  
Retention In Care ◽  
People Living With Hiv ◽  
Mental Health Assessment ◽  
Continuous Care ◽  
The Rich ◽  
Living With Hiv ◽  
Virological Monitoring

Background In the context of scaling up free antiretroviral therapy (ART), healthcare equality is essential for people living with HIV. We aimed to assess socioeconomic-related inequalities in uptake of continuous care for people living with HIV receiving ART, including retention in care in the last six months, routine toxicity monitoring, adequate immunological and virological monitoring, and uptake of mental health assessment in the last 12 months. We also determined the contributions of socioeconomic factors to the degree of inequalities. Methods A hospital-based cross-sectional survey was conducted among consecutive clients visiting an HIV treatment center in Kunming, China in 2019. Participants were 702 people living with HIV aged ≥18 years (median age: 41.0 years, 69.4% male) who had been on ART for 1–5 years. Socioeconomic-related inequality and its contributing factors were assessed by a normalized concentration index (CIn) with a decomposition approach. Results The uptake of mental health assessment was low (15%) but significantly higher among the rich (CIn 0.1337, 95% CI: 0.0140, 0.2534). Retention in care, toxicity, and immunological monitoring were over 80% but non-significant in favor of the rich (CIn: 0.0117, 0.0315, 0.0736, respectively). The uptake of adequate virological monitoring was 15% and higher among the poor (CIn = -0.0308). Socioeconomic status positively contributed to inequalities of all care indicators, with the highest contribution for mental health assessment (124.9%) and lowest for virological monitoring (2.7%). Conclusions These findings suggest virological monitoring and mental health assessment be given more attention in long-term HIV care. Policies allocating need-oriented resources geared toward improving equality of continuous care should be developed.

scholarly journals The CombinADO study to assess the impact of a combination intervention strategy on viral suppression, antiretroviral therapy adherence, and retention in HIV care among adolescents and young people living with HIV: protocol for a cluster-randomized controlled trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Phepo Mogoba ◽  
Maia Lesosky ◽  
Allison Zerbe ◽  
Joana Falcao ◽  
Claude Ann Mellins ◽  
...  
Keyword(s):  
Mental Health ◽  
Support Groups ◽  
Viral Suppression ◽  
Sub Saharan Africa ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Retention In Hiv Care ◽  
Cluster Randomized ◽  
Living With Hiv ◽  
The Impact

Abstract Background Adolescents and youth living with HIV (AYAHIV) have worse HIV outcomes than other age groups, particularly in sub-Saharan Africa (SSA). AYAHIV in SSA face formidable health system, interpersonal- and individual-level barriers to retention in HIV care, uptake of ART, and achievement of viral suppression (VS), underscoring an urgent need for multi-component interventions to address these challenges. This cluster-randomized control trial (cRCT) aims to evaluate the effectiveness and monitor implementation of a community-informed multi-component intervention (“CombinADO strategy”) addressing individual-, facility-, and community-level factors to improve health outcomes for AYAHIV. Methods This trial will be conducted in 12 clinics in Nampula Province, Northern Mozambique. All clinics will implement an optimized standard of care (control) including (1) billboards/posters and radio shows, (2) healthcare worker (HCW) training, (3) one-stop adolescent and youth-friendly services, (4) information/motivation walls, (5) pill containers, and (6) tools to be used by HCW during clinical visits. The CombinADO strategy (intervention) will be superadded to control conditions at 6 randomly selected clinics. It will include five additional components: (1) peer support, (2) informational/motivational video, (3) support groups for AYAHIV caregivers, (4) AYAHIV support groups, and (5) mental health screening and linkage to adolescent-focused mental health support. The study conditions will be in place for 12 months; all AYAHIV (ages 10–24 years, on ART) seeking care in the participating sites will be exposed to either the control or intervention condition based on the clinic they attend. The primary outcome is VS (viral load < 50 copies/mL) at 12 months among AYAHIV attending participating clinics. Secondary outcomes include ART adherence (self-reported and TDF levels) and retention in care (engagement in the preceding 90 days). Uptake, feasibility, acceptability, and fidelity of the CombinADO strategy during implementation will be measured. Trial outcomes will be assessed in AYAHIV, caregivers, healthcare workers, and key informants. Statistical analyses will be conducted and reported in line with CONSORT guidelines for cRCTs. Discussion The CombinADO study will provide evidence on effectiveness and inform implementation of a novel community-informed multi-component intervention to improve retention, adherence, and VS among AYAHIV. If found effective, results will strengthen the rationale for scale up in SSA. Trial registration ClinicalTrials.gov NCT04930367. Registered on 18 June 2021

Comparison of Clinical Outcomes of Persons Living With HIV by Enrollment Status in Washington, DC: Evaluation of a Large Longitudinal HIV Cohort Study (Preprint)

2019 ◽  
Author(s):  
Jenevieve Opoku ◽  
Rupali K Doshi ◽  
Amanda D Castel ◽  
Ian Sorensen ◽  
Michael Horberg ◽  
...  
Keyword(s):  
Cohort Study ◽  
Health Outcomes ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Hiv Care ◽  
Disease Stage ◽  
People Living With Hiv ◽  
Hiv Disease ◽  
Persons Living With Hiv ◽  
Living With Hiv

BACKGROUND HIV cohort studies have been used to assess health outcomes and inform the care and treatment of people living with HIV disease. However, there may be similarities and differences between cohort participants and the general population from which they are drawn. OBJECTIVE The objective of this analysis was to compare people living with HIV who have and have not been enrolled in the DC Cohort study and assess whether participants are a representative citywide sample of people living with HIV in the District of Columbia (DC). METHODS Data from the DC Health (DCDOH) HIV surveillance system and the DC Cohort study were matched to identify people living with HIV who were DC residents and had consented for the study by the end of 2016. Analysis was performed to identify differences between DC Cohort and noncohort participants by demographics and comorbid conditions. HIV disease stage, receipt of care, and viral suppression were evaluated. Adjusted logistic regression assessed correlates of health outcomes between the two groups. RESULTS There were 12,964 known people living with HIV in DC at the end of 2016, of which 40.1% were DC Cohort participants. Compared with nonparticipants, participants were less likely to be male (68.0% vs 74.9%, <i>P</i>&lt;.001) but more likely to be black (82.3% vs 69.5%, <i>P</i>&lt;.001) and have a heterosexual contact HIV transmission risk (30.3% vs 25.9%, <i>P</i>&lt;.001). DC Cohort participants were also more likely to have ever been diagnosed with stage 3 HIV disease (59.6% vs 47.0%, <i>P</i>&lt;.001), have a CD4 &lt;200 cells/µL in 2017 (6.2% vs 4.6%, <i>P</i>&lt;.001), be retained in any HIV care in 2017 (72.9% vs 59.4%, <i>P</i>&lt;.001), and be virally suppressed in 2017. After adjusting for demographics, DC Cohort participants were significantly more likely to have received care in 2017 (adjusted odds ratio 1.8, 95% CI 1.70-2.00) and to have ever been virally suppressed (adjusted odds ratio 1.3, 95% CI 1.20-1.40). CONCLUSIONS These data have important implications when assessing the representativeness of patients enrolled in clinic-based cohorts compared with the DC-area general HIV population. As participants continue to enroll in the DC Cohort study, ongoing assessment of representativeness will be required.

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