Physical symptoms and sleep disturbances activate coping strategies among HIV-infected Asian Americans: a pathway analysis.

How to activate adaptive coping strategies has an important and practical meaning for the quality of life of people living with HIV (PLHIV); however, few studies have focused on the effects of sleep disturbances and HIV-related physical symptoms on coping strategies. The specific relationships among coping strategies, sleep disturbances and HIV-related physical symptoms were unknown. We performed a path analysis to examine the proposed model of relationships among sleep disturbances, physical symptoms, and coping strategies. A convenience sample of 69 HIV-positive Asian Americans in San Francisco, Los Angeles, and New York City were recruited and data were collected on demographics, sleep disturbances, HIV-related physical symptoms, and coping strategies. Sleep disturbances directly affect maladaptive coping (ß = 0.34), and physical symptoms directly affect adaptive coping (ß = 0.30) and maladaptive coping (ß = 0.24). Interventions designed to decrease sleep disturbances and physical symptoms should be developed to enhance adaptive coping and reduce maladaptive coping among Asian Americans with HIV.

Experiences and needs of family support for HIV-infected Asian Americans: A qualitative dyadic analysis.

BACKGROUND: When coping with HIV-related challenges, family support is the first line that Asian Americans living with HIV (AALHIV) lean on; however, few studies have explored the dyadic aspects of family support among AALHIV. We aimed to explore the dyadic aspects of family support among AALHIV and their family caregivers. METHODS: From September 2017 to January 2020, we recruited 18 dyads among AALHIV and their caregivers in Los Angeles and New York City by the purposive sampling method. Using qualitative dyadic analysis of semi-structured, in-depth interviews, we explored dyadic aspects of family support among participants based on Fitch's Supportive Care Framework. RESULTS: We found that AALHIV obtained support from family caregivers to cover the domains of their physical, psychological, spiritual, informational, social, and practical supportive care. This dyadic analysis indicated congruence in most supportive care; however, there were also dissimilar in the support perceptions. CONCLUSIONS: Our findings exemplify the physical, psychological, spiritual, informational, social, and practical support from AALHIV and their family caregivers. When developing a culturally sensitive intervention for AALHIV, we need to consider the different aspects of the support. Especially, family support can enhance patients-providers' relationships as well as health engagement with HIV care.

Revising the American dream: how Asian immigrants adjust after an HIV diagnosis.

AIM: We explored how acculturation and self-actualization affect depression in the HIV-positive Asians and Pacific Islanders immigrant population. BACKGROUND: Asians and Pacific Islanders are among the fastest growing minority groups in the USA. Asians and Pacific Islanders are the only racial/ethnic group to show a significant increase in HIV diagnosis rate. DESIGN: A mixed-methods study was conducted. METHODS: Thirty in-depth interviews were conducted with HIV-positive Asians and Pacific Islanders in San Francisco and New York. Additionally, cross-sectional audio computer-assisted self-interviews were conducted with a sample of 50 HIV-positive Asians and Pacific Islanders. Content analysis was used to analyse the in-depth interviews. Also, descriptive, bivariate statistics and multivariable regression analysis was used to estimate the associations among depression, acculturation and self-actualization. The study took place from January-June 2013. DISCUSSION: Major themes were extracted from the interview data, including self-actualization, acculturation and depression. The participants were then divided into three acculturation levels correlating to their varying levels of self-actualization. For those with low acculturation, there was a large discrepancy in the Center for Epidemiologic Studies Depression Scale scores between those who had totally lost their self-actualization and those who believed they could still achieve their 'American dreams'. Among those who were less acculturated, there was a significant difference in depression scores between those who felt they had totally lost their ability to self-actualize and those who still believed they could 'make their dreams come true.' CONCLUSION: Acculturation levels influence depression and self-actualization in the HIV-positive Asians and Pacific Islanders population. Lower acculturated Asian Americans achieved a lower degree of self-actualization and suffered from depression. Future interventions should focus on enhancing acculturation and reducing depression to achieve self-actualization.

Acculturation and perceived stress in HIV+ immigrants: depression symptomatology in Asian and Pacific Islanders.

Asians and Pacific Islanders (API) are among the fastest growing minority groups within the USA, and this growth has been accompanied by an increase in HIV incidence. Between 2000 and 2010, the API HIV infection rate increased from 4.5% to 8.7%; however, there is a paucity of HIV-related research for this group, and even less is known about the prevalence and correlates of antiretroviral therapy adherence behavior, quality of life, impact of stress, and efficacious self-management among HIV+ API Americans. This paper examines how acculturation and perceived stress affect depression symptomatology and treatment seeking in the HIV+ API population. A series of cross-sectional audio computer-assisted self-interviews were conducted with a convenience sample of 50 HIV+ API (29 in San Francisco and 21 in New York City). The relationship between acculturation and perceived stress was analyzed, and the results indicate that for those HIV+ API who reported low or moderate acculturation (as compared to those who reported high acculturation), stress was significantly mediated by depression symptomology. Interventions to address acculturation and reduce perceived stress among API generally and Asians specifically are therefore needed.

Asian Pacific Americans Living with HIV Who Were Smuggled Immigrants: A Qualitative Study.

Migrant smuggling is a humanitarian crisis that impacts public health. A limited number of studies have focused on the links between migrant smuggling and its impact on the risk of infectious diseases, including HIV, for those smuggled. To explore these links, we conducted in-depth interviews with 11 Asian and Pacific Americans (APA) living with HIV in New York and Los Angeles. Qualitative content analysis revealed that smuggled immigrants described their experience as one with opportunity and danger. Smuggled immigrants, who aimed to achieve their American dream, were influenced by hometown pioneers who successfully journeyed to the United States and by the prospect of gaining legal status through immigration policy similar to the 1986 amnesty. Unfortunately, the long and dangerous journey exposed the immigrants to health problems, including risk for HIV. Thus, health care providers for immigrants should assess their migration routes and screen for infectious diseases.

Acculturation, HIV-Related Stigma, Stress, and Patient-Healthcare Provider Relationships Among HIV-Infected Asian Americans: A Path Analysis.

Acculturation may limit HIV-positive Asian Americans' active interactions with patient-healthcare providers (HCP) and utilization of HIV healthcare services; however, the specific mediation effect of acculturation still unknown. A bias-corrected factor score path analysis was performed to examine the proposed model of relations among acculturation, stigma, stress, and patient-HCP relationships. A convenience sample of 69 HIV-positive Asian Americans in San Francisco, Los Angeles, and New York City were recruited and collect data were collected on demographics, HIV-related stigma, stress, and patient-HCP relationships. HIV stigma and stress had a direct, negative effect on patient-HCP relationships. Acculturation had a positive total effect on patient-HCP relationships, and was mediated by HIV stigma and stress. A acculturation also had a direct impact on stigma and stress. Acculturation, HIV-related stigma, and stress are key elements to achieving good patient-HCP relationships, and provide insights on the design of culturally sensitive interventions to improve patient-HCP relationships.