Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 15.420
Filtrar
1.
J Acquir Immune Defic Syndr ; 85(4): 475-482, 2020 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-33136748

RESUMO

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.


Assuntos
Betacoronavirus , Infecções por Coronavirus/psicologia , Infecções por HIV/psicologia , Saúde Mental/tendências , Pneumonia Viral/psicologia , Transtornos de Estresse Traumático Agudo/psicologia , Adaptação Psicológica , Adulto , Idoso , Idoso de 80 Anos ou mais , Argentina , Infecções por Coronavirus/complicações , Infecções por Coronavirus/economia , Infecções por Coronavirus/prevenção & controle , Feminino , Infecções por HIV/complicações , Humanos , Violência por Parceiro Íntimo/tendências , Análise dos Mínimos Quadrados , Modelos Logísticos , Solidão , Masculino , Serviços de Saúde Mental/normas , Pessoa de Meia-Idade , Pandemias/economia , Pandemias/prevenção & controle , Pneumonia Viral/complicações , Pneumonia Viral/economia , Pneumonia Viral/prevenção & controle , Resiliência Psicológica , Fatores Sexuais , Isolamento Social/psicologia , Apoio Social , Transtornos de Estresse Traumático Agudo/etiologia , Transtornos Relacionados ao Uso de Substâncias/etiologia , Transtornos Relacionados ao Uso de Substâncias/terapia , Inquéritos e Questionários , Cooperação e Adesão ao Tratamento , Adulto Jovem
2.
BMC Psychol ; 8(1): 116, 2020 Nov 03.
Artigo em Inglês | MEDLINE | ID: mdl-33143747

RESUMO

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.


Assuntos
Adaptação Psicológica , Infecções por HIV/psicologia , Soronegatividade para HIV , Soropositividade para HIV , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Irã (Geográfico) , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto Jovem
3.
PLoS One ; 15(10): e0239291, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33007781

RESUMO

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.


Assuntos
Depressão/complicações , Pessoas com Deficiência/psicologia , Emprego/psicologia , Infecções por HIV/psicologia , Aposentadoria/psicologia , Adolescente , Adulto , Idoso , Estudos de Coortes , Feminino , Infecções por HIV/complicações , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Risco , Apoio Social , Adulto Jovem
4.
PLoS One ; 15(10): e0239753, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33052921

RESUMO

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.


Assuntos
Ansiedade/psicologia , Esgotamento Profissional/psicologia , Depressão/psicologia , Médicos/psicologia , Adulto , Estudos Transversais , Despersonalização/psicologia , Emoções/fisiologia , Estudos de Avaliação como Assunto , Feminino , Governo , Infecções por HIV/epidemiologia , Infecções por HIV/psicologia , Recursos em Saúde , Hospitais , Humanos , Satisfação no Emprego , Masculino , Prevalência , África do Sul , Estresse Psicológico/psicologia , Inquéritos e Questionários
5.
PLoS One ; 15(10): e0239310, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33064737

RESUMO

Infants born to HIV-infected mothers are more likely to be low birthweight (LBW) than other infants, a condition that is stigmatized in many settings worldwide, including sub-Saharan Africa. Few studies have characterized the social-cultural context and response to LBW stigma among mothers in sub-Saharan Africa or explored the views of women living with HIV (WLHIV) on the causes of LBW. We purposively sampled thirty postpartum WLHIV, who had given birth to either LBW or normal birthweight infants, from two tertiary hospitals in Accra, Ghana. Using semi-structured interviews, we explored women's understanding of the etiology of LBW, and their experiences of caring for a LBW infant. Interviews were analyzed using interpretive phenomenology. Mothers assessed their babies' smallness based on the baby's size, not hospital-recorded birthweight. Several participants explained that severe depression and a loss of appetite, linked to stigma following an HIV diagnosis during pregnancy, contributed to infants being born LBW. Women with small babies also experienced stigma due to the newborns' "undesirable" physical features and other people's unfamiliarity with their size. Consequently, mothers experienced blame, reluctance showing the baby to others, and social gossip. As a result of this stigma, women reported self-isolation and depressive symptoms. These experiences were layered on the burden of healthcare and infant feeding costs for LBW infants. LBW stigma appeared to attenuate with increased infant weight gain. A few of the women also did not breastfeed because they thought their baby's small size indicated pediatric HIV infection. Among WLHIV in urban areas in Ghana, mother and LBW infants may experience LBW-related stigma. A multi-component intervention that includes reducing LBW incidence, treating antenatal depression, providing psychosocial support after a LBW birth, and increasing LBW infants' weight gain are critically needed.


Assuntos
Infecções por HIV/psicologia , Mães/psicologia , Período Pós-Parto/psicologia , Estereotipagem , Adolescente , Adulto , Depressão/etiologia , Feminino , Gana , Infecções por HIV/patologia , Humanos , Lactente , Recém-Nascido de Baixo Peso , Entrevistas como Assunto , Isolamento Social , Ganho de Peso , Adulto Jovem
6.
Niger J Clin Pract ; 23(10): 1419-1425, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33047700

RESUMO

Background: Nigeria ranks second globally with a HIV/AIDS prevalence of 3.2%. HIV infected children are surviving to adolescence because of anti-retroviral therapy, but many do not know why they need to take these medicines. Disclosure is critical to long-term disease management, yet, if, how and when caregivers and or health professionals disclose to children is not well known in resource-limited settings. The barriers to disclosure remain largely undocumented. Objectives: To determine the prevalence and age of HIV disclosure to children in Abuja, Nigeria and identify caregivers perspectives as well as barriers to disclosure. Methods: A cross-sectional study was done June-July 2016 using a structured questionnaire, convenience sampling and quantitative methods at the infectious disease clinics of National Hospital Abuja. A sample of 164 caregivers of HIV-positive children aged 5-16 years receiving antiretroviral therapy for at least 1 year were enrolled. Results: Prevalence of full disclosure was 24.5%, partial disclosure 22.7%, with overall prevalence of 47.2%. Mean age at full disclosure was 11.87 years. Bivariate analysis showed significant difference between disclosure and child's level of education (χ2 for trend 26.710, P < 0.001), support for disclosure (χ2 4.399, P = 0.036) and if caregiver held the opinion that children should have disclosure done (Pearson's χ2 30.174, P < 0.001). However, on logistic regression, only the age of the child (P < 0.001, 95% CI 1.176-1.499) and the caregiver's opinion (P = < 0.001, 95% CI 4.914-2.542) remained significant. Various barriers to disclosure were identified. Conclusion: The prevalence of full disclosure is low and several barriers prevent early disclosure. Caregiver's and HCWs need empowerment with culturally appropriate skills and platforms to increase disclosure rates, which may help improve adherence.


Assuntos
Cuidadores/psicologia , Revelação/estatística & dados numéricos , Infecções por HIV/psicologia , Revelação da Verdade , Adolescente , Criança , Pré-Escolar , Estudos Transversais , Feminino , Infecções por HIV/epidemiologia , Pessoal de Saúde , Humanos , Masculino , Nigéria/epidemiologia , Prevalência , Inquéritos e Questionários
7.
BMC Public Health ; 20(1): 1598, 2020 Oct 23.
Artigo em Inglês | MEDLINE | ID: mdl-33097028

RESUMO

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.


Assuntos
Ansiedade/epidemiologia , Infecções por Coronavirus/epidemiologia , Infecções por HIV/psicologia , Pandemias , Pneumonia Viral/epidemiologia , Adulto , Antirretrovirais/uso terapêutico , Infecções por Coronavirus/prevenção & controle , Feminino , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Acesso aos Serviços de Saúde , Humanos , Índia/epidemiologia , Masculino , Adesão à Medicação/psicologia , Pessoa de Meia-Idade , Pandemias/prevenção & controle , Questionário de Saúde do Paciente , Pneumonia Viral/prevenção & controle , Pobreza , Prevalência
8.
Afr J AIDS Res ; 19(3): 231-241, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33119456

RESUMO

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.


Assuntos
Infecções por HIV/psicologia , Mentores , Mães/psicologia , Grupo Associado , Adolescente/legislação & jurisprudência , Feminino , Infecções por HIV/epidemiologia , Humanos , Mentores/legislação & jurisprudência , Mães/legislação & jurisprudência , Narração , Formulação de Políticas , Saúde Reprodutiva , Comportamento Sexual , África do Sul/epidemiologia
9.
Afr J AIDS Res ; 19(3): 249-262, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33119459

RESUMO

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.


Assuntos
Infecções por HIV/prevenção & controle , Infecções por HIV/psicologia , Relações Interpessoais , Parceiros Sexuais , Adulto , Feminino , Grupos Focais , Infecções por HIV/epidemiologia , Humanos , Masculino , Fatores de Risco , Comportamento Sexual/fisiologia , Parceiros Sexuais/psicologia , População Suburbana , Uganda/epidemiologia
10.
PLoS One ; 15(9): e0239330, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32997688

RESUMO

BACKGROUND: Hazardous alcohol use is prevalent among people living with HIV (PWH), leading to sub-optimal HIV treatment outcomes. In Vietnam, alcohol use is highly normative making it socially challenging for PWH to reduce or abstain. We used mixed methods to develop a quantitative scale to assess alcohol abstinence stigma and examined the association between alcohol abstinence stigma with alcohol use among PWH in Vietnam. METHODS: We conducted qualitative interviews with 30 PWH with hazardous alcohol use from an antiretroviral therapy (ART) clinic in the Thai Nguyen to inform item development. Alcohol use was assessed using the Alcohol Use Disorders Identification Test. We tested items in a survey of 1,559 ART clinic patients to assess internal consistency and structural validity. We used log binomial modeling to estimate associations between any reported alcohol abstinence stigma and alcohol use. RESULTS: Using the results from the qualitative interview data, we developed the alcohol abstinence stigma scale with seven final items with scores ranging from 0 (no stigma) to 28 (high stigma). The scale had good internal consistency (α = 0.75). Exploratory factor analysis suggested the presence of three factors: internalized, experienced, and anticipated stigma that explained 56.9% of the total variance. The mean score was 2.74, (SD = 4.28) and 46% reported any alcohol abstinence stigma. We observed a dose-response relationship between alcohol abstinence stigma and alcohol use. PWH who reported any alcohol abstinence stigma had greater hazardous alcohol use (aPR = 1.32, 95% CI: 1.12, 1.56), harmful alcohol use (aPR = 2.26, 95% CI: 1.37, 3.72), and dependence symptoms (aPR = 3.81, 95% CI: 2.19, 6.64). CONCLUSION: Alcohol abstinence stigma is associated with increased alcohol levels of alcohol use among PWH in Vietnam, signaling challenges for alcohol reduction. Consideration of alcohol abstinence stigma will be essential for the design of effective alcohol reduction interventions and policy efforts to prevent adverse health consequences of alcohol use among PWH.


Assuntos
Abstinência de Álcool/psicologia , Consumo de Bebidas Alcoólicas/psicologia , Infecções por HIV/psicologia , Estigma Social , Adulto , Feminino , Humanos , Masculino , Vietnã
11.
An. psicol ; 36(2): 232-241, mayo 2020. tab
Artigo em Inglês | IBECS | ID: ibc-192059

RESUMO

BACKGROUND: The cardinal aim of the present study was to assess the level of social support, self esteem and quality of life among people living with HIV/AIDS in Jammu and Kashmir State of India. Further, the study strived to explore the relationship between independent and dependent variables. METHOD: The study consists a sample of 460 AIDS patients selected through purposive sampling technique, out of them 177 (38.3%) were male, 283 (61.5%) were female patients; 295 (64.1%) were married and 165 (35.9%) were unmarried. Measures included Enriched Social Support Inventory by Mitchell et al., (2003), Rosenberg's Self-Esteem Scale (1965) and Quality of Life Scale by Sharma & Nasreen (2014). For the statistical analysis of data Mean, Standard deviation, Frequency distribution, t-test, one way analysis of variance, correlation analysis and Scheffe's post hoc test was applied by SPSS 20.0 version. Findings: The findings illustrated that majority of patients have poor social support, lower self-esteem and poor quality of life; also it reveals that patient's social support, and self-esteem differs by age, occupation, duration of illness, gender, and marital status. However their quality of life differs only by their age, occupation, duration of illness, and marital status. Further the result shows social support and self-esteem are positively correlated with quality of life


ANTECEDENTES: El objetivo principal del presente estudio fue evaluar el nivel de apoyo social, autoestima y calidad de vida entre las personas que viven con el VIH / SIDA en Jammu y el Esta do de Cachemira de la India. Además, el estudio se esforzó por explorar la relación entre variables independientes y dependientes. Método: El estudio consiste en una muestra de 460 pacientes con SIDA seleccionados mediante una técnica de muestreo intencional, de ellos 177 (38.3%) eran hombres, 283 (61.5%) eran pacientes femeninas; 295 (64.1%) estaban casados y 165 (35.9%) no estaban casados. Las medidas incluyeron el Inventario de apoyo social enriquecido de Mitchell et al. (2003), la Escala de autoestima de Rosenberg (1965) y la Escala de calidad de vida de Sharma y Nasreen (2014). Para el análisis estadístico de los datos, la versión SPSS 20.0 aplicó la media, la desviación estándar, la distribución de frecuencia, la prueba t, el análisis de varianza unidireccional, el cuadrado de eta, el análisis de correlación y la prueba post hoc de Scheffe. Hallazgos: Los hallazgos ilustran que la mayoría de los pacientes tienen poco apoyo social, baja autoestima y mala calidad de vida; también revela que el apoyo social y la autoestima del paciente difieren según la edad, la ocupación, la duración de la enfermedad, el género y el estado civil. Sin embargo, su calidad de vida difiere solo por su edad, ocupación, duración de la enfermedad y estado civil. Además, el resultado muestra que el apoyo social y la autoestima se correlacionan positivamente con la calidad de vida


Assuntos
Humanos , Masculino , Feminino , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Infecções por HIV/epidemiologia , Síndrome de Imunodeficiência Adquirida/epidemiologia , Síndrome de Imunodeficiência Adquirida/psicologia , Apoio Social , Qualidade de Vida/psicologia , Autoimagem , Infecções por HIV/psicologia , Índia/epidemiologia , Análise de Variância
12.
Medicine (Baltimore) ; 99(35): e21360, 2020 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-32871863

RESUMO

HIV prevalence is higher among Men who have Sex with Men (MSM), owing to their unsafe sexual behavior. Further, MSM indulge in behaviors such as consumption of alcohol/oral drugs and/or injecting during/before sex that poses the risk of unsafe behaviors, thereby increasing their vulnerability to HIV. The study aims to analyze the factors associated with HIV infection among the multi-risk MSM using any substances with those MSM who do not use substances.Community-based cross-sectional survey design using probability-based sampling between October 2014 and November 2015.For the nation-wide Integrated Biological and Behavioral Surveillance (IBBS), 23,081 MSM were recruited from 4067 hotspots in 108 districts across India. Information on demographics, sexual behaviors, substance use, sexual partners, and awareness on HIV and its management was collected from the consented respondents using computer-assisted personal interview (CAPI) by trained personnel. Blood samples were tested for HIV. Statistical analyses were done, to study the associations between substance use and its influence on high-risk sexual behaviors and HIV infection.One in 3 MSM (33.88%) in India were substance users, thus exhibiting "multi-risk" (MR) behaviors. Significantly higher HIV prevalence (3.8%, P < .05) was reported among MR-MSM, despite 97.2% of them being aware of HIV. Higher HIV prevalence among MSM exhibiting homosexual behavior for ≤1 year is of specific concern, as this accounts to recent infections and indicates the increased vulnerability of the infection among the new entrants.Substance-use resulting in high-risk sexual behavior was significantly associated with higher HIV prevalence among MR-MSM. Integrated targeted interventions focusing on safe sex and safe-IDU practices among MR-MSM are required to end the disease transmission.


Assuntos
Infecções por HIV/epidemiologia , Infecções por HIV/transmissão , Homossexualidade Masculina/estatística & dados numéricos , Comportamento Sexual/etnologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adolescente , Adulto , Consumo de Bebidas Alcoólicas/epidemiologia , Conscientização , Estudos Transversais , Usuários de Drogas/estatística & dados numéricos , Infecções por HIV/psicologia , Homossexualidade Masculina/etnologia , Humanos , Índia/epidemiologia , Masculino , Prevalência , Assunção de Riscos , Comportamento Sexual/psicologia , Parceiros Sexuais/classificação , Adulto Jovem
13.
PLoS One ; 15(9): e0238240, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32886666

RESUMO

The aim of the study is to compare sociodemographic characteristics, psychosocial factors, HIV knowledge and risk behaviors of people living with HIV (PLH) and their social network members (NMs) to inform HIV prevention programs that engage PLH as prevention educators in their communities. We compared baseline characteristics of PLH enrolled in an intervention to become HIV prevention Change Agents (CAs) (n = 458) and 602 NMs they recruited. CAs and NMs responded to questionnaires through a computer-driven interface with Audio Computer-Assisted Self Interview (ACASI) software. Although NMs scored higher on socio-economic status, self-esteem and general self-efficacy, they had lower HIV knowledge (AOR 1.5; 95% CI: 1.1-2.1), greater inconsistent condom use (AOR 3.2; 95% CI: 2.4-4.9), and recent experience as perpetrators of physical (AOR 2.5; 95% CI: 1.2-5.1) or sexual (AOR 4.1; 95% CI: 1.4-12.7) intimate partner violence; and as victims of physical (AOR 1.5; 95% CI: 1.0-2.3) or sexual (AOR 2.2; 95% CI: 1.3-3.8) forms of violence than CAs. Higher HIV knowledge and lower sexual risk behaviors among CAs suggest PLH's potential as communicators of HIV prevention information to NMs. CAs' training should also focus on improving self-esteem, general self-efficacy and social support to increase their potential effectiveness as HIV prevention educators and enhance their own overall health and well-being.


Assuntos
Transmissão de Doença Infecciosa/prevenção & controle , Infecções por HIV/psicologia , Infecções por HIV/transmissão , HIV/isolamento & purificação , Assunção de Riscos , Parceiros Sexuais/psicologia , Rede Social , Adolescente , Adulto , Antirretrovirais/uso terapêutico , Estudos Transversais , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/virologia , Humanos , Masculino , Fatores de Risco , Comportamento Sexual/psicologia , Apoio Social , Tanzânia/epidemiologia , Adulto Jovem
14.
Medicine (Baltimore) ; 99(35): e21606, 2020 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-32871876

RESUMO

The increasing availability of antiretroviral therapy (ART) worldwide is yet to result in decreasing HIV-related mortality among adolescents (10-19 years old) living with HIV (ALHIV) in part because of poor adherence. the poor adherence might itself be due to high level of depression. We assess the prevalence of depressive symptomatology and it's associated with adherence among ALHIV receiving ART care in Brazzaville and Pointe Noire, Republic of Congo (RoC).Adolescents aged 10 to 19 years, on antiretroviral therapy (ART), followed in the two Ambulatory Treatment Centers (ATC) in Brazzaville and Pointe Noire, RoC were included in this cross-sectional study. From April 19 to July 9, 2018, participants were administered face to face interviews using a standardized questionnaire that included the nine-item Patient Health Questionnaire (PHQ-9). Participants who reported failing to take their ART more than twice in the 7 days preceding the interview were classified as non-adherent. Bivariate and multivariable log-binomial models were used to estimate the prevalence ratio (PR) and 95% confidence interval (95%CI) assessing the strength of association between predictors and presence of depressive symptoms (PHQ-9 score ≥9).Overall, 135 adolescents represented 50% of ALHIV in active care at the 2 clinics were interviewed. Of those, 67 (50%) were male, 81 (60%) were 15 to 19 years old, 124 (95%) had been perinatally infected, and 71 (53%) knew their HIV status. Depressive symptoms were present in 52 (39%) participants and 78 (58%) were adherent. In univariate analyses, the prevalence of depressive symptoms was relative higher among participants who were not adherent compared to those who were (73% vs 33%; PR: 2.20 [95%CI: 1.42-3.41]). In multivariate analysis, after adjustment for report of been sexually active, alcohol drinking, age category (10-14 and 15-19), not in school, loss of both parents, the association between depression and adherence was strengthened (PR: 2.06 [95%CI: 1.23-3.45]).The prevalence of depressive symptoms in adolescents living with HIV is high and was strongly associated with poor adherence even after adjustment of potential confounders. Efforts to scale-up access to screening and management of depression among ALHIV in sub-Saharan is needed for them to realize the full of ART.


Assuntos
Antirretrovirais/uso terapêutico , Depressão/epidemiologia , Infecções por HIV/psicologia , Adesão à Medicação/psicologia , Adolescente , Instituições de Assistência Ambulatorial , Estudos de Casos e Controles , Criança , Congo/epidemiologia , Estudos Transversais , Depressão/psicologia , Feminino , Infecções por HIV/tratamento farmacológico , Humanos , Masculino , Programas de Rastreamento/métodos , Programas de Rastreamento/psicologia , Adesão à Medicação/estatística & dados numéricos , Assistência Perinatal/estatística & dados numéricos , Assistência Perinatal/tendências , Prevalência , Inquéritos e Questionários , Adulto Jovem
15.
Environ Health Prev Med ; 25(1): 50, 2020 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-32912181

RESUMO

BACKGROUND: From 2010 to 2015, there was a twofold growth of new HIV/AIDS infection in Beijing among young students aged 15-24. HIV/AIDS education was found effective in promoting positive behavior change related to HIV/AIDS prevention. However, little evidence was found on the evaluation of HIV/AIDS education policy. This study aimed to evaluate the college-based HIV/AIDS education policy in Beijing. METHODS: By using a mixed method approach, the current study reviewed college-based HIV/AIDS education policy at national level and in Beijing from 1985 to 2016 and conducted policy content analysis to evaluate the policy ability to structure implementation. Cross-sectional surveys in 2006 and 2016 were used to evaluate college's implementation of relevant policies. T test, χ2 test, and logistic regression were used to analyze college students' perception of HIV/AIDS education provided in their colleges and their knowledge of HIV/AIDS and their risk factors. RESULTS: Fourteen pieces of national policy and four pieces of Beijing's policy were identified. Policy's ability to structure implementation was at moderate level. The percentage of students in Beijing who ever perceived HIV/ADIS education at colleges decreased from 71.14 to 39.80%, and the percentage of students with comprehensive knowledge of HIV/AIDS dropped from 50.00% in 2006 to 40.42% in 2016. CONCLUSIONS: HIV/AIDS education in college had drawn considerable attentions from the Chinese government, while the policy implementation needs further strengthening.


Assuntos
Síndrome de Imunodeficiência Adquirida/psicologia , Infecções por HIV/psicologia , Educação em Saúde/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Política de Saúde , Adolescente , Pequim , Estudos Transversais , Feminino , Humanos , Masculino , Universidades/estatística & dados numéricos , Adulto Jovem
16.
AIDS Patient Care STDS ; 34(9): 399-416, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32931317

RESUMO

HIV disproportionately impacts US racial and ethnic minorities but they participate in treatment and vaccine clinical trials at a lower rate than whites. To summarize barriers and facilitators to this participation we conducted a scoping review of the literature guided by the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. Studies published from January 2007 and September 2019 were reviewed. Thirty-one articles were identified from an initial pool of 325 records using three coders. All records were then assessed for barriers and facilitators and summarized. Results indicate that while racial and ethnic minority participation in these trials has increased over the past 10 years, rates still do not proportionately reflect their burden of HIV infection. While many of the barriers mirror those found in other disease clinical trials (e.g., cancer), HIV stigma is a unique and important barrier to participating in HIV clinical trials. Recommendations to improve recruitment and retention of racial and ethnic minorities include training health care providers on the importance of recruiting diverse participants, creating interdisciplinary research teams that better represent who is being recruited, and providing culturally competent trial designs. Despite the knowledge of how to better recruit racial and ethnic minorities, few interventions have been documented using these strategies. Based on the findings of this review, we recommend that future clinical trials engage community stakeholders in all stages of the research process through community-based participatory research approaches and promote culturally and linguistically appropriate recruitment and retention strategies for marginalized populations overly impacted by HIV.


Assuntos
Ensaios Clínicos como Assunto , Grupos Étnicos , Infecções por HIV/tratamento farmacológico , Grupos Minoritários , Participação do Paciente/psicologia , Grupos de Populações Continentais , Infecções por HIV/etnologia , Infecções por HIV/psicologia , Humanos , Grupos Minoritários/estatística & dados numéricos , Seleção de Pacientes/ética , Vacinas/administração & dosagem
17.
PLoS One ; 15(9): e0238320, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32911529

RESUMO

AIM: In view of the current context of poverty and socio-economic inequalities and the high and rising burdens of HIV infection and non-communicable diseases in South Africa, this study aims to describe the distribution of adverse life events (ALEs) by age and gender, and examine the socio-demographic characteristics, psychosocial coping mechanisms, risky lifestyle behaviours and family burden of HIV-related ill-health associated with ALEs in 25-74-year-old black residents of Cape Town. MATERIALS AND METHODS: In a random cross-sectional sample, 12 ALEs, tobacco and alcohol use, sense of coherence (SOC), locus of control (LOC) and impact of HIV in the family were determined by administered questionnaires. Data analyses included descriptive statistics adjusted for the realised sample. Multivariable linear regression models assessed the independent associations of increasing number of ALEs. RESULTS: Among 1099 participants, mean lifetime score of ALE categories examined was 6.1 ±2.1 (range 0-12) with men reporting significantly higher number of events compared with women (p<0.001). The most frequent ALE was the death of a loved one (88.5%) followed by a major financial crisis (81.2%) with no trend across gender or age group. In the multivariable linear regression model, increasing ALEs were significantly associated with male gender, unemployment, having spent >50% of life in urban areas, >7 years of education, problematic alcohol use and poorer psychosocial coping mechanisms defined by low SOC and LOC. All four variables pertaining to HIV-related burden of ill-health in the family were significantly associated with increasing ALEs. CONCLUSIONS: Considering that lower SOC and LOC and problem drinking were significantly linked to ALEs, policymakers need to formulate strategies that improve coping mechanisms and promote problem-solving behaviours, target the high burden of alcohol misuse and address unemployment.


Assuntos
Adaptação Psicológica , Experiências Adversas da Infância/estatística & dados numéricos , Consumo de Bebidas Alcoólicas/epidemiologia , Infecções por HIV/complicações , Acontecimentos que Mudam a Vida , Fumar Tabaco/epidemiologia , População Urbana/estatística & dados numéricos , Adulto , Grupo com Ancestrais do Continente Africano , Idoso , Estudos Transversais , Feminino , HIV/isolamento & purificação , Infecções por HIV/psicologia , Infecções por HIV/virologia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , África do Sul/epidemiologia
18.
Ann Behav Med ; 54(10): 728-737, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-32940326

RESUMO

BACKGROUND: Severe acute respiratory syndrome coronavirus-2, the virus that causes COVID-19, is an emerging pandemic with heightened concerns for people with compromised immune systems, including people living with HIV. PURPOSE: In the absence of a vaccine, public health messaging to mitigate risks for COVID-19 primarily focuses on social distancing. Because people living with HIV commonly experience mistreatment associated with HIV, their response to social distancing may be complicated by psychosocial attitudes associated with COVID-19. METHODS: To evaluate these relationships, we conducted a rapid-response, cross-sectional survey with people living with HIV (N = 149) to assess social distancing practices, COVID-19 discriminatory attitudes, COVID-19 xenophobic attitudes, HIV microaggressions, and concern over contracting COVID-19. Data were collected from participants enrolled in a larger ongoing study between March 30, 2020 and April 17, 2020. RESULTS: Results indicated that choosing to socially distance to reduce COVID-19 exposure was associated with COVID-19 discriminatory attitudes, concerns of contracting COVID-19, and identifying as transgender. Likewise, social distancing imposed by others (e.g., cancelations and restrictions) was associated with concerns of contracting COVID-19. CONCLUSIONS: Findings demonstrate that social distancing measures are related to concerns of contracting the virus and discriminatory attitudes toward those who are presumed to be living with COVID-19. These potentially negative psychosocial attitudes toward people perceived to have COVID-19 echo the discriminatory actions and attitudes that we continue to observe in HIV social sciences research.


Assuntos
Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/psicologia , Infecções por HIV/psicologia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/psicologia , Discriminação Social/psicologia , Isolamento Social , Adulto , Betacoronavirus , Estudos Transversais , Feminino , Humanos , Masculino , Preconceito , Inquéritos e Questionários , Adulto Jovem
19.
Afr J AIDS Res ; 19(3): 206-213, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32892702

RESUMO

Over-integration of HIV-related trauma into the client's memory in a negative emotional valence could be a serious health debilitating process which may result in negative post-traumatic health outcomes, affecting health-related quality of life (HRQoL) of people living with HIV (PLWH). We hypothesized that post-traumatic stress disorder (PTSD) symptoms are the mediating link between negative event centrality (NEC) and HRQoL among PLWH. Nine hundred and sixty-nine PLWH in Nigeria completed measures of NEC, PTSD symptoms and HRQoL. Model 4 of Hayes' regression-based PROCESS macro version 3.0 for SPSS was employed to investigate relationships between variables of interest. NEC was positively associated with all domains of HRQoL. PLWH who had high negatively centralized identity on HIV also had high scores on PTSD symptoms. PTSD symptoms were also positively associated with all domains of HRQoL. PTSD symptoms also mediated the relationship between NEC and all domains of HRQoL. Assessing and treating PTSD symptoms among PLWH by clinicians could be helpful in enhancing HRQoL.


Assuntos
Infecções por HIV/psicologia , Negativismo , Qualidade de Vida/psicologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Adulto , Feminino , Humanos , Acontecimentos que Mudam a Vida , Masculino , Nigéria/epidemiologia , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/terapia
20.
Afr J AIDS Res ; 19(3): 214-221, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32892703

RESUMO

In spite of the high HIV burden and high prevalence and incidence of HIV infection among adolescent girls and young women (AGYW) in South Africa, uptake of HIV testing in this population falls short of the UNIADS 90-90-90 targets, leading to late diagnosis, late entry into HIV care and treatment, and poor uptake of prevention services. There is a critical need to update and deepen our understanding of attitudes towards testing in this population, in order to appropriately respond to their specific needs. This article reports on findings from an exploration of perceptions of HIV testing and testing behaviour amongst AGYW in South Africa using a combination of quantitative and qualitative data. Analysis included data on testing behaviour and reasons for never testing from a survey conducted with 4 399 AGYW aged 15-24 years in six provinces. Combined with survey data is qualitative analysis from 63 in-depth interviews and 24 focus group discussions with 237 AGYW from five provinces. Findings revealed complex, dualistic and often contradictory views towards HIV testing in this population, with fear of HIV and the consequences of testing positive existing alongside a lack of concern towards HIV infection because of the availability and accessibility of antiretrovirals. These findings can help to address barriers to HIV testing in this population and ensure appropriateness of future interventions and HIV messaging.


Assuntos
Atitude Frente a Saúde , Infecções por HIV/diagnóstico , Programas de Rastreamento/psicologia , Adolescente , Feminino , Grupos Focais , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Infecções por HIV/psicologia , Humanos , Entrevistas como Assunto , Comportamento Sexual/estatística & dados numéricos , África do Sul/epidemiologia , Inquéritos e Questionários , Adulto Jovem
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA