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1.
Int J Med Sci ; 18(3): 846-851, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33437221

RESUMEN

In the last 50 years we have experienced two big pandemics, the HIV pandemic and the pandemic caused by SARS-CoV-2. Both pandemics are caused by RNA viruses and have reached us from animals. These two viruses are different in the transmission mode and in the symptoms they generate. However, they have important similarities: the fear in the population, increase in proinflammatory cytokines that generate intestinal microbiota modifications or NETosis production by polymorphonuclear neutrophils, among others. They have been implicated in the clinical, prognostic and therapeutic attitudes.


Asunto(s)
/epidemiología , Infecciones por VIH/epidemiología , VIH-1/patogenicidad , Pandemias/historia , /patogenicidad , /inmunología , /transmisión , Citocinas/sangre , Citocinas/inmunología , Trampas Extracelulares/inmunología , Trampas Extracelulares/metabolismo , Miedo , Carga Global de Enfermedades/estadística & datos numéricos , Infecciones por VIH/inmunología , Infecciones por VIH/psicología , Infecciones por VIH/transmisión , VIH-1/inmunología , VIH-1/aislamiento & purificación , Historia del Siglo XX , Historia del Siglo XXI , Interacciones Huésped-Patógeno/inmunología , Humanos , Mediadores de Inflamación/sangre , Mediadores de Inflamación/inmunología , Mortalidad , Neutrófilos/inmunología , Neutrófilos/metabolismo , Pandemias/estadística & datos numéricos , Pronóstico , /aislamiento & purificación
2.
BMC Palliat Care ; 20(1): 8, 2021 Jan 09.
Artículo en Inglés | MEDLINE | ID: mdl-33422058

RESUMEN

BACKGROUND: Palliative care improves the quality of lives of patients and families affected by advanced illnesses through the prevention and relief of suffering. While palliative care is well established in developed countries, it is inadequate or non-existent in most developing countries. Palliative care is an emerging concept in Bhutan, a tiny Himalayan Kingdom. A small community palliative care service is available in the national referral hospital with three dedicated inpatient palliative care beds. This study explored the needs for palliative care among patients diagnosed with advanced illnesses and is a component of a larger project aimed to inform a suitable palliative care model for the country. METHODS: This is a cross-sectional descriptive study. A survey, using a structured questionnaire including the EORTC QLQ-C30, was carried out among patients with advanced illness in hospitals, primary care units and communities across the country. Purposeful and snowball sampling strategies were used to recruit study participants. RESULTS: Seventy (76%), out of 93 eligible patients, agreed to participate in the survey. Participants reported low to moderate scores on physical, role, emotional, cognitive and social functioning, a moderate score for the global health/ quality of life scale and moderately high (worse) scores in symptoms including fatigue, pain, insomnia, loss of appetite and the financial impact from the disease. CONCLUSIONS: The symptom burden experienced by patients affected by advanced illnesses demonstrates the need for palliative care in Bhutan. These findings will help inform the development of a public health-focused palliative care model, modified to the Bhutanese context, as recommended by the World Health Organization.


Asunto(s)
Infecciones por VIH/fisiopatología , Evaluación de Necesidades , Neoplasias/fisiopatología , Cuidados Paliativos , Calidad de Vida , Insuficiencia Renal Crónica/fisiopatología , Tuberculosis Resistente a Múltiples Medicamentos/fisiopatología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Técnicos Medios en Salud , Bután , Cognición , Femenino , Infecciones por VIH/psicología , Infecciones por VIH/terapia , Humanos , Hepatopatías Alcohólicas/fisiopatología , Hepatopatías Alcohólicas/psicología , Hepatopatías Alcohólicas/terapia , Enfermedades Pulmonares/fisiopatología , Enfermedades Pulmonares/psicología , Enfermedades Pulmonares/terapia , Masculino , Persona de Mediana Edad , Neoplasias/psicología , Neoplasias/terapia , Enfermeras y Enfermeros , Médicos , Insuficiencia Renal Crónica/psicología , Insuficiencia Renal Crónica/terapia , Traumatismos de la Médula Espinal/fisiopatología , Traumatismos de la Médula Espinal/psicología , Traumatismos de la Médula Espinal/terapia , Enfermo Terminal , Tuberculosis Resistente a Múltiples Medicamentos/psicología , Tuberculosis Resistente a Múltiples Medicamentos/terapia , Adulto Joven
3.
BMC Psychol ; 9(1): 13, 2021 Jan 25.
Artículo en Inglés | MEDLINE | ID: mdl-33494819

RESUMEN

BACKGROUND: People with HIV have always faced stigma and discrimination. Given the numerous papers that have addressed the psychological and social risk factors in spreading HIV, a pressing question is whether individuals' mere careless and behavioural flaws can still account for the spread of HIV. Barriers and opposing politic made a hard position for HIV and sex education in Iran. METHODS: The present study investigated the causes of contracting HIV/AIDS from the perspective of HIV-infected patients. To accomplish this, 150 patients referring to the voluntary counseling and testing Center, Shiraz were convenient selected based on the convenient sampling method and responded to a researcher-made questionnaire From June to August 2019. The data were analyzed through descriptive statistics (mean, SD, frequency tables) and inferential statistics (chi-square). RESULTS: Results revealed that the main cause of HIV infection amongst males was the injection of narcotics, and in the females it was sexual intercourse with an infected individual. Meanwhile, 57% of the females and 66% of the males blamed themselves for contracting and transmitting the disease. The patients stated that if they could return to pre-infection period, they would use one of the following ways to prevent the disease: (a) they would pay attention to hygienic/sanitary principles; (b) they would not get married; and (c) they would prevent drug addiction. Also only 44% of the individuals had successful siblings (those who were neither addicts nor HIV/AIDS-infected individuals), which was an observation that emphasizes on the epidemic of high-risk behaviors in the patients' families. CONCLUSIONS: According to participants' statements collected in our study, weakness in governmental public health education, along with family-related and individual factors, are important causes of HIV spread.


Asunto(s)
Infecciones por VIH/psicología , Conocimientos, Actitudes y Práctica en Salud , Conducta Sexual , Sexo Inseguro , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Estudios Transversales , Femenino , Infecciones por VIH/epidemiología , Educación en Salud , Humanos , Irán/epidemiología , Masculino , Persona de Mediana Edad , Investigación Cualitativa , Trastornos Relacionados con Sustancias/psicología , Encuestas y Cuestionarios , Adulto Joven
4.
BMC Infect Dis ; 21(1): 128, 2021 Jan 29.
Artículo en Inglés | MEDLINE | ID: mdl-33514346

RESUMEN

BACKGROUND: Transgender women (trans women) in Nepal are underserved in the HIV response. Data are needed to determine the HIV prevalence disaggregated from other key populations and to identify the particular risks faced by this community. Trans women are marginalized around the world and research is also needed to determine the impact of stigma on HIV risk to inform trans-specific interventions. METHODS: In 2019, we conducted the first population-based HIV behavioral surveillance study of trans women disaggregated from other key populations using respondent driven sampling (RDS). We estimated the HIV prevalence for trans women, and bivariate and multivariate Poisson binomial regression models were constructed to examine the relationship between HIV risk and stigma. RESULTS: Trans women participants (N = 200) had a mean age of 33 years old (SD = 10.96). We found a weighted HIV prevalence of 11.3% (95% CI 6·82% - 18·13). We found that depression and anxiety (aPR 0.81; 95% CI 0.67-0.97; p = 0·02) and current engagement in sex work (aPR 1.31; 95% CI 1.01-1.71; p = 0·046) were significantly associated with greater prevalence of condomless receptive anal intercourse. We found that experienced stigma of ever being verbally abused due to gender identity was significantly associated with lower prevalence of depression and anxiety (aPR 0.42; 95% CI 0.20-0.87; p = 0·002). Feeling unaccepted in Nepali society and believing people thought they were a criminal because of their trans identity was significantly associated greater prevalence of current sex work (aPR 1.36; 95% CI 1.03-1.78; p = 0·03; aPR 1.45; 95% CI 1.03-2.07; p = 0.04). Every measure of experienced stigma assessed was significantly associated with greater prevalence of current engagement in sex work. CONCLUSIONS: Trans women are highly stigmatized in Nepal, leading to individual and systems factors that impact their risk for HIV. Interventions are needed that support the economic and mental wellbeing of trans women to prevent their heighted risk of HIV from stigma.


Asunto(s)
Infecciones por VIH/epidemiología , Estigma Social , Personas Transgénero/estadística & datos numéricos , Adulto , Femenino , Infecciones por VIH/psicología , Humanos , Masculino , Nepal/epidemiología , Prevalencia , Factores de Riesgo , Trabajo Sexual/psicología , Trabajo Sexual/estadística & datos numéricos , Conducta Sexual , Trastornos Relacionados con Sustancias/complicaciones , Trastornos Relacionados con Sustancias/epidemiología , Trastornos Relacionados con Sustancias/psicología , Personas Transgénero/psicología , Transexualidad/complicaciones , Transexualidad/epidemiología , Transexualidad/psicología , Adulto Joven
5.
BMC Infect Dis ; 21(1): 129, 2021 Jan 30.
Artículo en Inglés | MEDLINE | ID: mdl-33516173

RESUMEN

BACKGROUND: HIV infection has become a chronic disease and well-being of people living with HIV (PLHIV) is now of particular concern. The objectives of this paper were to describe self-rated health among PLHIV, on ART and on ART virally suppressed and to analyse its determinants. METHODS: Data were obtained from a second-generation surveillance system based on a cross-sectional one-day survey in public hospitals. Epidemiological and clinical data were collected among HIV-infected inpatients and outpatients receiving HIV-related care the day of the survey in 86 hospitals in 2019. Self-rated health was measured using a question included in the National Health Survey: "In the last 12 months, how would you rate your health status?" an ordinal variable with five categories (very good, good, moderate, bad and very bad). For the analysis, these responses were dichotomized into two categories: 1 = very good/good and 0 = moderate, bad or very bad health status. Factors associated with very good/good self-rated health were estimated using logistic regression. RESULTS: Of 800 PLHIV, 67.5% perceived their health as very good/good, 68.4% among PLHIV on ART and 71.7% of those virally suppressed. Having university education (adjusted odds ratio (aOR):2.1), being unemployed (aOR:0.3) or retired (aOR:0.2), ever being diagnosed of AIDS (aOR:0.6), comorbidities (aOR:0.3), less than 2 year since HIV diagnosis (aOR:0.3) and not receiving ART (aOR:0.3) were associated with good self-rated health. Moreover, among PLHIV on ART, viral load less than 200 copies (aOR:3.2) were related to better perceived health. Bad adherence was inversely associated with good self-rated health among PLHIV on ART (aOR:0.5) and of those virally suppressed (aOR:0.4). CONCLUSIONS: Nearly seven in 10 PLHIV in Spain considered their health status as very good/good, being higher among virally suppressed PLHIV. Both demographic and clinical determinants affect quality of life.


Asunto(s)
Autoevaluación Diagnóstica , Infecciones por VIH/epidemiología , Estado de Salud , Adulto , Antirretrovirales/uso terapéutico , Estudios Transversales , Femenino , Infecciones por VIH/diagnóstico , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/psicología , Humanos , Masculino , Persona de Mediana Edad , Calidad de Vida , España/epidemiología , Encuestas y Cuestionarios , Carga Viral , Adulto Joven
6.
PLoS One ; 15(12): e0242881, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33351805

RESUMEN

In HIV prevention trials, male partners have influenced women's ability to adhere to investigational products, including antiretroviral (ARV) containing vaginal rings. Validated scales can be useful tools to systematically measure complex constructs, such as those related to male partner engagement. Although multiple scales exist to assess physical, psychological and sexual violence within intimate relationships, fewer scales focus on supportive behaviors within these relationships. Our intervention involved development of a Healthy Relationship Assessment Tool (HEART) that assessed both positive and negative aspects of male partner involvement in women's HIV prevention. We identified and refined 127 potential items, representing intimate partner violence, agency and social support. A structured survey, including potential items and other sociodemographic and behavioral variables was administered to former microbicide trial and non-trial participants. We conducted an exploratory factor analysis (EFA) to identify a reduced set of constructs and items to screen women who might experience social harms or benefits from vaginal ring use. We examined associations between constructs and with other survey variables to assess content and construct validity. In a subset of 10 women who participated in the survey and qualitative interviews, we used qualitative data to predict survey scores. We retained five constructs with theoretical relevance and good-to-strong reliability for the tool, including: Traditional Values; Partner Support; Partner Abuse & Control; Partner Resistance to HIV Prevention; and HIV Prevention Readiness. Predicted associations between HEART constructs, and correspondence between participants' qualitative data and HEART scores were generally correct, while those between constructs and other sociodemographic variables were more mixed. Initial validation of the HEART tool was promising. The tool will be used during the CHARISMA pilot study at the Johannesburg MTN 025/HOPE site and validated as part of a randomized controlled trial of CHARISMA within a PrEP demonstration project. Beyond clinical trial settings, HEART could assist PrEP or antiretroviral treatment (ART) providers with an easy-to-administer tool to identify risk and tailor risk reduction, empowerment and adherence counseling for microbicides, PrEP or ART related services.


Asunto(s)
Infecciones por VIH/prevención & control , Parejas Sexuales/psicología , Apoyo Social , Adulto , Femenino , Infecciones por VIH/psicología , Humanos , Masculino , Maltrato Conyugal/psicología , Encuestas y Cuestionarios
7.
PLoS One ; 15(12): e0242710, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33362248

RESUMEN

INTRODUCTION: The use of patient-reported outcomes (PROs) to systematically quantify adverse events (AE) will assist in the improvement of medical care and the QoL of patients living with HIV (PLWH). The aim of this study was to investigate the associations between self-reported side effects and other PROs, demographics and laboratory data, and further evaluate the Health Questionnaire (HQ) as a tool for following trends in patient-reported side effects over time in relation to trends in prescribed third agent in ART. MATERIALS AND METHODS: The Swedish National Registry InfCareHiv includes an annual self-reported nine-item HQwhich is used in patient-centered HIV care in all Swedish HIV units. In this study, the experience of side effects was addressed. We analyzed 9,476 HQs completed by 4,186 PLWH together with details about their prescribed ART and relevant biomarkers collected during 2011-2017. Data were analyzed using descriptive statistics, Pearson's correlation coefficient and mixed logistic regression. RESULTS: The cross-sectional analysis of the HQs showed that the frequency of reported side effects decreased from 32% (2011) to 15% (2017). During the same period, there was a shift in ART prescription from efavirenz (EFV) to dolutegravir (DTG) (positive correlation coefficient r = 0.94, p = 0.0016). Further, PLWH who reported being satisfied with their physical health (OR: 0.47, p = <0.001) or psychological health (OR: 0.70, p = 0.001) were less likely to report side effects than those less satisfied. CONCLUSIONS: Self-reported side effects were found to have a close relationship with the patient's ratings of their overall health situation and demonstrated a strong correlation with the sharp decline in use of EFV and rise in use of DTG, with reported side effects being halved. This study supports the feasibility of using the HQ as a tool for longitudinal follow up of trends in PROs.


Asunto(s)
Alquinos/efectos adversos , Fármacos Anti-VIH/efectos adversos , Terapia Antirretroviral Altamente Activa/efectos adversos , Benzoxazinas/efectos adversos , Ciclopropanos/efectos adversos , Infecciones por VIH/tratamiento farmacológico , Compuestos Heterocíclicos con 3 Anillos/efectos adversos , Oxazinas/efectos adversos , Piperazinas/efectos adversos , Piridonas/efectos adversos , Calidad de Vida/psicología , Sistema de Registros , Adulto , Alquinos/administración & dosificación , Fármacos Anti-VIH/administración & dosificación , Artralgia/inducido químicamente , Artralgia/diagnóstico , Artralgia/fisiopatología , Benzoxazinas/administración & dosificación , Estudios Transversales , Ciclopropanos/administración & dosificación , Disfunción Eréctil/inducido químicamente , Disfunción Eréctil/diagnóstico , Disfunción Eréctil/fisiopatología , Femenino , VIH/efectos de los fármacos , Infecciones por VIH/fisiopatología , Infecciones por VIH/psicología , Infecciones por VIH/virología , Compuestos Heterocíclicos con 3 Anillos/administración & dosificación , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Náusea/inducido químicamente , Náusea/diagnóstico , Náusea/fisiopatología , Oxazinas/administración & dosificación , Medición de Resultados Informados por el Paciente , Piperazinas/administración & dosificación , Piridonas/administración & dosificación , Suecia
8.
Afr J AIDS Res ; 19(4): 312-322, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33337977

RESUMEN

This article explores the experiences of HIV-positive adolescents disclosing their status to romantic partners in Bulawayo, Zimbabwe. Disclosure of HIV status continues to be one of the most pressing issues facing adolescents, especially those in relationships, yet health care workers have minimal tailored guidance on how to approach this except to encourage full disclosure. Motives for disclosure were: guilty conscience; legal and ethical obligations; preventing partners being infected; and supportive people, honesty and trust. Disclosure was done on a one-on-one basis in public spaces such as roadsides where the adolescents usually met, or in health care facilities through the help of health care workers, and through mobile phones using WhatsApp. Results revealed that disclosure was associated with negative and positive outcomes ranging from disruption of relationships, depression, breaches of confidential information and, in some instances, relationship and marriage assurance. However, results clearly showed that adolescents living with HIV struggle with disclosure because the process is complex and loaded with emotions and the outcomes can be unpredictable and difficult to handle. Optimism towards treatment, social support, rationalisation, and social comparison through attributing new meanings to the disease were employed to deal with negative outcomes of disclosure. Therefore, the development and implementation of evidence-based initiatives to raise awareness and train the youth to disclose is recommended. Through their experiences, we can learn what works well and what needs to be strengthened.


Asunto(s)
Revelación , Infecciones por VIH/psicología , Parejas Sexuales/psicología , Adolescente , Revelación/estadística & datos numéricos , Femenino , Personal de Salud/psicología , Humanos , Masculino , Motivación , Apoyo Social , Zimbabwe/epidemiología
9.
Afr J AIDS Res ; 19(4): 287-295, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33337980

RESUMEN

HIV/AIDS is a major health issue faced by the world, generally, but particularly sub-Saharan Africa. Nigeria ranked third in the world by number of people living with HIV/AIDS in 2019. Despite prominent HIV counselling and testing (HCT) intervention programmes, Nigeria faces serious challenges, such as inadequate funding and low utilisation rates. Paucity of research into such a critical topic has restricted the capacity of policy makers to address the problem adequately. Consequently, a cross-sectional study was carried out using the contingent valuation method to assess the economic quantum of payment and determining factors associated with people's willingness to pay for HCT services. Data were collected from 768 people selected by convenience sampling of three local government areas - Alimosho, Ikorodu and Surulere in Lagos State, Nigeria. Data were analysed using descriptive statistics, chi-square, Mann-Whitney, and general linear regression model analysis. Findings show that 75% of respondents were willing to pay an average fee of N1 291 ($4.22) for HCT services. Significant determinants of willingness to pay were: income; knowledge of someone living with HIV or died of AIDS; worry about HIV infection; and fear of HIV-related stigma. The findings offer vital information germane to co-payment schemes aimed at financial sustainability of HCT and HIV/AIDS programmes in Nigeria.


Asunto(s)
Consejo/economía , Financiación Personal/estadística & datos numéricos , Infecciones por VIH/economía , Tamizaje Masivo/economía , Adulto , Anciano , Actitud Frente a la Salud , Estudios Transversales , Femenino , Infecciones por VIH/diagnóstico , Infecciones por VIH/prevención & control , Infecciones por VIH/psicología , Humanos , Masculino , Tamizaje Masivo/psicología , Persona de Mediana Edad , Nigeria/epidemiología , Encuestas y Cuestionarios
10.
Afr J AIDS Res ; 19(4): 276-286, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33337981

RESUMEN

Domestic stigmatisation serves as an umbrella term for acts of enacted or felt stigma experienced in a person's domestic environment. This article reports on the term which transpired from a narrative inquiry in 2011 with people living with HIV (PLWH) who reported humiliation or segregation, experienced or perceived, within the domestic environment that rendered the individual disabled, diseased, unworthy, unhealthy, or deficient. A literature review about this form of stigma was conducted using the following inclusion criteria: 1) a peer-reviewed source; 2) published between 2011 and 2018; 3) access to full-text articles; 4) accessible in English; 5) reported from any country; and 6) using qualitative or mixed-method approaches. A total of 37 studies were included in the review - documenting 51 specific experiences of domestic stigmatisation (referred to as acts for the purpose of the review) across all studies. A matrix was developed detailing each study's' publication date, geographical context, participant gender (where possible) and the reported acts. A critical analysis is offered on the concept "domestic stigmatisation" and its relevance to domestic or family interventions. Deliberate attention to this concept can potentially refocus HIV stigma-reducing interventions to benefit families and promote coping strategies to reduce stigma-related stress associated with seropositive identities.


Asunto(s)
Infecciones por VIH/psicología , Estereotipo , Estrés Psicológico/prevención & control , Adaptación Psicológica , Adulto , Femenino , Humanos , Masculino , Literatura de Revisión como Asunto , Estigma Social
11.
PLoS One ; 15(12): e0243969, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33315916

RESUMEN

This study assessed the determinants that shape HIV knowledge and attitudes among South Sudanese women by analysing a Multiple Indicator Cluster Survey collected from 9,061 women in 9,369 households. Generalised linear mixed model regression was performed. Fifty percent of respondents were aware of HIV/AIDS, with 21% and 22% exhibiting good knowledge and positive attitudes towards people with HIV/AIDS, respectively. When controlled for individual and community-level variables, younger women (AOR = 1.28, 95% CI: 1.01-162), women with primary (AOR = 2.19; 95% CI: 1.86-2.58) and secondary (AOR = 4.48; 95% CI: 3.38-5.93) education, and those living in urban areas (AOR = 1.40; 95% CI: 1.12-1.76) had significantly good knowledge. Women in the richer (AOR = 1.60; 95% CI: 1.08-2.36) and the richest (AOR = 2.02; 95% CI: 1.35-3.02) wealth quintiles had significant positive attitudes towards people with HIV/AIDS. Well-designed social and behavioural campaigns targeting uneducated women and those living in rural and remote settings will enhance knowledge of perceived risk, awareness, and ability to carry out preventive behaviours.


Asunto(s)
Síndrome de Inmunodeficiencia Adquirida/epidemiología , Infecciones por VIH/epidemiología , Conocimientos, Actitudes y Práctica en Salud , Síndrome de Inmunodeficiencia Adquirida/psicología , Síndrome de Inmunodeficiencia Adquirida/virología , Adolescente , Adulto , Escolaridad , Femenino , Infecciones por VIH/psicología , Infecciones por VIH/virología , Humanos , Persona de Mediana Edad , Población Rural , Sudán del Sur/epidemiología , Encuestas y Cuestionarios , Adulto Joven
12.
Medicine (Baltimore) ; 99(51): e23683, 2020 Dec 18.
Artículo en Inglés | MEDLINE | ID: mdl-33371109

RESUMEN

BACKGROUND: The infection of human immunodeficiency virus (HIV) is 1 of the major causes of morbidity and mortality in the world. People with chronic diseases have a higher risk of depression. The HIV people are more likely to suffer from depression. Appropriate psychosocial interventions are effective, but their accessibility is limited by the resources needed for their transmission. Thus, it makes sense to develop more cost-effective alternatives, for instance the web-based intervention (WBI), which may be effective for the well-being and depression. The aim of our program is to explore the effects of a WBI on depressive symptoms and well-being in HIV-infected patients. METHOD: It is a randomized controlled experiment to be conducted from February 2021 to July 2021. It was permitted through the Ethics Committee of Changshan County People's Hospital (no.60928376). This study includes 100 HIV patients. Inclusion criteria: (1)18 + years, on effective antiretroviral therapy≥ 1 year before inclusion. Exclusion criteria: patients with severe kidney, liver, lung, and heart diseases. Patients are divided randomly into the study group and control group, each group is assigned 50. The primary results are subjective well-being and depressive symptoms, while the secondary result involves the patients' satisfaction with life. RESULTS: The following Table 1 will exhibit the comparison of outcomes between 2 groups. CONCLUSION: HIV infected patients can benefit from WBI, which can be utilized as an adjunct to medical treatment. TRIAL REGISTRATION NUMBER: researchregistry6215.


Asunto(s)
Depresión/prevención & control , Infecciones por VIH/psicología , Intervención basada en la Internet , Humanos , Ensayos Clínicos Controlados Aleatorios como Asunto
13.
J Acquir Immune Defic Syndr ; 85(4): 475-482, 2020 12 01.
Artículo en Inglés | MEDLINE | ID: mdl-33136748

RESUMEN

BACKGROUND: The spread of severe acute respiratory syndrome coronavirus 2, causative agent of the coronavirus disease 2019 (COVID-19), has necessitated widespread lockdown to mitigate the pandemic. This study examines the influence of resilience on the impact of COVID-related stress and enforced lockdown on mental health, drug use, and treatment adherence among people living with HIV (PLWH) in Argentina. SETTING: PLWH residing predominantly in Buenos Aires Metropolitan Area and urban regions of Argentina were identified from a private clinic electronic database. METHODS: Participants completed an anonymous online survey to evaluate the impact of COVID-19 on economic disruption, resilience, mental health outcomes (depression, anxiety, stress, and loneliness), adherence to HIV treatment, and substance use. We performed ordinary least squares and logistic regressions to test whether resilient coping buffered the impact of economic disruption on mental health and drug use during quarantine. RESULTS: A total of 1336 PLWH aged 18-82 were enrolled. The impact of economic disruption on mental health ΔF(1,1321) = 8.86, P = 0.003 and loneliness ΔF(1,1326) = 5.77, P = 0.016 was buffered by resilience. A 3-way interaction between resilient buffering, stress, and sex was significant ΔF(1,1325) = 4.76, P = 0.029. Participants reported less than excellent adherence to medication (33%), disruption to mental health services (11%), and disruption to substance abuse treatment (1.3%) during lockdown. DISCUSSION: The impact of COVID-stress and lockdown on emotional distress seemed mitigated by resilience coping strategies, and the buffering impact of resilience on perceived stress was greater among women. Results highlight PLWH's capacity to adhere to treatment in challenging circumstances and the importance of developing resilience skills for better coping with stress and adversity.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/psicología , Infecciones por VIH/psicología , Salud Mental/tendencias , Neumonía Viral/psicología , Trastornos de Estrés Traumático Agudo/psicología , Adaptación Psicológica , Adulto , Anciano , Anciano de 80 o más Años , Argentina , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/economía , Infecciones por Coronavirus/prevención & control , Femenino , Infecciones por VIH/complicaciones , Humanos , Violencia de Pareja/tendencias , Análisis de los Mínimos Cuadrados , Modelos Logísticos , Soledad , Masculino , Servicios de Salud Mental/normas , Persona de Mediana Edad , Pandemias/economía , Pandemias/prevención & control , Neumonía Viral/complicaciones , Neumonía Viral/economía , Neumonía Viral/prevención & control , Resiliencia Psicológica , Factores Sexuales , Aislamiento Social/psicología , Apoyo Social , Trastornos de Estrés Traumático Agudo/etiología , Trastornos Relacionados con Sustancias/etiología , Trastornos Relacionados con Sustancias/terapia , Encuestas y Cuestionarios , Cumplimiento y Adherencia al Tratamiento , Adulto Joven
14.
BMC Psychol ; 8(1): 116, 2020 Nov 03.
Artículo en Inglés | MEDLINE | ID: mdl-33143747

RESUMEN

BACKGROUND: Choosing the most useful and versatile way to solve one's personal and social problems is one of the most important choices in individual life. The aim of this study was to compare the coping styles of people living with Human immunodeficiency virus positive and negative. METHODS: This is a Cross-sectional study that accomplished in Shiraz Behavioural Disease Counselling Centre in 2019 and 2020. For this purpose, in the first phase, 40 HIV+ and 40 HIV- patients were randomly selected to answer the questionnaire of dealing with the stressful conditions of Andler and Parker. In the second phase, the same questionnaire was filled out along with a reality distortion questionnaire from similar individuals (40 HIV+ and 40 HIV-). RESULTS: 92% of the HIV population in this study was between 15 and 55 years and 8% was upper than 55 years. 90% of them had no university degree. Among all, 47.5% of them were, 48.5% were self-employed and 49% of them were infected sexually. The results showed that in the first stage there was a significant relationship between marital status and the chances of getting the disease in people, and after controlling the demographic factors, coping styles did not show a significant effect on the disease. In the second stage, the factors of age, sex, education, and marital status had significant effects on people living with HIV, but the effect of coping styles on people with HIV was not significant (P < 0.05). CONCLUSION: Therefore, it can be concluded that demographic factors more than coping styles can affect the chances of high-risk behaviours; so, what is identified and measured as a coping style in people in the process that leads to the manifestation of high-risk behaviours or healthy behaviour does not matter much. It should be noted that the reason for rejecting the hypotheses of this study could be the effect of cultural and social factors of Iranian society.


Asunto(s)
Adaptación Psicológica , Infecciones por VIH/psicología , Seronegatividad para VIH , Seropositividad para VIH , Adolescente , Adulto , Estudios Transversales , Femenino , Humanos , Irán , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios , Adulto Joven
15.
Rev Saude Publica ; 54: 108, 2020.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-33175026

RESUMEN

OBJECTIVE: To estimate the prevalence of smoking and evaluate the factors associated with this outcome in people living with HIV (PLHIV). METHODS: This is a cross-sectional study of a prospective concurrent cohort of 462 individuals initiating antiretroviral therapy at three HIV/AIDS specialized services in Belo Horizonte between 2015 and 2017. The following smoking status were used: current smoker (CS), former smoker (FS) and non-smoker (NS). Multinomial logistic regression was performed with NS as the reference category. RESULTS: Most participants were men (81.4%), young (up to 34 years old; 57.2%) and non-white (75.7%). Of the total number of individuals, 27.7% were CS, 22.9% FS, and 49.4% NS. Most smokers were light smokers (65.1%), consumed up to 10 cigarettes per day and had been smoking for more than 10 years (63.3%), starting on average at 17.2 years of age (SD = 5.1). In the multivariate analysis, higher chances of being CS were associated with: being female, having up to 9 years of schooling, current or prior use of alcohol and illicit drugs (marijuana, cocaine and crack) and presenting signs and/or symptoms of anxiety or depression. Higher chances of being FS were associated with having up to 9 years of schooling and current or prior use of alcohol and illicit drugs (marijuana and crack). CONCLUSIONS: The results show that smoking is highly prevalent among PLHIV, indicating the need for HIV specialized services to prioritize smoking cessation interventions. These interventions should consider the use of alcohol and illicit drugs and be targeted especially to young people, those with low schooling and with signs and/or symptoms of anxiety or depression.


Asunto(s)
Fármacos Anti-VIH/uso terapéutico , Terapia Antirretroviral Altamente Activa/métodos , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/psicología , Fumar/epidemiología , Adolescente , Adulto , Brasil/epidemiología , Estudios Transversales , Femenino , Infecciones por VIH/epidemiología , Humanos , Masculino , Prevalencia , Estudios Prospectivos , Factores Socioeconómicos
16.
PLoS One ; 15(10): e0239753, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33052921

RESUMEN

Globally, burnout in medical doctors (MDs) is concerning, with higher rates reported in studies conducted in South Africa (SA). This psychological syndrome leads to serious health consequences, and jeopardises patient care. Despite this, there is no data pertaining to these potential adverse mental health outcomes in KwaZulu-Natal (KZN) Province, SA, where it is overshadowed by the fight against priorities such as HIV and AIDS/TB. This study therefore aimed to establish the nature and extent of burnout, anxiety and depressive symptoms and their associations among public sector MDs in KZN. A cross sectional study was conducted among MDs at five KZN public sector training hospitals to investigate their associations with practitioner (individual) and organisational factors using the Maslach Burnout Inventory-Human Services Survey (MBI-HSS), the Generalised Anxiety Disorder-7 (GAD-7) questionnaire and the Patient Health Questionnaire-9 (PHQ-9). Of the 150 participants, 88 (59.0%) screened positive for burnout, as indicated by high scores on the emotional exhaustion or depersonalisation subscales in the MBI-HSS. One fifth screened positive for anxiety (n = 30) and depressive symptoms (n = 32). Burnout was significantly associated with individual factors of anxiety (p<0.01) and depressive (p<0.01) symptoms based on adjusted logistic regression models. Organisational factors, such as lack of clinical supervisor support (p<0.01) and hospital resources (p<0.01), were significantly associated with burnout based on the bivariate analyses. Burnout, anxiety and depressive symptoms in MDs are highly prevalent and intertwined in resource constrained KZN public training hospitals. Addressing burnout at individual and organisational levels is important to mitigate its adverse effects.


Asunto(s)
Ansiedad/psicología , Agotamiento Profesional/psicología , Depresión/psicología , Médicos/psicología , Adulto , Estudios Transversales , Despersonalización/psicología , Emociones/fisiología , Estudios de Evaluación como Asunto , Femenino , Gobierno , Infecciones por VIH/epidemiología , Infecciones por VIH/psicología , Recursos en Salud , Hospitales , Humanos , Satisfacción en el Trabajo , Masculino , Prevalencia , Sudáfrica , Estrés Psicológico/psicología , Encuestas y Cuestionarios
17.
BMC Public Health ; 20(1): 1598, 2020 Oct 23.
Artículo en Inglés | MEDLINE | ID: mdl-33097028

RESUMEN

INTRODUCTION: Globally, India has the third largest population of people living with HIV (PLHIV) and the second highest number of COVID-19 cases. Anxiety is associated with antiretroviral therapy (ART) nonadherence. It is crucial to understand the burden of anxiety and its sources among Asian Indian PLHIV during the COVID pandemic, but data are limited. METHODS: During the first month of government mandated lockdown, we administered an anxiety assessment via telephone among PLHIV registered for care at a publicly funded antiretroviral therapy (ART) center in Pune, India. Generalized anxiety was defined as GAD-7 score ≥ 10. Sociodemographic and clinical variables were compared by anxiety status (GAD-7 score ≥ 10 vs GAD-7 score < 10). Qualitative responses to an open-ended question about causes of concern were evaluated using thematic analysis. RESULTS: Among 167 PLHIV, median age was 44 years (IQR 40-50); the majority were cisgender women (60%) and had a monthly family income < 200 USD (81%). Prior history of tuberculosis and other comorbidities were observed in 38 and 27%, respectively. Overall, prevalence of generalized anxiety was 25% (n = 41). PLHIV with GAD-7 score ≥ 10 had fewer remaining doses of ART than those with lower GAD-7 scores (p = 0.05). Thematic analysis indicated that concerns were both health related and unrelated, and stated temporally. Present concerns were often also projected as future concerns. CONCLUSIONS: The burden of anxiety was high during COVID lockdown in our population of socioeconomically disadvantaged PLHIV in Pune and appeared to be influenced by concerns about ART availability. The burden of anxiety among PLHIV will likely increase with the worsening pandemic in India, as sources of anxiety are expected to persist. We recommend the regular use of short screening tools for anxiety to monitor and triage patients as an extension of current HIV services.


Asunto(s)
Ansiedad/epidemiología , Infecciones por Coronavirus/epidemiología , Infecciones por VIH/psicología , Pandemias , Neumonía Viral/epidemiología , Adulto , Antirretrovirales/uso terapéutico , Infecciones por Coronavirus/prevención & control , Femenino , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/epidemiología , Accesibilidad a los Servicios de Salud , Humanos , India/epidemiología , Masculino , Cumplimiento de la Medicación/psicología , Persona de Mediana Edad , Pandemias/prevención & control , Cuestionario de Salud del Paciente , Neumonía Viral/prevención & control , Pobreza , Prevalencia
18.
Afr J AIDS Res ; 19(3): 231-241, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-33119456

RESUMEN

Research on adolescent sexuality, health and parenting has gained much attention in recent years. This growing body of research, however, has arguably limited qualitative outputs on HIV-positive adolescent mothers' sexual and reproductive health choices, needs, and rights in South Africa that could lead to informed policymaking. Through in-depth interviews conducted with a select group of ten HIV-positive adolescents and three key informants, the article explores the sexual, motherhood, risk discourses and reproductive health issues and rights of HIV-positive adolescent mothers as they come to terms with choices they have made and the challenges ahead. The findings highlight the dominant narratives on what are deemed to be the forces that shape these adolescent mothers' new social realities. With existing policies in place for adolescents, it is argued that a "one-size-fits-all" policy approach does not work, especially for HIV-positive adolescent mothers. Drawing on this identified gap and the tensions between individual needs, and the public welfare provision, the article highlights the need for tailored policy that will accommodate and promote the overall well-being of HIV-positive adolescent mothers and their children.


Asunto(s)
Infecciones por VIH/psicología , Mentores , Madres/psicología , Grupo Paritario , Adolescente/legislación & jurisprudencia , Femenino , Infecciones por VIH/epidemiología , Humanos , Mentores/legislación & jurisprudencia , Madres/legislación & jurisprudencia , Narración , Formulación de Políticas , Salud Reproductiva , Conducta Sexual , Sudáfrica/epidemiología
19.
Afr J AIDS Res ; 19(3): 249-262, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-33119459

RESUMEN

Reducing multiple and concurrent partnerships has been identified as a priority in generalised HIV epidemics, yet developing successful interventions to bring about such behaviour change has proven challenging. We offered a three-session intervention aimed to improve couple relationship quality and address HIV risk factors, particularly concurrent sexual partnerships (CSP), in a peri-urban community of Kampala, Uganda. Before launching the intervention, a different group of community members participated in eight single-gender focus group discussions (FGDs) which explored issues of couple relationship quality and satisfaction. Findings from the FGDs guided the intervention. All 162 couples invited to the intervention completed a survey pre- and post-intervention. In FGDs, women and men discussed challenges faced in their relationships, including pervasive dissatisfaction, financial constraints, deception and lack of trust, poor communication, lack of sexual satisfaction, and concurrent sexual partnerships. A difference-in-difference analysis showed no measurable impact of the intervention on relationship quality or sexual risk behaviours over a six-month follow-up among 183 individuals who participated in the intervention, although many stated in response to open-ended questions that they had experienced positive relationship changes. Qualitative findings suggest high demand for couple-focused interventions but also reveal many individual-, couple-, community- and structural-level factors which contribute to women and men seeking concurrent sexual partnerships. More intensive interventions may be needed to overcome these barriers to behaviour change and reduce HIV risk. These findings also raise questions about how to interpret divergent qualitative and quantitative data, a topic which has received little attention in the literature.


Asunto(s)
Infecciones por VIH/prevención & control , Infecciones por VIH/psicología , Relaciones Interpersonales , Parejas Sexuales , Adulto , Femenino , Grupos Focales , Infecciones por VIH/epidemiología , Humanos , Masculino , Factores de Riesgo , Conducta Sexual/fisiología , Parejas Sexuales/psicología , Población Suburbana , Uganda/epidemiología
20.
PLoS One ; 15(10): e0239291, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33007781

RESUMEN

Many persons living with HIV (PLWH) either reduced their employment capacity or stopped work completely due to disease progression. With the advent of effective antiretroviral therapy, some PLWH were able to return to the workforce and many are now transitioning into retirement. We examined the histories of employment, retirement and disability status on depression among 1,497 Participants living with HIV from 1997 to 2015 in the Multicenter AIDS Cohort Study. Data were collected on depressive symptoms, employment, retirement, disability status as well as HIV-related and sociodemographic characteristics. Employment, retirement and disability status were lagged 2 years to assess whether the risk of depression at a given observation were temporally predicted by each respective status, adjusting for prior depressive symptoms and covariates. Being employed (aOR: 0.76; 95% CI: 0.71-0.82) had lower odds of depression risk two years later compared to those unemployed. There were higher odds of depression risk associated with disability (aOR: 1.43; 95% CI: 1.32-1.54) versus those not on disability. Retirement status was not associated with the risk of depressive symptoms. These findings could help inform policies and employment programs to facilitate the return to work for PLWH who are willing and able to work.


Asunto(s)
Depresión/complicaciones , Personas con Discapacidad/psicología , Empleo/psicología , Infecciones por VIH/psicología , Jubilación/psicología , Adolescente , Adulto , Anciano , Estudios de Cohortes , Femenino , Infecciones por VIH/complicaciones , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Riesgo , Apoyo Social , Adulto Joven
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