Dataset Information

The Impact of COVID-19 on HIV Self-Management, Affective Symptoms, and Stress in People Living with HIV in the United States.

ABSTRACT: COVID-19 has the potential to detrimentally impact HIV self-management in people living with HIV (PLHIV). Effective HIV-self management is critically important in managing symptoms as well as viral suppression. We examined the impact of the COVID-19 pandemic on HIV self-management, social support, social isolation, depressive symptoms, anxiety, and stress in PLHIV. 85 PLHIV were recruited from social media sites and completed an online survey. Data were collected between April 23 and 30, 2020. Participants reported increases in social isolation, depressive symptoms, anxiety, and stress and decreases in social support and overall HIV self-management from pre- to during the pandemic. Additionally, the Social Support domain and Chronic Nature of HIV domain of the HIV Self-Management Scale were also decreased from pre- to during the pandemic. The ability for PLHIV to maintain HIV self-management during this time is essential and HIV care providers should have plans in place to provide support.

SUBMITTER: Wion RK

PROVIDER: S-EPMC8204118 | biostudies-literature | 2021 Sep

REPOSITORIES: biostudies-literature

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The Impact of COVID-19 on HIV Self-Management, Affective Symptoms, and Stress in People Living with HIV in the United States.

Wion Rachel K RK Miller Wendy R WR

AIDS and behavior 20210615 9

COVID-19 has the potential to detrimentally impact HIV self-management in people living with HIV (PLHIV). Effective HIV-self management is critically important in managing symptoms as well as viral suppression. We examined the impact of the COVID-19 pandemic on HIV self-management, social support, social isolation, depressive symptoms, anxiety, and stress in PLHIV. 85 PLHIV were recruited from social media sites and completed an online survey. Data were collected between April 23 and 30, 2020. P ...[more]

PMID: 34129142

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Project description:BackgroundeHealth has enormous potential to support the self-management of depressive symptoms in people living with HIV. However, a lack of personalization is an important barrier to user engagement with eHealth. According to goal-directed design, personalized eHealth requires the identification of user personas before concrete design to understand the goals and needs of different users.ObjectiveThis study aimed to identify user personas for eHealth regarding the self-management of depressive symptoms in people living with HIV and explore the goals and needs of different user personas for future eHealth.MethodsWe used an explanatory sequential mixed methods design at the First Hospital of Changsha City, Hunan Province, China, from April to October 2022. In the quantitative phase, 572 people living with HIV completed validated questionnaires with questions related to demographics, self-efficacy, self-management abilities of depressive symptoms, and eHealth literacy. Latent profile analysis was performed to identify different user personas. In the qualitative phase, 43 one-to-one semistructured interviews across different user personas were conducted, transcribed verbatim, and analyzed using conventional content analysis. The findings from both phases were integrated during the interpretation phase.ResultsThree types of user personas could be identified, including "high-level self-managers" (254/572, 44.4%), "medium-level self-managers" (283/572, 49.5%), and "low-level self-managers" (35/572, 6.1%). High-level self-managers had relatively high levels of self-efficacy, self-management abilities of depressive symptoms, and eHealth literacy. High-level self-managers had a positive attitude toward using eHealth for the self-management of depressive symptoms and desired access to self-management support for depressive symptoms from eHealth with high usability. Medium-level self-managers had relatively medium levels of self-efficacy, self-management abilities of depressive symptoms, and eHealth literacy. Medium-level self-managers felt burdened by using eHealth for the self-management of depressive symptoms and preferred to access self-management support for HIV from eHealth with privacy. Low-level self-managers had relatively low levels of self-efficacy, self-management abilities of depressive symptoms, and eHealth literacy. Low-level self-managers had an acceptable attitude toward using eHealth for the self-management of depressive symptoms and desired access to professional guidance from eHealth with privacy and no cost ("free of charge").ConclusionsThe 3 user personas shed light on the possibility of personalized eHealth to support the self-management of depressive symptoms in different people living with HIV. Further research is needed to examine the generalizability of the user personas across study sites.

Project description:ObjectiveTo describe disparities along the depression treatment cascade, from indication for antidepressant treatment to effective treatment, in HIV-infected individuals by gender and race/ethnicity.MethodsThe Center for AIDS Research (CFAR) Network of Integrated Clinical Systems (CNICS) cohort includes 31,000 HIV-infected adults in routine clinical care at 8 sites. Individuals were included in the analysis if they had a depressive symptoms measure within one month of establishing HIV care at a CNICS site. Depressive symptoms were measured using the validated Patient Health Questionnaire-9 (PHQ-9). Indication for antidepressant treatment was defined as PHQ-9 ≥ 10 or a current antidepressant prescription. Antidepressant treatment was defined as a current antidepressant prescription. Evidence-based antidepressant treatment was considered treatment changes based on a person's most recent PHQ-9, in accordance with clinical guidelines. We calculated the cumulative probability of moving through the depression treatment cascade within 24 months of entering CNICS HIV care. We used multivariable Cox proportional hazards models to estimate associations between gender, race/ethnicity, and a range of depression outcomes.ResultsIn our cohort of HIV-infected adults in routine care, 47% had an indication for antidepressant treatment. Significant drop-offs along the depression treatment cascade were seen for the entire study sample. However, important disparities existed. Women were more likely to have an indication for antidepressant treatment (HR 1.54; 95% CI 1.34, 1.78), receive antidepressant treatment (HR 2.03; 95% CI 1.53, 2.69) and receive evidence-based antidepressant treatment (HR 1.67; 95% CI 1.03, 2.74), even after accounting for race/ethnicity. Black non-Hispanics (HR 0.47, 95% CI 0.35, 0.65), Hispanics (HR 0.63, 95% CI 0.44, 0.89) and other race/ethnicities (HR 0.35, 95% CI 0.17, 0.73) were less likely to initiate antidepressant treatment, compared to white non-Hispanics.ConclusionsIn our cohort of HIV-infected adults depressive symptoms were common. Important disparities in the prevalence of depressive symptoms and receipt of antidepressant treatment existed by gender and race/ethnicity.

Project description:There is little consensus about which of the many validated human immunodeficiency virus (HIV) stigma scales should be regularly used, with few being re-validated in different contexts or evaluated for how they compare to other, existing HIV stigma scales. The purpose of this exploratory study was to re-validate the Van Rie HIV/AIDS-Related Stigma Scale, originally validated in Thailand and using a third-person wording structure, for use with people living with HIV in the United States. Adult HIV clinic patients completed a survey including the Berger and Van Rie scales, and measures of social support and depression. Eighty-five of 211 (40%) eligible participants provided data for both stigma scales. Exploratory factor analyses identified three factors to the Van Rie scale: Loss of Social Relationships (new subscale), Managing HIV Concealment (new subscale), and Perceived Community Stigma (original subscale). These subscales were moderately inter-related (r = 0.51 to 0.58) with acceptable to excellent reliability (Cronbach's alpha = 0.69 to 0.90). The Van Rie subscales were also moderately inter-correlated with the Berger subscales (r = 0.44 to 0.76), had similar construct validity, and tended to have higher mean stigma scores when compared with Berger subscales that were conceptually most similar. The revised Van Rie HIV-related Stigma Scale demonstrates good validity and internal consistency, offering a valid measure of HIV stigma with a three-factor structure. The third-person wording may be particularly suitable for measuring stigmatizing attitudes during an individual's transition from at-risk and undergoing HIV testing to newly diagnosed, a time when experiences of discrimination and processing issues of disclosure have not yet occurred. The stigma mechanisms for individuals making this transition have not been well explored. These scenarios, combined with the observed non-response to the Berger Enacted Stigma subscale items (a surprise finding), highlight gaps in our understanding of HIV stigma and how best to measure it.

Dataset Information

The Impact of COVID-19 on HIV Self-Management, Affective Symptoms, and Stress in People Living with HIV in the United States.

Publications

The Impact of COVID-19 on HIV Self-Management, Affective Symptoms, and Stress in People Living with HIV in the United States.

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