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Sample records for Stigma, medication adherence and coping mechanism among people living with HIV attending General Hospital, Lagos Island, Nigeria

  1. Stigma, medication adherence and coping mechanism among people living with HIV attending General Hospital, Lagos Island, Nigeria

    Directory of Open Access Journals (Sweden)

    Adekemi O. Sekoni

    2012-11-01

    Objectives: This study assessed the various domains of stigma experienced by PLWHAs attending an HIV clinic at General Hospital, Lagos Island, their medication adherence patterns and their coping mechanisms for ensuring adherence to antiretroviral therapy. Method: A cross-sectional study design with a sample size of 200 was used. Respondents were selected using systematic random sampling. Interviewers administered structured questionnaires were used to collect information on the domains of stigma. Data was analysed using EPI info©. This was followed by a focus group discussion (FGD with seven participants at the clinic using an interview guide with open-ended questions. Results: Overall, stigma was experienced by 35% of the respondents. Within this group, 6.6%, 37.1%, 43.1% and 98.0% of the respondents reported experiencing negative self image stigma, personalised stigma, disclosure stigma and public attitude stigma respectively. Almost 90% of the respondents were adherent. The FGD revealed that disclosure was usually confined to family members and the coping mechanism for achieving adherence was to put antiretroviral (ARVs in unlabelled pill boxes. Conclusion: This study found that stigma was low and that the most common domain of stigma experienced was public attitude stigma. Medication adherence of respondents was good as a result of the coping mechanism, which involves putting ARVs in unlabelled pill boxes.

  2. Stigma, disclosure, coping, and medication adherence among people living with HIV/AIDS in Northern Tanzania

    NARCIS (Netherlands)

    Lyimo, R.A.; Stutterheim, S.E.; Hospers, H.J.; de Glee, T.; van der Ven, A.; de Bruin, M.

    2014-01-01

    This study examines a proposed theoretical model examining the interrelationships between stigma, disclosure, coping, and medication adherence among 158 HIV-infected patients on antiretroviral therapy (ART) in northern Tanzania. Perceived and self-stigma, voluntary and involuntary disclosure,

  3. The Role of HIV Stigma in ART Adherence and Quality of Life Among Rural Women Living with HIV in India.

    Science.gov (United States)

    Ekstrand, Maria L; Heylen, Elsa; Mazur, Amanda; Steward, Wayne T; Carpenter, Catherine; Yadav, Kartik; Sinha, Sanjeev; Nyamathi, Adey

    2018-05-22

    HIV stigma continues to be a barrier to physical and mental health among people living with HIV globally, especially in vulnerable populations. We examined how stigma is associated with health outcomes and quality of life among rural women living with HIV in South India (N = 600). Interviewer-administered measures assessed multiple dimensions of stigma, as well as loneliness, social support, ART adherence, time since diagnosis, and quality of life. Internalized stigma and a lack of social support were associated with a lower quality of life, while the association between internalized stigma and adherence was mediated by the use of stigma-avoidant coping strategies, suggesting that keeping one's diagnosis a secret may make it more difficult to take one's medications. These findings suggest that these women constitute a vulnerable population who need additional services to optimize their health and who might benefit from peer support interventions and stigma-reduction programs for family and community members.

  4. Assessment of Workplace Stigma and Discrimination among People Living with HIV/AIDS Attending Antiretroviral Clinics in Health Institutions in Enugu, Southeast Nigeria.

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    Aguwa, E N; Arinze-Onyia, S U; Okwaraji, F; Modebe, I

    2015-05-06

    The onset of HIV/AIDS has increased stigma and discrimination at workplaces, making those with these ailments worried about going to work to avoid being victimized. Most previous works focussed on stigma and discrimination in the communities with little emphasis on what occurs in the workplaces. This study assessed the prevalence of workplace stigma and discrimination among people living with HIV/AIDS (PLWHA) attending antiretroviral (ARV) clinics in health institutions in Enugu, southeast Nigeria. A cross-sectional descriptive study was done between February and May of 2014 using a selfadministered questionnaire to assess 489 PLWHA attending ARV clinics. Out of 489 studied, 255 (52.1%) were females. About 23.7% said being HIV positive had affected their relationship with other workers and 20.7% were blamed for their condition. Some were not given time off to go to hospital (72.5%). The commonest fears of PLWHA were stigmatization/discrimination from other workers (78.1%) and dying from the disease (62.8%). Gender did not significantly affect the way PLWHA were stigmatized or discriminated against in their workplaces. However, those who were employed in private establishments were more likely to have their schedule changed due to their status compared to government employees ( p discriminating practices were not significantly different between government and private employees. The prevalence of stigma and discrimination in workplaces is high. Efforts should be made by agencies to reduce such social problems in the workplace since they can affect overall management and productivity.

  5. HIV-related stigma and self-disclosure: the mediating and moderating role of anticipated discrimination among people living with HIV/AIDS in Akure Nigeria.

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    Olley, B O; Ogunde, M J; Oso, P O; Ishola, A

    2016-01-01

    Although links between HIV-related stigma and self-disclosure of HIV status among people living with HIV have been well established, it is unclear whether levels of perceived discrimination are differentially associated with self-disclosure. The present study using a multi-factorial survey design investigated the role of stigma and other self-related factors (e.g., anticipated discrimination, self-esteem, HIV-related factors [e.g., drug use combination; knowledge of duration of HIV diagnosis] and socio-demographic factors [e.g., multiple spouse; age, gender, educational level] and psychological distress [depression]) in self-disclosure among People living with HIV/AIDs has been added (PLWHA) on follow-up management in State Specialist Hospital Akure, Nigeria. One hundred and thirty nine HIV/AIDS patients (49 males and 90 females) participated in the study. Mean age and mean time in months since diagnosis were 39.56 ± 10.26 and 37.78 ± 48.34, respectively. Four variables: multiple spouse, anticipated discrimination, HIV-related stigma and self-esteem were related to self-disclosure at (p discrimination mediated the relationship between self-esteem (Sobel test: z = 2.09, Aroian = 2.06, p  .05, self-esteem t (5, 137) = .59, p > .05 and anticipated discrimination were non-significant, suggesting a non-moderation effect of discrimination and disclosure. The results indicate that anticipated discrimination may impact HIV-related stigma to reduce self-disclosure among the PLWHAs in Akure, Nigeria. Interventions should incorporate anticipated discrimination in educational programs of HIV stigma in encouraging self-disclosure among PLWHAs.

  6. Coping, social support, stigma, and gender difference among people living with HIV in Guangxi, China.

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    Xiao, Zhiwen; Li, Xiaoming; Qiao, Shan; Zhou, Yuejiao; Shen, Zhiyong

    2018-01-01

    The current study examined whether gender, HIV-related stigma, social support, and the interaction between gender and social support are associated with coping responses among people living with HIV and AIDS (PLWHA) in Guangxi, China. A total of 2987 PLWHA in Guangxi participated from October 2012 to August 2013. Multivariate analysis of covariance was conducted with gender and social support as main factors in the model, and stigma and other variables as covariates. After controlling for demographic variables and stigma, there were significant main effects of emotional social support (F = 1.61, p social support (F = 1.67, p social support (F = 3.67, p social support (F = 1.33, p social support differences in the coping strategies among PLWHA in Guangxi, China.

  7. Stigma, social support, and treatment adherence among HIV-positive patients in Chiang Mai, Thailand.

    Science.gov (United States)

    Li, Michael Jonathan; Murray, Jordan Keith; Suwanteerangkul, Jiraporn; Wiwatanadate, Phongtape

    2014-10-01

    Our study assessed the influence of HIV-related stigma on treatment adherence among people living with HIV in Chiang Mai, Thailand, and whether social support had a moderating effect on this relationship. We recruited 128 patients living with HIV from Sansai Hospital, a community hospital in Chiang Mai, Thailand, and collected data through structured interviews. All forms of HIV-related stigma considered in this study (personalized experience, disclosure, negative self-image, and public attitudes) were negatively correlated with adherence to anti-retroviral regimens. Multiple linear regression indicated that total HIV-related stigma was more predictive of treatment adherence than any individual stigma type, after adjusting for socio-demographic and health characteristics. Tests of interaction showed that social support did not appear to moderate the association between HIV stigma and treatment adherence. Our findings suggest that community and government efforts to improve public perceptions about people living with HIV might promote treatment adherence behaviors among HIV-positive patients.

  8. How Does Stigma Affect People Living with HIV? The Mediating Roles of Internalized and Anticipated HIV Stigma in the Effects of Perceived Community Stigma on Health and Psychosocial Outcomes.

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    Turan, Bulent; Budhwani, Henna; Fazeli, Pariya L; Browning, Wesley R; Raper, James L; Mugavero, Michael J; Turan, Janet M

    2017-01-01

    Few researchers have attempted to examine the mechanisms through which HIV-related stigma in the community is processed and experienced at an individual level by people living with HIV. We examined how the effects of perceived HIV stigma in the community on health outcomes for people living with HIV are mediated by internalized stigma and anticipated stigma. Participants (N = 203) from an HIV clinic completed self-report measures and their clinical data were obtained from medical records. Results suggested that the association between perceived community stigma and affective, cognitive, and mental health outcomes (self-esteem, depressive symptoms, avoidance coping, self-blame) are mediated by internalized stigma. Furthermore, a serial mediation model suggested that perceived community stigma leads to internalized stigma, which leads to anticipated community stigma, which in turn leads to lower medication adherence. The associations between perceived community stigma and interpersonal outcomes (social support, trust in physicians) were mediated by internalized stigma and anticipated stigma, again in a serial fashion (perceived community stigma leads to internalized stigma, which leads to anticipated stigma, which in turn leads to interpersonal outcomes). These results suggest that perceived HIV-related stigma in the community may cause people living with HIV to internalize stigma and anticipate stigmatizing experiences, resulting in adverse health and psychosocial outcomes-information that can be used to shape interventions.

  9. How Does Stigma Affect People Living with HIV? The Mediating Roles of Internalized and Anticipated HIV Stigma in the Effects of Perceived Community Stigma on Health and Psychosocial Outcomes

    Science.gov (United States)

    Budhwani, Henna; Fazeli, Pariya L.; Browning, Wesley R.; Raper, James L.; Mugavero, Michael J.; Turan, Janet M.

    2016-01-01

    Few researchers have attempted to examine the mechanisms through which HIV-related stigma in the community is processed and experienced at an individual level by people living with HIV. We examined how the effects of perceived HIV stigma in the community on health outcomes for people living with HIV are mediated by internalized stigma and anticipated stigma. Participants (N = 203) from an HIV clinic completed self-report measures and their clinical data were obtained from medical records. Results suggested that the association between perceived community stigma and affective, cognitive, and mental health outcomes (self-esteem, depressive symptoms, avoidance coping, self-blame) are mediated by internalized stigma. Furthermore, a serial mediation model suggested that perceived community stigma leads to internalized stigma, which leads to anticipated community stigma, which in turn leads to lower medication adherence. The associations between perceived community stigma and interpersonal outcomes (social support, trust in physicians) were mediated by internalized stigma and anticipated stigma, again in a serial fashion (perceived community stigma leads to internalized stigma, which leads to anticipated stigma, which in turn leads to interpersonal outcomes). These results suggest that perceived HIV-related stigma in the community may cause people living with HIV to internalize stigma and anticipate stigmatizing experiences, resulting in adverse health and psychosocial outcomes—information that can be used to shape interventions. PMID:27272742

  10. STIGMA, SOCIAL SUPPORT, AND TREATMENT ADHERENCE AMONG HIV-POSITIVE PATIENTS IN CHIANG MAI, THAILAND

    OpenAIRE

    Li, Michael Jonathan; Murray, Jordan Keith; Suwanteerangkul, Jiraporn; Wiwatanadate, Phongtape

    2014-01-01

    Our study assessed the influence of HIV-related stigma on treatment adherence among people living with HIV in Chiang Mai, Thailand, and whether social support had a moderating effect on this relationship. We recruited 128 patients living with HIV from Sansai Hospital, a community hospital in Chiang Mai, Thailand, and collected data through structured interviews. All forms of HIV-related stigma considered in this study (personalized experience, disclosure, negative self-image, and public attit...

  11. Stigma, activism, and well-being among people living with HIV.

    Science.gov (United States)

    Earnshaw, Valerie A; Rosenthal, Lisa; Lang, Shawn M

    2016-01-01

    Evidence demonstrates that HIV stigma undermines the psychological and physical health of people living with HIV (PLWH). Yet, PLWH describe engaging in HIV activism to challenge stigma, and research suggests that individuals may benefit from activism. We examine associations between experiences of HIV stigma and HIV activism, and test whether HIV activists benefit from greater well-being than non-activists. Participants include 93 PLWH recruited from drop-in centers, housing programs, and other organizations providing services to PLWH in the Northeastern USA between 2012 and 2013 (mean age = 50 years; 56% Black, 20% White, 18% Other; 61% non-Latino(a), 39% Latino(a); 59% male, 38% female, 3% transgender; 82% heterosexual, 15% sexual minority). Participants completed a cross-sectional written survey. Results of regression analyses suggest that PLWH who experienced greater enacted stigma engaged in greater HIV activism. Anticipated, internalized, and perceived public stigma, however, were unrelated to HIV activism. Moreover, results of a multivariate analysis of variance suggest that HIV activists reported greater social network integration, greater social well-being, greater engagement in active coping with discrimination, and greater meaning in life than non-activists. Yet, HIV activists also reported somewhat greater depressive symptoms than non-activists, suggesting that the association between HIV activism and well-being is complex. By differentiating between HIV stigma mechanisms, the current study provides a more nuanced understanding of which experiences of HIV stigma may be associated with HIV activism. It further suggests that engagement in activism may offer benefits to PLWH, while raising the possibility that activists could experience greater depressive symptoms than non-activists. Given the preliminary nature of this study, future research should continue to examine these complex associations between HIV stigma, activism, and well-being among PLWH

  12. Medication adherence among transgender women living with HIV

    OpenAIRE

    Baguso, Glenda N.; Gay, Caryl L.; Lee, Kathryn A.

    2016-01-01

    Medication adherence is linked to health outcomes among adults with HIV infection. Transgender women living with HIV (TWLWH) in the U.S. report suboptimal adherence to medications and are found to have difficulty integrating HIV medication into their daily routine, but few studies explore factors associated with medication adherence among transgender women. Thus, the purpose of this paper is to examine demographic and clinical factors related to self-reported medication adherence among transg...

  13. Benefits of adherence to psychotropic medications on depressive symptoms and antiretroviral medication adherence among men and women living with HIV/AIDS.

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    Cruess, Dean G; Kalichman, Seth C; Amaral, Christine; Swetzes, Connie; Cherry, Chauncey; Kalichman, Moira O

    2012-04-01

    Psychotropic medications are commonly used for depressive symptoms among people living with HIV/AIDS. We examined the relationships between adherence to psychotropic medications, depressive symptoms, and antiretroviral adherence. We assessed depressive symptoms among 324 people living with HIV/AIDS across a 3-month period (70% men; mean age 45 years; 90% African-American). Psychotropic and antiretroviral adherence was assessed using monthly, unannounced telephone pill counts. Multiple-regression and mediation analyses were utilized to examine associations under investigation. Greater depressive symptoms were associated with lower antiretroviral and psychotropic medication adherence. Greater adherence to psychotropic medications regardless of medication class was positively related to higher antiretroviral adherence. Greater adherence to psychotropic medications also significantly mediated the association between depressive symptoms and antiretroviral adherence. This study demonstrates the benefits of adherence to psychotropic medications on both depressive symptoms and antiretroviral adherence. Future work examining psychotropic medication adherence on disease outcomes in people living with HIV/AIDS is warranted.

  14. HIV-Related Stigma, Shame, and Avoidant Coping: Risk Factors for Internalizing Symptoms Among Youth Living with HIV?

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    Bennett, David S; Hersh, Jill; Herres, Joanna; Foster, Jill

    2016-08-01

    Youth living with HIV (YLH) are at elevated risk of internalizing symptoms, although there is substantial individual variability in adjustment. We examined perceived HIV-related stigma, shame-proneness, and avoidant coping as risk factors of internalizing symptoms among YLH. Participants (N = 88; ages 12-24) completed self-report measures of these potential risk factors and three domains of internalizing symptoms (depressive, anxiety, and PTSD) during a regularly scheduled HIV clinic visit. Hierarchical regressions were conducted for each internalizing symptoms domain, examining the effects of age, gender, and maternal education (step 1), HIV-related stigma (step 2), shame- and guilt-proneness (step 3), and avoidant coping (step 4). HIV-related stigma, shame-proneness, and avoidant coping were each correlated with greater depressive, anxiety, and PTSD symptoms. Specificity was observed in that shame-proneness, but not guilt-proneness, was associated with greater internalizing symptoms. In multivariable analyses, HIV-related stigma and shame-proneness were each related to greater depressive and PTSD symptoms. Controlling for the effects of HIV-related stigma and shame-proneness, avoidant coping was associated with PTSD symptoms. The current findings highlight the potential importance of HIV-related stigma, shame, and avoidant coping on the adjustment of YLH, as interventions addressing these risk factors could lead to decreased internalizing symptoms among YLH.

  15. Examining the associations between HIV-related stigma and health outcomes in people living with HIV/AIDS: a series of meta-analyses.

    Science.gov (United States)

    Rueda, Sergio; Mitra, Sanjana; Chen, Shiyi; Gogolishvili, David; Globerman, Jason; Chambers, Lori; Wilson, Mike; Logie, Carmen H; Shi, Qiyun; Morassaei, Sara; Rourke, Sean B

    2016-07-13

    To conduct a systematic review and series of meta-analyses on the association between HIV-related stigma and health among people living with HIV. A structured search was conducted on 6 electronic databases for journal articles reporting associations between HIV-related stigma and health-related outcomes published between 1996 and 2013. Controlled studies, cohort studies, case-control studies and cross-sectional studies in people living with HIV were considered for inclusion. Mental health (depressive symptoms, emotional and mental distress, anxiety), quality of life, physical health, social support, adherence to antiretroviral therapy, access to and usage of health/social services and risk behaviours. 64 studies were included in our meta-analyses. We found significant associations between HIV-related stigma and higher rates of depression, lower social support and lower levels of adherence to antiretroviral medications and access to and usage of health and social services. Weaker relationships were observed between HIV-related stigma and anxiety, quality of life, physical health, emotional and mental distress and sexual risk practices. While risk of bias assessments revealed overall good quality related to how HIV stigma and health outcomes were measured on the included studies, high risk of bias among individual studies was observed in terms of appropriate control for potential confounders. Additional research should focus on elucidating the mechanisms behind the negative relationship between stigma and health to better inform interventions to reduce the impact of stigma on the health and well-being of people with HIV. This systematic review and series of meta-analyses support the notion that HIV-related stigma has a detrimental impact on a variety of health-related outcomes in people with HIV. This review can inform the development of multifaceted, intersectoral interventions to reduce the impact of HIV-related stigma on the health and well-being of people living

  16. Examining the associations between HIV-related stigma and health outcomes in people living with HIV/AIDS: a series of meta-analyses

    Science.gov (United States)

    Mitra, Sanjana; Chen, Shiyi; Gogolishvili, David; Globerman, Jason; Chambers, Lori; Wilson, Mike; Logie, Carmen H; Shi, Qiyun; Morassaei, Sara; Rourke, Sean B

    2016-01-01

    Objective To conduct a systematic review and series of meta-analyses on the association between HIV-related stigma and health among people living with HIV. Data sources A structured search was conducted on 6 electronic databases for journal articles reporting associations between HIV-related stigma and health-related outcomes published between 1996 and 2013. Study eligibility criteria Controlled studies, cohort studies, case-control studies and cross-sectional studies in people living with HIV were considered for inclusion. Outcome measures Mental health (depressive symptoms, emotional and mental distress, anxiety), quality of life, physical health, social support, adherence to antiretroviral therapy, access to and usage of health/social services and risk behaviours. Results 64 studies were included in our meta-analyses. We found significant associations between HIV-related stigma and higher rates of depression, lower social support and lower levels of adherence to antiretroviral medications and access to and usage of health and social services. Weaker relationships were observed between HIV-related stigma and anxiety, quality of life, physical health, emotional and mental distress and sexual risk practices. While risk of bias assessments revealed overall good quality related to how HIV stigma and health outcomes were measured on the included studies, high risk of bias among individual studies was observed in terms of appropriate control for potential confounders. Additional research should focus on elucidating the mechanisms behind the negative relationship between stigma and health to better inform interventions to reduce the impact of stigma on the health and well-being of people with HIV. Conclusions This systematic review and series of meta-analyses support the notion that HIV-related stigma has a detrimental impact on a variety of health-related outcomes in people with HIV. This review can inform the development of multifaceted, intersectoral interventions to

  17. Stigma and Spiritual Well-being among People Living with HIV/AIDS in Southern Appalachia.

    Science.gov (United States)

    Hutson, Sadie P; Darlington, Caroline K; Hall, Joanne M; Heidel, R Eric; Gaskins, Susan

    2018-06-01

    The Appalachian South is disproportionately affected by HIV/AIDS. Partly due to the negative connotation that this disease carries in religiously conservative areas, HIV-related stigma remains a critical barrier to HIV care in the South. However, spirituality is a well-documented, effective coping mechanism among persons living with HIV/AIDS (PLWH). The purpose of this study was to examine the relationship between HIV-related stigma and spiritual well-being among a sample of PLWH (n = 216) in Appalachian counties of Tennessee and Alabama using the HIV Stigma Scale and the Spiritual Well-being Scale. Overall, disclosure of HIV status was the most highly reported stigma concern. Women reported higher levels of stigma and religious well-being than men. While existential well-being was negatively correlated with stigma, no significant overall correlation was found between religious well-being and stigma. Our findings reveal the importance of defining theology and differentiating between cultural religious conditioning and internalized beliefs.

  18. HIV Stigma and Unhealthy Alcohol Use Among People Living with HIV in Russia.

    Science.gov (United States)

    Lunze, Karsten; Lioznov, Dmitry; Cheng, Debbie M; Nikitin, Ruslan V; Coleman, Sharon M; Bridden, Carly; Blokhina, Elena; Krupitsky, Evgeny; Samet, Jeffrey H

    2017-09-01

    Unhealthy alcohol use, highly prevalent in the Russian Federation (Russia), is associated with HIV risk behaviors among people living with HIV (PLWH). HIV stigma contributes to the HIV risk environment in Russia. To examine HIV stigma among Russian PLWH and to explore its association with unhealthy alcohol use, we conducted a longitudinal analysis of 700 PLWH in St. Petersburg, Russia. We assessed the association between alcohol dependence and HIV stigma measured at baseline and 12 months follow-up. Participants with alcohol dependence (n = 446) reported significantly higher HIV stigma scores over time than those without dependence (n = 254) (adjusted mean difference 0.60, 95% CI 0.03-1.17; p = 0.04). In secondary analyses, we examined recent risky alcohol use and did not detect an association with HIV stigma. Alcohol dependence is associated with high HIV stigma among Russian PLWH but the nature of the association is conjectural. HIV prevention efforts in Russia that address alcohol use disorders hold potential to mitigate HIV-related stigma and its possible adverse effects among PLWH.

  19. Verifying quantitative stigma and medication adherence scales using qualitative methods among Thai youth living with HIV/AIDS.

    Science.gov (United States)

    Fongkaew, Warunee; Viseskul, Nongkran; Suksatit, Benjamas; Settheekul, Saowaluck; Chontawan, Ratanawadee; Grimes, Richard M; Grimes, Deanna E

    2014-01-01

    HIV/AIDS-related stigma has been linked to poor adherence resulting in drug resistance and the failure to control HIV. This study used both quantitative and qualitative methods to examine stigma and its relationship to adherence in 30 HIV-infected Thai youth aged 14 to 21 years. Stigma was measured using the HIV stigma scale and its 4 subscales, and adherence was measured using a visual analog scale. Stigma and adherence were also examined by in-depth interviews. The interviews were to determine whether verbal responses would match the scale's results. The mean score of stigma perception from the overall scale and its 4 subscales ranged from 2.14 to 2.45 on a scale of 1 to 4, indicating moderate levels of stigma. The mean adherence score was .74. The stigma scale and its subscales did not correlate with the adherence. Totally, 17 of the respondents were interviewed. Contrary to the quantitative results, the interviewees reported that the stigma led to poor adherence because the fear of disclosure often caused them to miss medication doses. The differences between the quantitative and the qualitative results highlight the importance of validating psychometric scales when they are translated and used in other cultures.

  20. AIDS-related stigma and mental disorders among people living with HIV: a cross-sectional study in Cambodia.

    Directory of Open Access Journals (Sweden)

    Siyan Yi

    Full Text Available AIDS-related stigma and mental disorders are the most common conditions in people living with HIV (PLHIV. We therefore conducted this study to examine the association of AIDS-related stigma and discrimination with mental disorders among PLHIV in Cambodia.A two-stage cluster sampling method was used to select 1,003 adult PLHIV from six provinces. The People Living with HIV Stigma Index was used to measure stigma and discrimination, and a short version of general health questionnaire (GHQ-12 was used to measure mental disorders. Multivariate logistic regression analysis was conducted.The reported experiences of discrimination in communities in the past 12 months ranged from 0.8% for reports of being denied health services to 42.3% for being aware of being gossiped about. Internal stigma was also common ranging from 2.8% for avoiding going to a local clinic and/or hospital to 59.6% for deciding not to have (more children. The proportions of PLHIV who reported fear of stigma and discrimination ranged from 13.9% for fear of being physically assaulted to 34.5% for fear of being gossiped about. The mean score of GHQ-12 was 3.2 (SD = 2.4. After controlling for several potential confounders, higher levels of mental disorders (GHQ-12≥ 4 remained significantly associated with higher levels of experiences of stigma and discrimination in family and communities (AOR = 1.9, 95% CI = 1.4-2.6, higher levels of internal stigma (AOR = 1.7, 95% CI = 1.2-2.3, and higher levels of fear of stigma and discrimination in family and communities (AOR = 1.5, 95% CI = 1.1-2.2.AIDS-related stigma and discrimination among PLHIV in Cambodia are common and may have potential impacts on their mental health conditions. These findings indicate a need for community-based interventions to reduce stigma and discrimination in the general public and to help PLHIV to cope with this situation.

  1. How Does Stigma Affect People Living with HIV? The Mediating Roles of Internalized and Anticipated HIV Stigma in the Effects of Perceived Community Stigma on Health and Psychosocial Outcomes

    OpenAIRE

    Turan, Bulent; Budhwani, Henna; Fazeli, Pariya L.; Browning, Wesley R.; Raper, James L.; Mugavero, Michael J.; Turan, Janet M.

    2017-01-01

    Few researchers have attempted to examine the mechanisms through which HIV-related stigma in the community is processed and experienced at an individual level by people living with HIV. We examined how the effects of perceived HIV stigma in the community on health outcomes for people living with HIV are mediated by internalized stigma and anticipated stigma. Participants (N = 203) from an HIV clinic completed self-report measures and their clinical data were obtained from medical records. Res...

  2. Cannabis Use, Medication Management and Adherence Among Persons Living with HIV.

    Science.gov (United States)

    Vidot, Denise C; Lerner, Brenda; Gonzalez, Raul

    2017-07-01

    Cannabis is used to relieve nausea, trigger weight gain, and reduce pain among adults living with HIV; however, the relationship between its use and medication adherence and management is unclear. Participants (N = 107) were from an ongoing cohort study of community-dwelling HIV+ adults, stratified by cannabis (CB) use: HIV+/CB+ (n = 41) and HIV+/CB- (n = 66). CB+ participants either tested positive in a urine toxicology screen for THC or had a self-reported history of regular and recent use. HIV-status was provided by physician results and/or biomarker assessment. Adherence was measured via the Morisky scale and medication management was assessed via the Medication Management Test-Revised. After adjusting for gender, we found no association between cannabis use group and adherence nor medication management. The amount of cannabis used was also not associated with measures of adherence and management. Preliminary findings suggest that cannabis use may not adversely influence medication adherence/management among adults living with HIV.

  3. The Daily Relationship Between Aspects of Food Insecurity and Medication Adherence Among People Living with HIV with Recent Experiences of Hunger.

    Science.gov (United States)

    Pellowski, Jennifer A; Kalichman, Seth C; Cherry, Sabrina; Conway-Washington, Christopher; Cherry, Chauncey; Grebler, Tamar; Krug, Larissa

    2016-12-01

    Limited access to resources can significantly impact health behaviors. Previous research on food insecurity and HIV has focused on establishing the relationship between lacking access to nutritious food and antiretroviral (ARV) medication non-adherence in a variety of social contexts. This study aims to determine if several aspects of food insecurity co-occur with missed doses of medication on a daily basis among a sample of people living with HIV who have recently experienced hunger. The current study utilized a prospective, observational design to test the daily relationship between food insecurity and medication non-adherence. Participants were followed for 45 days and completed daily assessments of food insecurity and alcohol use via interactive text message surveys and electronic medication adherence monitoring using the Wisepill. Fifty-nine men and women living with HIV contributed a total of 2,655 days of data. Results showed that severe food insecurity (i.e., hunger), but not less severe food insecurity (i.e., worrying about having food), significantly predicted missed doses of medication on a daily level. Daily alcohol use moderated this relationship in an unexpected way; when individuals were hungry and drank alcohol on a given day, they were less likely to miss a dose of medication. Among people living with HIV with recent experiences of hunger, this study demonstrates that there is a daily relationship between hunger and non-adherence to antiretroviral therapy. Future research is needed to test interventions designed to directly address the daily relationship between food insecurity and medication non-adherence.

  4. [HIV Stigma and Spiritual Care in People Living With HIV].

    Science.gov (United States)

    Yu, Chia-Hui; Chiu, Yi-Chi; Cheng, Su-Fen; Ko, Nai-Ying

    2018-06-01

    HIV infection has been a manageable and chronic illness in Taiwan since the highly active antiretroviral therapy was introduced in 1997. HIV infection is a stigmatized disease due to its perceived association with risky behaviors. HIV often carries a negative image, and people living with HIV(PLWH) face discrimination on multiple fronts. Internalized HIV stigma impacts the spiritual health of people living with HIV in terms of increased levels of shame, self-blame, fear of disclosing HIV status, and isolation and decreased value and connections with God, others, the environment, and the self. Nursing professionals provide holistic care for all people living with HIV and value their lives in order to achieve the harmony of body, mind, and spirit. This article describes the stigma that is currently associated with HIV and how stigma-related discrimination affects the spiritual health of PLWH and then proposes how to reduce discrimination and stigma in order to improve the spiritual health of PLWH through appropriate spiritual care. Reducing HIV stigma and promoting spiritual well-being will enable Taiwan to achieve the 'Three Zeros' of zero discrimination, zero infection, and zero death advocated by the Joint United Nations Programme on HIV/AIDS for ending the AIDS epidemic in 2030.

  5. Factors Associated with Perceived Stigma among People Living with HIV/AIDS in Post-Conflict Northern Uganda

    Science.gov (United States)

    Nattabi, Barbara; Li, Jianghong; Thompson, Sandra C.; Orach, Christopher G.; Earnest, Jaya

    2011-01-01

    HIV-related stigma continues to persist in several African countries including Uganda. This study quantified the burden of stigma and examined factors associated with stigma among 476 people living with HIV (PLHTV) in Gulu, northern Uganda. Data were collected between February and May 2009 using the HIV/AIDS Stigma Instrument-PLWA. Females more…

  6. Impact of HIV-related stigma on treatment adherence: systematic review and meta-synthesis

    Science.gov (United States)

    Katz, Ingrid T; Ryu, Annemarie E; Onuegbu, Afiachukwu G; Psaros, Christina; Weiser, Sheri D; Bangsberg, David R; Tsai, Alexander C

    2013-01-01

    Introduction Adherence to HIV antiretroviral therapy (ART) is a critical determinant of HIV-1 RNA viral suppression and health outcomes. It is generally accepted that HIV-related stigma is correlated with factors that may undermine ART adherence, but its relationship with ART adherence itself is not well established. We therefore undertook this review to systematically assess the relationship between HIV-related stigma and ART adherence. Methods We searched nine electronic databases for published and unpublished literature, with no language restrictions. First we screened the titles and abstracts for studies that potentially contained data on ART adherence. Then we reviewed the full text of these studies to identify articles that reported data on the relationship between ART adherence and either HIV-related stigma or serostatus disclosure. We used the method of meta-synthesis to summarize the findings from the qualitative studies. Results Our search protocol yielded 14,854 initial records. After eliminating duplicates and screening the titles and abstracts, we retrieved the full text of 960 journal articles, dissertations and unpublished conference abstracts for review. We included 75 studies conducted among 26,715 HIV-positive persons living in 32 countries worldwide, with less representation of work from Eastern Europe and Central Asia. Among the 34 qualitative studies, our meta-synthesis identified five distinct third-order labels through an inductive process that we categorized as themes and organized in a conceptual model spanning intrapersonal, interpersonal and structural levels. HIV-related stigma undermined ART adherence by compromising general psychological processes, such as adaptive coping and social support. We also identified psychological processes specific to HIV-positive persons driven by predominant stigmatizing attitudes and which undermined adherence, such as internalized stigma and concealment. Adaptive coping and social support were critical

  7. HIV Stigma, Retention in Care, and Adherence Among Older Black Women Living With HIV.

    Science.gov (United States)

    Sangaramoorthy, Thurka; Jamison, Amelia M; Dyer, Typhanye V

    Stigma is recognized as a barrier to the prevention, care, and treatment of HIV, including engagement in the HIV care continuum. HIV stigma in older Black women may be compounded by preexisting social inequities based on gender, age, and race. Using semi-structured interviews and survey questionnaires, we explore experiences of HIV stigma, retention in care, and antiretroviral therapy (ART) adherence in 35 older Black women with HIV from Prince George's County, Maryland. Study findings indicated that older Black women experienced high levels of HIV stigma, retention in care, and ART adherence. Findings suggest that experiences of HIV stigma were intensified for older Black women due to multiple stigmatized social positions. Participants also reported experiences of marginalization in health care that hindered retention in care and ART adherence. Interventions aimed at improving HIV prevention, care, and treatment outcomes should incorporate HIV stigma reduction strategies as core elements. Copyright © 2017 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

  8. Psychosocial challenges and strategies for coping with HIV among adolescents in Uganda: a qualitative study.

    Science.gov (United States)

    Mutumba, Massy; Bauermeister, José A; Musiime, Victor; Byaruhanga, Judith; Francis, Kiweewa; Snow, Rachel C; Tsai, Alexander C

    2015-02-01

    Although more than 90% of youth perinatally infected with HIV live in sub-Saharan Africa, little is known about the psychosocial factors that impact their wellbeing, or how these youth cope with these challenges. The purpose of this study was to identify the psychosocial challenges and coping strategies among perinatal HIV-infected adolescents in Uganda. In-depth interviews were conducted with a purposive sample of 38 HIV-infected adolescents aged 12-19 years at a large HIV treatment center in Kampala. Data were analyzed thematically to identify themes and domains related to stressors and specific coping strategies. Psychosocial challenges included stigma/discrimination, relationship challenges such as HIV status disclosure, and medication difficulties. Coping strategies included medication adherence, concealment or limited disclosure of HIV status, treatment optimism, social support, rationalizing, social comparison, spirituality/religiosity, avoidance, and distraction. Age and gender differences also emerged: younger participants generally lacked specific coping strategies; compared to females, male adolescents reported greater use of avoidance/distraction techniques. Findings underscore the need to address stigma within homes and schools, and to equip adolescents with the comprehensive knowledge and skills to address their varied challenges.

  9. Relationship between HIV stigma and self-isolation among people living with HIV in Tennessee.

    Directory of Open Access Journals (Sweden)

    Carolyn M Audet

    Full Text Available HIV stigma is a contributing factor to poor patient outcomes. Although HIV stigma has been documented, its impact on patient well-being in the southern US is not well understood.Thirty-two adults participated in cognitive interviews after completing the Berger HIV or the Van Rie stigma scale. Participant responses were probed to ensure the scales accurately measured stigma and to assess the impact stigma had on behavior.Three main themes emerged regarding HIV stigma: (1 negative attitudes, fear of contagion, and misperceptions about transmission; (2 acts of discrimination by families, friends, health care providers, and within the workplace; and (3 participants' use of self-isolation as a coping mechanism. Overwhelming reluctance to disclose a person's HIV status made identifying enacted stigma with a quantitative scale difficult.Fear of discrimination resulted in participants isolating themselves from friends or experiences to avoid disclosure. Participant unwillingness to disclose their HIV status to friends and family could lead to an underestimation of enacted HIV stigma in quantitative scales.

  10. Selenium deficiency and pregnancy outcome in pregnant women with HIV in Lagos, Nigeria.

    Science.gov (United States)

    Okunade, Kehinde S; Olowoselu, Olusola F; Osanyin, Gbemisola E; John-Olabode, Sarah; Akanmu, Sulaimon A; Anorlu, Rose I

    2018-04-16

    To investigate the prevalence of maternal selenium deficiency and its effects on pregnancy outcomes in pregnant women with HIV in Lagos, Nigeria. The present descriptive cross-sectional study enrolled women aged 15-49 years with HIV who were at 14-26 weeks of a singleton pregnancy and were attending Lagos University Teaching Hospital, Lagos, Nigeria, between August 1, 2016, and April 30, 2017. Participants were selected by consecutive sampling and baseline data were collected through interviews. Venous blood samples were obtained to measure selenium concentrations, and associations between low maternal selenium concentrations (defined as <0.89 μmol/L) and pregnancy outcomes were examined using bivariate and multivariate analysis. The final analysis included 113 patients; selenium deficiency was recorded in 23 (20.4%) patients. Women with selenium deficiency had an approximately eight-fold higher risk of preterm delivery (adjusted odds ratio 7.61, 95% confidence interval 4.37-18.89; P=0.031) and of delivering a term neonate with a low delivery weight (adjusted odds ratio 8.11, 95% confidence interval 3.27-17.22; P=0.012), compared with women with a normal selenium concentration. The prevalence of selenium deficiency among pregnant women with HIV in Lagos was relatively high. The significant associations observed between maternal selenium deficiency and adverse pregnancy outcomes could have implications for the future management of HIV in pregnancy. © 2018 International Federation of Gynecology and Obstetrics.

  11. Hopefulness Fosters Affective and Cognitive Constructs for Actions to Cope and Enhance Quality of Life among People Living with HIV in Dar Es Salaam, Tanzania.

    Science.gov (United States)

    Siril, Hellen; Fawzi, Mary C Smith; Todd, Jim; Wyatt, Monique; Kilewo, Japheth; Ware, Norma; Kaaya, Sylvia

    The aims of this study were to describe how people living with HIV (PLWH) perceive hope and illustrate implications for HIV care and treatment. This is a qualitative study done to explore perceptions and meanings of hope among PLWH attending care and treatment clinics in Dar es Salaam, Tanzania. In all, 10 focus group discussions and 9 in-depth interviews were conducted. People living with HIV described the following 3 dimensions of hope: cognitive, positive emotions, and normalization. Being cognizant of the effectiveness of antiretroviral treatment (ART) often led to positive emotions, such as feeling comforted or strengthened, which in turn was related to positive actions toward normalizing life. Improved treatment outcomes facilitated hope, while persistent health problems, such as ART side effects, were sources of negative emotions contributing to loss of hope among PLWH. Hope motivated positive health-seeking behaviors, including adherence to ART, and this may guide interventions to help PLWH cope and live positively with HIV.

  12. The people living with HIV stigma survey UK 2015: HIV-related sexual rejection and other experiences of stigma and discrimination among gay and heterosexual men.

    Science.gov (United States)

    Hibbert, M; Crenna-Jennings, W; Kirwan, P; Benton, L; Lut, I; Okala, S; Asboe, D; Jeffries, J; Kunda, C; Mbewe, R; Morris, S; Morton, J; Nelson, M; Thorley, L; Paterson, H; Ross, M; Reeves, I; Sharp, L; Sseruma, W; Valiotis, G; Wolton, A; Jamal, Z; Hudson, A; Delpech, V

    2018-05-27

    We aim to understand the difference in stigma and discrimination, in particular sexual rejection, experienced between gay and heterosexual men living with HIV in the UK. The People Living with HIV StigmaSurvey UK 2015 recruited a convenience sample of persons with HIV through over 120 cross sector community organisations and 46 HIV clinics to complete an online survey. 1162 men completed the survey, 969 (83%) gay men and 193 (17%) heterosexual men, 92% were on antiretroviral therapy. Compared to heterosexual men, gay men were significantly more likely to report worrying about workplace treatment in relation to their HIV (21% vs. 11%), worrying about HIV-related sexual rejection (42% vs 21%), avoiding sex because of their HIV status (37% vs. 23%), and experiencing HIV-related sexual rejection (27% vs. 9%) in the past 12 months. In a multivariate logistic regression controlling for other sociodemographic factors, being gay was a predictor of reporting HIV-related sexual rejection in the past 12 months (aOR 2.17, CI 1.16, 4.02). Both gay and heterosexual men living with HIV experienced stigma and discrimination in the past 12 months, and this was higher for gay men in terms of HIV-related sexual rejection. Due to the high proportion of men reporting sexual rejection, greater awareness and education of the low risk of transmission of HIV among people on effective treatment is needed to reduce stigma and sexual prejudice towards people living with HIV.

  13. Optimism, well-being, and perceived stigma in individuals living with HIV.

    Science.gov (United States)

    Ammirati, Rachel J; Lamis, Dorian A; Campos, Peter E; Farber, Eugene W

    2015-01-01

    Given the significant psychological challenges posed by HIV-related stigma for individuals living with HIV, investigating psychological resource factors for coping with HIV-related stigma is important. Optimism, which refers to generalized expectations regarding favorable outcomes, has been associated with enhanced psychological adaptation to health conditions, including HIV. Therefore, this cross-sectional study investigated associations among optimism, psychological well-being, and HIV stigma in a sample of 116 adults living with HIV and seeking mental health services. Consistent with study hypotheses, optimism was positively associated with psychological well-being, and psychological well-being was negatively associated with HIV-related stigma. Moreover, results of a full structural equation model suggested a mediation pattern such that as optimism increases, psychological well-being increases, and perceived HIV-related stigma decreases. The implications of these findings for clinical interventions and future research are discussed.

  14. Assessing Factors that affect Childbirth Choices of People living positively with HIV/AIDS in Abia State of Nigeria.

    Science.gov (United States)

    Enwereji, Ezinne E; Enwereji, Kelechi O

    2010-04-01

    Poor interpersonal relationships with women especially those living positively with HIV/AIDS can make them take risks that would expose their new born and others to infection during childbirth. The factors that influence childbirth choices of people living positively with HIV/AIDS (PLWHA) deserve attention. Sometimes, women, especially PLWHA, for several reasons, resort to the use of other health care services instead of the general hospitals equipped for ante-natal care (ANC). This study aims to identify factors and conditions that determine childbirth choices of PLWHA in the Abia State of Nigeria. A cross-sectional descriptive study was carried out using a total sample of 96 PLWHA who attend meetings with the network of PLWHA and also a purposive convenience sample of 45 health workers. Data collection instruments were questionnaire, focus group discussions and interview guides. Data was analyzed both qualitatively and quantitatively using simple percentages. There was a low patronage for hospital services. A total of 79 (82%) PLWHA did not use hospital services due to the lack of confidentiality. In total, 61 (64%) PLWHA had their childbirth with Traditional Birth Attendants (TBAs) at home. Embarrassment, rejection, interpersonal conflicts with health workers, non-confidentiality, cultural stigma and stigmatization were among the factors that encouraged childbirth choices. On the whole, 82 (85%) of the PLWHA discontinued ANC services because of stigmatization. Poor interpersonal relationships between health workers and PLWHA facilitated PLWHA childbirth choices more than other factors. PLWHA and health workers termed management of belligerent tendencies against each other as their greatest concern. Therefore, concerted effort is needed to improve health workers/PLWHA relationship in hospitals. This would minimize factors and/or conditions that encourage HIV infection. Exposing PLWHA to factors that influence childbirth at home demonstrates high risks of mother

  15. Assessing Factors that affect Childbirth Choices of People living positively with HIV/AIDS in Abia State of Nigeria

    Directory of Open Access Journals (Sweden)

    Ezinne E. Enwereji

    2010-04-01

    Full Text Available Objectives: Poor interpersonal relationships with women especially those living positively with HIV/AIDS can make them take risks that would expose their new born and others to infection during childbirth. The factors that influence childbirth choices of people living positively with HIV/AIDS (PLWHA deserve attention. Sometimes, women, especially PLWHA, for several reasons, resort to the use of other health care services instead of the general hospitals equipped for ante-natal care (ANC. This study aims to identify factors and conditions that determine childbirth choices of PLWHA in the Abia State of Nigeria.Methods:A cross-sectional descriptive study was carried out using a total sample of 96 PLWHA who attend meetings with the network of PLWHA and also a purposive convenience sample of 45 health workers. Data collection instruments were questionnaire, focus group discussions and interview guides. Data was analyzed both qualitatively and quantitatively using simple percentages.Results: There was a low patronage for hospital services. A total of 79 (82% PLWHA did not use hospital services due to the lack of confidentiality. In total, 61 (64% PLWHA had their childbirth with Traditional Birth Attendants (TBAs at home. Embarrassment, rejection, interpersonal conflicts with health workers, non-confidentiality, cultural stigma and stigmatization were among the factors that encouraged childbirth choices. On the whole, 82 (85% of the PLWHA discontinued ANC services because of stigmatization.Conclusion: Poor interpersonal relationships between health workers and PLWHA facilitated PLWHA childbirth choices more than other factors. PLWHA and health workers termed management of belligerent tendencies against each other as their greatest concern. Therefore, concerted effort is needed to improve health workers/PLWHA relationship in hospitals. This would minimize factors and/or conditions that encourage HIV infection. Exposing PLWHA to factors that influence

  16. HIV Stigma and Its Relation to Mental, Physical and Social Health Among Black Women Living with HIV/AIDS.

    Science.gov (United States)

    Travaglini, Letitia E; Himelhoch, Seth S; Fang, Li Juan

    2018-02-07

    Black women living with HIV/AIDS (LWHA) are a subgroup with the highest growing rates of HIV infection in the United States. Stigma and co-occurring mental and physical health problems have been reported among Black women LWHA, and research on the benefits of social and religious support, often major protective factors among Black women, has been met with mixed findings. The current study examined the relation between anticipated HIV stigma and mental and physical health symptoms and risk and protective factors (discrimination, coping, social support) among Black women LWHA (N = 220). Results showed that greater anticipated stigma was significantly related to poorer mental health status, greater discrimination, and greater use of negative coping strategies. Stigma was not related to physical health, perceived social support or use of positive coping strategies. This study lends support to the need for psychosocial interventions that reduce anticipated stigma among individuals LWHA, particularly Black women LWHA.

  17. Association between Perceived Discrimination in Healthcare Settings and HIV Medication Adherence: Mediating Psychosocial Mechanisms.

    Science.gov (United States)

    Turan, Bulent; Rogers, Anna Joy; Rice, Whitney S; Atkins, Ghislaine C; Cohen, Mardge H; Wilson, Tracey E; Adimora, Adaora A; Merenstein, Daniel; Adedimeji, Adebola; Wentz, Eryka L; Ofotokun, Igho; Metsch, Lisa; Tien, Phyllis C; Johnson, Mallory O; Turan, Janet M; Weiser, Sheri D

    2017-12-01

    There is insufficient research on the impact of perceived discrimination in healthcare settings on adherence to antiretroviral therapy (ART), particularly among women living with HIV, and even less is known about psychosocial mechanisms that may mediate this association. Cross-sectional analyses were conducted in a sample of 1356 diverse women living with HIV enrolled in the Women's Interagency HIV Study (WIHS), a multi-center cohort study. Indirect effects analysis with bootstrapping was used to examine the potential mediating roles of internalized stigma and depressive symptoms in the association between perceived discrimination in healthcare settings and ART adherence. Perceived discrimination in healthcare settings was negatively associated with optimal (95% or better) ART adherence (adjusted odds ratio (AOR) = 0.81, p = 0.02, 95% confidence interval (CI) [0.68, 0.97]). Furthermore, internalization of stigma and depressive symptoms mediated the perceived discrimination-adherence association: Serial mediation analyses revealed a significant indirect effect of perceived discrimination in healthcare settings on ART adherence, first through internalized HIV stigma, and then through depressive symptoms (B = - 0.08, SE = 0.02, 95% CI [- 0.12, - 0.04]). Perceiving discrimination in healthcare settings may contribute to internalization of HIV-related stigma, which in turn may lead to depressive symptoms, with downstream adverse effects on ART adherence among women. These findings can guide the design of interventions to reduce discrimination in healthcare settings, as well as interventions targeting psychosocial mechanisms that may impact the ability of women living with HIV to adhere to ART regimens.

  18. Factors Predicting Internalized Stigma Among Men Who Have Sex with Men Living with HIV in Beijing, China.

    Science.gov (United States)

    Xu, Xiaohua; Sheng, Yu; Khoshnood, Kaveh; Clark, Kirsty

    Internalized stigma in people living with HIV is associated with negative outcomes including sexual risk behaviors and depression. Little research has focused on internalized stigma in men who have sex with men living with HIV (MSMLWH) in China. We measured internalized stigma and examined its potential predictors in a sample of 277 MSMLWH from two infectious disease specialist hospitals in Beijing, China. Descriptive analysis showed an intermediate high level of internalized stigma in these men. Multiple linear regression revealed that higher levels of stereotypes, negative affect, older age, lower levels of mastery, and limited information and emotional support were significant predictors of internalized stigma. Cognitive reconstruction interventions should be developed to change negative stereotypes and reduce internalized stigma, and information and emotional support should be provided to develop mastery, foster coping skills for internalized stigma, and alleviate negative affect. MSMLWH of older ages need more attention in stigma reduction programs. Copyright © 2016 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

  19. Stigma, disclosure, and depressive symptoms among informal caregivers of people living with HIV/AIDS.

    Science.gov (United States)

    Mitchell, Mary M; Knowlton, Amy

    2009-08-01

    Informal care receipt is associated with better HIV treatment outcomes among patients vulnerable to treatment failure. Yet, informal caregiving can be highly stressful, leading to distress and cessation of caregiving. Research on factors contributing to informal caregivers' psychological distress may advance our understanding of how to improve caregivers' well-being and sustained HIV caregiving for a vulnerable population. We examined relationships among caregiver stigma, disclosure, and depressive symptoms in a cross-sectional sample of 207 informal caregivers of people living with HIV/AIDS (PLWHAs) in Baltimore, Maryland. Caregivers were primarily African American, low-income, urban adults participating in the Action, Resources, and Knowledge (ARK) study (2003-2005), which recruited urban PLWHAs and their main supporters. Results indicated that among caregivers, HIV caregiving-related stigma was associated with more depressive symptoms, while disclosure of caregiving status was associated with fewer symptoms. We also explored the buffering effect of disclosure in the relationship between stigma and depressive symptoms. Results indicated that among those who reported greater stigma, there was a significant decrease in depressive symptoms as the number of disclosures increased. In contrast, participants who indicated lower stigma had consistently fewer depressive symptoms regardless of number of disclosures. These results suggest the need for interventions to address high levels of depressive symptoms among informal HIV caregivers, particularly those who report greater caregiving stigma and less disclosure of their caregiver status. In addition, future research should examine these relationships further using longitudinal data from informal caregivers and their care recipients.

  20. Predictors of adherence to antiretroviral therapy among people living with HIV and AIDS at the regional hospital of Sokodé, Togo.

    Science.gov (United States)

    Yaya, Issifou; Landoh, Dadja Essoya; Saka, Bayaki; Patchali, P'Niwè Massoubayo; Wasswa, Peter; Aboubakari, Abdoul-Samadou; N'Dri, Mathias Kouamé; Patassi, Akouda Akessiwe; Kombaté, Koussake; Pitche, Palokinam

    2014-12-19

    Adherence to antiretroviral therapy (ART) is beneficial in reducing the risk of emergence of HIV resistant strains. Adherence to ART among Persons Living with HIV/AIDS (PLWHA) is influenced by several factors related to the patient, the medication, and health facilities. In Togo, previous studies on adherence to ART have reported good adherence to ART during the first year of follow-up. However these may hide many disparities dues to cultural specificities which may differ across geographic areas of the country. We sought to determine the level of adherence to ART and document the associated factors among PLWHA at the regional hospital of Sokodé, Togo. This was an analytical cross-sectional study conducted from May to July 2013 at the regional hospital of Sokodé among 291 PLWHA who had been on ART for at least three months before the study. A total of 291 PLWHA on ART were enrolled in the study. The mean age (±SD) was 37.3 ± 9.3 years and the sex ratio (Male/Female) was 0.4. Among them, 195 (67.0%) were living with their partners and 210 (72.2%) had formal education. Two-thirds (194/291; 66.7%) of the PLWHA interviewed lived in urban areas. The global adherence to ART was 78.4%; the factors associated with ART adherence were: level of education (aOR = 3.54; p = 0.027), alcohol consumption (aOR = 0.43; p = 0.033), ART perception (aOR = 2.90; p = 0.026) and HIV status disclosure to sexual partner (aOR = 7.19; p ≤ 0.001). Although the level of adherence to ART in this study was higher than those reported in some studies in Sub-Saharan Africa, it remains sub-optimal and needs improvement. This may therefore hinder the implementation of efficient interventions related to access to ART services.

  1. HIV-Related Self-Stigma and Health-Related Quality of Life of People Living With HIV in Finland.

    Science.gov (United States)

    Nobre, Nuno; Pereira, Marco; Roine, Risto P; Sutinen, Jussi; Sintonen, Harri

    We examined how HIV-related self-stigma was associated with different domains of quality of life (QoL), as measured by the World Health Organization Quality of Life in HIV-infected persons instrument (WHOQOL-HIV-Bref), and health-related quality of life (HRQoL) as measured by the generic 15D (15-dimensional measure of HRQoL), to identify the factors associated with self-stigma of people living with HIV (PLWH). The study sample included 440 patients living with HIV followed at the Infectious Disease Clinic of Helsinki University Hospital. Participants with more severe self-stigma reported significantly lower QoL and HRQoL. Male gender, cohabiting with a partner, and disclosure of HIV status were associated with less self-stigma; high education level and financial difficulties were associated with greater self-stigma. Having lived longer with HIV, being unemployed, and living alone were also predictors of self-stigma via financial difficulties. The findings suggest that self-stigma is a complex and multidimensional phenomenon that impacts the HRQoL of PLWH. Psychosocial interventions to enhance the well-being of PLWH are increasingly needed. Copyright © 2017 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

  2. Reducing HIV-related stigma among traders in model markets in ...

    African Journals Online (AJOL)

    Background: HIV/AIDS is a major Public health problem in Nigeria where the National seroprevalence rate is 4.1%. The objective of this study was to determine the effect of health education on knowledge of HIV and the stigmatization of people living with HIV/AIDS among traders in model markets in Lagos State.

  3. Kaposi Sarcoma among HIV Infected Patients in Lagos University Teaching Hospital, Nigeria: A 14-Year Retrospective Clinicopathological Study

    Directory of Open Access Journals (Sweden)

    Olakanmi Akinde

    2016-01-01

    Full Text Available Background. Despite the increased incidence of Kaposi sarcoma (KS resulting from the Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS pandemic, there is still significant underreporting of KS in this environment. Objectives. This study was aimed at determining the incidence and clinicopathologic patterns of KS among HIV infected patients in Lagos University Teaching Hospital (LUTH, Nigeria, over a 14-year period: January 2000 to December 2013. Methodology. The materials for this study included patients’ hospital clinical files, duplicate copies of histopathologic reports, and tissue blocks and corresponding archival slides in the Anatomic and Molecular Pathology Department and the HIV/AIDS unit of the Department of Haematology. Results. Within the study period, 182 cases of KS were diagnosed, accounting for 1.2% of all patients managed for HIV/AIDS and 2.99% of solid malignant tumours. The male-to-female ratio and modal age group were 1 : 1.3 and 5th decade, respectively. Most cases (90% had purely mucocutaneous involvement with the lower limb being the commonest site (65.8%. The majority of lesions were plaques (65.8%. Vascular formation was the predominant histologic type seen (43.5%. Conclusion. KS in Lagos followed the same epidemiologic trend as other centers in Nigeria, with an increasing incidence in this era of HIV/AIDS.

  4. HIV, violence, blame and shame: pathways of risk to internalized HIV stigma among South African adolescents living with HIV.

    Science.gov (United States)

    Pantelic, Marija; Boyes, Mark; Cluver, Lucie; Meinck, Franziska

    2017-08-21

    Internalized HIV stigma is a key risk factor for negative outcomes amongst adolescents living with HIV (ALHIV), including non-adherence to anti-retroviral treatment, loss-to-follow-up and morbidity. This study tested a theoretical model of multi-level risk pathways to internalized HIV stigma among South African ALHIV. From 2013 to 2015, a survey using t otal population sampling of ALHIV who had ever initiated anti-retroviral treatment (ART) in 53 public health facilities in the Eastern Cape, South Africa was conducted. Community-tracing ensured inclusion of ALHIV who were defaulting from ART or lost to follow-up. 90.1% of eligible ALHIV were interviewed ( n  = 1060, 55% female, mean age = 13.8, 21% living in rural locations). HIV stigma mechanisms (internalized, enacted, and anticipated), HIV-related disability, violence victimization (physical, emotional, sexual abuse, bullying victimization) were assessed using well-validated self-report measures. Structural equation modelling was used to test a theoretically informed model of risk pathways from HIV-related disability to internalized HIV stigma. The model controlled for age, gender and urban/rural address. Prevalence of internalized HIV stigma was 26.5%. As hypothesized, significant associations between internalized stigma and anticipated stigma, as well as depression were obtained. Unexpectedly, HIV-related disability, victimization, and enacted stigma were not directly associated with internalized stigma. Instead significant pathways were identified via anticipated HIV stigma and depression. The model fitted the data well (RMSEA = .023; CFI = .94; TLI = .95; WRMR = 1.070). These findings highlight the complicated nature of internalized HIV stigma. Whilst it is seemingly a psychological process, indirect pathways suggest multi-level mechanisms leading to internalized HIV stigma. Findings suggest that protection from violence within homes, communities and schools may interrupt risk pathways from HIV

  5. Stigma, access to healthcare, and HIV risks among men who sell sex to men in Nigeria.

    Science.gov (United States)

    Crowell, Trevor A; Keshinro, Babajide; Baral, Stefan D; Schwartz, Sheree R; Stahlman, Shauna; Nowak, Rebecca G; Adebajo, Sylvia; Blattner, William A; Charurat, Manhattan E; Ake, Julie A

    2017-04-20

    Among men who have sex with men (MSM), men who sell sex (MSS) may be subject to increased sexual behaviour-related stigma that affects uptake of healthcare and risk of sexually transmitted infections (STIs). The objectives of this study were to characterize stigma, access to care, and prevalence of HIV among MSS in Nigeria. Respondent-driven sampling was used to recruit MSM in Abuja and Lagos into the ongoing TRUST/RV368 study, which provides HIV testing and treatment. Detailed behavioural data were collected by trained interviewers. MSS were identified by self-report of receiving goods or money in exchange for sex with men. Poisson regression with robust error variance was used to explore the impact of sex-selling on the risk of HIV. From 12 initial seed participants, 1552 men were recruited from March 2013-March 2016. Of these, 735 (47.4%) reported sex-selling. Compared to other MSM, MSS were younger (median 22 vs. 24 years, p harassment (39.2% vs. 26.8%, p sexual behaviour-related stigma affecting MSS, as compared with other MSM, that limits uptake of healthcare services. The distinct characteristics and risks among MSS suggest the need for specific interventions to optimize linkage to HIV prevention and treatment services in Nigeria.

  6. Perceived social support affects disease coping among people living with HIV: a study in Tehran, Iran

    Directory of Open Access Journals (Sweden)

    Elham Faraji

    2015-05-01

    Full Text Available Objective: To examine potential correlations between perceived social support and disease coping styles among people living with HIV infection at a referral center in Tehran. Methods: In an observational study, 112 patients were recruited between April and July 2012. Along with demographic characteristics, availability of tangible, informational, and emotional support was measured using subscales extracted from the medical outcomes study: social support survey; disease coping styles were investigated in four groups (problem-focused, emotion-focused, engagement-based, and meaning-based. Data were analyzed to examine whether social support subscales predict coping styles. Results: Almost 70% of the patients were male, and 52% reported sexual contact as their perceived route of infection. Use of coping styles was positively correlated with social support scores (rs = 0.53, P < 0.001, and informational support had significant influence on implementation of three out of the four coping styles (emotion-focused, problem-focused, engagement-based. Being married and not reporting the route of infection were associated with higher social support scores; monthly income and level of education had significant associations with the use of various coping styles. Conclusions: Patients who implement strategies to cope with HIV/AIDS have received more informational and emotional support. This study recommends that the delivery of informational support in a comprehensive package can practically target the current demands of our patients; while thorough investigation of potential effects on disease coping, response to treatment, and compliance can aid us in the design of interventions to target stigma at societal level.

  7. Factors influencing HIV disclosure among people living with HIV/AIDS in Nigeria: a systematic review using narrative synthesis and meta-analysis.

    Science.gov (United States)

    Adeoye-Agboola, D I; Evans, H; Hewson, D; Pappas, Y

    2016-07-01

    To critically review, appraise and evaluate quality of evidence on HIV disclosure among people living with HIV/AIDS (PLWHA) in Nigeria, and to identify a possible gap in knowledge on HIV/AIDS and disclosure. A systematic review using narrative synthesis and meta-analysis. MedLine, PsycINFO, PubMed Central, Scopus and CINAHL were searched. Data were extracted with the use of spread sheet. An analysis of heterogeneity was performed for the disclosure rate and the presence of a supportive reaction from partners. A meta-analysis was performed for the disclosure rates to sexual partners, with data available for all ten studies. Ten studies met the inclusion criteria. The outcomes show that HIV disclosure of sero-positive status is most common between spouses or sexual partners than disclosure to relatives/family members, friends, pastor/Imam or work colleagues/employers. The participants in most of these studies are women, and amongst the most influential factors on disclosure are gender, anticipated outcome, marital status and knowledge of partners' status. Some studies reported non-disclosure as a way of limiting stigma. Almost all of the studies highlighted that there is fear of stigma and social exclusion associated with disclosure. This review discusses the overall experience of HIV disclosure on the management of the disease and barriers to disclosure. We found that PLWHA in Nigeria disclosed to at least one person within their social networks. Stigma is still a major consideration for PLWHA who experience a range of misconceptions around HIV transmission. The findings of this study may inform local policies and plans for improving the PLWHA quality of life. Targeted policies to increase disclosure of sero-positive status and reduce stigma may facilitate disease prevention. The methodological rigour of the included studies was appraised low. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  8. HIV disclosure and stigma among women living with HIV in Denmark

    DEFF Research Database (Denmark)

    Wessman, Maria; Thorsteinsson, Kristina; Storgaard, Merete

    2017-01-01

    OBJECTIVE: To identify disclosure, stigma and predictors of non-disclosure among women living with HIV in Denmark. METHODS: A questionnaire study of women living with HIV in Denmark was performed. The enrolment period was from February 2013 to March 2014. Logistic regression was used to estimate......%), friends (63%) and children (41%). The primary reason for non-disclosure was a feeling that it did not concern others (55%), although reactions upon disclosure were mainly positive in 53%. Predictors of non-disclosure were being of black or Asian ethnicity. Following their HIV diagnosis, 40% no longer...... diagnosis to fewer than three people and black or Asian ethnicity predicted non-disclosure. HIV-related stigma regarding sex and contact with others is still highly prevalent; however, reactions to disclosure were mainly positive and associated with secondary positive gains. We strongly urge healthcare...

  9. Psychological Stressors and Coping Strategies Used by Adolescents Living with and Not Living with Hiv Infection in Nigeria.

    Science.gov (United States)

    Folayan, Morenike O; Cáceres, Carlos F; Sam-Agudu, Nadia A; Odetoyinbo, Morolake; Stockman, Jamila K; Harrison, Abigail

    2017-09-01

    Little is known about stressful triggers and coping strategies of Nigerian adolescents and whether or not, and how, HIV infection modulates these sources of stress and coping. This study evaluated differences in stressors and coping strategies among Nigerian adolescents based on HIV status. We analysed the data of six hundred 10-19 year old adolescents recruited through a population-based survey from 12 States of Nigeria who self-reported their HIV status. Data on stressors and coping strategies were retrieved by self-report from participants, using a validated structured questionnaire. We compared results between adolescents with and without HIV with respect to identification of specific life events as stressors, and use of specific coping strategies to manage stress. Logistic regression analysis adjusted for age and sex. Adolescents living with HIV (ALHIV) had significantly increased odds of identifying 'having to visit the hospital regularly' (AOR: 5.85; 95 % CI: 2.11-16.20; P = 0.001), and 'having to take drugs regularly' (AOR: 9.70; 95 % CI: 4.13-22.81; P stressors; and 'Seeking social support' (AOR: 3.14; 95 % CI: 1.99-4.93; p stressor (AOR: 6.59; 95 % CI: 3.62-11.98; P stressors for ALHIV. Providing targeted psychosocial support could help reduce the impact of such HIV status-related stressors on ALHIV.

  10. Actor and partner effects of perceived HIV stigma on social network components among people living with HIV/AIDS and their caregivers.

    Science.gov (United States)

    Hao, Chun; Liu, Hongjie

    2015-06-01

    Few studies have investigated the relationship between HIV stigma and social network components at the dyadic level. The objective of this study was to examine the actor and partner effects of perceived HIV stigma by people living with HIV/AIDS (PLWHAs) and their caregivers on social network variables at the dyadic level. An egocentric social network study was conducted among 147 dyads consisting of one PLWHA and one caregiver (294 participants) in Nanning, China. The actor-partner interdependence model (APIM) was used to analyze the relationships between perceived HIV stigma and social network components (network relations, network structures, and network functions) at the dyadic level. We found in this dyadic analysis that: (1) social network components were similar between PLWHAs and their caregivers; (2) HIV stigma perceived by PLWHAs influenced their own social network components, whereas this influence did not exist between caregivers' perceived HIV stigma and their own social network components; (3) a few significant partner effects were observed between HIV stigma and social network components among both PLWHAs and caregivers. The interrelationships between HIV stigma and social network components were complex at the dyadic level. Future interventions programs targeting HIV stigma should focus on the interpersonal relationship at the dyadic level, beyond the intrapersonal factors. © The Author(s) 2014.

  11. Stigma in Ethiopia: association with depressive symptoms in people with HIV.

    Science.gov (United States)

    Endeshaw, Meheret; Walson, Judd; Rawlins, Sarah; Dessie, Abere; Alemu, Shitaye; Andrews, Nancy; Rao, Deepa

    2014-01-01

    Rates of depression among people living with HIV can be as high as 50%. In many settings, HIV-related stigma has been associated with depressive symptoms which may lead to poor engagement in care and ultimately, poorer health outcomes. Stigma is a major issue in Ethiopia but data examining the relationship between stigma and depression in Ethiopia are lacking. We performed a mixed-methods cross-sectional study to examine the relationship between stigma of HIV/AIDS and depressive symptoms in Gondar, Ethiopia. We interviewed patients who presented for routine HIV care at Gondar University Hospital during the study period, examining depressive symptoms and HIV/AIDS-related stigma using standardized measures. Multiple-regression was used to assess the relationship between depressive symptoms, stigma, and gender. Of 55 patients included in this analysis, 63.6% were female and most participants had limited formal education (69%, less than 12th grade education). The majority reported experiencing both stigma (78%) and depressive symptoms (60%) ranging in severity from mild to moderately severe. Higher levels of HIV-related stigma were significantly associated with higher levels of depressive symptoms (β = 0.464, p ≤ 0.001). Although gender was associated with stigma, it was not associated with depressive symptoms (β = -0.027, p > 0.05). Results suggest the importance of psychosocial issues in the lives of people with HIV in Ethiopia.

  12. HIV disclosure and stigma among women living with HIV in Denmark

    DEFF Research Database (Denmark)

    Wessman, Maria; Thorsteinsson, Kristina; Storgaard, Merete

    2017-01-01

    OBJECTIVE: To identify disclosure, stigma and predictors of non-disclosure among women living with HIV in Denmark. METHODS: A questionnaire study of women living with HIV in Denmark was performed. The enrolment period was from February 2013 to March 2014. Logistic regression was used to estimate...... professionals to initiate a dialogue regarding stigma and disclosure with women living with HIV with a view to increasing disclosure and minimising stigmatisation in this vulnerable population....

  13. TEMPOROMANDIBULAR PAIN DYSFUNCTION SYNDROME IN PATIENTS ATTENDING LAGOS UNIVERSITY TEACHING HOSPITAL, LAGOS, NIGERIA.

    Science.gov (United States)

    Eweka, O M; Ogundana, O M; Agbelusi, G A

    2016-01-01

    Temporomandibular joint pain dysfunction syndrome (TMJPDS) is the most common temporomandibular disorder. This condition presents with symptoms of pain, restricted jaw movement and joint noise. Other symptoms include otalgia, headache, neck pain and trismus. To determine the pattern of Temporomandibular joint pain dysfunction syndrome patients managed at the Lagos University Teaching Hospital, Lagos, Nigeria. A descriptive study of patients with signs and symptoms of Temporomandibular joint pain dysfunction syndrome attending the Oral Medicine Clinic of Lagos University Teaching Hospital. Twenty-one patients with Temporomandibular joint pain dysfunction syndrome were enrolled into the study, out of which 10(48%) were females and 11(52%) were males. The age range was 23-81years with a mean of 45.2 ± 18.9 years. Majority of the patients 20(95.2%) complained of pain around the joint, in the pre-auricular region, in the muscles of mastication and the ear. While 7(35%) complained of clicking sounds, 10(47.6%) complained of pain on mouth opening and during mastication only. In all 5(23.8%) had impaired movement of the jaws, mouth opening was normal in 18(85.7%) but reduced in 3(14.3%) patients. Over half of patients 12(57%) experienced clicking sounds, there was tenderness around the temporomandibular joint in 16(76.2%) cases, pain in the ear of 7(33.3%) patients and 13(61.9%) people presented with tenderness of the muscles of mastication. Conservative management of all the cases resulted in resolution of the symptoms. Temporomandibular joint pain dysfunction syndrome has diverse clinical presentation and though distressing, it responds to prompt and effective conservative management.

  14. Stigma, discrimination and the implications for people living with HIV/AIDS in South Africa.

    Science.gov (United States)

    Skinner, D; Mfecane, S

    2004-11-01

    Stigma and discrimination play significant roles in the development and maintenance of the HIV epidemic. It is well documented that people living with HIV and AIDS experience stigma and discrimination on an ongoing basis. This impact goes beyond individuals infected with HIV to reach broadly into society, both disrupting the functioning of communities and complicating prevention and treatment of HIV. This paper reviews the available scientific literature on HIV/AIDS and stigma in South Africa, as well as press reports on the same subject over a period of 3 years. Analysis of this material indicates that stigma drives HIV out of the public sight, so reducing the pressure for behaviour change. Stigma also introduces a desire not to know one's own status, thus delaying testing and accessing treatment. At an individual level stigma undermines the person's identity and capacity to cope with the disease. Fear of discrimination limits the possibility of disclosure even to potential important sources of support such as family and friends. Finally, stigma impacts on behaviour change as it limits the possibility of using certain safer sexual practices. Behaviour such as wanting to use condoms could be seen as a marker of HIV, leading to rejection and stigma. All interventions need to address stigma as part of their focus. However, the difficulty of the task should not be underestimated, as has been shown by the persistence of discrimination based on factors such as race, gender and sexual orientation.

  15. Medication Adherence in People Dually Treated for HIV Infection and Mental Health Conditions: Test of the Medications Beliefs Framework

    OpenAIRE

    Kalichman, Seth C.; Pellowski, Jennifer; Kegler, Christopher; Cherry, Chauncey; Kalichman, Moira O.

    2015-01-01

    Beliefs about medication necessity and concerns predict treatment adherence in people with a wide-array of medical conditions, including HIV infection. However, medication beliefs have not been examined in people dually treated with psychotropic medications and antiretroviral therapy. In the current study, we used a prospective design to investigate the factors associated with adherence to psychotropic medications and antiretrovirals among 123 dually treated persons living with HIV. We used u...

  16. Access to HIV Care and Resilience in a Long-Term Conflict Setting: A Qualitative Assessment of the Experiences of Living with Diagnosed HIV in Mogadishu, Somali.

    Science.gov (United States)

    Kulane, Asli; Owuor, John O A; Sematimba, Douglas; Abdulahi, Sacdia Abdisamad; Yusuf, Hamdi Moalim; Mohamed, Lul M

    2017-07-05

    Human Immunodeficiency Virus (HIV) continues to take a heavy toll on the lives of many people, with the worst impact on health and wellbeing for the affected individuals in fragile states. The HIV situation in Somalia is not clearly known and experiences of the people living with HIV in this war-torn region are often unexpressed. This pilot qualitative study sought to explore the experiences of people diagnosed with HIV living in Mogadishu, and their resilience in access to care and social support. Participants were recruited through drug dispensers at the HIV clinic in Banadir Hospital. Face-to-face in-depth interviews were conducted in Somali in May 2013 among patients who were receiving antiretroviral therapy (ART) from the HIV clinic in Mogadishu. These were tape-recorded, transcribed, and translated for content analysis. Three women and four men who were living with HIV shared the following narratives. Their perception was that they had either got HIV from their spouses or through health care contamination. They were very knowledgeable about the realities of HIV, how the medication works, nutritional requirements, and drug adherence. They were always willing to go an extra mile to secure a good life for themselves. However, the external HIV stigma impacted their access to care. They faced challenges in their homes and at work which compelled them to seek support from non-governmental organizations (NGOs) or close family members. This stigma often affected their disclosure to the wider community due to the uncertainty of the repercussions, leading to a life of extreme loneliness and financial difficulties. The participants' coping mechanisms included living together and starting their own NGO for support with very strong optimism about their prognosis. The people diagnosed with HIV living in Mogadishu are highly knowledgeable about HIV transmission, the realities of living with a diagnosed HIV infection, and the efficacy of HIV treatment. Our small sample

  17. Access to HIV Care and Resilience in a Long-Term Conflict Setting: A Qualitative Assessment of the Experiences of Living with Diagnosed HIV in Mogadishu, Somali

    Science.gov (United States)

    Kulane, Asli; Owuor, John O. A.; Abdulahi, Sacdia Abdisamad; Yusuf, Hamdi Moalim; Mohamed, Lul M.

    2017-01-01

    Background: Human Immunodeficiency Virus (HIV) continues to take a heavy toll on the lives of many people, with the worst impact on health and wellbeing for the affected individuals in fragile states. The HIV situation in Somalia is not clearly known and experiences of the people living with HIV in this war-torn region are often unexpressed. This pilot qualitative study sought to explore the experiences of people diagnosed with HIV living in Mogadishu, and their resilience in access to care and social support. Methods: Participants were recruited through drug dispensers at the HIV clinic in Banadir Hospital. Face-to-face in-depth interviews were conducted in Somali in May 2013 among patients who were receiving antiretroviral therapy (ART) from the HIV clinic in Mogadishu. These were tape-recorded, transcribed, and translated for content analysis. Results: Three women and four men who were living with HIV shared the following narratives. Their perception was that they had either got HIV from their spouses or through health care contamination. They were very knowledgeable about the realities of HIV, how the medication works, nutritional requirements, and drug adherence. They were always willing to go an extra mile to secure a good life for themselves. However, the external HIV stigma impacted their access to care. They faced challenges in their homes and at work which compelled them to seek support from non-governmental organizations (NGOs) or close family members. This stigma often affected their disclosure to the wider community due to the uncertainty of the repercussions, leading to a life of extreme loneliness and financial difficulties. The participants’ coping mechanisms included living together and starting their own NGO for support with very strong optimism about their prognosis. Conclusions: The people diagnosed with HIV living in Mogadishu are highly knowledgeable about HIV transmission, the realities of living with a diagnosed HIV infection, and the

  18. The Role of Alcohol on Antiretroviral Therapy Adherence Among Persons Living With HIV in Urban India.

    Science.gov (United States)

    Schensul, Stephen L; Ha, Toan; Schensul, Jean J; Vaz, Melita; Singh, Rajendra; Burleson, Joseph A; Bryant, Kendall

    2017-09-01

    The purpose of this study was to estimate the prevalence of alcohol use among men living with HIV on antiretroviral therapy (ART) and examine the association of alcohol use and psychosocial variables on ART adherence. The study was a cross-sectional survey supplemented by medical records and qualitative narratives as a part of the initial formative stage of a multilevel, multicentric intervention and evaluation project. A screening instrument was administered to men living with HIV (n = 3,088) at four ART Centers using the Alcohol Use Disorders Identification Test-consumption questions (AUDIT-C) to determine alcohol use for study eligibility. Alcohol screening data were triangulated with medical records of men living with HIV (n = 15,747) from 13 ART Centers to estimate alcohol consumption among men on ART in greater Mumbai. A survey instrument to identify associations between ART adherence and alcohol, psychosocial, and contextual factors was administered to eligible men living with HIV (n = 361), and in-depth interviews (n = 55) were conducted to elucidate the ways in which these factors are manifest in men's lives. Nearly one fifth of men living with HIV on ART in the Mumbai area have consumed alcohol in the last 30 days. Non-adherence was associated with a higher AUDIT score, consumption of more types of alcohol, and poorer self-ratings on quality of life, depression, and external stigma. The qualitative data demonstrate that non-adherence results from avoiding the mixing of alcohol with medication, forgetfulness when drinking, and skipping medication for fear of disclosure of HIV status when drinking with friends. As the demand for ART expands, Indian government programs will need to more effectively address alcohol to reduce risk and maintain effective adherence.

  19. Measuring HIV stigma for PLHAs and nurses over time in five African ...

    African Journals Online (AJOL)

    HIV stigma has been shown to negatively affect the quality of life for people living with HIV infection, their adherence to medication, and their access to care. Few studies have documented HIV stigma by association as experienced by nurses or other health care workers who care for people living with HIV infection.

  20. HIV-Related Stress and Life Chaos Mediate the Association Between Poverty and Medication Adherence Among People Living with HIV/AIDS.

    Science.gov (United States)

    Kalichman, Seth C; Kalichman, Moira O

    2016-12-01

    HIV treatment depends on high-levels of antiretroviral therapy (ART) adherence, which is severely impeded by poverty. Men and women living with HIV infection (N = 92) completed computerized interviews of demographic and health characteristics, poverty markers, stressful life events, and life chaos, as well as unannounced pill counts to determine prospective medication adherence and medical record chart abstractions for HIV viral load. Poverty markers were associated with both stressors and chaos, and the direct effects of all three factors predicted ART non-adherence. The multiple mediation model showed that accounting for stressors and chaos resulted in a non-significant association between poverty markers and ART adherence. The indirect effect of poverty markers on adherence through life chaos was significant, whereas the indirect effect of poverty markers on adherence through stressors was not significant. Factors that render HIV-related stress and create chaos offer intervention targets that are more amenable to change than poverty itself.

  1. Network stigma towards people living with HIV/AIDS and their caregivers: An egocentric network study.

    Science.gov (United States)

    Wu, Fei; He, Xin; Guida, Jennifer; Xu, Yongfang; Liu, Hongjie

    2015-10-01

    HIV stigma occurs among peers in social networks. However, the features of social networks that drive HIV stigma are not well understood. The objective of this study is to investigate anticipated HIV stigma within the social networks of people living with HIV/AIDS (PLWHA) (N = 147) and the social networks of PLWHA's caregivers (N = 148). The egocentric social network data were collected in Guangxi, China. More than half of PLWHA (58%) and their caregivers (53%) anticipated HIV stigma from their network peers. Both PLWHA and their caregivers anticipated that spouses or other family members were less likely to stigmatise them, compared to friend peers or other relationships. Married network peers were believed to stigmatise caregivers more than unmarried peers. The association between frequent contacts and anticipated stigma was negative among caregivers. Being in a close relationship with PLWHA or caregivers (e.g., a spouse or other family member) was associated with less anticipated stigma. Lower network density was associated with higher anticipated stigma among PLWHA's alters, but not among caregivers' alters. Findings may shed light on innovative stigma reduction interventions at the social network level and therefore improve HIV/AIDS treatment utilisation.

  2. High prevalence of HIV, chlamydia and gonorrhoea among men who have sex with men and transgender women attending trusted community centres in Abuja and Lagos, Nigeria.

    Science.gov (United States)

    Keshinro, Babajide; Crowell, Trevor A; Nowak, Rebecca G; Adebajo, Sylvia; Peel, Sheila; Gaydos, Charlotte A; Rodriguez-Hart, Cristina; Baral, Stefan D; Walsh, Melissa J; Njoku, Ogbonnaya S; Odeyemi, Sunday; Ngo-Ndomb, Teclaire; Blattner, William A; Robb, Merlin L; Charurat, Manhattan E; Ake, Julie

    2016-01-01

    Sexually transmitted infection (STI) and HIV prevalence have been reported to be higher amongst men who have sex with men (MSM) in Nigeria than in the general population. The objective of this study was to characterize the prevalence of HIV, chlamydia and gonorrhoea in this population using laboratory-based universal testing. TRUST/RV368 represents a cohort of MSM and transgender women (TGW) recruited at trusted community centres in Abuja and Lagos, Nigeria, using respondent-driven sampling (RDS). Participants undergo a structured comprehensive assessment of HIV-related risks and screening for anorectal and urogenital Chlamydia trachomatis and Neisseria gonorrhoeae , and HIV. Crude and RDS-weighted prevalence estimates with 95% confidence intervals (CIs) were calculated. Log-binomial regression was used to explore factors associated with prevalent HIV infection and STIs. From March 2013 to January 2016, 862 MSM and TGW (316 in Lagos and 546 in Abuja) underwent screening for HIV, chlamydia and gonorrhoea at study enrolment. Participants' median age was 24 years [interquartile range (IQR) 21-27]. One-third (34.2%) were identified as gay/homosexual and 65.2% as bisexual. The overall prevalence of HIV was 54.9%. After adjusting for the RDS recruitment method, HIV prevalence in Abuja was 43.5% (95% CI 37.3-49.6%) and in Lagos was 65.6% (95% CI 54.7-76.5%). The RDS-weighted prevalence of chlamydia was 17.0% (95% CI 11.8-22.3%) in Abuja and 18.3% (95% CI 11.1-25.4%) in Lagos. Chlamydia infection was detected only at the anorectal site in 70.2% of cases. The RDS-weighted prevalence of gonorrhoea was 19.1% (95% CI 14.6-23.5%) in Abuja and 25.8% (95% CI 17.1-34.6%) in Lagos. Overall, 84.2% of gonorrhoea cases presented with anorectal infection only. Over 95% of STI cases were asymptomatic. In a multivariable model, increased risk for chlamydia/gonorrhoea was associated with younger age, gay/homosexual sexual orientation and higher number of partners for receptive anal sex

  3. The Interaction of Mindful-based Attention and Awareness and Disengagement Coping with HIV/AIDS-related Stigma in regard to Concurrent Anxiety and Depressive Symptoms Among Adults with HIV/AIDS

    OpenAIRE

    Gonzalez, Adam; Solomon, Sondra E.; Zvolensky, Michael J.; Miller, Carol T.

    2009-01-01

    The present investigation examined the interaction of disengagement coping with HIV/AIDS-related stigma and mindful-based attention and awareness in regard to levels of anxiety and depressive symptoms among people with HIV/AIDS. Participants included 98 (31 women; Mage = 44.97 years, SD = 7.70) adults with HIV/AIDS. As predicted, there was a significant interaction for disengagement coping with HIV/AIDS-related stigma and mindful-based attention and awareness in regard to anxiety symptoms. In...

  4. Religious and spiritual coping in people living with HIV/Aids

    Directory of Open Access Journals (Sweden)

    Clarissa Mourão Pinho

    Full Text Available ABSTRACT Objective: evaluate the religiosity and the religious/spiritual coping of people living with HIV/Aids. Method: descriptive, cross-sectional study with quantitative approach, conducted in a reference HIV/Aids outpatient clinic in a university hospital of Recife-PE, Brazil, from June to November 2015. At total of 52 people living with HIV/Aids (PLWHA participated in the research, which employed own questionnaire, the Duke University Religion Index (DUREL, and the Religious/Spiritual Coping Scale (RCOPE. Results: the sample presented high indices of organizational religiosity (4.23±1.66, non-organizational religiosity (4.63±1.50, and intrinsic religiosity (13.13±2.84. Positive RCOPE was used in high mean scores (3.66±0.88, and negative RCOPE had low use (2.12 ± 0.74. In total, use of RCOPE was high (3.77±0.74, having predominated the positive RCOPE (NegRCOPE/PosRCOPE ratio=0.65±0.46. Conclusion: it is evident the importance of encouraging religious activity and RCOPE strategies, seen in the past as inappropriate interventions in clinical practice.

  5. Depressive Symptoms Mediate the Effect of HIV-Related Stigmatization on Medication Adherence Among HIV-Infected Men Who Have Sex with Men.

    Science.gov (United States)

    Mitzel, Luke D; Vanable, Peter A; Brown, Jennifer L; Bostwick, Rebecca A; Sweeney, Shannon M; Carey, Michael P

    2015-08-01

    This study tested the hypothesis that depressive symptoms would mediate the association of HIV-related stigma to medication adherence. We recruited HIV-infected men who have sex with men (MSM; N = 66; 66 % White, 23 % African-American) from an outpatient infectious disease clinic, and asked them to complete self-report measures. Mediational analyses showed that depressive symptoms fully mediated the association between HIV-related stigma and adherence. That is, stigma-related experiences were positively associated with depressive symptoms and negatively associated with adherence, and, in the final model, depressive symptoms remained a significant correlate of adherence while stigma did not. A test of the indirect effect of stigma on adherence through depressive symptoms was also significant (unstandardized b = -0.19; bootstrap 95 % CI -0.45 to -0.01). These results highlight the importance of treating depressive symptoms in interventions aiming to improve medication adherence among HIV-infected MSM.

  6. Usage of Complementary and Alternative Medicine (CAM) among osteoarthritis patients attending an urban multi-specialist hospital in Lagos, Nigeria.

    Science.gov (United States)

    Obalum, D C; Ogo, C N

    2011-03-01

    Osteoarthritis (OA), a chronic degenerative disease of synovial joints is characterised by pain and stiffness. Aim of treatment is pain relief. Complementary and alternative medicine (CAM) refers to practices which are not an integral part of orthodox medicine. To determine the pattern of usage of CAM among OA patients in Nigeria. Consecutive patients with OA attending orthopaedic clinic of Havana Specialist Hospital, Lagos, Nigeria were interviewed over a 6- month period st st of 1 May to 31 October 2007 on usage of CAM. Structured and open-ended questions were used. Demographic data, duration of OA and treatment as well as compliance to orthodox medications were documented. One hundred and sixty four patients were studied.120 (73.25%) were females and 44(26.89%) were males. Respondents age range between 35-74 years. 66(40.2%) patients used CAM. 35(53.0%) had done so before presenting to the hospital. The most commonly used CAM were herbal products used by 50(75.8%) of CAM users. Among herbal product users, 74.0% used non- specific local products, 30.0% used ginger, 36.0% used garlic and 28.0% used Aloe Vera. Among CAM users, 35(53.0%) used local embrocation and massage, 10(15.2%) used spiritual methods. There was no significant difference in demographics, clinical characteristics and pain control among CAM users and non-users. Many OA patients receiving orthodox therapy also use CAM. Medical doctors need to keep a wary eye on CAM usage among patients and enquire about this health-seeking behaviour in order to educate them on possible drug interactions, adverse effects and long term complications.

  7. Mental Health Experiences of Older Adults Living with HIV: Uncertainty, Stigma, and Approaches to Resilience.

    Science.gov (United States)

    Furlotte, Charles; Schwartz, Karen

    2017-06-01

    This study describes the mental health experiences of older adults living with HIV in Ottawa. Eleven participants aged 52 to 67 completed in-depth personal interviews. Mental health concerns pervaded the lives of these older adults. We identified three central themes common to the participants' stories: uncertainty, stigma, and resilience. For some of these participants, uncertainty impacting mental health centred on unexpected survival; interpretation of one's symptoms; and medical uncertainty. Participants' experiences of stigma included discrimination in health care interactions; misinformation; feeling stigmatized due to aspects of their physical appearance; compounded stigma; and anticipated stigma. Participants reported using several coping strategies, which we frame as individual approaches to resilience. These strategies include reducing the space that HIV takes up in one's life; making lifestyle changes to accommodate one's illness; and engaging with social support. These findings inform understandings of services for people aging with HIV who may experience mental health concerns.

  8. Mechanisms for the Negative Effects of Internalized HIV-Related Stigma on Antiretroviral Therapy Adherence in Women: The Mediating Roles of Social Isolation and Depression.

    Science.gov (United States)

    Turan, Bulent; Smith, Whitney; Cohen, Mardge H; Wilson, Tracey E; Adimora, Adaora A; Merenstein, Daniel; Adedimeji, Adebola; Wentz, Eryka L; Foster, Antonina G; Metsch, Lisa; Tien, Phyllis C; Weiser, Sheri D; Turan, Janet M

    2016-06-01

    Internalization of HIV-related stigma may inhibit a person's ability to manage HIV disease through adherence to treatment regimens. Studies, mainly with white men, have suggested an association between internalized stigma and suboptimal adherence to antiretroviral therapy (ART). However, there is a scarcity of research with women of different racial/ethnic backgrounds and on mediating mechanisms in the association between internalized stigma and ART adherence. The Women's Interagency HIV Study (WIHS) is a multicenter cohort study. Women living with HIV complete interviewer-administered questionnaires semiannually. Cross-sectional analyses for the current article included 1168 women on ART for whom data on medication adherence were available from their last study visit between April 2013 and March 2014, when the internalized stigma measure was initially introduced. The association between internalized stigma and self-reported suboptimal ART adherence was significant for those in racial/ethnic minority groups (AOR = 0.69, P = 0.009, 95% CI: 0.52 to 0.91), but not for non-Hispanic whites (AOR = 2.15, P = 0.19, 95% CI: 0.69 to 6.73). Depressive symptoms, loneliness, and low perceived social support mediated the association between internalized stigma and suboptimal adherence in the whole sample, as well as in the subsample of minority participants. In serial mediation models, internalized stigma predicted less-perceived social support (or higher loneliness), which in turn predicted more depressive symptoms, which in turn predicted suboptimal medication adherence. Findings suggest that interconnected psychosocial mechanisms affect ART adherence, and that improvements in adherence may require multifaceted interventions addressing both mental health and interpersonal factors, especially for minority women.

  9. Age, Stigma, Adherence and Clinical Indicators in HIV-Infected Women.

    Science.gov (United States)

    McCoy, Katryna; Higgins, Melinda; Zuñiga, Julie Ann; Holstad, Marcia McDonnell

    Stigma has become a gendered phenomenon that affects increasing numbers of HIV-infected women worldwide. This study examined the role of age as a possible moderator of the relationship between stigma and antiretroviral therapy adherence, CD4% and viral load among 120 HIV-infected women. A secondary analysis was conducted using data from the Keeping Healthy and Active with Risk Reduction and Medication Adherence (KHARMA) Project, an National Institutes of Health (NIH) funded randomized controlled trial to improve Antiretroviral treatment (ART) adherence and reduce risky behaviors in HIV-infected women at five clinical sites in a South-eastern city from 2005 to 2008. Stigma was measured using the Perceived Personal Stigma of Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome (HIV/AIDS) scale. Among participants stigma was negatively associated with CD4% (r =-.26, p=.02). For the 30 participants >50 years old, age was not significantly associated with viral load, stigma or CD4%, and there was no significant association between stigma and CD4% (r=.07, p=.70). These findings indicate the need for further study regarding this potential moderating effect and possible interventions to address the susceptibility of younger women to the harmful effects of stigma.

  10. The effects of HIV stigma on health, disclosure of HIV status, and risk behavior of homeless and unstably housed persons living with HIV.

    Science.gov (United States)

    Wolitski, Richard J; Pals, Sherri L; Kidder, Daniel P; Courtenay-Quirk, Cari; Holtgrave, David R

    2009-12-01

    HIV-related stigma negatively affects the lives of persons living with HIV/AIDS (PLWHA). Homeless/unstably housed PLWHA experience myriad challenges and may be particularly vulnerable to the effects of HIV-related stigma. Homeless/unstably housed PLWHA from 3 U.S. cities (N = 637) completed computer-assisted interviews that measured demographics, self-assessed physical and mental health, medical utilization, adherence, HIV disclosure, and risk behaviors. Internal and perceived external HIV stigma were assessed and combined for a total stigma score. Higher levels of stigma were experienced by women, homeless participants, those with a high school education or less, and those more recently diagnosed with HIV. Stigma was strongly associated with poorer self-assessed physical and mental health, and perceived external stigma was associated with recent non-adherence to HIV treatment. Perceived external stigma was associated with decreased HIV disclosure to social network members, and internal stigma was associated with drug use and non-disclosure to sex partners. Interventions are needed to reduce HIV-related stigma and its effects on the health of homeless/unstably housed PLWHA.

  11. A Novel Integrated Cognitive-Behavioral Therapy for Anxiety and Medication Adherence Among Persons Living With HIV/AIDS.

    Science.gov (United States)

    Brandt, Charles P; Paulus, Daniel J; Garza, Monica; Lemaire, Chad; Norton, Peter J; Zvolensky, Michael J

    2018-02-01

    Persons living with HIV/AIDS (PLHIV) are able to live full lifespans after infection, however, rates of anxiety disorders among this population are elevated compared to national samples. Importantly, these anxiety symptoms and disorders have a negative effect on medication adherence, quality of life and other psychological disorders, such as depression. In order to reduce the impact of anxiety among PLHIV, a six-session transdiagnostic CBT-based treatment manual for anxiety among PLHIV named the HIV/Anxiety Management-Reduction Treatment (HAMRT) was developed and implemented. The current manuscript discusses the content of this manual as well as results from three cases examining the impact of HAMRT. Results indicated that HAMRT was effective in reducing symptoms of anxiety, anxiety sensitivity, depression, and negative affect among our sample. Additionally, results indicated that HAMRT was effective in increasing HIV medication adherence as well as quality of life. Results are discussed in terms of the potential utility of an anxiety-reduction therapy program aimed at increasing medication adherence among PLHIV.

  12. A structural equation model of perceived and internalized stigma, depression, and suicidal status among people living with HIV/AIDS.

    Science.gov (United States)

    Zeng, Chengbo; Li, Linghua; Hong, Yan Alicia; Zhang, Hanxi; Babbitt, Andrew Walker; Liu, Cong; Li, Lixia; Qiao, Jiaying; Guo, Yan; Cai, Weiping

    2018-01-15

    Previous studies have shown positive association between HIV-related stigma and depression, suicidal ideation, and suicidal attempt among people living with HIV/AIDS (PLWH). But few studies have examined the mechanisms among HIV-related stigma, depression, and suicidal status (suicidal ideation and/or suicidal attempt) in PLWH. The current study examined the relationships among perceived and internalized stigma (PIS), depression, and suicidal status among PLWH in Guangzhou, China using structural equation modeling. Cross-sectional study by convenience sampling was conducted and 411 PLWH were recruited from the Number Eight People's Hospital from March to June, 2013 in Guangzhou, China. Participants were interviewed on their PIS, depressive symptoms, suicidal status, and socio-demographic characteristics. PLWH who had had suicidal ideation and suicidal attempts since HIV diagnosis were considered to be suicidal. Structural equation model was performed to examine the direct and indirect associations of PIS and suicidal status. Indicators to evaluate goodness of fit of the structural equation model included Chi-square Statistic, Comparative Fit Index (CFI), Root Mean Square Error of Approximation (RMSEA), Standardized Root Mean Square Residual (SRMR), and Weighted Root Mean Square Residual (WRMR). More than one-third (38.4%) of the PLWH had depressive symptoms and 32.4% reported suicidal ideation and/or attempt since HIV diagnosis. The global model showed good model fit (Chi-square value = 34.42, CFI = 0.98, RMSEA = 0.03, WRMR = 0.73). Structural equation model revealed that direct pathway of PIS on suicidal status was significant (standardized pathway coefficient = 0.21), and indirect pathway of PIS on suicidal status via depression was also significant (standardized pathway coefficient = 0.24). There was a partial mediating effect of depression in the association between PIS and suicidal status. Our findings suggest that PIS is associated

  13. Social impact of HIV/AIDS on clients attending a teaching hospital in Southern Nigeria.

    Science.gov (United States)

    Johnson, Ofonime E

    2012-01-01

    People living with human immunodeficiency virus and acquired immune deficiency syndrome (PLWHA) face numerous social challenges. The objectives of this study were to assess the level of self-disclosure of status by PLWHA, to describe the level and patterns of stigma and discrimination, if any, experienced by the PLWHA and to assess the effect of sero-positivity on the attitude of friends, family members, health workers, colleagues and community. This was a cross-sectional descriptive study carried out among PLWHA attending the University of Uyo Teaching Hospital, Uyo, Southern Nigeria. Information was obtained using an interviewer-administered semi-structured questionnaire, which was analysed using the Epi 6 software. A total of 331 respondents were interviewed. A majority, 256 (77.3%), of the respondents were within the age range of 25-44 years. A total of 121 (36.6%) PLWHA were single and 151 (46.6%) were married, while the rest were widowed, divorced or separated. A majority, 129 (85.4%), of the married respondents disclosed their status to their spouses and 65 (50.4%) were supportive. Apart from spouses, disclosure to mothers (39.9%) was highest. Most clients (57.7%) did not disclose their status to people outside their immediate families for fear of stigmatization. Up to 111 (80.4%) of the respondents working for others did not disclose their status to their employers. Among those whose status was known, discrimination was reported to be highest among friends (23.2%) and at the workplace (20.2%). Attitudes such as hostility (14.5%), withdrawal (11.7%) and neglect (6.8%) were reported from the private hospitals. Apart from disclosure to spouses, the level of disclosure to others was very low. Those whose status was known mainly received acceptance from their families but faced discriminatory attitudes such as hostility, neglect and withdrawal from friends, colleagues and hospital workers. There is a need for more enlightenment campaigns on HIV/AIDS by

  14. Social Network Characteristics Moderate the Association Between Stigmatizing Attributions About HIV and Non-adherence Among Black Americans Living with HIV: a Longitudinal Assessment.

    Science.gov (United States)

    Bogart, Laura M; Wagner, Glenn J; Green, Harold D; Mutchler, Matt G; Klein, David J; McDavitt, Bryce

    2015-12-01

    Stigma may contribute to HIV-related disparities among HIV-positive Black Americans. We examined whether social network characteristics moderate stigma's effects. At baseline and 6 months post-baseline, 147 HIV-positive Black Americans on antiretroviral treatment completed egocentric social network assessments, from which we derived a structural social support capacity measure (i.e., ability to leverage support from the network, represented by the average interaction frequency between the participant and each alter). Stigma was operationalized with an indicator of whether any social network member had expressed stigmatizing attributions of blame or responsibility about HIV. Daily medication adherence was monitored electronically. In a multivariate regression, baseline stigma was significantly related to decreased adherence over time. The association between stigma and non-adherence was attenuated among participants who increased the frequency of their interactions with alters over time. Well-connected social networks have the potential to buffer the effects of stigma.

  15. Age, Stigma, Adherence and Clinical Indicators in HIV-Infected Women

    OpenAIRE

    McCoy, Katryna; Higgins, Melinda; Zuñiga, Julie Ann; Holstad, Marcia McDonnell

    2015-01-01

    Stigma has become a gendered phenomenon that affects increasing numbers of HIV-infected women worldwide. This study examined the role of age as a possible moderator of the relationship between stigma and antiretroviral therapy adherence, CD4% and viral load among 120 HIV-infected women. A secondary analysis was conducted using data from the Keeping Healthy and Active with Risk Reduction and Medication Adherence (KHARMA) Project, an National Institutes of Health (NIH) funded randomized control...

  16. Changeover-time in psychosocial wellbeing of people living with HIV and people living close to them after an HIV stigma reduction and wellness enhancement community intervention.

    Science.gov (United States)

    Chidrawi, H Christa; Greeff, Minrie; Temane, Q Michael; Ellis, Suria

    2015-01-01

    HIV stigma continues to affect the psychosocial wellbeing of people living with HIV (PLWH) and people living close to them (PLC). Literature unequivocally holds the view that HIV stigma and psychosocial wellbeing interact with and have an impact on each other. This study, which is part of a larger research project funded by the South Africa Netherlands research Programme on Alternatives in Development (SANPAD), responds to the lack of interventions mitigating the impactful interaction of HIV stigma and psychosocial wellbeing and tests one such intervention. The research objectives were to test the changeover-time in the psychosocial wellbeing of PLWH and PLC in an urban and a rural setting, following a comprehensive community-based HIV stigma reduction and wellness enhancement intervention. An experimental quantitative single system research design with a pre- and four repetitive post-tests was used, conducting purposive voluntary sampling for PLWH (n = 18) and snowball sampling for PLC (n = 60). The average age of participants was 34 years old. The five measuring instruments used for both groups were the mental health continuum short-form scale, the patient health questionnaire, the satisfaction with life scale, the coping self-efficacy scale and the spirituality wellbeing scale. No significant differences were found between the urban-rural settings and data were pooled for analysis. The findings show that initial psychosocial wellbeing changes after the intervention were better sustained (over time) by the PLC than by the PLWH and seemed to be strengthened by interpersonal interaction. Recommendations included that the intervention should be re-utilised and that its tenets, content and activities be retained. A second intervention three to six months after the first should be included to achieve more sustainability and to add focused activities for the enhancement of psychosocial wellbeing. PLWH and PLC are to be encouraged to engage with innovative community

  17. Stigma, discrimination and HIV outcomes among people living with HIV in Rio de Janeiro, Brazil: The intersection of multiple social inequalities.

    Science.gov (United States)

    Kerrigan, Deanna; Vazzano, Andrea; Bertoni, Neilane; Malta, Monica; Bastos, Francisco Inacio

    2017-02-01

    Limited research has examined the social context surrounding stigma and discrimination and HIV outcomes among people living with HIV (PLHIV). We surveyed 900 PLHIV in Brazil and examined the relationship between stigma, discrimination and HIV outcomes utilising multivariable logistic regression. HIV stigma and discrimination were inversely associated with age (AOR Stigma 0.65, 95% CI 0.49-0.88; AOR Discrimination 0.72, 95% CI 0.54-0.95) and income (AOR Stigma 0.74, 95% CI 0.55-0.99; AOR Discrimination 0.62, 95% CI 0.46-0.82). Stigma was inversely associated with education (AOR 0.71, 95% CI 0.52-0.96) and no history of sex work (AOR 0.56, 95% CI 0.35-0.90), and positively associated with having children (AOR 1.71, 95% CI 1.18-2.48). Discrimination was inversely associated with no history of drug use (AOR 0.63, 95% CI 0.42-0.95). Stigma and discrimination were found to be inversely associated with overall health (AOR Stigma 0.54, 95% CI 0.40-0.74; AOR Discrimination 0.71, 95% CI 0.52-0.97). Discrimination was associated with having a sexually transmitted infection since HIV diagnosis (AOR 1.63, 95% CI 1.14-2.32). Findings suggest that future interventions should address multiple social inequalities faced by PLHIV to reduce HIV stigma and discrimination and improve health and HIV outcomes.

  18. HIV-Related Stigma, Social Support, and Psychological Distress Among Individuals Initiating ART in Ethiopia.

    Science.gov (United States)

    Parcesepe, Angela; Tymejczyk, Olga; Remien, Robert; Gadisa, Tsigereda; Kulkarni, Sarah Gorrell; Hoffman, Susie; Melaku, Zenebe; Elul, Batya; Nash, Denis

    2018-02-16

    Recent World Health Organization HIV treatment guideline expansion may facilitate timely antiretroviral therapy (ART) initiation. However, large-scale success of universal treatment strategies requires a more comprehensive understanding of known barriers to early ART initiation. This work aims to advance a more comprehensive understanding of interrelationships among three known barriers to ART initiation: psychological distress, HIV-related stigma, and low social support. We analyzed cross-sectional interview data on 1175 adults initiating ART at six HIV treatment clinics in Ethiopia. Experience of each form of HIV-related stigma assessed (e.g., anticipatory, internalized, and enacted) was associated with increased odds of psychological distress. However, among those who reported enacted HIV-related stigma, there was no significant association between social support and psychological distress. Interventions to improve mental health among people living with HIV should consider incorporating components to address stigma, focusing on strategies to prevent or reduce the internalization of stigma, given the magnitude of the relationship between high internalized stigma and psychological distress. Interventions to increase social support may be insufficient to improve the mental health of people living with HIV who experienced enacted HIV-related stigma. Future research should examine alternative strategies to manage the mental health consequences of enacted HIV-related stigma, including coping skills training.

  19. Adherence to antiretroviral therapy (ART) among people living with HIV (PLHIV): a cross-sectional survey to measure in Lao PDR.

    Science.gov (United States)

    Hansana, Visanou; Sanchaisuriya, Pattara; Durham, Jo; Sychareun, Vanphanom; Chaleunvong, Kongmany; Boonyaleepun, Suwanna; Schelp, Frank Peter

    2013-06-28

    Since 2001, antiretroviral therapy (ART) for people living with HIV (PLHIV) has been available in the Lao People's Democratic Republic (PDR). A key factor in the effectiveness of ART is good adherence to the prescribed regimen for both individual well-being and public health. Poor adherence can contribute to the emergence of drug resistant strains of the virus and transmission during risky behaviors. Increased access to ART in low-income country settings has contributed to an interest in treatment adherence in resource-poor contexts. This study aims to investigate the proportion of adherence to ART and identify possible factors related to non-adherence to ART among people living with HIV (PLHIV) in Lao PDR. A cross-sectional study was conducted with adults living with HIV receiving free ART at Setthathirath hospital in the capital Vientiane and Savannakhet provincial hospitals from June to November 2011. Three hundred and forty six PLHIV were interviewed using an anonymous questionnaire. The estimation of the adherence rate was based on the information provided by the PLHIV about the intake of medicine during the previous three days. The statistical software Epidata 3.1 and Stata 10.1 were used for data analysis. Frequencies and distribution of each variable were calculated by conventional statistical methods. The chi square test, Mann-Whitney test and logistic regression were used for bivariate analyses. Multiple logistic regression analysis was conducted to determine the predictors of non-adherence to ART. A p-value ART. Reasons for not taking medicine as required were being busy (97.0%), and being forgetful (62.2%). In the multivariate analysis, educational level at secondary school (OR=3.7, 95% CI:1.3-10.1, p=0.012); illicit drug use (OR=16.1, 95% CI:1.9-128.3, p=0.011); dislike exercise (OR=0.6, 95% CI:0.4-0.9, p=0.028), and forgetting to take ARV medicine during the last month (OR=2.3, 95% CI:1.4-3.7, p=0.001) were independently associated with non-adherence

  20. Factors Associated with Medication Nonadherence among Hypertensives in Ghana and Nigeria

    Directory of Open Access Journals (Sweden)

    Vincent Boima

    2015-01-01

    Full Text Available Background. Blood pressure (BP control is poor among hypertensives in many parts of sub-Saharan Africa. A potentially modifiable factor for control of BP is medication nonadherence (MNA; our study therefore aimed to determine factors associated with MNA among hypertensives in Ghana and Nigeria. Methodology. We conducted a multicenter cross-sectional study. Patients were recruited from Korle-Bu Hospital (n=120, Ghana; and University of Port Harcourt Teaching Hospital, (n=73 Apapa General Hospital Lagos (n=79 and University College Hospital Ibadan (n=85, Nigeria. Results. 357 hypertensive patients (42.6% males participated. MNA was found in 66.7%. Adherence showed correlation with depression (r=-0.208, P<0.001, concern about medications (r=-0.0347, P=0.002, and knowledge of hypertension (r=0.14, P=0.006. MNA was associated with formal education (P=0.001 and use of herbal preparation (P=0.014. MNA was found in 61.7% of uninsured participants versus 73.1% of insured participants (P=0.032. Poor BP control was observed in 69.7% and there was significant association between MNA and poor BP control (P=0.006. Conclusion. MNA is high among hypertensives in Ghana and Nigeria and is associated with depression, concern about hypertensive medications, formal education, and use of herbal preparations. The negative association between health insurance and MNA suggests interplay of other factors and needs further investigation.

  1. The relationship between negative responses to HIV status disclosure and psychosocial outcomes among people living with HIV.

    Science.gov (United States)

    Cama, Elena; Brener, Loren; Slavin, Sean; de Wit, John

    2017-07-01

    This report examines rates of HIV status disclosure and negative responses to disclosure among people living with HIV in Australia. Among 697 people living with HIV, most (>90%) had disclosed their status to friends, sexual partners and health providers. Almost a third had not disclosed to family, and half had not told any work colleagues. Negative responses to disclosure (e.g. blame, rejection) by all groups were associated with increased HIV-related stigma, psychological distress and diminished social support and health satisfaction. These results shed light on rates of disclosure among people living with HIV in Australia and the adverse health impacts of negative responses to disclosure.

  2. A preliminary study of medical waste management in Lagos metropolis, Nigeria

    Directory of Open Access Journals (Sweden)

    E. O. Longe, A. Williams

    2006-04-01

    Full Text Available A survey of medical waste management (MWM practices and their implications to health and environment was carried out in metropolitan Lagos. Lagos is currently the most populous and urbanized city in the country with an estimated population of over 13 million people. The study assessed management practices in four (2 privates and 2 publics hospitals ranging in capacity from 40 to 600 beds. Empirical data was obtained on medical waste generation, segregation, storage, collection, transportation and disposal. The observed MWM practices in all hospitals indicate absence of full compliance with the protocol for handling medical waste as stipulated in the relevant sections of the guidelines and standards for environmental pollution control in Nigeria. Three hospitals demonstrated high priority for segregation of infectious medical waste. Average generation rate of medical waste in the investigated hospitals ranged from 0.562 kg/bed.day to 0.670 kg/bed.day. Infectious waste accounts for between 26 to 37% of this volume. Only two of the hospitals investigated carry out treatment of their infectious and sharp waste types by incineration before final disposal. Burning and burial of medical waste is an unusual but common practice among the hospitals. All the hospitals employ the services of the state owned solid waste management company, the Lagos State Waste Management Authority (LAWMA for final collection, and disposal of their medical waste at government approved sites.

  3. HIV Status Disclosure Among People Living with HIV in the Era of Combination Antiretroviral Therapy (cART).

    Science.gov (United States)

    Madi, Deepak; Gupta, Parul; Achappa, Basavaprabhu; Bhaskaran, Unnikrishnan; Ramapuram, John T; Rao, Satish; Mahalingam, Soundarya

    2015-08-01

    As patients with HIV live longer due to Combination Anti-Retroviral Therapy (cART) serostatus disclosure becomes an important issue. Disclosure can have both positive and negative outcomes. Disclosure of HIV status has been associated with better adherence to medication and reduction in levels of psychological distress. Stigma and disruption of family relationships are barriers for disclosure. Most studies regarding disclosure status have been conducted in West. There are many cultural differences in Indian society when compared to west. There is a dearth of research in the field of disclosure of HIV infection in India. To determine the prevalence of HIV status disclosure among people living with HIV (PLHIV) in South India. This descriptive cross-sectional study was done in the hospital attached to Kasturba Medical College (KMC), Mangalore, India from May-June 2013. PLHIV of age more than 18 years were included. During the study period 111 consecutive patients who consented for the study were enrolled. Data was collected using a pre-tested interviewer administered semi structured questionnaire. Data collected was analysed using SPSS Version 11.5 statistical software. Descriptive statistics were done and the results are presented as proportions and mean. The mean age of the study population was 44.86 ± 10.8 years. Majority of the study subjects were men 76 (68.4%). Out of 111 study subjects, 102 (91.9%) had disclosed their HIV status to at least one person while 9 (8.1%) had not disclosed their HIV status to anyone. Disclosure on doctor's advice was the main reason for 56 (54.9%) participants to disclose their HIV status. The main reason for non-disclosure was fear of shame in family. Disclosure rate was high in our study in the era of cART. Society must stop discriminating against PLHIV so that they can disclose their serostatus and gain access to care and treatment services without any fear of stigma. In our study the main reason for disclosure was doctor

  4. Stigma and discrimination against people living with HIV by healthcare providers, Southwest Ethiopia

    Directory of Open Access Journals (Sweden)

    Feyissa Garumma T

    2012-07-01

    Full Text Available Abstract Background Stigma and discrimination against people living with human immunodeficiency virus (HIV are obstacles in the way of effective responses to HIV. Understanding the extent of stigma / discrimination and the underlying causes is necessary for developing strategies to reduce them. This study was conducted to explore stigma and discrimination against PLHIV amongst healthcare providers in Jimma zone, Southwest Ethiopia. Methods A cross-sectional study, employing quantitative and qualitative methods, was conducted in 18 healthcare institutions of Jimma zone, during March 14 to April 14, 2011. A total of 255 healthcare providers responded to questionnaires asking about sociodemographic characteristics, HIV knowledge, perceived institutional support and HIV-related stigma and discrimination. Factor analysis was employed to create measurement scales for stigma and factor scores were used in one way analysis of variance (ANOVA, T-tests, Pearson’s correlation and multiple linear regression analyses. Qualitative data collected using key-informant interviews and Focus Group Discussions (FGDs were employed to triangulate with the findings from the quantitative survey. Results Mean stigma scores (as the percentages of maximum scale scores were: 66.4 for the extra precaution scale, 52.3 for the fear of work-related HIV transmission, 49.4 for the lack of feelings of safety, 39.0 for the value-driven stigma, 37.4 for unethical treatment of PLHIV, 34.4 for discomfort around PLHIV and 31.1 for unofficial disclosure. Testing and disclosing test results without consent, designating HIV clients and unnecessary referral to other healthcare institutions and refusal to treat clients were identified. Having in-depth HIV knowledge, the perception of institutional support, attending training on stigma and discrimination, educational level of degree or higher, high HIV case loads, the presence of ART service in the healthcare facility and claiming to be

  5. Barriers to adherence to highly active antiretroviral therapy as expressed by people living with HIV/AIDS.

    Science.gov (United States)

    Proctor, V E; Tesfa, A; Tompkins, D C

    1999-09-01

    The primary objective of this study was to gain a clearer understanding of the barriers to adherence to highly active antiretroviral therapy (HAART) faced by people living with HIV/AIDS (PLWHIV/AIDS) on Long Island, New York. Focus group, a qualitative research method, was used to study these barriers. The study was conducted in 1998 on Long Island, NY, at five institutions that provide services to 1700 PLWHIV/AIDS. Five focus groups were conducted with 6 to 13 PLWHIV/AIDS in each group, a total of 39 subjects. PLWHIV/AIDS identified eight common barriers to adherence to HAART. In descending order, the barriers include: (1) frequency and severity of side effects, (2) conflicts with daily routines, (3) dietary requirements, (4) frequency of taking medications, (5) number and dosage of medications, (6) psychosocial factors (i.e., stress, feeling good, and bad news), (7) pharmacy refills, and (8) physiological needs (i.e., sleep, hunger, or thirst). Many factors play a role in the success or failure of HAART, including preexisting drug resistance, drug-drug interactions, and the ability of PLWHIV/AIDS to adhere to a rigid and frequently changing medication regimen. The information gleaned from focus groups is limited in that it may not be generalized to a larger population with any known reliability. However, clinicians sensitive to barriers to adherence to HAART, including those identified by PLWHIV/AIDS in this study, may play a more proactive role in supporting adherence to the medication regimen, increasing the durability of effective viral suppression, decreasing morbidity and mortality, and decreasing the selection and transmission of resistant strains of HIV.

  6. Status Disclosure among People Living With HIV/AIDS in Ilorin ...

    African Journals Online (AJOL)

    Background: HIV/AIDS is a disease that is characterised by discrimination and stigmatisation particularly in Africa. Objective: To determine rate of disclosure of HIV status among People Living with HIV/AIDS (PLWHA) in Ilorin, Nigeria. Methods: A semi-structured, interviewer administered questionnaire containing 40 items ...

  7. Knowledge and practice of prevention of mother-to-child transmission of HIV among traditional birth attendants in Lagos State, Nigeria.

    Science.gov (United States)

    Balogun, Mobolanle; Odeyemi, Kofo

    2010-04-29

    Traditional birth attendants (TBAs) assist most deliveries in Nigeria. Knowing and understanding all issues surrounding HIV/AIDS and Prevention of Mother-To-Child Transmission of HIV (PMTCT) can help them to protect themselves and others. This study aimed to assess the knowledge and practice of PMTCT amongst TBAs in Lagos, Nigeria. This was a cross-sectional survey. Multistage sampling method was used to select 108 registered TBAs in 2 local governments areas who were interviewed using a pre-tested questionnaire. All the respondents were aware of HIV but their awareness of PMTCT specifically was not as high. Only 8.3% of the respondents had good level of knowledge about HIV and PMTCT and up to 13% of them claimed to be able to cure HIV using native remedies. The practices of HIV counseling of patients and referral of patients for HIV testing were low and higher levels of knowledge positively influenced these practices significantly (p < 0.05). They were also deficient in certain measures to prevent infection of patients and themselves. Most of the TBAs did not have adequate knowledge and practice of PMTCT illustrating the need for periodic PMTCT training for TBAs.

  8. HIV-Related Self-Stigma and Health-Related Quality of Life of People Living With HIV in Finland

    OpenAIRE

    Nobre, Nuno; Pereira, Marco; Roine, Risto P.; Sutinen, Jussi; Sintonen, Harri

    2017-01-01

    We examined how HIV-related self-stigma was associated with different domains of quality of life (QoL), as measured by the World Health Organization Quality of Life in HIV-infected persons instrument (WHOQOL-HIV-Bref), and health-related quality of life (HRQoL) as measured by the generic 15D (15-dimensional measure of HRQoL), to identify the factors associated with self-stigma of people living with HIV (PLWH). The study sample included 440 patients living with HIV followed at the Infectious D...

  9. Internalised HIV-stigma, loneliness, depressive symptoms and sleep quality in people living with HIV.

    Science.gov (United States)

    Fekete, Erin M; Williams, Stacey L; Skinta, Matthew D

    2018-03-01

    People living with HIV (PLWH) commonly report sleep disturbances which are associated with long-term health consequences, including disease progression. PLWH also experience internalised stigma as a result of their HIV status, which can be associated with increased loneliness and depression. Little attention focuses on the impact of these factors on sleep. Therefore, we examined whether internalised HIV-stigma was indirectly related to poorer sleep quality through higher levels of loneliness and depressive symptoms. 181 PLWH from across the United States completed an online survey. Main Study Measures: Internalised HIV-stigma was assessed using the HIV-Stigma Scale, loneliness was assessed using the UCLA-Loneliness Scale-Short Form, depressive symptoms were assessed with the Center for Epidemiologic Studies-Depression Index, and Sleep Quality was assessed using the Pittsburgh Sleep Quality Index. Internalised HIV-stigma was indirectly associated with poorer global sleep quality and daytime sleep dysfunction through both loneliness and depressive symptoms. PLWH who experience HIV-related stigma may experience greater feelings of loneliness, which are related to increased depressive symptoms and poorer sleep quality. Interventions focused on improving sleep in PLWH should focus on multiple factors that influence sleep, including psychosocial factors such as stigma, social isolation and depressive symptoms.

  10. The impact of HIV-related stigma on older and younger adults living with HIV disease: does age matter?

    Science.gov (United States)

    Emlet, Charles A; Brennan, David J; Brennenstuhl, Sarah; Rueda, Sergio; Hart, Trevor A; Rourke, Sean B

    2015-01-01

    The purpose of this study was to examine the independent influence of age on levels of HIV-related stigma experienced by adults living with HIV/AIDS. To accomplish this, cross-sectional data from the Ontario HIV Treatment Network Cohort Study were used to determine whether older age is associated with overall stigma among HIV-positive adults living in Ontario, Canada (n = 960). The relationship was also tested for enacted, anticipated, and internalized stigma. Covariates included sociodemographic (e.g., gender, sexual orientation, race) and psychosocial variables (e.g., depression). Modifying effects of covariates were also investigated. Those 55 and older have significantly lower overall and internalized stigma than adults under age 40, even when accounting for gender, sexual orientation, income, time since diagnosis, depression, maladaptive coping, and social support. Age does not predict enacted or Anticipated Stigma when accounting for the demographic and psychosocial variables. A significant interaction between depression and age suggests that stigma declines with age among those who are depressed but increases to age 50 and then decreases in older age groups among those who are not depressed. Age matters when it comes to understanding stigma among adults living with HIV/AIDS; however, the relationship between age and stigma is complex, varying according to stigma type and depression level.

  11. Stigmatization and discrimination towards people living with or affected by HIV/AIDS by the general public in Malaysia.

    Science.gov (United States)

    Wong, L P; Syuhada, A R Nur

    2011-09-01

    Globally, HIV/AIDS-related stigma and discriminatory attitudes deter the effectiveness of HIV prevention and care programs. This study investigated the general public's perceptions about HIV/AIDS-related stigma and discrimination towards people living with or affected by HIV/AIDS in order to understand the root of HIV/AIDS-related stigma and discriminatory attitudes. Study was carried out using qualitative focus group discussions (FGD). An interview guide with semi-structured questions was used. Participants were members of the public in Malaysia. Purposive sampling was adopted for recruitment of participants. A total 14 focus group discussions (n = 74) was carried out between March and July 2008. HIV/AIDS-related stigma and discrimination towards people living with HIV/AIDS (PLWHA) was profound. Key factors affecting discriminatory attitudes included high-risk taking behavior, individuals related to stigmatized identities, sources of HIV infection, stage of the disease, and relationship with an infected person. Other factors that influence attitudes toward PLWHA include ethnicity and urban-rural locality. Malay participants were less likely than other ethnic groups to perceive no stigmatization if their spouses were HIV positive. HIV/AIDS-related stigma and discrimination were stronger among participants in rural settings. The differences indicate attitudes toward PLWHA are influenced by cultural differences.

  12. Nonadherence to antiretroviral therapy among people living with HIV/AIDS attending two tertiary care hospitals in district of northern India

    Directory of Open Access Journals (Sweden)

    Mukesh Shukla

    2016-01-01

    Full Text Available Introduction: Adherence to antiretroviral therapy is a principal predictor for the success of human immunodeficiency virus (HIV treatment. It remains as a challenge to acquired immunodeficiency syndrome (AIDS treatment and care with the widespread of the associated risks. Therefore, study aims to assess nonadherence level and factors associated with nonadherence to ART among people living with HIV/AIDS (PLHA. Materials and Methods: A hospital-based, cross-sectional study was conducted at two tertiary care hospital of Lucknow. A total of 322 adult HIV-positive patients registered in the ART center were included. Systematic random sampling was used to recruit patients. Nonadherence was assessed on the basis of pill count method. Results: A total of 10.9% of patients were found to be nonadherent to ART. Principal causes cited were being busy with other work (40.0%, felt sick or ill (28.5%, not having money (14.2%, and being away from home (11.4. Multivariate logistic regression analysis revealed that nonadherence was significantly associated with nonbeneficial perceptions towards ART (odds ratio (OR 18.5; 95% confidence interval (CI 3.2-106.6; P = 0.001, being counseled for adherence for more than 3 months (OR 13.9; 95% CI 1.6-118.9; P = 0.01, presence of depression (OR 2.6; 95% CI 1.0-6.7; P = 0.04, and those who were not satisfied with healthcare facilities (OR 5.63; 95% CI 1.88-16.84; P = 0.00. Conclusion: Although adherence to ART varies between individuals and over time, the factors that affect nonadherence can be addressed with proper periodic counseling and motivation of patients and their family members. Adherence to highly active antiretroviral therapy (HAART could delay the progression of this lethal disease and minimize the risk of developing drug resistance.

  13. An exploratory survey measuring stigma and discrimination experienced by people living with HIV/AIDS in South Africa: the People Living with HIV Stigma Index.

    Science.gov (United States)

    Dos Santos, Monika Ml; Kruger, Pieter; Mellors, Shaun E; Wolvaardt, Gustaaf; van der Ryst, Elna

    2014-01-27

    The continued presence of stigma and its persistence even in areas where HIV prevalence is high makes it an extraordinarily important, yet difficult, issue to eradicate. The study aimed to assess current and emerging HIV/AIDS stigma and discrimination trends in South Africa as experienced by people living with HIV/AIDS (PLHIV). The PLHIV Stigma Index, a questionnaire that measures and detects changing trends in relation to stigma and discrimination experienced by PLHIV, was used as the survey tool. The study was conducted in 10 clinics in four provinces supported by the Foundation for Professional Development (FPD), with an interview total of 486 PLHIV. A cross-sectional design was implemented in the study, and both descriptive and inferential analysis was conducted on the data. Findings suggest that PLHIV in this population experience significant levels of stigma and discrimination that negatively impact on their health, working and family life, as well as their access to health services. Internalised stigma was prominent, with many participants blaming themselves for their status. The findings can be used to develop and inform programmes and interventions to reduce stigma experienced by PLHIV. The current measures for dealing with stigma should be expanded to incorporate the issues related to health, education and discrimination experienced in the workplace, that were highlighted by the study.

  14. Association of Internalized and Social Network Level HIV Stigma With High-Risk Condomless Sex Among HIV-Positive African American Men.

    Science.gov (United States)

    Wagner, Glenn J; Bogart, Laura M; Klein, David J; Green, Harold D; Mutchler, Matt G; McDavitt, Bryce; Hilliard, Charles

    2016-08-01

    We examined whether internalized HIV stigma and perceived HIV stigma from social network members (alters), including the most popular and most similar alter, predicted condomless intercourse with negative or unknown HIV status partners among 125 African American HIV-positive men. In a prospective, observational study, participants were administered surveys at baseline and months 6 and 12, with measures including sexual behavior, internalized HIV stigma, and an egocentric social network assessment that included several measures of perceived HIV stigma among alters. In longitudinal multivariable models comparing the relative predictive value of internalized stigma versus various measures of alter stigma, significant predictors of having had condomless intercourse included greater internalized HIV stigma (in all models), the perception that a popular (well-connected) alter or alter most like the participant agrees with an HIV stigma belief, and the interaction of network density with having any alter that agrees with a stigma belief. The interaction indicated that the protective effect of greater density (connectedness between alters) in terms of reduced risk behavior dissipated in the presence of perceived alter stigma. These findings call for interventions that help people living with HIV to cope with their diagnosis and reduce stigma, and inform the targets of social network-based and peer-driven HIV prevention interventions.

  15. Assessment of radiation protection practices among radiographers in Lagos, Nigeria.

    Science.gov (United States)

    Eze, Cletus Uche; Abonyi, Livinus Chibuzo; Njoku, Jerome; Irurhe, Nicholas Kayode; Olowu, Oluwabola

    2013-11-01

    Use of ionising radiation in diagnostic radiography could lead to hazards such as somatic and genetic damages. Compliance to safe work and radiation protection practices could mitigate such risks. The aim of the study was to assess the knowledge and radiation protection practices among radiographers in Lagos, Nigeria. The study was a prospective cross sectional survey. Convenience sampling technique was used to select four x-ray diagnostic centres in four tertiary hospitals in Lagos metropolis. Data were analysed with Epi- info software, version 3.5.1. Average score on assessment of knowledge was 73%. Most modern radiation protection instruments were lacking in all the centres studied. Application of shielding devices such as gonad shield for protection was neglected mostly in government hospitals. Most x-ray machines were quite old and evidence of quality assurance tests performed on such machines were lacking. Radiographers within Lagos metropolis showed an excellent knowledge of radiation protection within the study period. Adherence to radiation protection practices among radiographers in Lagos metropolis during the period studied was, however, poor. Radiographers in Lagos, Nigeria should embrace current trends in radiation protection and make more concerted efforts to apply their knowledge in protecting themselves and patients from harmful effects of ionising radiation.

  16. A Structural Equation Model of HIV-related Symptoms, Depressive Symptoms, and Medication Adherence.

    Science.gov (United States)

    Yoo-Jeong, Moka; Waldrop-Valverde, Drenna; McCoy, Katryna; Ownby, Raymond L

    2016-05-01

    Adherence to combined antiretroviral therapy (cART) remains critical in management of HIV infection. This study evaluated depression as a potential mechanism by which HIV-related symptoms affect medication adherence and explored if particular clusters of HIV symptoms are susceptible to this mechanism. Baseline data from a multi-visit intervention study were analyzed among 124 persons living with HIV (PLWH). A bifactor model showed two clusters of HIV-related symptom distress: general HIV-related symptoms and gastrointestinal (GI) symptoms. Structural equation modeling showed that both general HIV-related symptoms and GI symptoms were related to higher levels of depressive symptoms, and higher levels of depressive symptoms were related to lower levels of medication adherence. Although general HIV-related symptoms and GI symptoms were not directly related to adherence, they were indirectly associated with adherence via depression. The findings highlight the importance of early recognition and evaluation of symptoms of depression, as well as the underlying physical symptoms that might cause depression, to improve medication adherence.

  17. HIV/AIDS Related Stigma and Discrimination against PLWHA in Nigerian Population

    Science.gov (United States)

    Bulgiba, Awang; Oche, Oche Mansur; Adekunjo, Felix Oluyemi

    2015-01-01

    Background HIV/AIDS remain a major public health concern in Nigeria. People living with HIV/AIDS (PLWHA) face not only personal medical problems but also social problems associated with the disease such as stigma and discriminatory attitudes. This study provides an insight into HIV/AIDS related stigma and discrimination against PLWHA in Nigeria. Methods The data for this study was extracted from the 2013 Nigeria Demographic and Health Survey conducted by the National Population Commission. All men and women aged 15–49 years, permanent residents and visitors of the households were eligible for the interview. Several questionnaires were used in the survey, some covering questions on HIV/AIDS. Results A total of 56 307 men and women aged 15–49 years participated in this national survey. About half of the population in Nigeria have HIV stigma. Younger persons, men, those without formal education and those within poor wealth index are more likely to have stigma towards PLWHA. In addition, married people are more likely to have stigma on PLWHA and are more likely to blame PLWHA for bringing the disease to the community. Also about half of the population discriminates against PLWHA. However, those with higher levels of education and those from higher wealth index seem to be more compassionate towards PLWHA. About 70% in the population are willing to care for relative with AIDS, even more so among those with higher level of education. Conclusion There is a high level of HIV stigma and discrimination against PLWHA in the Nigerian population. Education seems to play a major role in the society with respect to HIV stigma and discrimination against PLWHA. Educating the population with factual information on HIV/AIDS is needed to reduce stigma and discrimination towards PLWHA in the community. PMID:26658767

  18. HIV/AIDS Related Stigma and Discrimination against PLWHA in Nigerian Population.

    Science.gov (United States)

    Dahlui, Maznah; Azahar, Nazar; Bulgiba, Awang; Zaki, Rafdzah; Oche, Oche Mansur; Adekunjo, Felix Oluyemi; Chinna, Karuthan

    2015-01-01

    HIV/AIDS remain a major public health concern in Nigeria. People living with HIV/AIDS (PLWHA) face not only personal medical problems but also social problems associated with the disease such as stigma and discriminatory attitudes. This study provides an insight into HIV/AIDS related stigma and discrimination against PLWHA in Nigeria. The data for this study was extracted from the 2013 Nigeria Demographic and Health Survey conducted by the National Population Commission. All men and women aged 15-49 years, permanent residents and visitors of the households were eligible for the interview. Several questionnaires were used in the survey, some covering questions on HIV/AIDS. A total of 56 307 men and women aged 15-49 years participated in this national survey. About half of the population in Nigeria have HIV stigma. Younger persons, men, those without formal education and those within poor wealth index are more likely to have stigma towards PLWHA. In addition, married people are more likely to have stigma on PLWHA and are more likely to blame PLWHA for bringing the disease to the community. Also about half of the population discriminates against PLWHA. However, those with higher levels of education and those from higher wealth index seem to be more compassionate towards PLWHA. About 70% in the population are willing to care for relative with AIDS, even more so among those with higher level of education. There is a high level of HIV stigma and discrimination against PLWHA in the Nigerian population. Education seems to play a major role in the society with respect to HIV stigma and discrimination against PLWHA. Educating the population with factual information on HIV/AIDS is needed to reduce stigma and discrimination towards PLWHA in the community.

  19. HIV Stigma and Substance Use Among HIV-Positive Russians with Risky Drinking.

    Science.gov (United States)

    Edelman, E Jennifer; Lunze, Karsten; Cheng, Debbie M; Lioznov, Dmitry A; Quinn, Emily; Gnatienko, Natalia; Bridden, Carly; Chaisson, Christine E; Walley, Alexander Y; Krupitsky, Evgeny M; Raj, Anita; Samet, Jeffrey H

    2017-09-01

    The link between HIV stigma with substance use is understudied. We characterized individuals with high HIV stigma and examined whether HIV stigma contributes to substance use among HIV-positive Russians reporting risky alcohol use. We analyzed data from HERMITAGE, a randomized controlled trial of 700 people living with HIV/AIDS (PLWHA) with past 6-month risky sex and risky alcohol use in St. Petersburg, Russia (2007-2011). Participants who were female and reported depressive symptoms and lower social support were more likely to endorse high HIV stigma (all p's stigma was not significantly associated with the primary outcome unhealthy substance use and was not consistently associated with secondary substance use outcomes. Interventions to enhance social and mental health support for PLWHA, particularly women, may reduce stigma, though such reductions may not correspond to substantial decreases in substance use among this population.

  20. Knowledge and practice of prevention of mother-to-child transmission of HIV among traditional birth attendants in Lagos State, Nigeria

    Directory of Open Access Journals (Sweden)

    Mobolanle Balogun

    2010-04-01

    Full Text Available BACKGROUND:Traditional birth attendants (TBAs assist most deliveries in Nigeria. Knowing and understanding all issues surrounding HIV/AIDS and Prevention of Mother-To-Child Transmission of HIV (PMTCT can help them to protect themselves and others. This study aimed to assess the knowledge and practice of PMTCT amongst TBAs in Lagos, Nigeria. METHODS: This was a cross-sectional survey. Multistage sampling method was used to select 108 registered TBAs in 2 local governments areas who were interviewed using a pre-tested questionnaire. RESULTS: All the respondents were aware of HIV but their awareness of PMTCT specifically was not as high. Only 8.3% of the respondents had good level of knowledge about HIV and PMTCT and up to 13% of them claimed to be able to cure HIV using native remedies. The practices of HIV counseling of patients and referral of patients for HIV testing were low and higher levels of knowledge positively influenced these practices significantly (p < 0.05. They were also deficient in certain measures to prevent infection of patients and themselves. CONCLUSION: Most of the TBAs did not have adequate knowledge and practice of PMTCT illustrating the need for periodic PMTCT training for TBAs.

  1. Treatment acceptance and adherence in HIV disease: patient identity and the perceived impact of physician–patient communication

    Directory of Open Access Journals (Sweden)

    Laws MB

    2012-12-01

    Full Text Available M Barton Laws,1 Gary S Rose,2 Tanya Bezreh,1 Mary Catherine Beach,3 Tatiana Taubin,1 Laura Kogelman,4 Marcia Gethers,3 Ira B Wilson11Department of Health Services Policy and Practice, Brown University, Providence, RI, USA; 2Massachusetts School of Professional Psychology, Boston, MA, USA; 3Johns Hopkins University School of Medicine, Baltimore, MD, USA; 4Tufts Medical Center, Boston, MA, USAAbstract: Studies have found that physician–patient relationships and communication quality are related to medication adherence and outcomes in HIV care. Few qualitative studies exist of how people living with HIV experience clinical communication about their self-care behavior. Eight focus groups with people living with HIV in two US cities were conducted. Participants responded to a detailed discussion guide and to reenactments of actual physician–patient dialogue about antiretroviral adherence. The 82 participants were diverse in age, sex, and ethnicity. Most had been living with HIV for many years and had stable relationships with providers. They appreciated providers who knew and cared about their personal lives, who were clear and direct about instructions, and who were accessible. Most had struggled to overcome addiction, emotional turmoil, and/or denial before gaining control over their lives and becoming adherent to medications. They made little or no causal attribution for their transformation to any outside agency, including their providers. They generally saw medication adherence as a function of autonomous motivation. Successful coping with HIV with its prevalent behavioral comorbidities, stigma, and other challenges requires a transformation of identity and internalization of motivation to maintain health. Effective methods for clinicians to support such development are needed.Keywords: HIV, physician–patient communication, treatment adherence

  2. Work related stress and coping mechanisms among bankers in Lagos, Nigeria.

    Science.gov (United States)

    Olatona, F A; Ezeobika, E N; Okafor, I P; Owoeye, O B A

    2014-03-01

    This study assessed knowledge, prevalence, associated factors and mechanisms of coping with stress among bankers in Lagos State. It was a descriptive cross sectional study. A two stage sampling technique was used to select two hundred and twenty seven (227) respondents. Data was collected using a structured self administered questionnaire. The analysis was done using Epi-info version 2002 software and Chi Square was used to determine association between variables at p value 0.05. Fischer's Exact test was used where Chi-square was not valid. The age range of respondents was between 20 and 49 years while the mean age was 31.3 +/- 5.0 years. Only 3.6% had good level of knowledge about stress, 42.2% had fair level while more than half of the respondents had poor level of knowledge about stress (54.3%). Majority (67.0%) of the respondents were moderately stressed while one quarter (24.7%) were highly stressed. Majority (92.4%) of the respondents used good coping mechanisms though 69.5% of the respondents also used bad coping mechanisms. A greater proportion of those who had poor knowledge about stress were stressed or highly stressed (p = 0.002). A statistically significant association was also found between the departments in the bank and level of stress of the respondents (p = 0.002). The prevalence of stress was high among the bank workers studied. It is recommended that effective stress management programmes are implemented to address the problem of stress among bank workers.

  3. Understanding HIV-related stigma among Indonesian nurses.

    Science.gov (United States)

    Waluyo, Agung; Culbert, Gabriel J; Levy, Judith; Norr, Kathleen F

    2015-01-01

    Evidence indicates widespread stigmatization of persons living with HIV (PLWH) in Indonesia. Such attitudes among health care workers could impede the country's policies for effective diagnosis and medical treatment of PLWH. Nonetheless, research to guide interventions to reduce stigma in health care settings is lacking. Also, the contributions of workplace, religion, and HIV knowledge to nurses' HIV-related stigma are poorly understood. Our cross-sectional study aimed to describe factors associated with nurses' stigmatizing attitudes toward PLWH. Four hundred nurses recruited from four hospitals in Jakarta, Indonesia, were surveyed using the Nurse AIDS Attitude Scale to measure stigma. Stigmatizing attitudes were significantly predicted by education, HIV training, perceived workplace stigma, religiosity, Islamic religious identification, and affiliation with the Islamic hospital. HIV knowledge was not a significant predictor of stigmatizing attitudes. Organization changes fostering workplace diversity are likely to substantially reduce stigmatizing attitudes in nurses. Copyright © 2015 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

  4. The role of enacted stigma in parental HIV disclosure among HIV-infected parents in China.

    Science.gov (United States)

    Qiao, Shan; Li, Xiaoming; Zhou, Yuejiao; Shen, Zhiyong; Tang, Zhenzhu; Stanton, Bonita

    2015-01-01

    Existing studies have delineated that HIV-infected parents face numerous challenges in disclosing their HIV infection to the children ("parental HIV disclosure"), and practices of parental HIV disclosure vary with individual characteristics, family contexts, and social environment. Using cross-sectional data from 1254 HIV-infected parents who had children aged 5-16 years in southwest China, the current study examined the association of parental HIV disclosure with mental health and medication adherence among parents and explored the possible effect of enacted stigma on such association. Multivariate analysis of variance revealed that parents who had experienced disclosure to children reported higher level enacted stigma, worse mental health conditions, and poorer medication adherence. Enacted stigma partially mediated the associations between disclosure and both mental health and medication adherence after controlling basic background characteristics. Our findings highlight the importance of providing appropriate disclosure-related training and counseling service among HIV-infected parents. In a social setting where HIV-related stigma is still persistent, disclosure intervention should address and reduce stigma and discrimination in the practice of parental HIV disclosure.

  5. A Structural Equation Model of HIV-related Symptoms, Depressive Symptoms, and Medication Adherence

    OpenAIRE

    Yoo-Jeong, Moka; Waldrop-Valverde, Drenna; McCoy, Katryna; Ownby, Raymond L

    2016-01-01

    Adherence to combined antiretroviral therapy (cART) remains critical in management of HIV infection. This study evaluated depression as a potential mechanism by which HIV-related symptoms affect medication adherence and explored if particular clusters of HIV symptoms are susceptible to this mechanism. Baseline data from a multi-visit intervention study were analyzed among 124 persons living with HIV (PLWH). A bifactor model showed two clusters of HIV-related symptom distress: general HIV-rela...

  6. Nurses' job satisfaction and attitudes towards people living with HIV/AIDS in Russia.

    Science.gov (United States)

    Hamama, L; Tartakovsky, E; Eroshina, K; Patrakov, E; Golubkova, A; Bogushevich, J; Shardina, L

    2014-03-01

    Previous studies internationally have highlighted that working with people living with HIV/AIDS may lead to nurses' stress and burnout. However, this topic has not been well explored in Russia, a country with an exponential growth in HIV/AIDS. This study focused on nurses' job satisfaction and their attitudes towards people living with HIV/AIDS in centres where nurses regularly treat such patients, and in a general hospital where nurses rarely treat such patients. We distributed three self-report questionnaires: demographics, job satisfaction and attitudes towards people living with HIV/AIDS to nurses working in six HIV/AIDS centres and the largest general hospital in Ekaterinburg, Russia. Sixty-nine nurses from the HIV/AIDS centres and 66 from the general hospital (about 90% of those approached) completed these. Nurses who regularly treated people with HIV/AIDS were significantly younger and a greater number held master degrees than those who rarely treated such patients. No significant differences between the two settings emerged for job satisfaction but what did emerge were differences in nurses' attitudes: nurses in HIV/AIDS centres reported less avoidance than nurses in the general hospital. Regarding empathetic attitudes, no significant differences emerged, but empathetic attitudes contributed to the explained variance of job satisfaction. Although our sample was small, the associations found between avoidant attitudes and job satisfaction highlight the need for stigma-reduction strategies and increased disease knowledge. Healthcare managers should consider attitudes towards people living with HIV/AIDS as an important factor in ensuring adequate care for them and initiate education programmes for nurses, especially programmes dealing with HIV/AIDS in general hospitals. Support and supervision can be used as a strategy, for empowering nurses to meet the challenges of working with HIV/AIDS patients. © 2013 International Council of Nurses.

  7. Disability and Quality of Life among People Living With HIV/AIDS in ...

    African Journals Online (AJOL)

    Hence, the focus of management for People Living With HIV/AIDS (PLWHA) has shifted to issues relating to function and Quality of Life (QoL). Information is scarce on disability issues and quality of life among people living with HIIV/AIDS in Nigeria. This was the premise of this study that assessed the level of disability and ...

  8. Framing Mechanisms Linking HIV-Related Stigma, Adherence to Treatment, and Health Outcomes

    Science.gov (United States)

    Hatcher, Abigail M.; Weiser, Sheri D.; Johnson, Mallory O.; Rice, Whitney S.; Turan, Janet M.

    2017-01-01

    We present a conceptual framework that highlights how unique dimensions of individual-level HIV-related stigma (perceived community stigma, experienced stigma, internalized stigma, and anticipated stigma) might differently affect the health of those living with HIV. HIV-related stigma is recognized as a barrier to both HIV prevention and engagement in HIV care, but little is known about the mechanisms through which stigma leads to worse health behaviors or outcomes. Our conceptual framework posits that, in the context of intersectional and structural stigmas, individual-level dimensions of HIV-related stigma operate through interpersonal factors, mental health, psychological resources, and biological stress pathways. A conceptual framework that encompasses recent advances in stigma science can inform future research and interventions aiming to address stigma as a driver of HIV-related health. PMID:28426316

  9. Stigma against People Living with HIV/AIDS in China: Does the Route of Infection Matter?

    Directory of Open Access Journals (Sweden)

    Chen Zhang

    Full Text Available In the current study, we tested the hypothesis that people who contracted HIV from "blameless" routes (e.g., blood transfusion, sex with stable partners are less stigmatized compared to people who contracted HIV from "blamable" routes (e.g., injection drug use, sex with sex workers. A cross-sectional study was conducted among 2,987 participants in Guangxi province, China, between 2012 and 2013. We employed both explanatory and predictive modeling strategy by using multivariate linear regression models. In the explanatory models, we assessed the association between routes of infection and three types of stigma (perceived, internalized, and enacted. From identified routes of infection that significantly contributed to higher stigma, we employed predictive modeling to explore predictors for the specific type of stigma. Multiple-imputation was employed for sensitivity analyses. Of the total sample, 63% were male and the average age was 42.9 years (ranged between 18 and 88. Multivariate regression models revealed that contraction from commercial sex increased the perceived (β = 0.46, 95%CI = 0.02, 0.90 and internalized stigma (β = 0.60, 95%CI = 0.09, 1.10, while injecting drug use increased the perceived (β = 0.65, 95%CI = 0.07, 1.22 and enacted stigma (β = 0.09, 95%CI = 0.02, 0.16 after controlling for confounders. Among PLWHA who were infected via commercial sex partners, social support was negatively associated with perceived (β = -0.47, 95%CI = -0.79, -0.14 and internalized stigma (β = -0.80, 95%CI = -1.24, -0.35. Among PLWHA who were infected via injecting drugs, no adherence to antiretroviral treatment (β = 0.41, 95%CI = 0.01, 0.82 was positively associated with perceived stigma, and disclosure of serostatus to others was negatively associated with enacted stigma (β = -0.20, 95%CI = -0.34, -0.05. Knowledge of the association between routes of infection and stigma can guide health professionals and policy makers to develop tailored

  10. Gender and ethnicity differences in HIV-related stigma experienced by people living with HIV in Ontario, Canada.

    Science.gov (United States)

    Loutfy, Mona R; Logie, Carmen H; Zhang, Yimeng; Blitz, Sandra L; Margolese, Shari L; Tharao, Wangari E; Rourke, Sean B; Rueda, Sergio; Raboud, Janet M

    2012-01-01

    This study aimed to understand gender and ethnicity differences in HIV-related stigma experienced by 1026 HIV-positive individuals living in Ontario, Canada that were enrolled in the OHTN Cohort Study. Total and subscale HIV-related stigma scores were measured using the revised HIV-related Stigma Scale. Correlates of total stigma scores were assessed in univariate and multivariate linear regression. Women had significantly higher total and subscale stigma scores than men (total, median = 56.0 vs. 48.0, pwomen, Black individuals had the highest, Aboriginal and Asian/Latin-American/Unspecified people intermediate, and White individuals the lowest total stigma scores. The gender-ethnicity interaction term was significant in multivariate analysis: Black women and Asian/Latin-American/Unspecified men reported the highest HIV-related stigma scores. Gender and ethnicity differences in HIV-related stigma were identified in our cohort. Findings suggest differing approaches may be required to address HIV-related stigma based on gender and ethnicity; and such strategies should challenge racist and sexist stereotypes.

  11. Mortality among people living with HIV on antiretroviral treatment in Bali, Indonesia: incidence and predictors.

    Science.gov (United States)

    Utami, Sri; Sawitri, Anak Agung Sagung; Wulandari, Luh Putu Lila; Artawan Eka Putra, I Wayan Gede; Astuti, Putu Ayu Swandewi; Wirawan, Dewa Nyoman; Causer, Louise; Mathers, Bradley

    2017-10-01

    Indonesia has the third highest number of people living with HIV/AIDS (PLWH) and the greatest increase in proportion of AIDS-related mortality in the Asia Pacific region between 2005 and 2013. Longitudinal mortality data among PLWH in Indonesia are limited. We conducted a retrospective cohort study from medical records of antiretroviral treatment (ART) recipients attending Badung General Hospital (BGH) and Bali Medica Clinic (BMC) between 2006 and 2014. We explored incidence of mortality by Kaplan-Meier analysis and identified predictors using a Cox proportional hazard model. In total, 575 patients were included in the analysis; the majority were male. The overall mortality rate was 10% per year. Multivariate analysis suggested that being male (adjusted hazard ratio [aHR]: 2.74; 95% confidence interval [CI]: 1.34-5.59), having a lower education (aHR: 2.17; 95%CI: 1.31-3.61), having heterosexual (aHR: 7.40; 95% CI: 2.61-21.00) or injecting drug use (aHR: 13.20; 95% CI: 3.17-55.00) as the likely transmission risk category, starting treatment with low CD4 cell counts (aHR: 3.18; 95% CI: 1.16-8.69), and not having a treatment supervisor (aHR: 4.02; 95% CI: 2.44-6.65) were independent predictors of mortality. The mortality was high, particularly in the first three months after initiating ART. These findings highlight the need to encourage HIV testing and early diagnosis and prompt treatment. Applying aspects of BMCs targeted HIV services model in more generalised services such as BGH may be beneficial. Providing adherence support as part of ART services is key to promoting adherence to ART.

  12. Measuring HIV-related stigma among healthcare providers: a systematic review.

    Science.gov (United States)

    Alexandra Marshall, S; Brewington, Krista M; Kathryn Allison, M; Haynes, Tiffany F; Zaller, Nickolas D

    2017-11-01

    In the United States, HIV-related stigma in the healthcare setting is known to affect the utilization of prevention and treatment services. Multiple HIV/AIDS stigma scales have been developed to assess the attitudes and behaviors of the general population in the U.S. towards people living with HIV/AIDS, but fewer scales have been developed to assess HIV-related stigma among healthcare providers. This systematic review aimed to identify and evaluate the measurement tools used to assess HIV stigma among healthcare providers in the U.S. The five studies selected quantitatively assessed the perceived HIV stigma among healthcare providers from the patient or provider perspective, included HIV stigma as a primary outcome, and were conducted in the U.S. These five studies used adapted forms of four HIV stigma scales. No standardized measure was identified. Assessment of HIV stigma among providers is valuable to better understand how this phenomenon may impact health outcomes and to inform interventions aiming to improve healthcare delivery and utilization.

  13. Perceptions of intersectional stigma among diverse women living with HIV in the United States.

    Science.gov (United States)

    Rice, Whitney S; Logie, Carmen H; Napoles, Tessa M; Walcott, Melonie; Batchelder, Abigail W; Kempf, Mirjam-Colette; Wingood, Gina M; Konkle-Parker, Deborah J; Turan, Bulent; Wilson, Tracey E; Johnson, Mallory O; Weiser, Sheri D; Turan, Janet M

    2018-05-04

    Attitudes and behavior that devalue individuals based upon their HIV status (HIV-related stigma) are barriers to HIV prevention, treatment, and wellbeing among women living with HIV. Other coexisting forms of stigma (e.g., racism, sexism) may worsen the effects of HIV-related stigma, and may contribute to persistent racial and gendered disparities in HIV prevention and treatment. Few studies examine perceptions of intersectional stigma among women living with HIV. From June to December 2015, we conducted 76 qualitative interviews with diverse women living with HIV from varied socioeconomic backgrounds enrolled in the Women's Interagency HIV Study (WIHS) in Birmingham, Alabama; Jackson, Mississippi; Atlanta, Georgia; and San Francisco, California. Interview guides facilitated discussions around stigma and discrimination involving multiple interrelated identities. Interviews were audio-recorded, transcribed verbatim, and coded using thematic analysis. Interviewees shared perceptions of various forms of stigma and discrimination, most commonly related to their gender, race, and income level, but also incarceration histories and weight. Women perceived these interrelated forms of social marginalization as coming from multiple sources: their communities, interpersonal interactions, and within systems and structures. Our findings highlight the complexity of social processes of marginalization, which profoundly shape life experiences, opportunities, and healthcare access and uptake among women living with HIV. This study highlights the need for public health strategies to consider community, interpersonal, and structural dimensions across intersecting, interdependent identities to promote the wellbeing among women living with HIV and to reduce social structural and health disparities. Copyright © 2018 Elsevier Ltd. All rights reserved.

  14. Effects of Aerobic Exercise on the Pulmonary Functions, Respiratory Symptoms and Psychological Status of People Living With HIV.

    Science.gov (United States)

    Aweto, Happiness Anulika; Aiyegbusi, Ayoola Ibifubara; Ugonabo, Adaora Justina; Adeyemo, Titilope Adenike

    2016-01-01

    Pulmonary complications, respiratory symptoms and depression are common occurrences which contribute to the morbidity and mortality seen in individuals living with HIV/AIDS. This study investigated the effect of aerobic exercise on the pulmonary functions, respiratory symptoms and psychological status of people living with HIV. This study was conducted in Lagos, Nigeria from October 2014 to May 2015. Forty eligible individuals with HIV aged 18 yr and above participated, of which 33 cooperated to the end. They were recruited from the HIV/AIDS Prevention and Intervention Initiative (APIN) Clinic, Lagos University Teaching Hospital, Nigeria and were randomly assigned to either the study or the control group. The study group received aerobic exercise training three times a week for six weeks and counselling while the control group received only counselling. Pulmonary functions, respiratory symptoms and psychological status were evaluated at baseline and at six weeks. Inferential statistics of paired and independent t-test were used to analyse the data. Comparison of mean changes in the pulmonary variables of the study group with those of the control group showed significant differences in all but in the respiratory rate (RR) - [Forced Expiratory Volume in one second: P=0.001, Forced Vital Capacity: P=0.001, Peak Expiratory Flow: P=0.001]. There were also significant differences between the mean changes in respiratory symptoms (P=0.001) and depressive symptoms (P=0.001) of study group and those of the control group. Aerobic exercise training significantly improved pulmonary functions as well as significantly reduced respiratory and depressive symptoms in people living with HIV.

  15. Assessing the Impact of Food Assistance on Stigma Among People Living with HIV in Uganda Using the HIV/AIDS Stigma Instrument-PLWA (HASI-P).

    Science.gov (United States)

    Maluccio, John A; Wu, Fan; Rokon, Redwan B; Rawat, Rahul; Kadiyala, Suneetha

    2017-03-01

    HIV-related stigma among persons living with HIV/AIDS (PLHIV) is prevalent throughout sub-Saharan Africa. There is limited evidence, however, on which interventions are effective in reducing it. We used data from a prospective impact evaluation of a 12-month food assistance intervention among 904 antiretroviral therapy (ART)- naïve PLHIV in Uganda to examine the program impact on stigma. Stigma was measured using the comprehensive HASI-P scale, which demonstrated good internal consistency (Cronbach's alpha = 0.87) and was correlated with several related constructs including physical and mental health-related quality of life, disclosure, and physical health symptoms in the sample. Using quasi-experimental difference-in-difference matching methods to better infer causality, we tested whether the intervention improved the overall stigma scale and its subscales. The food assistance intervention had a significant effect on reported internalized (but not external) stigma of approximately 0.2 SD (p stigma scale is a useful tool for measuring and tracking stigma. Food assistance interventions, embedded in an HIV care program, can reduce internalized stigma.

  16. Medication adherence and blood pressure control amongst adults with primary hypertension attending a tertiary hospital primary care clinic in Eastern Nigeria

    Science.gov (United States)

    Ofoedu, John N.; Njoku, Patrick U.; Amadi, Agwu N.; Godswill-Uko, Ezinne U.

    2013-01-01

    Abstract Background As the case detection rates of hypertension increase in adult Nigerians, achieving target blood pressure (BP) control has become an important management challenge. Objectives To describe medication adherence and BP control amongst adult Nigerians with primary hypertension attending a primary care clinic of a tertiary hospital in a resource-poor environment in Eastern Nigeria. Methods A cross-sectional study was carried out in 140 adult patients with primary hypertension who have been on treatment for at least 6 months at the primary care clinic of Federal Medical Centre, Umuahia. A patient was said to have achieved goal BP control if the BP was < 140 per 90 mmHg. Adherence was assessed in the previous 30 days using a pretested researcher-administered questionnaire on 30 days of self-reported therapy. Adherence was graded using an ordinal scoring system of 0–4; an adherent patient was one who scored 4 points in the previous 30 days. Reasons for non-adherence were documented. Results Adherence to medication and BP control rates were 42.9% and 35.0% respectively. BP control was significantly associated with medication adherence (p = 0.03), antihypertensive medication duration ≥3 years (p = 0.042), and taking ≥ one form of antihypertensive medication (p = 0.04). BP at the recruitment visit was significantly higher than at the end of the study (p = 0.036). The most common reason for non-adherence was forgetfulness (p = 0.046). Conclusions The rate of BP control amongst the study population was low, which may be connected with low medication adherence. This study urges consideration of factors relating to adherence alongside other factors driving goal BP control.

  17. Medication adherence and blood pressure control amongst adults with primary hypertension attending a tertiary hospital primary care clinic in Eastern Nigeria

    Directory of Open Access Journals (Sweden)

    Gabriel UP. Iloh

    2013-02-01

    Full Text Available Background: As the case detection rates of hypertension increase in adult Nigerians, achieving target blood pressure (BP control has become an important management challenge.Objectives: To describe medication adherence and BP control amongst adult Nigerians with primary hypertension attending a primary care clinic of a tertiary hospital in a resource-poor environment in Eastern Nigeria.Methods: A cross-sectional study was carried out in 140 adult patients with primary hypertension who have been on treatment for at least 6 months at the primary care clinic of Federal Medical Centre, Umuahia. A patient was said to have achieved goal BP control if the BP was < 140 per 90 mmHg. Adherence was assessed in the previous 30 days using a pretested researcher-administered questionnaire on 30 days of self-reported therapy. Adherence was graded using an ordinal scoring system of 0–4; an adherent patient was one who scored 4 points in the previous 30 days. Reasons for non-adherence were documented.Results: Adherence to medication and BP control rates were 42.9% and 35.0% respectively. BP control was significantly associated with medication adherence (p = 0.03, antihypertensive medication duration ≥3 years (p = 0.042, and taking ≥ one form of antihypertensive medication (p = 0.04. BP at the recruitment visit was significantly higher than at the end of the study (p = 0.036. The most common reason for non-adherence was forgetfulness (p = 0.046. Conclusion: The rate of BP control amongst the study population was low, which may be connected with low medication adherence. This study urges consideration of factors relating to adherence alongside other factors driving goal BP control.

  18. Coping with stigma: the experiences of Chinese patients living with lung cancer

    OpenAIRE

    Liu, Huaxia; Yang, Qianqian; Narsavage, Georgia L.; Yang, Chunling; Chen, Yue; Xu, Guiying; Wu, Xia

    2016-01-01

    Purpose/objectives To describe the experiences of stigma and coping strategies among patients with lung cancer in China. Research approach Qualitative. Setting The oncology department at Liaocheng Peoples Hospital. Participants A purposive sample of 17 patients experiencing stigma related to lung cancer voluntarily participated in data collection. Methodologic approach Individual, semistructured qualitative interviews were chosen. Participants completed about a 30-min focused interview. Explo...

  19. Exploring HIV-related stigma among HIV-infected men who have sex with men in Beijing, China: a correlation study.

    Science.gov (United States)

    Li, Zhen; Hsieh, Evelyn; Morano, Jamie P; Sheng, Yu

    2016-11-01

    Human immunodeficiency virus (HIV)-related stigma among HIV-infected men who have sex with men (MSM) has been associated with adverse health outcomes, including poor adherence to antiretroviral therapy and care, and increased participation in behaviors linked to higher rates of HIV transmission. In China, the incidence of HIV is growing more rapidly among MSM than among other subgroups. This study characterizes and quantifies HIV stigma among HIV-infected MSM in Beijing, China, which arguably may be driving this epidemic. A cross-sectional survey study was performed among 266 HIV-positive MSM in Beijing, China, in 2014. The Berger HIV Stigma Scale was used to measure levels of HIV-related stigma. Participants additionally answered questions regarding socio-demographic characteristics and HIV-associated risk factors; previously validated Mandarin-language scales assessed depression, coping style, and social support networks. Multivariable linear regression models were used to identify variables significantly associated with HIV stigma. The mean overall HIV stigma score among the study population was 112.78 ± 18.11 (score range: 40-160). Higher HIV stigma scores were positively associated with depression (β = 7.99, 95% CI:3.69, 12.29, p stigma. The results of this study can inform the development of culturally sensitive interventions to reduce HIV-related stigma among MSM with HIV in China, with the overarching goal of reducing HIV transmission in this vulnerable population.

  20. Coping strategies and self-stigma in patients with schizophrenia-spectrum disorders

    Directory of Open Access Journals (Sweden)

    Holubova M

    2016-06-01

    Full Text Available Michaela Holubova,1,2 Jan Prasko,1 Radovan Hruby,3 Klara Latalova,1 Dana Kamaradova,1 Marketa Marackova,1 Milos Slepecky,4 Terezia Gubova2 1Department of Psychiatry, Faculty of Medicine and Dentistry, Palacký University Olomouc, University Hospital Olomouc, Olomouc, Czech Republic; 2Department of Psychiatry, Hospital Liberec, Liberec, Czech Republic; 3Private Psychiatric Practice, Martin, Slovak Republic; 4Department of Psychology Sciences, Faculty of Social Science and Health Care, Constantine the Philosopher University, Nitra, Slovak Republic Background: Maladaptive coping strategies may adversely disturb the overall functioning of people with mental disorders. Also, self-stigma is considered a maladaptive psychosocial phenomenon that can affect many areas of patient life. It has a negative impact on self-image, and may lead to dysphoria, social isolation, reduced adherence, using of negative coping strategies, and lower quality of life. The objective of this study was to determine the relationship between coping strategies and self-stigma among persons with schizophrenia and related psychotic disorders.Subjects and methods: A total of 104 clinically stable outpatients with chronic schizophrenia-spectrum disorders were enrolled in a cross-sectional study. Sociodemographic and clinical data were recorded. Patients were examined by psychiatrists with the Stress Coping Style Questionnaire, the Internalized Stigma of Mental Illness scale, and the Clinical Global Impression scale. Correlation and multiple-regression analyses were performed to discover contributing factors to self-stigma.Results: Positive coping strategies were used by patients with schizophrenia-spectrum disorders to the same extent as in the healthy population. Negative coping strategies were overused by these patients. There were significant associations between self-stigma, severity of the disorder, and coping strategies in schizophrenia. The ability to use positive coping

  1. Risk Factors for Non-Adherence to cART in Immigrants with HIV Living in the Netherlands: Results from the ROtterdam ADherence (ROAD Project.

    Directory of Open Access Journals (Sweden)

    Sabrina K Been

    Full Text Available In the Netherlands, immigrant people living with HIV (PLWH have poorer psychological and treatment outcomes than Dutch PLWH. This cross-sectional field study examined risk factors for non-adherence to combination Antiretroviral Therapy (cART among immigrant PLWH. First and second generation immigrant PLWH attending outpatient clinics at two HIV-treatment centers in Rotterdam were selected for this study. Socio-demographic and clinical characteristics for all eligible participants were collected from an existing database. Trained interviewers subsequently completed questionnaires together with consenting participants (n = 352 to gather additional data on socio-demographic characteristics, psychosocial variables, and self-reported adherence to cART. Univariable and multivariable logistic regression analyses were conducted among 301 participants who had used cART ≥6 months prior to inclusion. Independent risk factors for self-reported non-adherence were (I not having attended formal education or only primary school (OR = 3.25; 95% CI: 1.28-8.26, versus University, (II experiencing low levels of social support (OR = 2.56; 95% CI: 1.37-4.82, and (III reporting low treatment adherence self-efficacy (OR = 2.99; 95% CI: 1.59-5.64. Additionally, HIV-RNA >50 copies/ml and internalized HIV-related stigma were marginally associated (P<0.10 with non-adherence (OR = 2.53; 95% CI: 0.91-7.06 and OR = 1.82; 95% CI: 0.97-3.43. The findings that low educational attainment, lack of social support, and low treatment adherence self-efficacy are associated with non-adherence point to the need for tailored supportive interventions. Establishing contact with peer immigrant PLWH who serve as role models might be a successful intervention for this specific population.

  2. Care centre visits to married people living with HIV: an indicator for measuring AIDS-related stigma & discrimination.

    Science.gov (United States)

    Green, D A; Devi, S; Paulraj, L S

    2007-08-01

    We tested whether observation of the presence and relationship of attendants (i.e. those that accompany upon admission) and visitors to a sample of 230 (128 male, 102 female) married HIV-positive people in an HIV care centre provides an indicator of caregiving, AIDS-related stigma and discrimination. Sensitivity to gender, location (urban vs. rural), age (35) and source of infection (spouse vs. non-spouse) were factors considered to modulate AIDS-related stigma and assess discrimination. HIV-positive people were accompanied by their spouse (53%), mother (14%), father (7%), with only 7% attending alone. Immediate family most commonly accompanied on admission (80%), but visitors were mainly from the 'extended' family (32%) with many receiving no visitors (48%). Females (11%) were more likely than males to attend alone (11% vs. 4%; prate of no visitors than persons not infected by their spouse (54% vs. 40%; pdiscrimination. The measure appears particularly sensitive to the gender of the HIV-positive person. Such a measure may aid healthcare professionals to focus resources such as relational counselling upon the family and close friends of people experiencing AIDS-related stigma and discrimination, with the aim of improving the provision of care within the community.

  3. 'Triply cursed': racism, homophobia and HIV-related stigma are barriers to regular HIV testing, treatment adherence and disclosure among young Black gay men.

    Science.gov (United States)

    Arnold, Emily A; Rebchook, Gregory M; Kegeles, Susan M

    2014-06-01

    In the USA, young Black gay men are disproportionately impacted upon by HIV. In this qualitative study consisting of in-depth interviews with 31 young Black gay men and nine service providers, where we used thematic analysis to guide our interpretations, we found that HIV-related stigma and homophobia, within the larger societal context of racism, were related to sexual risk behaviour, reluctance to obtain HIV testing or care, lower adherence to treatment medication, and non-disclosure of a positive HIV status to sexual partners. Participants experienced homophobia and HIV-related stigma from churches and families within the Black community and from friends within the Black gay community, which otherwise provide support in the face of racism. Vulnerability to HIV was related to strategies that young Black gay men enacted to avoid being stigmatised or as a way of coping with alienation and rejection.

  4. [Stigma and discrimination experienced by people living with HIV in Togo, in 2013].

    Science.gov (United States)

    Saka, Bayaki; Tchounga, Boris; Ekouevi, Didier K; Sehonou, Céphas; Sewu, Essèboè; Dokla, Augustin; Maboudou, Angèle; Kassankogno, Yao; Palokinam Pitche, Vincent

    2017-01-01

    Stigma and discrimination experienced by people living with HIV (PLWHA) prevent and delay access to prevention and treatment services. The aim of this study was to describe the patterns of stigma and discrimination experienced by PLWHA in Togo and to identify the associated factors. A cross-sectional study was conducted in 2013 among PLWHA in Togo in order to collect data on stigma or discrimination experiences. Univariate and multivariate analyses were performed to identify associated factors. A total of 891 PLWHA were interviewed, including 848 (95.2%) receiving antiretroviral therapy. External stigma (37.9%) was the major form of stigmatization followed by internalized stigma (35.4%). The main features of external stigma were gossip (36.5%) and issues to access education (36.0%). Internalized stigma mainly consisted of a feeling of guilt (37.6%) and self-devaluation (36.0%). In univariate and multivariate analysis, female gender was significantly associated with stigma (aOR = 1.73, 95% CI [1.08-2.77]). Of the 891 PLWHA, 75 (8.4%) reported a violation of their rights. Finally 27 (4.1%) were discouraged from having children by a health professional because of their HIV status. Stigma affects more than one-third of PLWHA in Togo, more particularly females. It appears necessary to design new interventions and integrate psychosocial care in the management of PLWHA, in addition to antiretroviral therapy.

  5. Gender-related power differences, beliefs and reactions towards people living with HIV/AIDS: an urban study in Nigeria

    Directory of Open Access Journals (Sweden)

    De Vries Nanne K

    2010-06-01

    Full Text Available Abstract Background Although there are an increasing number of studies on HIV-related stigma in Nigeria, very little research has focused on how power differences based on gender perpetuate the stigmatization of people living with HIV/AIDS (PLWHA and how these gender differences affect the care that PLWHA receive in health care institutions. We explore gender-related beliefs and reactions of society, including health care professionals (HCPs, with regard to PLWHA, using Connell's theoretical framework of gender and power (1987. With Connell's structural theory of gender and power (financial inequality, authority and structure of social norms, we can describe gender differences in stigmatization of PLWHA. Method We conducted in-depth semi-structured interviews, lasting 60 to 90 minutes, with 100 persons (40 members of the general public, 40 HCPs and 20 PLWHA in Port Harcourt, Nigeria. The interviews were tape-recorded and transcribed verbatim. The Nvivo 7 computer package was used to analyze the data. Results There are similarities and differences between the general public and HCPs towards PLWHA in gender-related beliefs and reactions. For instance, although association with promiscuity and power differences were commonly acknowledged in the different groups, there are differences in how these reactions are shown; such as HCPs asking the female PLWHA to inform their partners to ensure payment of hospital bills. Women with HIV/AIDS in particular are therefore in a disadvantaged position with regard to the care they receive. Conclusion Despite the fact that men and women with HIV/AIDS suffer the same illness, clear disparities are apparent in the negative reaction women and men living with HIV/AIDS experience in society. We show that women's generally low status in society contributes to the extreme negative reactions to which female PLWHA are subject. The government should create policies aimed at reducing the power differences in family, society

  6. Knowledge of HIV/AIDS and attitudes towards people living with HIV among the general staff of a public university in Malaysia.

    Science.gov (United States)

    Tee, Yvonne; Huang, Mary

    2009-12-01

    Stigma and discrimination towards people living with HIV have been widely documented, and have extended their impact into the workplace. Stigmatising attitudes towards people living with HIV (PLHIV) in the workplace significantly hinder HIV prevention efforts and indirectly affect national development. This cross-sectional study was designed to determine the level of knowledge about HIV and AIDS and assess attitudes towards PLHIV among the general staff of Universiti Putra Malaysia (UPM), as well as to identify factors that are associated with it. Self-administered questionnaires were posted to a total of 344 general staff from six randomly selected faculties, and they were a given a week to return the questionnaires. The response rate was 38%. Data were analysed using Pearson's correlation, independent t-test and multiple linear regression. The respondents showed a considerably high level of knowledge about HIV/AIDS (mean knowledge score of 15.57+/-1.93 out of 18 points) although there were some misconceptions (N=129). Likert scale responses to 20 attitude statements revealed that respondents generally had moderately positive attitudes toward PLHIV (average score of 69.65+/-10.08 out of 100 points). Attitudes were inconsistent when it involved direct contact and interaction with PLHIV. Factors significantly associated with level of knowledge and attitudes included age, education and income. There was no difference in mean score for knowledge and attitudes by gender. Further efforts are necessary to improve attitudes of the general staff towards PLHIV, particularly in areas of direct contact with PLHIV.

  7. Perceived medication use challenges and coping strategies among medical outpatients in Nigeria.

    Science.gov (United States)

    Yusuff, Kazeem B

    2013-02-01

    The use of medicines is an action that involves a change in behaviour and it is a complex construct involving reciprocal interactions between social, environmental and cognitive factors. This is particularly true when a patient uses medicines for asymptomatic chronic conditions, requiring life-long use. To identify patient-perceived medication use challenges, determine the coping strategies used and investigate the relationship between patient-perceived challenges and self-initiation of coping strategies. A premier 900-bed tertiary/teaching hospital located in Ibadan, Nigeria. Ten pharmacists conducted cross-sectional medication use interviews for a random sample of 324 medical outpatients in 4 weeks (25th October-19th November 2006). Patient-perceived challenges with prescribed medications, self-initiated coping strategies used and relationship between patient-perceived challenges and self-initiation of coping strategies Eighty-one percent (324) of the random sample of 400 patients consented and completed the interview. Of these, 50.3 % were males while 49.7 % were females with mean age (SD) of 51.5 (17.6) and 52.1 (17.4) years respectively. The most frequent diagnoses were hypertension (53 %) and type-2 diabetes + hypertension (14.5 %). Two hundred and twenty-four patients reported one or more perceived challenges. Of these, 43.8 % were 65 years or older and about half reported at least 3 challenges. The majority (95.6 %) of patients who reported perceived challenges initiated one or more coping strategies without the knowledge of their physicians or pharmacists. Of 100 patients who did not report any perceived challenge, 43 % admitted initiating strategies to maintain perceived "cure" of their medical conditions. Self-initiation and use of coping strategies was far more likely among patients who reported perceived challenges (OR: 28.4, 95 % CI 26.1-30.5). The number of coping strategies reported appeared strongly related to the number of perceived challenges (r

  8. Stigmatization among people living with HIV in Hong Kong: A qualitative study.

    Science.gov (United States)

    Mo, Phoenix K H; Ng, Charlson T Y

    2017-10-01

    HIV/AIDS is one of the most stigmatized medical conditions across the world. Self-stigma is prevalent among people living with HIV (PLHIV) and a major obstacle to HIV prevention and care. This study aimed to describe the experiences of stigmatization and explore the possible factors that might be associated with stigmatization among PLHIV in Hong Kong. Qualitative in-depth interviews were conducted. 15 PLHIV were recruited from two local non-governmental organizations on HIV prevention. Participants were interviewed about their views and feelings towards oneself as a PLHIV and contributing factors, experiences of discriminations, stigmatizing behaviours, issues about disclosure, social relationships and potential impact of HIV. Thematic analyses revealed three levels of factors which might be associated with stigmatization: (i) intrapersonal level (misconceptions about HIV, attribution of self-responsibility, severe state of illness, side-effects of medication), (ii) interpersonal level (discrimination, social rejection) and (iii) social level (mass media, public stereotypes). Findings provide important insights into which interventions to reduce stigmatization of PLHIV could be designed. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

  9. Nonadherence Factors and Sociodemographic Characteristics of HIV-Infected Adults Receiving Antiretroviral Therapy in Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria.

    Science.gov (United States)

    Okoronkwo, Ijeoma; Okeke, Uchenna; Chinweuba, Anthonia; Iheanacho, Peace

    2013-01-01

    Adherence to treatment instructions with antiretroviral therapy (ART) is very crucial for successful treatment outcome. However, sticking to treatment instructions pose-great challenges to HIV/AIDS patients. This cross-sectional study was on HIV infected adults attending ART clinic in Nigeria to explore nonadherence factors in relation to their socioeconomic characteristics. Validated structured questionnaire was administered to 221 participants. Results showed a high nonadherence rate of 85.1%. The commonest occurring factors of non-adherence were forgetfulness (53.8%), busy schedule (38.8%), side effects of drugs (31.9%), and stigma (31.9%). Males were more likely to complain from busy schedule, feeling healthy, fear of partner disclosure, long waiting period, and long term regimen. Patients with no formal education were more likely to attribute non-adherence to poor communication, side effects of drugs, and stigma. Employed patients seemed to miss their drugs more than the unemployed and artisans. The high non-adherence rate has serious implications for the control of HIV in infected individuals and management of HIV in general. Nurses should intensify efforts on patient education and counseling.

  10. Experiences of stigma and discrimination in social and healthcare settings among trans people living with HIV in the UK.

    Science.gov (United States)

    Hibbert, M; Wolton, A; Crenna-Jennings, W; Benton, L; Kirwan, P; Lut, I; Okala, S; Ross, M; Furegato, M; Nambiar, K; Douglas, N; Roche, J; Jeffries, J; Reeves, I; Nelson, M; Weerawardhana, C; Jamal, Z; Hudson, A; Delpech, V

    2018-07-01

    The People Living with HIV StigmaSurvey UK 2015 was a community led national survey investigating experiences of people living with HIV in the UK in the past 12 months. Participants aged 18 and over were recruited through over 120 cross-sector community organisations and 46 HIV clinics to complete an anonymous online survey. Trans is an umbrella term which refers to individuals whose current gender identity is different to the gender they were assigned at birth. Trans participants self-identified via gender identity and gender at birth questions. Descriptive analyses of reported experiences in social and health care settings were conducted and multivariate logistic regression analyses were used to identify sociodemographic predictors of reporting being treated differently to non-HIV patients, and being delayed or refused healthcare treatment in the past 12 months. 31 out of 1576 participants (2%) identified as trans (19 trans women, 5 trans men, 2 gender queer/non-binary, 5 other). High levels of social stigma were reported for all participants, with trans participants significantly more likely to report worrying about verbal harassment (39% vs. 23%), and exclusion from family gatherings (23% vs. 9%) in the last 12 months, compared to cisgender participants. Furthermore, 10% of trans participants reported physical assault in the last 12 months, compared to 4% of cisgender participants. Identifying as trans was a predictor of reporting being treated differently to non-HIV patients (48% vs. 30%; aOR 2.61, CI 1.06, 6.42) and being delayed or refused healthcare (41% vs. 16%; aOR 4.58, CI 1.83, 11.44). Trans people living with HIV in the UK experience high levels of stigma and discrimination, including within healthcare settings, which is likely to impact upon health outcomes. Trans-specific education and awareness within healthcare settings could help to improve service provision for this demographic.

  11. The Socioeconomic Implications among People Living with HIV/AIDS in Sudan: Challenges and Coping Strategies.

    Science.gov (United States)

    Ismail, Salwa M; Kari, Fatimah; Kamarulzaman, Adeeba

    To determine the socioeconomic impacts among HIV-infected persons in Sudan and examine whether there are significant variations in coping strategies between infected men and women, a primary survey was conducted among infected persons (n = 555). Discriminant function was used to analyze the data. We found significant variation in the coping strategies (<.001). HIV/AIDS impacts were more critical for women. Infected people have 3 alternatives in coping with the changes in their income and expenditure, that is, borrow, utilize savings, or sell assets. Policy makers should consider economic information in planning health care to mitigate the impacts and remove the gender gap.

  12. “Triply cursed”: Racism, homophobia, and HIV-related stigma are barriers to regular HIV testing, treatment adherence, and disclosure among young Black gay men

    Science.gov (United States)

    Arnold, Emily A.; Rebchook, Gregory M.; Kegeles, Susan M.

    2014-01-01

    In the USA, young Black gay men are disproportionately impacted by HIV. In this qualitative study consisting of in-depth interviews with 31 young Black gay men and 9 service providers, where we used thematic analysis to guide our interpretations, we found that HIV-related stigma and homophobia, within the larger societal context of racism, were related to sexual risk behaviour, reluctance to obtain HIV testing or care, lower adherence to treatment medication, and disclosure of a positive HIV status to sexual partners. Participants experienced homophobia and HIV-related stigma from churches and families within the Black community, and from friends within the Black gay community, that otherwise provide support in the face of racism. Vulnerability to HIV was related to strategies that young Black gay men enacted to avoid being stigmatised or as a way of coping with their alienation and rejection. PMID:24784224

  13. Perceptions, motivations, and concerns about living organ donation among people living with HIV.

    Science.gov (United States)

    Van Pilsum Rasmussen, Sarah E; Henderson, Macey L; Bollinger, Juli; Seaman, Shanti; Brown, Diane; Durand, Christine M; Segev, Dorry L; Sugarman, Jeremy

    2018-05-03

    Recent changes to United States law now permit people living with HIV (PLWH) to donate organs to HIV-infected (HIV+) recipients under research protocols. PLWH may have unique motivations for and concerns about living donation and understanding them is critical to ensuring the integrity of this novel approach to organ transplantation. We conducted in-depth interviews with PLWH from an urban HIV clinic who had previously indicated their willingness to be a living donor. Interviews elicited information on their motivations, perceived benefits, and concerns regarding living donation. Codes were identified inductively and then organized into themes and subthemes. Two coders independently analyzed the interviews and reconciled differences in coding by consensus. Thematic saturation was reached after 20 interviews. Motivations for living donation among PLWH included an altruistic desire to help others as well as HIV-specific motivations including solidarity with potential recipients and a desire to overcome HIV-related stigma. Perceived benefits of living donation included gratification from saving or improving the recipient's life and conferring a sense of normalcy for the HIV+ donor. Concerns about donation included the possibility of a prolonged recovery period, organ failure, and transmission of another strain of the virus to the recipients. PLWH had unique motivations, perceived benefits, and concerns about living donation in addition to those previously identified in the general population. These unique factors should be addressed in research protocols, informed consent processes, and the education and training of independent living donor advocates so that these endeavors are ethically sound.

  14. "People try and label me as someone I'm not": The social ecology of Indigenous people living with HIV, stigma, and discrimination in Manitoba, Canada.

    Science.gov (United States)

    Woodgate, Roberta L; Zurba, Melanie; Tennent, Pauline; Cochrane, Carla; Payne, Mike; Mignone, Javier

    2017-12-01

    Indigenous peoples (First Nations, Inuit, and Métis) are currently overrepresented in the HIV epidemic in Canada and are infected at a younger age than those who are not Indigenous. This article presents our findings on the stigma and discrimination (as well as related themes such as disclosure) experienced by Indigenous people who contracted HIV in their youth and live in urban and non-urban settings in Manitoba, Canada. The findings were derived from a qualitative study that sought to understand the experiences and needs of Indigenous people living with HIV (including AIDS). We situate such experiences within a social ecological framework towards developing a better structural understanding of the impacts of stigma and discrimination on the lives of Indigenous people who are HIV positive. Stigma and discrimination caused barriers for Indigenous people living with HIV through inhibiting their ease of access to supports including family, peers, community, and long- and short-term health services. Creative forms of outreach and education that are culturally appropriate and/or rooted in culture were considered to be possibly impactful ways of reducing stigma and discrimination at the community level. Learning from communities who are successfully managing stigma also showed promise for developing new programming. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Housing Status, Medical Care, and Health Outcomes Among People Living With HIV/AIDS: A Systematic Review

    Science.gov (United States)

    Wilson, Michael G.; Shubert, Virginia; Gogolishvili, David; Globerman, Jason; Rueda, Sergio; Bozack, Anne K.; Caban, Maria; Rourke, Sean B.

    2016-01-01

    Background. Accumulating evidence suggests responses to HIV that combine individual-level interventions with those that address structural or contextual factors that influence risks and health outcomes of infection. Housing is such a factor. Housing occupies a strategic position as an intermediate structural factor, linking “upstream” economic, social, and cultural determinants to the more immediate physical and social environments in which everyday life is lived. The importance of housing status for HIV prevention and care has been recognized, but much of this attention has focused on homeless individuals as a special risk group. Analyses have less often addressed community housing availability and conditions as factors influencing population health or unstable, inadequate, or unaffordable housing as a situation or temporary state. A focus on individual-level characteristics associated with literal homelessness glosses over social, economic, and policy drivers operating largely outside any specific individual’s control that affect housing and residential environments and the health resources or risk exposures such contexts provide. Objectives. We examined the available empirical evidence on the association between housing status (broadly defined), medical care, and health outcomes among people with HIV and analyzed results to inform future research, program development, and policy implementation. Search methods. We searched 8 electronic health and social science databases from January 1, 1996, through March 31, 2014, using search terms related to housing, dwelling, and living arrangements and HIV and AIDS. We contacted experts for additional literature. Selection criteria. We selected articles if they were quantitative analyses published in English, French, or Spanish that included at least 1 measure of housing status as an independent variable and at least 1 health status, health care, treatment adherence, or risk behavior outcome among people with HIV in

  16. Housing Status, Medical Care, and Health Outcomes Among People Living With HIV/AIDS: A Systematic Review.

    Science.gov (United States)

    Aidala, Angela A; Wilson, Michael G; Shubert, Virginia; Gogolishvili, David; Globerman, Jason; Rueda, Sergio; Bozack, Anne K; Caban, Maria; Rourke, Sean B

    2016-01-01

    Accumulating evidence suggests responses to HIV that combine individual-level interventions with those that address structural or contextual factors that influence risks and health outcomes of infection. Housing is such a factor. Housing occupies a strategic position as an intermediate structural factor, linking "upstream" economic, social, and cultural determinants to the more immediate physical and social environments in which everyday life is lived. The importance of housing status for HIV prevention and care has been recognized, but much of this attention has focused on homeless individuals as a special risk group. Analyses have less often addressed community housing availability and conditions as factors influencing population health or unstable, inadequate, or unaffordable housing as a situation or temporary state. A focus on individual-level characteristics associated with literal homelessness glosses over social, economic, and policy drivers operating largely outside any specific individual's control that affect housing and residential environments and the health resources or risk exposures such contexts provide. We examined the available empirical evidence on the association between housing status (broadly defined), medical care, and health outcomes among people with HIV and analyzed results to inform future research, program development, and policy implementation. We searched 8 electronic health and social science databases from January 1, 1996, through March 31, 2014, using search terms related to housing, dwelling, and living arrangements and HIV and AIDS. We contacted experts for additional literature. We selected articles if they were quantitative analyses published in English, French, or Spanish that included at least 1 measure of housing status as an independent variable and at least 1 health status, health care, treatment adherence, or risk behavior outcome among people with HIV in high-income countries. We defined housing status to include

  17. Knowledge of HIV/AIDS and attitudes towards people living with HIV ...

    African Journals Online (AJOL)

    Stigma and discrimination towards people living with HIV have been widely documented, and have extended their impact into the workplace. Stigmatising attitudes towards people living with HIV (PLHIV) in the workplace significantly hinder HIV prevention efforts and indirectly affect national development.

  18. Stigma and suicide among gay and bisexual men living with HIV.

    Science.gov (United States)

    Ferlatte, Olivier; Salway, Travis; Oliffe, John L; Trussler, Terry

    2017-11-01

    HIV positive gay and bisexual men (GBM) continue to struggle with the pervasiveness of HIV stigma, but little is known about the health effects of stigma. In this article, suicidal ideation and attempts are measured among GBM living with HIV, evaluating the extent to which these experiences are associated with stigma and suicide. Drawing from an online national survey of Canadian GBM completed by 7995 respondents, a sub-set of data provided by respondents self-reporting HIV-positive status was used for the current study. The associations between suicidal ideation (SI) and attempts (SA) and four measures of HIV stigma were measured: social exclusion, sexual rejection, verbal abuse and physical abuse. A total of 673 HIV-positive men completed the survey (8% of total sample). Among this group, 22% (n = 150) reported SI and 5% (n = 33) SA in the last 12 months. After adjusting for sociodemographic factors, SI and SA were associated with each of the four measures of HIV stigma: being excluded socially for being HIV positive (SI adjusted odds ratio, AOR 2.0 95% CI 1.4-3.1; SA AOR 3.8 95% CI 1.9-7.9), rejected as a sexual partner (SI AOR 1.6 95% CI 1.1-2.4; SA AOR 2.6 95% CI 1.1-6.0), verbally abused (SI AOR 2.9 95% CI 1.9-4.5; SA AOR 2.4 95% CI 1.1-5.1), and physically abused (SI AOR 4.5 95% CI 1.8-11.7; SA AOR 6.4 95% CI 2.0-20.1). Furthermore, experiencing multiple forms of stigma was associated with significantly increased risk of SI and SA. The authors conclude that HIV positive GBM experience significant levels of stigma that are associated with heightened risk for suicide. The findings affirm the need for targeted interventions to prevent suicide amid public health efforts to de-stigmatize HIV and mental illness.

  19. HIV stigma trends in the general population during antiretroviral treatment expansion: analysis of 31 countries in sub-Saharan Africa, 2003-2013.

    Science.gov (United States)

    Chan, Brian T; Tsai, Alexander C

    2016-08-15

    HIV-related stigma is associated with increased risk-taking behavior, reduced uptake of HIV testing, and decreased adherence to antiretroviral therapy (ART). Although ART scale-up may reduce HIV-related stigma, the extent to which levels of stigma in the general population have changed during the era of ART scale-up in sub-Saharan Africa is unknown. Social distance and anticipated stigma were operationalized using standard HIV-related stigma questions contained in the Demographic and Health Surveys and AIDS Indicator Surveys of 31 African countries between 2003 and 2013. We fitted multivariable linear regression models with cluster-correlated robust standard errors and country fixed effects, specifying social distance or anticipated stigma as the dependent variable and year as the primary explanatory variable of interest. We estimated a statistically significant negative association between year and desires for social distance (b = -0.020; P stigma (b = 0.023; P stigma in the general population increased despite a decrease in social distancing toward people living with HIV. Although ART scale-up may help reduce social distancing toward people living with HIV, particularly in high-prevalence countries, other interventions targeting symbolic or instrumental concerns about HIV may be needed.

  20. Cultural adaptation of an evidence-based nursing intervention to improve medication adherence among people living with HIV/AIDS (PLWHA) in China.

    Science.gov (United States)

    Williams, Ann B; Wang, Honghong; Burgess, Jane; Li, Xianhong; Danvers, Karina

    2013-04-01

    Adapting nursing interventions to suit the needs and culture of a new population (cultural adaptation) is an important early step in the process of implementation and dissemination. While the need for cultural adaptation is widely accepted, research-based strategies for doing so are not well articulated. Non-adherence to medications for chronic disease is a global problem and cultural adaptation of existing evidence-based interventions could be useful. This paper aims to describe the cultural adaptation of an evidence-based nursing intervention to improve medication adherence among people living with HIV/AIDS and to offer recommendations for adaptation of interventions across cultures and borders. SITE: The intervention, which demonstrated efficacy in a randomized controlled trial in North America, was adapted for the cultural and social context of Hunan Province, in south central China. The adaptation process was undertaken by intervention stakeholders including the original intervention study team, the proposed adaptation team, and members of a Community Advisory Board, including people living with HIV/AIDS, family members, and health care workers at the target clinical sites. The adaptation process was driven by quantitative and qualitative data describing the new population and context and was guided by principles for cultural adaptation drawn from prevention science research. The primary adaptation to the intervention was the inclusion of family members in intervention activities, in response to the cultural and social importance of the family in rural China. In a pilot test of the adapted intervention, self-reported medication adherence improved significantly in the group receiving the intervention compared to the control group (p=0.01). Recommendations for cultural adaptation of nursing interventions include (1) involve stakeholders from the beginning; (2) assess the population, need, and context; (3) evaluate the intervention to be adapted with attention to

  1. Impact of HIV testing and counseling (HTC) knowledge on HIV prevention practices among traditional birth attendants in Nigeria.

    Science.gov (United States)

    Osuji, Alice; Pharr, Jennifer R; Nwokoro, Uche; Ike, Anulika; Ali, Christiana; Ejiro, Ogheneaga; Osuyali, John; Obiefune, Michael; Fiscella, Kevin; Ezeanolue, Echezona E

    2015-02-10

    Nigeria is second in the world for the number of people with HIV and has a high rate of mother-to-child transmission (MTCT). Over 60% of births in Nigeria occur outside of health care facilities, and because of this, Traditional Birth Attendants (TBAs) play a significant role in maternal and child health. It is important that TBAs be knowledgeable about HIV prevention. The purpose of this study was to determine the impact of HIV testing and counseling (HTC) knowledge on the HIV prevention practices among TBAs in Nigeria. Five hundred TBAs were surveyed. Chi-square and logistic regression were used to assess differences in HIV prevention practices between TBAs with and without HTC knowledge. TBAs with HTC knowledge are significantly more likely to engage in HIV prevention practices than TBAs without HTC. Prevention practices included: wearing gloves during delivery (p births occur outside health care facilities in Nigeria, there will be a need for TBAs. Providing TBAs with HTC training increases HIV prevention practices and can be a key to improve maternal and child health.

  2. Employment discrimination and HIV stigma: survey results from civil society organisations and people living with HIV in Africa.

    Science.gov (United States)

    Sprague, Laurel; Simon, Sara; Sprague, Courtenay

    2011-01-01

    The article presents findings from three surveys of people living with HIV (PLHIV) and civil society organisations about the experience of employment discrimination and stigma in the workplace. The work seeks to contribute to efforts by businesses and other organisations to effectively respond to the HIV epidemic within the world of work, and to deepen our understanding of the ways in which HIV stigma and employment discrimination persist in the workplace. The findings of global and regional surveys indicate the existence of high levels of employment discrimination based on HIV status worldwide, including forced disclosure of HIV status, exclusion in the workplace, refusals to hire or promote, and terminations of people known to be living with HIV. The survey findings show that employment discrimination based on HIV status is experienced in all African subregions. Country-level surveys conducted in Kenya and Zambia indicated that PLHIV face marked barriers to employment, including discrimination in hiring, loss of promotions, and termination because of HIV status. Additionally, large variances were found in the degree of support versus discrimination that employees living with HIV in those two countries received following their disclosure. The discussion emphasises the importance of the workplace as a site for intervention and behaviour change. To address this, we introduce a conceptual framework - the employment continuum - that maps multiple points of entry within the workplace to address HIV-related stigma and discrimination. Additional recommendations include: actions to ensure equal opportunity in hiring for PLHIV; ensuring that HIV testing is voluntary, never mandatory, and that disclosure is not necessary for employment; ensuring confidentiality of HIV status; communicating and enforcing HIV-related antidiscrimination policies; establishing support groups in the workplace; providing safe and confidential processes for resolving complaints of employment

  3. Stigma, discrimination, and sexual (dis)satisfaction among people living with HIV: results from the "AIDES et toi" survey.

    Science.gov (United States)

    Rojas Castro, D; Le Gall, J M; Andreo, C; Spire, B

    2010-08-01

    The effects of HIV-related stigma and discrimination have been studied in several areas, such as access to testing, quality of care quality, and access to work. Nevertheless, the effects of stigma and discrimination on the sexual life of people living with HIV/AIDS (PLWHA) have not been studied enough. AIDES, a French community-based organization, has developed a biannual survey which assesses several socioeconomical and psychosocial dimensions of the people in contact with this organization. A focus on the results concerning sexual (dis)satisfaction and the factors associated are presented here. A convenience sample of 521 HIV-positive men having sex with men, heterosexual men and women was analyzed. A logistic regression was performed to examine which factors were significantly associated with sexual dissatisfaction. Results showed that being older, not having a full-time job, not having a steady sexual partner, lower frequency of sexual intercourse, discrimination in the sexual relationship setting, and the perception of loneliness were independently associated with sexual dissatisfaction. A quality health approach must include the aspects linked to sexual life and sexual satisfaction. Given the potentially harmful effects that HIV-related stigma and discrimination have on PLWHA's well-being, more specific actions and advocacy in this direction should be developed and implemented.

  4. Experiences and Impact of Stigma and Discrimination among People on Antiretroviral Therapy in Dar es Salaam: A Qualitative Perspective

    OpenAIRE

    Mhode, Maisara; Nyamhanga, Tumaini

    2016-01-01

    Background. The impact of stigma on adherence to antiretroviral therapy (ART) has been less studied in Tanzania. Recent studies indicate that people on ART still experience stigma. Qualitative information on the subject matter is especially insufficient. Objective. This paper reports on the dimensions of stigma and discrimination and their impact on adherence to ART as experienced by people living with HIV (PLHIV). Design. A phenomenological approach was used to gather information on the live...

  5. Self-stigma among caregivers of people with mental illness: toward caregivers' empowerment.

    Science.gov (United States)

    Girma, Eshetu; Möller-Leimkühler, Anne Maria; Dehning, Sandra; Mueller, Norbert; Tesfaye, Markos; Froeschl, Guenter

    2014-01-01

    In addition to economic and material burdens, caregivers of people with mental illness are exposed to psychosocial challenges. Self-stigma is among the psychological challenges that can be exacerbated by intrinsic and/or extrinsic factors. Caregivers' self-stigma can negatively influence the patients' treatment and rehabilitation process. The objective of this study was to measure the level and correlates of self-stigma among caregivers of people with mental illness. An interviewer-administered cross-sectional study was conducted in the Jimma University Specialized Hospital Psychiatry Clinic in Ethiopia on a sample of 422 caregivers. Data were collected by trained nurses working in the clinic using a pretested questionnaire. Multivariate linear regression was performed to identify the correlates of self-stigma among caregivers of people with mental illness. The majority (70.38%) of the caregivers were male. On a scale of 0 to 15, with 0 being low and 15 being high, the average self-stigmatizing attitude score was 4.68 (±4.11). A statistically significant difference in mean self-stigma score was found between urban and rural respondents (t=3.95, PSelf-stigma of caregivers showed significant positive correlation with perceived signs of mental illness (r=0.18, Pself-stigma was perceived supernatural explanation of mental illness (standardized β=0.22, Pself-stigma in this study was significantly correlated with perceived supernatural explanation of mental illness. Since caregivers' self-stigma may negatively influence patients' treatment-seeking, adherence, and rehabilitation processes, programs that enhance coping strategies by strengthening self-esteem and empowerment by health care providers and establish family support groups may be helpful to tackle self-stigma among caregivers of people with mental illness.

  6. Self-stigma among caregivers of people with mental illness: toward caregivers’ empowerment

    Science.gov (United States)

    Girma, Eshetu; Möller-Leimkühler, Anne Maria; Dehning, Sandra; Mueller, Norbert; Tesfaye, Markos; Froeschl, Guenter

    2014-01-01

    Background In addition to economic and material burdens, caregivers of people with mental illness are exposed to psychosocial challenges. Self-stigma is among the psychological challenges that can be exacerbated by intrinsic and/or extrinsic factors. Caregivers’ self-stigma can negatively influence the patients’ treatment and rehabilitation process. The objective of this study was to measure the level and correlates of self-stigma among caregivers of people with mental illness. Methods An interviewer-administered cross-sectional study was conducted in the Jimma University Specialized Hospital Psychiatry Clinic in Ethiopia on a sample of 422 caregivers. Data were collected by trained nurses working in the clinic using a pretested questionnaire. Multivariate linear regression was performed to identify the correlates of self-stigma among caregivers of people with mental illness. Results The majority (70.38%) of the caregivers were male. On a scale of 0 to 15, with 0 being low and 15 being high, the average self-stigmatizing attitude score was 4.68 (±4.11). A statistically significant difference in mean self-stigma score was found between urban and rural respondents (t=3.95, PSelf-stigma of caregivers showed significant positive correlation with perceived signs of mental illness (r=0.18, Pself-stigma was perceived supernatural explanation of mental illness (standardized β=0.22, Pself-stigma in this study was significantly correlated with perceived supernatural explanation of mental illness. Since caregivers’ self-stigma may negatively influence patients’ treatment-seeking, adherence, and rehabilitation processes, programs that enhance coping strategies by strengthening self-esteem and empowerment by health care providers and establish family support groups may be helpful to tackle self-stigma among caregivers of people with mental illness. PMID:24470760

  7. Experiences and Impact of Stigma and Discrimination among People on Antiretroviral Therapy in Dar es Salaam: A Qualitative Perspective.

    Science.gov (United States)

    Mhode, Maisara; Nyamhanga, Tumaini

    2016-01-01

    Background. The impact of stigma on adherence to antiretroviral therapy (ART) has been less studied in Tanzania. Recent studies indicate that people on ART still experience stigma. Qualitative information on the subject matter is especially insufficient. Objective. This paper reports on the dimensions of stigma and discrimination and their impact on adherence to ART as experienced by people living with HIV (PLHIV). Design. A phenomenological approach was used to gather information on the lived experiences of stigma and discrimination. The sample size was determined according to the saturation principle. Results. Respondents experienced different forms of HIV-related stigma such as verbal, social, and perceived stigma. Various forms of discrimination were experienced, including relational discrimination, mistreatment by health care workers, blame and rejection by spouses, and workplace discrimination. HIV-related stigma and discrimination compromised ART adherence by reinforcing concealment of HIV status and undermining social suppport. Conclusion. After nearly a decade of increasing the provision of ART in Tanzania, PLHIV still experience stigma and discrimination; these experiences still appear to have a negative impact on treatment adherence. Efforts to reduce stigma and discrimination remain relevant in the ART period and should be given more impetus in order to maximize positive treatment outcomes.

  8. Experiences and Impact of Stigma and Discrimination among People on Antiretroviral Therapy in Dar es Salaam: A Qualitative Perspective

    Directory of Open Access Journals (Sweden)

    Maisara Mhode

    2016-01-01

    Full Text Available Background. The impact of stigma on adherence to antiretroviral therapy (ART has been less studied in Tanzania. Recent studies indicate that people on ART still experience stigma. Qualitative information on the subject matter is especially insufficient. Objective. This paper reports on the dimensions of stigma and discrimination and their impact on adherence to ART as experienced by people living with HIV (PLHIV. Design. A phenomenological approach was used to gather information on the lived experiences of stigma and discrimination. The sample size was determined according to the saturation principle. Results. Respondents experienced different forms of HIV-related stigma such as verbal, social, and perceived stigma. Various forms of discrimination were experienced, including relational discrimination, mistreatment by health care workers, blame and rejection by spouses, and workplace discrimination. HIV-related stigma and discrimination compromised ART adherence by reinforcing concealment of HIV status and undermining social suppport. Conclusion. After nearly a decade of increasing the provision of ART in Tanzania, PLHIV still experience stigma and discrimination; these experiences still appear to have a negative impact on treatment adherence. Efforts to reduce stigma and discrimination remain relevant in the ART period and should be given more impetus in order to maximize positive treatment outcomes.

  9. Effect of social relationships on antiretroviral medication adherence for people living with HIV and substance use disorders and transitioning from prison.

    Science.gov (United States)

    Rozanova, Julia; Brown, Shan-Estelle; Bhushan, Ambika; Marcus, Ruthanne; Altice, Frederick L

    This paper examines how family and social relations facilitate and inhibit adherence to antiretroviraltherapy (ART) for people living with HIV (PLH) who have underlying substance use disorders and are transitioningto the community post-incarceration. Combining the methods of inductive close reading and constantcomparison, we analyzed the data from 30 semi-structured interviews of PLH who had recently transitioned to thecommunity within the previous 90 days. Three central themes were anticipated as important socialrelationships post-release: self-reported family, friends and clinicians. Among these, four sub-themes (social isolation, 'double jeopardy', search for belonging, and trust and respect) emerged, highlighting how they impacted ART adherence. Post-release, participants returned to resource-poor communities where they experienced socialisolation. ART adherence was enabled by having a purpose in life, which correlated with having robust family support structures. Many former prisoners felt that a chasm between them and their families existed, both because of HIV stigma and their addiction problems. In this context, relationships with untrustworthy friends from their druguse networks led to relapse of drug use and risky behaviors, jeopardizing participants' ART adherence and persistence. To avoid the double jeopardy, defined as seeking friends for support but who were also the ones who contributed to drug relapse, participants searched for new social anchors, which often included their healthcare providers who represented trusted and respected persons in their life. While some former prisonersperceived doctors as uncaring and their relationships asymmetrical, positive relationships with these providers,when respect and trust was mutual, reinforced the participants' sense of belonging to what they called 'the world that don't do drugs' and motivated them to adhere to ART.

  10. Intersectional health-related stigma in persons living with HIV and chronic pain: implications for depressive symptoms.

    Science.gov (United States)

    Goodin, Burel R; Owens, Michael A; White, Dyan M; Strath, Larissa J; Gonzalez, Cesar; Rainey, Rachael L; Okunbor, Jennifer I; Heath, Sonya L; Turan, Janet M; Merlin, Jessica S

    2018-05-30

    "Intersectional health-related stigma" (IHRS) refers to stigma that arises at the convergence of multiple health conditions. People living with HIV (PLWH) and chronic pain have two highly stigmatized health conditions, and thus may be at especially high risk for internalizing these stigmas and consequently experiencing depression. This study examined the intersectionality of internalized HIV and chronic pain stigma in relation to depressive symptoms in a sample of PLWH and chronic pain. Sixty participants were recruited from an HIV clinic in the Southeastern United States. Chronic pain was defined as pain that has been present for at least three consecutive months, and that has been an ongoing problem for at least half the days in the past six months. All participants completed the HIV Stigma Mechanisms Scale, Internalized Stigma in Chronic Pain Scale, the Short-Form Brief Pain Inventory, and the Center for Epidemiological Studies - Depression Scale. Clinical data was collected from medical records. An intersectional HIV and chronic pain composite variable was created and participants were categorized as either high (28%), moderate (32%), or low (40%). Results revealed that intersectional HIV and chronic pain stigma was significantly associated with severity of depressive symptoms (p = .023). Pairwise contrasts revealed that participants with high (p = .009) and moderate (p = .033) intersectional stigma reported significantly greater mean depressive symptom severity than those with low intersectional stigma. Participants who reported the highest levels of internalized HIV and chronic pain stigma also reported the greatest severity of depressive symptoms. This suggests that the experience of both HIV and chronic pain stigma (i.e., IHRS) among PLWH and chronic pain may synergistically perpetuate negative mood in a more profound manner than experiencing either one stigma alone.

  11. Details for Manuscript Number SSM-D-06-00290R2 “Internalized Stigma, Discrimination, and Depression among Men and Women Living with HIV/AIDS in Cape Town, South Africa”

    OpenAIRE

    Simbayi, Leickness C.; Strebel, Anna; Cloete, Allanise; Henda, Nomvo; Mqeketo, Ayanda

    2007-01-01

    AIDS stigmas interfere with HIV prevention, diagnosis and treatment and can become internalized by people living with HIV/AIDS. However, the effects of internalized AIDS stigmas have not been investigated in Africa, home to two-thirds of the more than 40 million people living with AIDS in the world. The current study examined the prevalence of discrimination experiences and internalized stigmas among 420 HIV positive men and 643 HIV positive women recruited from AIDS services in Cape Town, So...

  12. Educational intervention and the health seeking attitude and adherence to therapy by tuberculosis patients from an urban slum in lagos Nigeria.

    Science.gov (United States)

    Olayemi, S O; Oreagba, I A; Akinyede, A; Adepoju, G E

    2009-12-01

    Community based participation has been advocated by a number of international health organisations including the World Health Organization (WHO) as a solution to the problems of poor patient adherence and default from Directly Observed Treatment Short course [DOTs] programmes for tuberculosis control. To determine the impact of a health educational intervention on the management of tuberculosis in relation to the outcome and adherence to therapy by Tuberculosis patients residing in a densely populated urban slum in Lagos, Nigeria. The study was conducted using forty tuberculosis patients (confirmed by acid fast bacilli positive sputum), and selected randomly from those who attend the Mainland Hospital in Lagos. They were divided into two groups of twenty each made up of those to be provided with education intervention at the community level and the control groups followed up at the hospital level only. An initial assessment of the knowledge about tuberculosis management was done through a structured questionnaire for both groups. This was followed by continuous health talks for intervention group in form of neighbourhood self help approach. The results showed that the intervention had a significant impact on the understanding of disease and its management (X(2) =11.842 peducation is therefore beneficial for TB control in Nigeria.

  13. Association of Depressive Symptoms with Lapses in Antiretroviral Medication Adherence Among People Living with HIV: A Test of an Indirect Pathway.

    Science.gov (United States)

    Babowitch, Jacklyn D; Sheinfil, Alan Z; Woolf-King, Sarah E; Vanable, Peter A; Sweeney, Shannon M

    2018-03-23

    Viral suppression, a critical component of HIV care, is more likely when individuals initiate antiretroviral therapy (ART) early in disease progression and maintain optimal levels of adherence to ART regimens. Although several studies have documented the negative association of depressive symptoms with ART adherence, less is known about how depressed mood relates to intentional versus unintentional lapses in adherence as well as the mechanisms underlying this association. The purpose of the current study was to examine the association of depressive symptoms with ART adherence, assessed as a multidimensional construct. Secondarily, this study conducted preliminary indirect path models to determine if medication self-efficacy could explain the depressed mood-adherence relationship. Depressive symptoms were not associated with 95% ART taken, self-reported viral load, deliberate adjustments to ART regimens or skipped ART doses. However, the indirect association of depressive symptoms via decrements in medication self-efficacy was significant for 95% ART taken, self-reported viral load and skipped ART doses, but not deliberate changes to ART regimens. In this sample of HIV-positive outpatients, there is evidence to support medication self-efficacy as a potential mechanism underlying the association between depressive symptoms and ART adherence. Additional longitudinal studies are needed to formally examine medication taking self-efficacy as a mediator.

  14. The differences between medical trust and mistrust and their respective influences on medication beliefs and ART adherence among African-Americans living with HIV.

    Science.gov (United States)

    Pellowski, Jennifer A; Price, Devon M; Allen, Aerielle M; Eaton, Lisa A; Kalichman, Seth C

    2017-09-01

    The purpose of this study was to examine the relationships between medical mistrust and trust and to determine if these measures differentially predict antiretroviral therapy (ART) medication adherence for African-American adults living with HIV. A total of 458 HIV positive African-Americans completed a cross-sectional survey. Self-reported ART adherence was collected using the visual-analog scale. The Beliefs About Medicines Questionnaire was used to assess medication necessity and concern beliefs. All measures of medical mistrust and trust were significantly negatively correlated, ranging from r = -.339 to -.504. Race-based medical mistrust significantly predicted medication necessity and concern beliefs, whereas general medical mistrust only significantly predicted medication concerns. Both measures of trust significantly predicted medication necessity beliefs and medication concerns. Higher levels of race-based medical mistrust predicted lower medication adherence, whereas, neither trust in own physician nor trust in health care provider significantly predicted medication adherence. However, trust in own physician significantly predicted medication necessity beliefs, which predicted medication adherence. Trust and mistrust are not simply opposites of one another. These findings provide evidence for the complexity of understanding the relationship between health care trust, mistrust and patient-related health beliefs and behaviours.

  15. Intersectionality of internalized HIV stigma and internalized substance use stigma: Implications for depressive symptoms.

    Science.gov (United States)

    Earnshaw, Valerie A; Smith, Laramie R; Cunningham, Chinazo O; Copenhaver, Michael M

    2015-08-01

    We adopted an intersectionality framework and examined whether the relationship between internalized HIV stigma and depressive symptoms is moderated by internalized substance use stigma. A total of 85 people living with HIV with a history of substance use in the Bronx, New York, completed a survey. Results revealed evidence of moderation: Participants who internalized HIV stigma experienced greater depressive symptoms only if they also internalized substance use stigma. Researchers should examine stigma associated with multiple socially devalued characteristics to best understand how stigma impacts mental health among people living with HIV. Healthcare providers should address stigma associated with the full range of socially devalued characteristics with which people living with HIV live. © The Author(s) 2013.

  16. Validity and Reliability of Persian Version of HIV/AIDS Related Stigma Scale for People Living With HIV/AIDS in Iran

    Directory of Open Access Journals (Sweden)

    Davoud Pourmarzi

    2016-04-01

    Full Text Available Objective: To assess the perceived HIV/AIDS related stigma a comprehensive and well developed stigma instrument is necessary. This study aimed to assess validity and reliability of the Persian version of HIV/AIDS related stigma scale which was developed by Kang et al for people living with HIV/AIDS in Iran.Materials and methods: Thescale was forward translatedby two bilingual academic members then both translations were discussed by expert team. Back-translation was done by two other bilingual translators then we carried out discussion with both of them. To evaluate understandability the scale was administered to 10 Persons Living with HIV/AIDS (PLWHA. Final Persian version was administered to 80 PLWHA in Qom, Iran in 2014. Test–retest reliability was assessed in a sample of 20 PLWHA after a week by intra-class correlation coefficient (ICC.Results: Cronbach’s alpha coefficient for overall scale was 0.85. Also Cronbach’s alpha coefficients for the five subscales were as follows: social rejection (9 items, α = 0.84, negative self-worth (4 items, α = 0.70, perceived interpersonal insecurity (2 items, α = 0.57, financial insecurity (3 items, α = 0.70, discretionary disclosure (2 items, α = 0.83. Test–retest reliability was also approved with ICC = 0.78. Correlation between items and their hypothesized subscale is greater than 0.5. Correlation between an item and its own subscale was significantly higher than its correlation with other subscales.Conclusion: This study demonstrate that the Persian version of HIV/AIDS related stigma scale is valid and reliable to assess HIV/AIDS related stigma perceived by people living whit HIV/AIDS in Iran.

  17. HIV status disclosure and ARV adherence among patients attending ...

    African Journals Online (AJOL)

    HIV status disclosure and ARV adherence among patients attending Jomo Kenyatta University comprehensive care clinic. ... Failure to daily intake of Anti Retrovirals (ARV) not only prevents treatment failure but may also lead to viral development of resistance to the drugs. The fact that HIV is mainly sexually transmitted ...

  18. Internalized stigma and HIV status disclosure among HIV-positive black men who have sex with men

    OpenAIRE

    Overstreet, Nicole M.; Earnshaw, Valerie A.; Kalichman, Seth C.; Quinn, Diane M.

    2012-01-01

    Black men who have sex with men (BMSM) are severely affected by the HIV epidemic, yet research on the relationship between HIV stigma and status disclosure is relatively limited among this population. Within this epidemic, internalized HIV stigma, the extent to which people living with HIV/AIDS (PLWHA) endorse the negative beliefs associated with HIV as true of themselves, can negatively shape interpersonal outcomes and have important implications for psychological and physical health. In a s...

  19. Perception of orthodox health care centers among pregnant women attending traditional birth attendants clinics in two local government areas of Lagos State

    Directory of Open Access Journals (Sweden)

    A Okewole

    2013-01-01

    Full Text Available Background and Objective: Adequate antenatal care and skilled obstetric assistance during delivery are important strategies that significantly reduce maternal mortality and morbidity. This study aimed to assess the awareness, attitudes and perception of orthodox health care centres among pregnant women patronizing traditional birth attendants in Mushin and Lagos Island local government areas of Lagos state. Methods: The survey was a community-based descriptive cross-sectional survey that employed interviews to collect data from 300 antenatal care attendees of seven traditional birth attendants′ clinics in Lagos Island and Mushin local government areas between December 2010 and January 2011 using a structured questionnaire. Results: The women ranged in age from 17-43 years with a mean age of 27.6 ± 4.6 SD and most of them were primigravidas (41.5%, married (88% and traders (44.1%. Most of the women (61% and their husbands (56.7% had completed their secondary education. The majority (81.7% of respondents were aware of a modern health facility around where they lived, the most commonly known being private hospitals (43.7%. Most of them (67.3% were aware of antenatal care services provided at these facilities but only 31.3% had ever made use of the antenatal services. Most of the women were not willing to deliver in hospitals because they didn′t like the attitude of the health workers (37.3% and because it was far from their houses (12.7%; the majority (75% preferring to deliver with traditional birth attendants because they give good service. However, almost all (98.5% of the women that had children took them to the orthodox health facilities for immunization, primarily the primary health care centers (55.7%. Conclusion: Traditional birth attendants are patronized by a wide array of women who are aware of orthodox health facilities but have a negative attitude towards their services. Improvements in communication and interpersonal skills of

  20. Substance use and adherence among people living with HIV/AIDS receiving cART in Latin America

    Science.gov (United States)

    De Boni, Raquel B.; Shepherd, Bryan E.; Grinsztejn, Beatriz; Cesar, Carina; Cortés, Claudia; Padgett, Denis; Gotuzzo, Eduardo; Belaunzarán-Zamudio, Pablo F.; Rebeiro, Peter F.; Duda, Stephany N.; McGowan, Catherine C.

    2016-01-01

    This cross-sectional study describes substance use prevalence and its association with cART adherence among 3343 individuals receiving care at HIV clinics in Argentina, Brazil, Chile, Honduras, Mexico, and Peru. A rapid screening tool evaluated self-reported 7-day recall of alcohol, marijuana, cocaine, heroin, and methamphetamine use, and missed cART doses. Overall, 29.3% individuals reported having ≥ 1 alcoholic drinks, 5.0% reported any illicit drug use and 17.0% reported missed cART doses. In the logistic regression model, compared to no substance use, alcohol use (adjusted odds ratio (AOR)=2.46, 95% confidence interval (CI): 1.99–3.05), illicit drug use (AOR=3.57, 95% CI: 2.02–6.30), and using both alcohol and illicit drugs (AOR=4.98, 95% CI: 3.19–7.79) were associated with missed cART doses. The associations between substance use and likelihood of missing cART doses point to the need of targeting alcohol and illicit drug use to improve adherence among people living with HIV in Latin America. PMID:27091028

  1. Felt stigma and self-esteem among psychiatric hospital outdoor and community camp attending patients

    Directory of Open Access Journals (Sweden)

    Shantna Kumari

    2014-01-01

    Full Text Available Background: Self-stigma of people with mental illness is a major obstacle to recovery, limiting opportunities and undermining self-esteem. Aim: The aim of this study is to compare felt stigma and self-esteem in psychiatric patients receiving treatment from hospital outdoor clinic or from Community Outreach Program (COP. Materials and Methods: This cross-sectional study was conducted on psychiatric patients who were on outpatient treatment for at least 6 months, but had never been hospitalized. The study sample included 130 patients receiving outdoor treatment from a Psychiatric Hospital and a matched group of 140 patients receiving treatment from COP of the same hospital. Demographic and clinical details of the patients were recorded on a specially designed proforma. Modified felt stigma scale and Rosenberg self-esteem scale were used to assess stigma and self-esteem, respectively. Results: On the modified felt stigma scale, the mean (±standard deviation [SD] score of psychiatric hospital outpatients (31.89 ± 6.51 was significantly higher than the scores of patients attending COP (29.20 ± 6.80. On Rosenberg self-esteem scale, mean (±SD scores of patients with psychosis (17.98 ± 1.69 was significantly lower compared to scores of patients with epilepsy (21.83 ± 1.60. There was no significant correlation between stigma and self-esteem. Conclusion: As psychiatric hospital outpatients have significantly more self-stigma when compared to patients attending community outreach camps, the availability of more community outreach camps along with educating people about psychiatric illnesses may help in lowering stigma of psychiatric disorders.

  2. Perspectives Regarding Adherence to Prescribed Treatment in Highly Adherent HIV-Infected Gay Men.

    Science.gov (United States)

    Brion, John M; Menke, Edna M

    2008-01-01

    Focus group methodology was used to describe the medication adherence experience of 24 HIV-infected gay men who reported being adherent to their medication regimens. A conceptualization of medication adherence as an evolving process consisted of challenges to adherence (learning the diagnosis, starting the medications, struggling with the medications, dealing with side effects, coping with stigma) as well as those factors supportive of adherence (believing in medications, finding motivating factors, using reminders, depending on others, owning the disease). Themes associated with challenges to adherence focused on diagnosis and the physical and emotional adjustments individuals made to incorporate antiretroviral medications into their daily lives and move toward medication adherence. The factors supportive of adherence were related to the ongoing behaviors identified with establishing and maintaining adherence behaviors. What can be taken from the study is that adherence is a complex and dynamic process rather than a static behavior.

  3. Attitudes toward people with HIV/AIDS among medical practitioners and nonmedical specialists in Ukraine

    Directory of Open Access Journals (Sweden)

    Zhabenko, Nataliya

    2012-07-01

    Full Text Available INTRODUCTION: AIDS is the disease that has been stigmatized since its development; stigmatization of people living with HIV is an important barrier to using HIV testing and treatment. It is well known, that stigma is associated with mental disorders including depression and anxiety. Ukraine is a country with one of the highest number of annual HIV infection cases. GOALS: The goal of this study was to evaluate medical practitioners’ (surgeons, psychiatrists, therapists and students and nonmedical specialists’ attitude toward people with HIV/AIDS.METHODS: A total of 180 individuals participated in the study. Acceptance of people who have AIDS or are infected with HIV was assessed with the help of the “Attitudes toward people with HIV or AIDS”. Total scores range from 50 to 10, higher scores indicate high acceptance of persons with HIV/AIDS.RESULTS: Younger participants reported higher acceptance of persons with HIV or AIDS (p.05. Medical practitioners showed greater total score, compare to nonmedical specialists (38.0 ± 6.0 vs. 34.0 ± 5.5, respectively, p<.05. A one-way between-groups analysis of variance was conducted to explore the impact of medical specialty on levels of positive attitudes toward people with HIV or AIDS. The actual difference in mean scores between the 4 groups was moderate (.06. Students and psychiatrists reported more positive attitudes (higher acceptance toward people with HIV and AIDS, but analyses showed, that there was not a statistically significant difference at the level in total score for the groups.CONCLUSION: In this study we evaluated the level of attitudes toward people with HIV or AIDS in Ukraine. Young age and medical education were significantly associated with the positive attitudes toward people with HIV and AIDS. Our findings are important for the programs reducing the stigma and discrimination that should be addressed to the wide layers of the society.

  4. Healing of the haemorrhaging woman as a model for checkmating stigma of people living with HIV

    Directory of Open Access Journals (Sweden)

    Ruth O. Oke

    2017-01-01

    Full Text Available Diseases in human history are not just originating as a hit out of space. Some theologians contend that they must have originated with the human race. Apparently, it is inferred that they have come as a result of human disobedience to God in the Garden of Eden, or as a means of expression of his wrath. Other biblical perspectives ascribe disease to the work of the adversary or the Devil (Job 2:7, jealousy from others (Job 5:2 and self-indulgence (1 Sm 15:1�17, 16:14�15; 23, 1 Cor 10:1ff.. Stigmatisation of people with haemorrhaging condition (the issues of blood in the biblical accounts of the old Jewish society compares well with stigmatisation of people living with HIV (PLH in the current dispensation. It is needful to ask whether stigmatisation, discrimination and exclusion of the sick are a recent phenomenon. Landman observes that people with communicable diseases were separated from the rest of the congregation in the Old Testament dispensation. However, in the New Testament, a more charitable standpoint was anticipated because of the revolutionary stance of Jesus Christ in the Gospels. During his ministry, Jesus regarded the outcasts as integral members of the Jewish community. He in fact associated with and touched those who had dreadful diseases like leprosy (Mk 1:40�43, 2:1ff., Jn 8:1�9. Stigmatisation is associated with HIV in Nigeria and all over the world. However, the model of interaction set by Jesus with the Woman with the Issue of Blood in Mark�s narrative in the Gospel proposed a charitable standpoint which if adopted by the Nigerian society will go a long way in stemming the stigma associated with HIV. It is anticipated that these biblical indices will facilitate reduction, if not the eradication of stigma in the society. The text under study will be contextualised.Intradisciplinary and/or interdisciplinary implications: In this article, the African reading of the Bible is brought to the fore using a liberating

  5. East African Journal of Public Health - Vol 8, No 4 (2011)

    African Journals Online (AJOL)

    Some Factors Associated with Non – Adherence to Antiretroviral Therapy (ART) in People Living with HIV/AIDS (PLHA) in Tanzania: A Case Study of Dar es Salaam ... A study on job satisfaction among clinical and non-clinical hospital staff in a teaching hospital in Lagos, Nigeria · EMAIL FULL TEXT EMAIL FULL TEXT

  6. Mechanism of Change in Cognitive Behavioral Therapy for Body Image and Self-Care on ART Adherence Among Sexual Minority Men Living with HIV.

    Science.gov (United States)

    Lamb, Kalina M; Nogg, Kelsey A; Safren, Steven A; Blashill, Aaron J

    2018-05-11

    Body image disturbance is a common problem reported among sexual minority men living with HIV, and is associated with poor antiretroviral therapy (ART) adherence. Recently, a novel integrated intervention (cognitive behavioral therapy for body image and self-care; CBT-BISC) was developed and pilot tested to simultaneously improve body image and ART adherence in this population. Although CBT-BISC has demonstrated preliminary efficacy in improving ART adherence, the mechanisms of change are unknown. Utilizing data from a two-armed randomized controlled trial (N = 44 sexual minority men living with HIV), comparing CBT-BISC to an enhanced treatment as usual (ETAU) condition, sequential process mediation via latent difference scores was assessed, with changes in body image disturbance entered as the mechanism between treatment condition and changes in ART adherence. Participants assigned to CBT-BISC reported statistically significant reductions in body image disturbance post-intervention, which subsequently predicted changes in ART adherence from post-intervention to long term follow-up (b = 20.01, SE = 9.11, t = 2.19, p = 0.028). One pathway in which CBT-BISC positively impacts ART adherence is through reductions in body image disturbance. Body image disturbance represents one, of likely several, mechanism that prospectively predicts ART adherence among sexual minority men living with HIV.

  7. HIV Stigma Mediates the Association Between Social Cohesion and Consistent Condom Use Among Female Sex Workers Living with HIV in the Dominican Republic.

    Science.gov (United States)

    Carrasco, Maria Augusta; Nguyen, Trang Q; Barrington, Clare; Perez, Martha; Donastorg, Yeycy; Kerrigan, Deanna

    2018-07-01

    Evidence indicates that social cohesion is a successful strategy to improve consistent condom use (CCU) among female sex workers. However, the individual and layered or combined effect that various types of overlapping stigmas may have on CCU between female sex workers living with HIV and their clients and steady partners has not been analyzed. Drawing on the Abriendo Puertas cohort of female sex workers living with HIV in the Dominican Republic, we used structural equation modeling to test the hypothesis that both HIV stigma and sex work stigma mediate the association between social cohesion and CCU and that they have a layered effect. The results indicated that HIV stigma mediated the association between social cohesion and CCU with clients and partners, while sex work-related stigma did not. There was no evidence of a layered HIV stigma and sex work stigma effect, which may be due to methodological limitations to handle highly correlated latent variables. Findings highlight the need to address internalized HIV stigma within the context of community-based approaches to enhance their HIV prevention impact. This will help to reduce the risk of HIV re-infection with a new distinct HIV viral strain, STI infection, and onward HIV transmission among female sex workers living with HIV.

  8. The impact of exposure to mass media campaigns and social support on levels and trends of HIV-related stigma and discrimination in Nigeria: tools for enhancing effective HIV prevention programmes.

    Science.gov (United States)

    Fakolade, R; Adebayo, S B; Anyanti, J; Ankomah, A

    2010-05-01

    People living with HIV and AIDS (PLWHAs) often face stigma and discrimination, especially in developing countries. HIV-related stigma is expressed through social ostracism, personal rejection, direct and indirect discrimination, and denial from families and friends. Consequently, it is associated with reduced adoption of preventive and care behaviours, including condom use, seeking for HIV test and care-seeking behaviour subsequent to diagnosis. Ignorance about the epidemiology of the disease on modes of transmission and prevention aggravates HIV-related stigma in Nigeria. Behaviour change communication activities through mass media have been shown to be an effective approach in improving people's knowledge about the disease. This paper monitors trends in the level of accepting attitudes towards PLWHAs in Nigeria between 2003 and 2007. It also evaluates the impact of exposure to mass media and social support on the levels of accepting attitudes towards PLWHAs. A significant and positive trend was evident between 2003 and 2007 (pmedia communications on HIV and AIDS issues and social support were significantly related to the reduced stigma and discrimination against PLWHAs (p<0.0001).

  9. Vestibular disorders among adults in a tertiary hospital in Lagos, Nigeria.

    Science.gov (United States)

    Somefun, O A; Giwa, O S; Bamgboye, B A; Okeke-Igbokwe, I Irene; Azeez, A A Abdul

    2010-10-01

    Dizziness is not an uncommon complaint in the Otolaryngological clinics among other symptoms. To a large number of practitioners, the treatment of dizziness remains the same irrespective of the etiology, i.e., anti-vertiginous drugs. The objective of this study was to document the evaluation, causes and treatment of vestibular disorders among our patients. The design includes descriptive prospective study conducted in the Oto-rhino-laryngology and Orthopedic Clinics of Lagos University Teaching Hospital, Lagos and Nigerian Army Audiological Centre, 68 Nigerian Army Reference Hospital, Yaba, Lagos, Nigeria. Adult patients referred to the audiology clinic for dizziness had detailed history obtained by using structured questionnaire. General physical and neuro-otological examinations were done. Clinical diagnoses were made on standardized criteria. The patients had hearing evaluation, videonystagmography (VNG) evaluation using infrared videonystagmography system. X-ray of the cervical spine and computerized tomogram scan of internal auditory meatus and brain when indicated were done. A total of 102 patients were seen with age range between 21 and 90 years. Thirty patients (29.4%) recorded average duration of episode of vertiginous attacks in seconds, 69 (67.6%) recorded within minutes to hours and 3 (2.9%) with no definite pattern. Clinical signs on neuro-otological examination were elicited on 39 (38.2%) of the patients while on VNG the vestibular subtest mainly caloric test was abnormal unilaterally and bilaterally in 47 (46.1%) while with the oculomotor subtests, smooth pursuit tests were abnormal in 5 (6.9%), saccade tests were abnormal in 8 (7.8%) and OPK were abnormal in 9 (8.8%). Peripheral vestibular disorders are common of which benign paroxysmal positional vertigo (BPPV) was seen in 29 (28.4%), Meniere's disease in 22 (21.6%), recurrent vestibulopathy in 20 (19.6%), cervical vertigo in 18 (17.6%), psychogenic vertigo in 2 (2%), vestibular schwannoma

  10. Episodic medication adherence in adolescents and young adults with perinatally acquired HIV: a within-participants approach.

    Science.gov (United States)

    Hawkins, Amy; Evangeli, Michael; Sturgeon, Kate; Le Prevost, Marthe; Judd, Ali

    2016-01-01

    Due to the success of antiretroviral (ART) medications, young people living with perinatally acquired HIV (PHIV+) are now surviving into adolescence and young adulthood. Understanding factors influencing ART non-adherence in this group is important in developing effective adherence interventions. Most studies of ART adherence in HIV-positive populations assess differences in adherence levels and adherence predictors between participants, over a period of time (global adherence). Many individuals living with HIV, however, including PHIV+ young people, take medication inconsistently. To investigate this pattern of adherence, a within-participants design, focussing on specific episodes of adherence and non-adherence, is suitable (episodic adherence). A within-participants design was used with 29 PHIV+ young people (17 female, median age 17 years, range 14-22 years), enrolled in the UK Adolescents and Adults Living with Perinatal HIV cohort study. Participants were eligible if they could identify one dose of medication taken and one dose they had missed in the previous two months. For each of the two episodes (one adherent, one non-adherent), behavioural factors (whom they were with, location, routine, day, reminders) and psychological factors at the time of the episode (information about medication, adherence motivation, perceived behavioural skills to adhere to medication - derived from the Information-Motivation-Behavioural Skills (IMB) Model - and affect) were assessed in a questionnaire. Non-adherence was significantly associated with weekend days (Friday to Sunday versus Monday to Thursday, p = .001), lack of routine (p = .004), and being out of the home (p = .003), but not with whom the young person was with or whether they were reminded to take medication. Non-adherence was associated with lower levels of behavioural skills (p ART, or ART motivation. The use of situationally specific strategies to enhance adherence in young people who take their

  11. HIV coping self-efficacy: a key to understanding stigma and HIV test acceptance among incarcerated men in Jamaica.

    Science.gov (United States)

    Andrinopoulos, Katherine; Kerrigan, Deanna; Figueroa, J Peter; Reese, Richard; Ellen, Jonathan M

    2010-03-01

    Although prisons have been noted as important venues for HIV testing, few studies have explored the factors within this context that may influence HIV test acceptance. Moreover, there is a dearth of research related to HIV and incarcerated populations in middle and low-income countries, where both the burden of HIV and the number of people incarcerated is higher compared to high-income countries. This study explores the relationship between HIV coping self-efficacy, HIV-related stigma, and HIV test acceptance in the largest prisons in Jamaica. A random sample of inmates (n=298) recruited from an HIV testing demonstration project were asked to complete a cross-sectional quantitative survey. Participants who reported high HIV coping self-efficacy (adjusted odds ratio (AOR) 1.86: 95% confidence interval CI 1.24-2.78, p-value=0.003), some perceived risk of HIV (AOR 2.51: 95% (CI) 1.57-4.01, p-value=0.000), and low HIV testing stigma (AOR 1.71: 95% CI 1.05-2.79, p-value=0.032) were more likely to test for HIV. Correlates of HIV coping self-efficacy included external and internal HIV stigma (AOR 1.28: 95% CI 1.25-1.32, p-value=0.000 and AOR 1.76: 95% CI 1.34-2.30, p-value=0.000, respectively), social support (AOR 2.09: 95% CI 1.19-3.68, p-value=0.010), and HIV knowledge (AOR 2.33: 95% CI 1.04-5.22, p-value=0.040). Policy and programs should focus on the interrelationships of these constructs to increase participation in HIV testing in prison.

  12. Acceptability of Mobile Phone Technology for Medication Adherence Interventions among HIV-Positive Patients at an Urban Clinic.

    Science.gov (United States)

    Miller, Christopher W T; Himelhoch, Seth

    2013-01-01

    Mobile phone technology is increasingly used to overcome traditional barriers limiting access to care. The goal of this study was to evaluate access and willingness to use smart and mobile phone technology for promoting adherence among people attending an urban HIV clinic. One hundred consecutive HIV-positive patients attending an urban HIV outpatient clinic were surveyed. The questionnaire evaluated access to and utilization of mobile phones and willingness to use them to enhance adherence to HIV medication. The survey also included the CASE adherence index as a measure of adherence. The average age was 46.4 (SD = 9.2). The majority of participants were males (63%), black (93%), and Hispanic (11.4%) and reported earning less than $10,000 per year (67.3%). Most identified themselves as being current smokers (57%). The vast majority reported currently taking HAART (83.5%). Approximately half of the participants reported some difficulty with adherence (CASE mobile phone. Among owners of mobile phones 47.4% reported currently owning more than one device. Over a quarter reported owning a smartphone. About 60% used their phones for texting and 1/3 used their phone to search the Internet. Nearly 70% reported that they would use a mobile device to help with HIV adherence. Those who reported being very likely or likely to use a mobile device to improve adherence were significantly more likely to use their phone daily (P = 0.03) and use their phone for text messages (P = 0.002). The vast majority of patients in an urban HIV clinic own mobile phones and would use them to enhance adherence interventions to HIV medication.

  13. Experiences of HIV stigma: the role of visible symptoms, HIV centrality and community attachment for people living with HIV.

    Science.gov (United States)

    Brener, Loren; Callander, Denton; Slavin, Sean; de Wit, John

    2013-01-01

    For many people living with HIV (PLHIV), disclosure or concealment of their HIV status may be under their personal control; however, for PLHIV with visible symptoms of their illness, disclosure may no longer be a choice. Previous research suggests that those with visible HIV symptoms have poorer mental and physical health than those without visible HIV symptoms. This study aimed to extend these findings and assess the role of perceived centrality of HIV in the lives of PLHIV as well as the role of attachment to an HIV-positive community in understanding the negative effects on health and well-being for PLHIV with visible HIV symptoms. Participants were 697 PLHIV who completed an online survey that assessed symptom visibility, HIV-status disclosure, perceived stigma, health and well-being, how central HIV was to identity and HIV community attachment. Results indicate that those with visible symptoms experienced more HIV-related stigma and had poorer outcomes on a range of psychological and mental health measures than those who were able to conceal their stigma. These effects remained after controlling for length of time since diagnosis, time on HIV treatment, perceived health satisfaction and age. PLHIV with visible symptoms also reported that HIV was more central to their identity and reported greater attachment to an HIV-positive community. Furthermore, findings suggest that while HIV centrality appears to increase the negative effects of having visible symptoms associated with HIV, greater community attachment seems to ameliorate these effects. This suggests the need for a nuanced understanding of the implications of visible HIV symptoms for PLHIV. The study also highlights the potential benefits of HIV-positive community attachment in buffering PLHIV from the negative effect of visible HIV symptoms on their health and well-being.

  14. Personality dimensions, positive emotions and coping strategies in the caregivers of people living with HIV in Lahore, Pakistan.

    Science.gov (United States)

    Ashraf, Mujeeba; Sitwat, Aisha

    2016-08-01

    The aim of this research was to study the relationship between personality dimensions, positive emotions and coping mechanisms of caregivers of patients living with HIV. This study used a cross-sectional research design. A sample comprising 56 caregivers was recruited from HIV/AIDS clinics in three teaching hospitals in Lahore, Pakistan. Data were collected between February and July 2010. Most caregivers were men, and of low socio-economic status. Individuals with both high and low extraversion used problem-focused coping, self-control and accepting responsibility, but those with low extraversion used more escape-avoidance coping, and they had also high levels of negative emotions. Those high in neuroticism used more tension-reduction coping than problem-focused coping, and experienced fewer positive emotions. Regression analysis findings revealed neuroticism as a significant predictor of negative emotions as well as emotion-focused coping, and only extraversion significantly predicted negative emotions. This research could help in devising psychological management plans for caregivers of patients living with HIV in order to assist them in coping with the burden of care. © 2016 John Wiley & Sons Australia, Ltd.

  15. Social-cultural factors of HIV-related stigma among the Chinese general population in Hong Kong.

    Science.gov (United States)

    Yeo, Tien Ee Dominic; Chu, Tsz Hang

    2017-10-01

    HIV-related stigma in the wider community compounds the suffering of people living with HIV (PLWH) and hampers effective HIV prevention and care. This study examines the level of public stigma toward PLWH in Hong Kong and associated social-cultural factors. A telephone survey was conducted in June-July 2016 with 1080 Chinese adults aged 18-94 randomly selected from the general population. The results indicate substantial degree of public stigma toward PLWH. Overall, 58.1% of the participants endorsed at least one statement indicating negative social judgment of PLWH. Over 40% attributed HIV infections to irresponsible behaviors and nearly 30% perceived most PLWH as promiscuous. About 20% considered HIV to be a punishment for bad behavior and believed that PLWH should feel ashamed of themselves. These statistics indicate that HIV-related stigma among the general Hong Kong population had no noticeable reduction in a decade but is lower than that among rural and urban populations in China. Our findings suggest that the lower stigma in Hong Kong may be linked to higher education levels rather than Hongkongers' more Westernized outlook. The results of a multiple regression analysis showed that education level (β = -.19), homophobia (β = .30), and conformity to norms (β = .14) were independent predictors of HIV-related stigma but not age, income, or cultural orientations. By differentiating between associated social-cultural factors, this study provides a more nuanced understanding of the layered nature of HIV-related stigma: not broadly grounded in religion or Chinese culture but stemming from more specific social-cultural beliefs - perceptions of norm violation and negative attitudes toward homosexuality, which were not mutually exclusive. These findings have implications for HIV-related stigma reduction by providing evidence for the importance of addressing homophobia. Existing HIV publicity activities should be re-examined for inadvertent contribution

  16. Re-Validation of the Van Rie HIV/AIDS-Related Stigma Scale for Use with People Living with HIV in the United States

    Science.gov (United States)

    Kipp, Aaron M.; Audet, Carolyn M.; Earnshaw, Valerie A.; Owens, Jared; McGowan, Catherine C.; Wallston, Kenneth A.

    2015-01-01

    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

  17. Examining the relationship between psychological distress and adherence to anti-retroviral therapy among Ugandan adolescents living with HIV.

    Science.gov (United States)

    Mutumba, Massy; Musiime, Victor; Lepkwoski, James M; Harper, Gary W; Snow, Rachel C; Resnicow, Ken; Bauermeister, Jose A

    2016-07-01

    Psychological distress is common among adolescents living with HIV (ALHIV) worldwide, and has been associated with non-adherence to anti-retroviral therapy (ART), leading to poor virologic suppression, drug resistance, and increased risk for AIDS morbidity and mortality. However, only a few studies have explored the relationship between psychological distress and ART adherence among adolescents in sub-Saharan Africa. The paper examines the relationship between psychological distress and ART adherence, and effect of psychosocial resources on ART adherence. We conducted a cross-sectional survey of 464 ALHIV (aged 12-19; 53% female) seeking HIV care at a large HIV treatment center in Kampala, Uganda. ALHIV were recruited during routine clinic visits. Three self-reported binary adherence measures were utilized: missed pills in the past three days, non-adherence to the prescribed medical regimen, and self-rated adherence assessed using a visual analog scale. Psychological distress was measured as a continuous variable, and computed as the mean score on a locally developed and validated 25-item symptom checklist for Ugandan ALHIV. Psychosocial resources included spirituality, religiosity, optimism, social support, and coping strategies. After adjusting for respondents' socio-demographic characteristics and psychosocial resources, a unit increase in psychological distress was associated with increased odds of missing pills in past 3 days (Odds Ratio(OR) = 1.75; Confidence Interval (CI): 1.04-2.95), not following the prescribed regimen (OR = 1.63; CI: 1.08-2.46), and lower self-rated adherence (OR = 1.79; CI: 1.19-2.69). Psychosocial resources were associated with lower odds for non-adherence on all three self-report measures. There is a need to strengthen the psychosocial aspects of adolescent HIV care by developing interventions to identify and prevent psychological distress among Ugandan ALHIV.

  18. HIV Futures 8: Protocol for a Repeated Cross-sectional and Longitudinal Survey of People Living with HIV in Australia

    OpenAIRE

    Power, Jennifer; Brown, Graham; Lyons, Anthony; Thorpe, Rachel; Dowsett, Gary W.; Lucke, Jayne

    2017-01-01

    Introduction More than 27,000 Australians currently live with HIV. Most of these people have access to quality clinical care and antiretroviral treatment (ART) and can expect good general health. However, HIV-related stigma is a problem and many people living with HIV experience poorer than average mental health. Issues of aging are also of increasing concern. This paper describes the methods and sample for the HIV Futures 8 study, a national survey of people living with HIV in Australia that...

  19. Alcohol use and psychiatric morbidity in people living with HIV/AIDS ...

    African Journals Online (AJOL)

    Background: Concerns have been raised about the increasing use of alcohol among the people living with HIV/AID in Nigeria. A better understanding of the source and prevention of alcohol use in these people may serve as a useful strategy for reducing the burden associated with HIV/AIDS. Aims: This study assesses the ...

  20. Qualitative Comparison of Barriers to Antiretroviral Medication Adherence Among Perinatally and Behaviorally HIV-Infected Youth.

    Science.gov (United States)

    Fields, Errol L; Bogart, Laura M; Thurston, Idia B; Hu, Caroline H; Skeer, Margie R; Safren, Steven A; Mimiaga, Matthew J

    2017-07-01

    Medication adherence among youth living with HIV (28%-69%) is often insufficient for viral suppression. The psychosocial context of adherence barriers is complex. We sought to qualitatively understand adherence barriers among behaviorally infected and perinatally infected youth and develop an intervention specific to their needs. We conducted in-depth interviews with 30 youth living with HIV (aged 14-24 years) and analyzed transcripts using the constant comparative method. Barriers were influenced by clinical and psychosocial factors. Perinatally infected youth barriers included reactance, complicated regimens, HIV fatigue, and difficulty transitioning to autonomous care. Behaviorally infected youth barriers included HIV-related shame and difficulty initiating medication. Both groups reported low risk perception, medication as a reminder of HIV, and nondisclosure, but described different contexts to these common barriers. Common and unique barriers emerged for behaviorally infected and perinatally infected youth reflecting varying HIV experiences and psychosocial contexts. We developed a customizable intervention addressing identified barriers and their psychosocial antecedents.

  1. Hospital environment: Generator of stigma and rejection of pregnant women with HIV/aids

    Directory of Open Access Journals (Sweden)

    Yolanda Munévar-Torres

    2016-10-01

    Full Text Available Introduction: For the mothers included in this study, pregnancy is normal until they are diagnosed with HIV/AIDS. Studies on experiences in hospital environments are scarce. Objective: To understand the experiences of pregnant women living with HIV/AIDS during prenatal attention in two hospitals. Materials and methods: Interpretative phenomenological qualitative study, in which ten women, diagnosed with HIV during pregnancy and selected according to relevance and adequacy, participated. The sample size was established by theoretical saturation. Data were collected during in-depth interviews and analyzed through Colaizzi strategy. Results: Categorizing the hospital environment as a generator of stigma and rejection of pregnant women with HIV/AIDS is part of a research project on living with HIV/AIDS during pregnancy. The hospital environment shows the spaces and actors around these mothers during diagnosis and treatment of this infection. Participants refer to the first stage as “accidental diagnosis” and described attention as full of “reckless professionals”. Conclusions: Attitudes and behaviors of health professionals can generate a hostile environment for pregnant women with HIV/AIDS, heightening negative feelings, fears and uncertainties. However, they can also offer a friendly and human scenario that contributes to care and trust between professionals and pregnant women, thus helping mothers to cope with this complex experience.

  2. Identity, Physical Space, and Stigma Among African American Men Living with HIV in Chicago and Seattle.

    Science.gov (United States)

    Singleton, Judith L; Raunig, Manuela; Brunsteter, Halley; Desmond, Michelle; Rao, Deepa

    2015-12-01

    African American men have the highest rates of HIV in the USA, and research has shown that stigma, mistrust of health care, and other psychosocial factors interfere with optimal engagement in care with this population. In order to further understand reducing stigma and other psychosocial issues among African American men, we conducted qualitative interviews and focus groups with African American men in two metropolitan areas in the USA: Chicago and Seattle. We examined transcripts for relationships across variables of stigma, anonymity, self-identity, and space within the context of HIV. Our analysis pointed to similarities between experiences of stigma across the two cities and illustrated the relationships between space, isolation, and preferred anonymity related to living with HIV. The men in our study often preferred that their HIV-linked identities remain invisible and anonymous, associated with perceived and created isolation from physical community spaces. This article suggests that our health care and housing institutions may influence preferences for anonymity. We make recommendations in key areas to create safer spaces for African American men living with HIV and reduce feelings of stigma and isolation.

  3. FAMILY INTERACTION AND SOCIAL STIGMATIZATION OF PEOPLE LIVING WITH HIV AND AIDS IN PUERTO RICO.

    Science.gov (United States)

    Rivera-Díaz, Marinilda; Varas-Díaz, Nelson; Padilla, Mark; de Los Ángeles Vargas-Cancel, María; Serrano, Neisha

    2017-01-01

    This article aims to describe the manifestation of HIV stigma in the family context and how this could impact the life of people living with HIV (PLWH). The data derive from a larger phenomenological study addressing manifestations of stigma in the lives of PLWH when interacting with the health sector. Nine focus groups were carried out in 2011 with PLWH (N=67). Eight themes emerged from the qualitative analysis. For the purpose of this article, we focus on the categories related to family dynamics: the negotiation of disclosure and non-disclosure, fear of the HIV virus and family dynamics, and life as a couple. Socio demographic information showed that 53% were between 44 to 54 years old, 80% were single, 51% were male, 42% did not complete a high school diploma, 82% were unemployed. Also, 82% described themselves as religious persons and 41% had lived with HIV for 10 years or less. Qualitative results show stigma is still present in the family context. PLWH experience fear of disclosure, discrimination, avoid initiating families or couple relationships, experience physical and verbal abuse from relatives, and even separation from other family members. After more than 30 years of the ongoing HIV epidemic, stigma is still manifested by family members with detrimental social and medical implications for PLWH. Research and educational efforts should continue addressing manifestations of stigma among family members of PLWH.

  4. Factors associated with undernourishment among people 20 years old or over with HIV/AIDS, attending public health services in the São Paulo municipality, Brazil

    Directory of Open Access Journals (Sweden)

    Katia Cristina Bassichetto

    2014-12-01

    Full Text Available The study evaluated the nutritional status of 629 people living with HIV/AIDS attended at 12 specialized services of São Paulo's Municipal Health Department, Brazil. Data were obtained from medical records and through interviews during nutritional consultation. We used the classification criteria established by World Health Organization to assess malnourished individuals, a BMI < 18.5kg/m2. The prevalence of malnutrition in people with AIDS is 3.12 times that observed among people with HIV, and among people with co-infection it is 3.41 times that obtained among people without co-infection. This indicates how these conditions can harm the maintenance of the nutritional status, and shows that they demand a comprehensive understanding of the mechanisms involved in this phenomenon, as well as the development of strategies to improve the health care of individuals at nutritional risk.

  5. HIV stigma and social capital in women living with HIV

    OpenAIRE

    Cuca, Yvette P.; Asher, Alice; Okonsky, Jennifer; Kaihura, Alphoncina; Dawson-Rose, Carol; Webel, Allison

    2016-01-01

    Women living with HIV (WLWH) continue to experience HIV-related stigma. Social capital is one resource that could mitigate HIV stigma. Our cross-sectional study examined associations between social capital and HIV-related stigma in 135 WLWH in the San Francisco Bay Area. The mean age of study participants was 48 years; 60% were African American; 29% had less than a high school education; and 19% were employed. Age was significantly associated with perceived HIV stigma (p = .001), but total so...

  6. Anticipated stigma and quality of life among people living with chronic illnesses.

    Science.gov (United States)

    Earnshaw, Valerie A; Quinn, Diane M; Park, Crystal L

    2012-06-01

    We examined the process by which anticipated stigma relates to quality of life among people living with chronic illnesses. We hypothesized that stress, social support and patient satisfaction mediate the relationships between three sources of anticipated stigma and quality of life. Data were collected from adults living with chronic illnesses recruited from support groups and online communities, and were analysed with path analysis. Results demonstrated that stress mediated the relationships between anticipated stigma from friends and family, and work colleagues with quality of life; social support mediated the relationships between anticipated stigma from friends and family, and work colleagues with quality of life; and patient satisfaction mediated the relationship between anticipated stigma from healthcare providers with quality of life. The final path model fit the data well (χ (2) (8) = 8.66, p = 0.37; RMSEA = 0.02; CFI = 0.99; SRMR = 0.03), and accounted for 60% of the variance in participants' quality of life. This work highlights potential points of intervention to improve quality of life. It calls attention to the importance of differentiating between sources of anticipated stigma in clinical settings, interventions and research involving people living with chronic illnesses.

  7. Social context surrounding HIV diagnosis and construction of masculinity: a qualitative study of stigma experiences of heterosexual HIV positive men in southwest Nigeria

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    Titilayo Ainegbesua Okoror

    2016-06-01

    Full Text Available Abstract Background Though research has documented experiences of stigma and its effects on the lives of women living with HIV/AIDS, there is limited research on heterosexual positive HIV men experience of stigma in Nigeria. This study explored how social context surrounding HIV diagnosis impacts stigma experiences of heterosexual HIV positive men and their construction of masculinity in southwest Nigeria. Methods Using purposive sampling, 17 heterosexual HIV positive men were recruited through community based organization to participate in two hours focus group discussions or 45 min in-depth interviews that were audio-recorded. Without using the word stigma, discussions and interviews were guided by four questions that explored participants’ experiences of living with HIV/AIDS. Interviews and discussions were conducted in three languages: English, Yoruba and Pidgin English. Thematic data analysis approach was in coding transcribed data, while social constructivist thinking guided data analysis. Results Participants ranged in age from 30 to 57 years old, and all were receiving antiretroviral therapy. Findings indicated that participants’ experiences of stigma might be moderated by the social context surrounding their HIV diagnosis, and whether they have met the socio-cultural construction of masculinity. Participants whose diagnosis were preceded by immediate family members’ diagnosis were less likely to report experiencing HIV stigma and more likely to report “not feeling less than a man” and educating others about HIV/AIDS. Contrarily, participants whose diagnosis was preceded by their own sickness were more likely to report isolation, sigma and feeling of being less than a man. All participants reported limiting their sexual intimacy, and those with children reported adjusting how they performed their role as fathers. Conclusions Social context surrounding HIV diagnosis impact how heterosexual HIV positive men experience HIV

  8. Social context surrounding HIV diagnosis and construction of masculinity: a qualitative study of stigma experiences of heterosexual HIV positive men in southwest Nigeria.

    Science.gov (United States)

    Okoror, Titilayo Ainegbesua; Falade, Catherine Olufunke; Walker, Ebunlomo Mary; Olorunlana, Adetayo; Anaele, Agaptus

    2016-06-13

    Though research has documented experiences of stigma and its effects on the lives of women living with HIV/AIDS, there is limited research on heterosexual positive HIV men experience of stigma in Nigeria. This study explored how social context surrounding HIV diagnosis impacts stigma experiences of heterosexual HIV positive men and their construction of masculinity in southwest Nigeria. Using purposive sampling, 17 heterosexual HIV positive men were recruited through community based organization to participate in two hours focus group discussions or 45 min in-depth interviews that were audio-recorded. Without using the word stigma, discussions and interviews were guided by four questions that explored participants' experiences of living with HIV/AIDS. Interviews and discussions were conducted in three languages: English, Yoruba and Pidgin English. Thematic data analysis approach was in coding transcribed data, while social constructivist thinking guided data analysis. Participants ranged in age from 30 to 57 years old, and all were receiving antiretroviral therapy. Findings indicated that participants' experiences of stigma might be moderated by the social context surrounding their HIV diagnosis, and whether they have met the socio-cultural construction of masculinity. Participants whose diagnosis were preceded by immediate family members' diagnosis were less likely to report experiencing HIV stigma and more likely to report "not feeling less than a man" and educating others about HIV/AIDS. Contrarily, participants whose diagnosis was preceded by their own sickness were more likely to report isolation, sigma and feeling of being less than a man. All participants reported limiting their sexual intimacy, and those with children reported adjusting how they performed their role as fathers. Social context surrounding HIV diagnosis impact how heterosexual HIV positive men experience HIV related stigma and how they perceive themselves as men, which may influence their

  9. Factors Influencing Patronage Of Medical Tourism In Metropolitan Lagos Nigeria

    Directory of Open Access Journals (Sweden)

    Omisore

    2015-08-01

    Full Text Available Since medical tourism attract patient from various origin to seek medical services at different destinations it is paramount to consider the factors that motivate patrons decision on medical tourism. Hence this study assesses the factors influencing patronage of medical tourism in Lagos metropolis Nigeria. Lagos State is situated in the southwestern corner of Nigeria it lies within Latitudes 62N to 64N of the Equator and Longitudes 245E to 420E of the Greenwich meridian. Metropolitan Lagos is a statistical division and not an administrative unit it extends over 16 of the 20 LGAs of Lagos State it contains 88 of the population of Lagos State and includes semi-rural areas. Data were collected from primary source. Primary data collection was carried out through the use of structured questionnaire. Systematic sampling technique was employed to select 15 specialized private hospitals and 14 Public hospitals in the study area resulting to a sample size of 29 hospitals. Ten 10 patrons were contacted in each of the selected hospitals consequently 290 patrons were sampled. The study revealed three factors influencing patronage of medical tourism in the study area to be service related economic and facilities. These were further established by factor analysis result which combine service related economic factor as factor one with 29.5 variance explained and Eigen value of 5.605 Facility factor as factor two with 28.6 variance explained and Eigen value of 5.435 Service related factor as factor three with 14.7 variance explained and Eigen value of 2.788 and Economic factor as factor four with 9.2 variance explained and Eigen value of 1.754. The relevant authority in charge of health facilities in the study area would have to employ adequate manpower in-terms of doctors and other healthcare personnel across the public hospital while also regulating the scale of charges of the registered private hospitals in the study area. There is need to improve upon the

  10. HIV stigma and social capital in women living with HIV

    Science.gov (United States)

    Cuca, Yvette P.; Asher, Alice; Okonsky, Jennifer; Kaihura, Alphoncina; Dawson-Rose, Carol; Webel, Allison

    2016-01-01

    Women living with HIV (WLWH) continue to experience HIV-related stigma. Social capital is one resource that could mitigate HIV stigma. Our cross-sectional study examined associations between social capital and HIV-related stigma in 135 WLWH in the San Francisco Bay Area. The mean age of study participants was 48 years; 60% were African American; 29% had less than a high school education; and 19% were employed. Age was significantly associated with perceived HIV stigma (p = .001), but total social capital was not. Women with lower Value of Life social capital scores had significantly higher total stigma scores (p = .010) and higher Negative Self-image stigma scores (p = .001). Women who felt less valued in their social worlds may have been more likely to perceive HIV stigma, which could have negative health consequences. This work begins to elucidate the possible relationships between social capital and perceived HIV stigma. PMID:27697368

  11. Living situation affects adherence to combination antiretroviral therapy in HIV-infected adolescents in Rwanda: a qualitative study.

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    Philippe R Mutwa

    Full Text Available INTRODUCTION: Adherence to combination antiretroviral therapy (cART is vital for HIV-infected adolescents for survival and quality of life. However, this age group faces many challenges to remain adherent. We used multiple data sources (role-play, focus group discussions (FGD, and in-depth interviews (IDI to better understand adherence barriers for Rwandan adolescents. Forty-two HIV positive adolescents (ages 12-21 and a selection of their primary caregivers were interviewed. All were perinatally-infected and received (cART for ≥ 12 months. Topics discussed during FGDs and IDIs included learning HIV status, disclosure and stigma, care and treatment issues, cART adherence barriers. RESULTS: Median age was 17 years, 45% female, 45% orphaned, and 48% in boarding schools. We identified three overarching but inter-related themes that appeared to influence adherence. Stigma, perceived and experienced, and inadvertent disclosure of HIV status hampered adolescents from obtaining and taking their drugs, attending clinic visits, carrying their cARTs with them in public. The second major theme was the need for better support, in particular for adolescents with different living situations, (orphanages, foster-care, and boarding schools. Lack of privacy to keep and take medication came out as major barrier for adolescents living in congested households, as well the institutionalization of boarding schools where privacy is almost non-existent. The third important theme was the desire to be 'normal' and not be recognized as an HIV-infected individual, and to have a normal life not perturbed by taking a regimen of medications or being forced to disclose where others would treat them differently. CONCLUSIONS: We propose better management of HIV-infected adolescents integrated into boarding school, orphanages, and foster care; training of school-faculty on how to support students and allow them privacy for taking their medications. To provide better care and

  12. Clinic Attendance for Medication Refills and Medication Adherence amongst an Antiretroviral Treatment Cohort in Uganda: A Prospective Study

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    Setor Kunutsor

    2010-01-01

    Full Text Available Background. Regular clinic attendance for antiretroviral (ARV drug refills is important for successful clinical outcomes in HIV management. Methods. Clinic attendance for ARV drug refills and medication adherence using a clinic-based pill count in 392 adult patients receiving antiretroviral therapy (ART in a district hospital in Uganda were prospectively monitored over a 28-week period. Results. Of the 2267 total scheduled clinic visits, 40 (1.8% were missed visits. Among the 392 clients, 361 (92% attended all appointments for their refills (regular attendance. Clinic attendance for refills was statistically significantly associated with medication adherence with regular attendant clients having about fourfold greater odds of achieving optimal (≥95% medication adherence [odds ratio (OR=3.89, 95% CI: 1.48 to 10.25, exact P=.013]. In multivariate analysis, clients in age category 35 years and below were less likely to achieve regular clinic attendance. Conclusion. Monitoring of clinic attendance may be an objective and effective measure and could be a useful adjunct to an adherence measure such as pill counting in resource-constrained settings. Where human resource constraints do not allow pill counts or other time-consuming measures, then monitoring clinic attendance and acting on missed appointments may be an effective proxy measure.

  13. Systematic procedures to promote U.S. HIV medication adherence via Photovoice.

    Science.gov (United States)

    Teti, Michelle; Shaffer, Victoria; Majee, Wilson; Farnan, Rose; Gerkovich, Mary

    2017-06-21

    Medication adherence is essential to promote the health of people living with HIV (PL-HIV) and prevent HIV transmission in the U.S. Novel medication health promotion interventions are needed that address patient-centeredness, understandability, and communication with providers. The aims of this article are to define the systematic stages we used to develop an effective health promotion intervention via the products (e.g. images and stories) of Photovoice. We designed an intervention to improve HIV adherence knowledge, attitudes, and communication with providers through Photovoice. 16 PL-HIV used Photovoice strategies to describe their experiences with medication via images and captions and create an intervention (10 adherence promotion posters) that integrated photo-stories of their adherence motivators, journeys from sickness to health, and how they manage and counter HIV stigma. We outline the systematic process we used to adapt Photovoice to create the effective intervention for replication. The process included six stages: (i) identify scope of the project; (ii) create collaborative project team; (iii) design project materials; (iv) review and revise materials with team members; (v) disseminate materials; and (vi) evaluate materials. Photovoice is used traditionally as a social action research method. In this project, it was adapted to create patient-driven images and stories for health promotion posters. Poster viewers experienced improved self-efficacy for HIV medication adherence. Describing the adaptation of the Photovoice process in a deliberate and transparent way can support fidelity to the essence of the participant-driven method, while also allowing researchers and practitioners to replicate Photovoice as a successful health promotion intervention. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  14. Determinants of adherence to antiretroviral drugs among people living with HIV/AIDS in the Ife-Ijesa zone of Osun state, Nigeria

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    Muhammed O. Afolabi

    2009-04-01

    Method: 120 subjects who received ARV drugs at a federal government-designated ART site located within the Obafemi Awolowo University Teaching Hospital complex, (OAUTHC, Ile-Ife, and a community-based non-governmental organisation, Living Hope Care (LIHOC, Ilesa, from February to May 2006 were serially recruited and studied. Relevant data were collected using an interviewer-administered, patient medication adherence questionnaire. Focus group discussions were also held among the subjects to further elicit qualitative information on factors influencing adherence to ART. Results: The age of participants ranged from 21 to 65 years with a mean age of 40.2 + 10.3 years. Participants had been on ARV drugs for a period ranging between three and 60 months. The overall adherence rate in the study population was 44%. 66% of participants who accessed ARV drugs from LIHOC, Ilesa, had good adherence while only 14% of participants who accessed ARV drugs from OAUTHC, Ile-Ife, had good adherence. Participants with good adherence did not pay funds for the preliminary ARV eligibility investigations and they were also offered regular adherence counselling. These facilities were barely available in the group with poor adherence. Demographic factors such as age, gender and marital status did not seem to have any significant association with adherence level (p > 0.05. Conclusion: The level of adherence was high in a cohort of PLWHA accessing ARV drugs in Ilesa while it was low among PLWHA receiving ART in Ife. The most important reasons for this difference were lack of funds for investigations and poor psycho-social counselling.

  15. Implementation and assessment of a prevention with positives intervention among people living with HIV at five hospitals in Thailand.

    Science.gov (United States)

    Baipluthong, Benjamas; Anekthananon, Thanomsak; Munsakul, Warangkana; Jirajariyavej, Supunnee; Asavapiriyanont, Suvanna; Hancharoenkit, Ubonsri; Roongpisuthipong, Anuvat; Pattanasin, Sarika; Martin, Michael; Guntamala, Lisa; Lolekha, Rangsima

    2017-01-01

    We implemented a hospital-based prevention with positives (PwP) intervention among people living with HIV (PLHIV) that included HIV transmission risk screening, short HIV prevention messages, family planning, HIV disclosure counseling, and partner HIV testing at five hospitals in Thailand. We assessed changes in sexual risk behaviors among PLHIV who received the PwP services at the hospitals. From January 2008-March 2009, we systematically selected a subset of PLHIV receiving care at the five hospitals to offer participation in the PwP intervention. We collected demographic, risk behavior, and laboratory data using a standardized questionnaire. We analyzed data from PLHIV who completed at least four visits, using generalized estimating equations to identify baseline participant characteristics that were associated with adopting sexual practices less likely to be associated with HIV transmission during follow-up. A total of 830 PLHIV were interviewed and 756 (91.1%) completed four visits. The median age of these 756 participants was 37 years, 400 (52.9%) were women, and 475 (62.8%) had a steady partner. At baseline, 353 (74.3%) of the steady partners had been tested for HIV and 132 (37.4%) had tested negative. Among the 756 PLHIV, 427 (56.5%) reported having sex in the 3 months before enrollment and 413 (54.6%) in the 3 months before the fourth visit. The proportion reporting having vaginal or anal sex without a condom decreased from 20.8% at baseline to 5.1% at the fourth visit (p<0.001). Factors associated (p<0.05) with abstinence or 100% condom use at follow-up visits included: completing ≥ two visits, being diagnosed with HIV for longer than 3 months, and receiving HIV prevention messages from a doctor (versus a nurse or counselor). Safe sex behaviors increased among PLHIV receiving PwP services, suggesting that expansion of hospital-based PwP services may reduce the number of new HIV infections in Thailand.

  16. Coping with stigma by association and family burden among family members of people with mental illness.

    Science.gov (United States)

    van der Sanden, Remko L M; Stutterheim, Sarah E; Pryor, John B; Kok, Gerjo; Bos, Arjan E R

    2014-10-01

    In this study, we explored stigma by association, family burden, and their impact on the family members of people with mental illness. We also studied the ways in which family members coped with these phenomena. We conducted semistructured interviews with 23 immediate family members of people with mental illness. Participants reported various experiences of stigma by association and family burden. Social exclusion, being blamed, not being taken seriously, time-consuming caregiving activities, and exhaustion appeared to be the predominant forms of stigma by association and family burden experienced by the participants. The participants used problem-focused and emotion-focused coping strategies, separately or simultaneously, to cope with the negative impact of stigma by association and family burden. The results suggest that family members should have access to services to address these problems. Social, instrumental, and emotional support should be given to family members by community members and mental health professionals.

  17. A Mobile Gaming Intervention to Increase Adherence to Antiretroviral Treatment for Youth Living With HIV: Development Guided by the Information, Motivation, and Behavioral Skills Model.

    Science.gov (United States)

    Whiteley, Laura; Brown, Larry; Lally, Michelle; Heck, Nicholas; van den Berg, Jacob J

    2018-04-23

    Highly active combination antiretroviral treatment has been shown to markedly improve the health of HIV-infected adolescents and young adults. Adherence to antiretroviral treatment leads to decreased morbidity and mortality and decreases the number of hospitalizations. However, these clinical achievements can only occur when young persons with HIV are adherent to care. Unfortunately, adolescents and young adults have poorer rates of adherence to antiretroviral medications and poorer rates of retention in care than older adults. Novel and engaging digital approaches are needed to help adolescents and young adults living with HIV be adherent to treatment. The aim of this study was to develop an immersive, action-oriented iPhone gaming intervention to improve adherence to antiretroviral medication and treatment. Game development was guided by social learning theory, taking into consideration the perspectives of adolescents and young adults living with HIV. A total of 20 adolescents and young adults were recruited from an HIV care clinic in Rhode Island, and they participated in qualitative interviews guided by the information-motivation-behavioral skills model of behavior change. The mean age of participants was 22 years, 60% (12/20) of the participants identified as male, and 60% (12/20) of the sample reported missing a dose of antiretroviral medication in the previous week. Acceptability of the game was assessed with client service questionnaire and session evaluation form. A number of themes emerged that informed game development. Adolescents and young adults living with HIV desired informational game content that included new and comprehensive details about HIV, details about HIV as it relates to doctors' visits, and general health information. Motivational themes that emerged were the desire for enhancement of future orientation; reinforcement of positive influences from partners, parents, and friends; collaboration with health care providers; decreasing stigma

  18. Factors Influencing Patronage Of Medical Tourism In Metropolitan Lagos Nigeria

    OpenAIRE

    Omisore; E.O.; Agbabiaka; H. I.

    2015-01-01

    Since medical tourism attract patient from various origin to seek medical services at different destinations it is paramount to consider the factors that motivate patrons decision on medical tourism. Hence this study assesses the factors influencing patronage of medical tourism in Lagos metropolis Nigeria. Lagos State is situated in the southwestern corner of Nigeria it lies within Latitudes 62N to 64N of the Equator and Longitudes 245E to 420E of the Greenwich meridian. Metropolitan Lagos is...

  19. A HIV stigma reduction intervention for people living with HIV and their families

    Directory of Open Access Journals (Sweden)

    Johanna B. Pretorius

    2016-10-01

    Aim: To explore and describe the experiences of PLWH and CFM during and after a community-based HIV stigma reduction intervention in both an urban and rural setting in the North-West. Method: A qualitative description approach through in-depth interviews was used in both settings. Purposive sampling was used for the PLWH and snowball sampling for the CFM. Data was analysed using open coding. Results: Both urban and rural groups gained a richer understanding of HIV stigma and how to cope with it. The relationships were enriched by PLWH feeling more supported and CFM realising how they stigmatised PLWH and that they should be more supportive. Leadership was activated in PLWH and CFM through the stigma reduction project that they participated in. Conclusion: No significant differences were found between rural and urban communities, thus the intervention can be implemented with similar results in both settings. The intervention showed positive outcomes for both PLWH and CFM. Bringing PLWH and CFM together during an intervention in an equalised relationship proved to be useful as PLWH felt more supported and CFM showed much more compassion towards PLWH after the intervention.

  20. HIV in Harare: the role and relevance of social stigma.

    Science.gov (United States)

    O'Brien, Stephen; Broom, Alex

    2014-01-01

    HIV is a significant social, political and economic problem in Zimbabwe. However, few researchers have explored peoples' experiences of living with HIV in that country. Drawing on 60 qualitative interviews conducted with Zimbabweans living in Harare in 2010, this paper focuses on how people from four different urban communities cope with HIV-related social stigma. To provide theoretical context to this issue, we utilised the ideas of Erving Goffman for exploring the individual experience of stigma and the concept of structural violence to understand stigma as a social phenomenon. This paper considers the relevance and role of stigma in the context of a country undergoing significant social, political and economic crisis. We investigated the strategies adopted by the Zimbabwean state and the influence of traditional and religious interpretations to appreciate the historical roots of HIV-related stigma. We took into account the ways in which the articulation of HIV with gender has caused women to experience stigma differently than men, and more intensely, and how grassroots activism and biomedical technologies have transformed the experience of stigma.

  1. Engagement with Health Care Providers Affects Self- Efficacy, Self-Esteem, Medication Adherence and Quality of Life in People Living with HIV.

    Science.gov (United States)

    Chen, Wei-Ti; Wantland, Dean; Reid, Paula; Corless, Inge B; Eller, Lucille S; Iipinge, Scholastika; Holzemer, William L; Nokes, Kathleen; Sefcik, Elizbeth; Rivero-Mendez, Marta; Voss, Joachim; Nicholas, Patrice; Phillips, J Craig; Brion, John M; Rose, Caro Dawson; Portillo, Carmen J; Kirksey, Kenn; Sullivan, Kathleen M; Johnson, Mallory O; Tyer-Viola, Lynda; Webel, Allison R

    2013-11-01

    The engagement of patients with their health care providers (HCP) improves patients' quality of life (QOL), adherence to antiretroviral therapy, and life satisfaction. Engagement with HCP includes access to HCP as needed, information sharing, involvement of client in decision making and self-care activities, respect and support of the HCP for the client's choices, and management of client concerns. This study compares country-level differences in patients' engagement with HCP and assesses statistical associations relative to adherence rates, self-efficacy, self-esteem, QOL, and symptom self-reporting by people living with HIV (PLHIV). A convenience sample of 2,182 PLHIV was enrolled in the United States, Canada, Puerto Rico, Namibia, and China. Cross-sectional data were collected between September 2009 and January 2011. Inclusion criteria were being at least 18 years of age, diagnosed with HIV, able to provide informed consent, and able to communicate in the local language with site researchers. In the HCP scale, a low score indicated greater provider engagement. Country comparisons showed that PLHIV in Namibia had the most HCP engagement (OR 2.80, p Western countries. Individuals having better HCP engagement showed better self-efficacy for adherence (t = -5.22, p < 0.0001), missed fewer medication doses (t = 1.92, p ≤ 0.05), had lower self-esteem ratings (t = 2.67, p < 0.01), fewer self-reported symptoms (t = 3.25, p < 0.0001), and better overall QOL physical condition (t = -3.39, p < 0.001). This study suggests that promoting engagement with the HCP is necessary to facilitate skills that help PLHIV manage their HIV. To improve ART adherence, HCPs should work on strategies to enhance self-efficacy and self-esteem, therefore, exhibiting fewer HIV-related symptoms and missing less medication doses to achieve better QOL.

  2. Factors Associated with Pregnant Women’s Anticipations and Experiences of HIV-related Stigma in Rural Kenya

    Science.gov (United States)

    Cuca, Yvette P.; Onono, Maricianah; Bukusi, Elizabeth; Turan, Janet M.

    2012-01-01

    Pregnant women who fear or experience HIV-related stigma may not get care for their own health or medications to reduce perinatal transmission of HIV. This study examined factors associated with anticipating and experiencing HIV-related stigma among 1,777 pregnant women attending antenatal care clinics in rural Kenya. Women were interviewed at baseline, offered HIV testing and care, and a sub-set was re-interviewed at 4–8 weeks postpartum. Women who were older, had less education, whose husbands had other wives, and who perceived community discrimination against people with HIV had significantly greater adjusted odds of anticipating HIV stigma. Over half of the HIV-positive women interviewed postpartum reported having experienced stigma, much of which was self-stigma. Women experiencing minor depression, and those whose family knew of their HIV status had significantly greater adjusted odds of experiencing stigma. Lack of women’s empowerment, as well as depression, may be important risk factors for HIV-related stigma and discrimination. PMID:22799618

  3. Socio-demographic characteristics and challenges experienced by disabled patients living with HIV/AIDS in a tertiary hospital in Ibadan, Nigeria.

    Science.gov (United States)

    Olowookere, S A; Adewole, I F

    2012-09-01

    HIV/AIDS is highly prevalent in sub-Saharan Africa and few studies had looked at physically and mentally challenged people living with HIV/AIDS (PLHIV) in this environment. This study aimed to describe the socio-demographic characteristics and challenges faced by these patients attending University College Hospital, Ibadan. A descriptive cross-sectional study design was done. A semi-structured interviewer administered questionnaire was administered to consecutive disabled PLHIV over a period of six months. Data obtained were analyzed using descriptive and inferential statistics. A total of ninety-nine patients were seen during the study period. The mean age of these patients was 39.9 +/- 9.4 years (range 23-60 years). There were 30 (30.3%) males and 69 (69.7%) females. Twenty-four percent had no formal education while 12% had tertiary education. All respondents had suffered stigmatization/discrimination while most were poor. Eighty-seven percent had AIDS at presentation. Musculoskeletal impairments (46.5%), hearing loss (16.2%) and visual impairment (31.3%) were the commonest disability. Over twenty-three percent had prior history of road traffic accident as the cause of disability. Physically and mentally challenged people living with HIV/AIDS are poor and highly stigmatized. They require special assistance to cope and need economic empowerment to reduce their poverty level.

  4. A study on job satisfaction among clinical and non-clinical hospital staff in a teaching hospital in Lagos, Nigeria.

    Science.gov (United States)

    Coker, O O; Coker, A O; Onuoha, B

    2011-12-01

    Previous studies had demonstrated that continuous and effective productivity of hospital staff are linked to job satisfaction and only those who are satisfied with their job can be maximally effective and productive. This cross-sectional descriptive survey was designed to determine the levels of job satisfaction among various groups of health care professionals working in a teaching hospital in Lagos, Nigeria. Two hundred clinical and non-clinical hospital staff were invited to take part in the study. They completed a sociodemographic questionnaire and the Job Descriptive Index (JDI). The results indicated that majority clinical and non-clinical staff were satisfied with their jobs as regards the parameters of the JDI compared with those not satisfied with their jobs. The government and health policy makers should continue to pay attention to boost job morale and satisfaction of medical health workers to continue to make them to be satisfied with their job.

  5. Stigma and social participation in Southern India: differences and commonalities among persons affected by leprosy and persons living with HIV/AIDS.

    Science.gov (United States)

    Stevelink, S A M; van Brakel, W H; Augustine, V

    2011-12-01

    Stigma is a common phenomenon worldwide and infectious diseases like HIV/AIDS and leprosy are often associated with high levels of stigma. Several studies have been conducted concerning the effects of stigma and the impact on social participation, but comparative studies are rare. The objective of this study was to identify differences and similarities between HIV/AIDS and leprosy-related stigma. From April till July 2009, 190 questionnaire-based interviews were conducted to assess the levels of internalized stigma (Internalized Stigma of Mental Illness scale), perceived stigma (Explanatory Model Interview Catalogue stigma scale) and social participation (Participation scale) in a cross-sectional sample of people affected by leprosy (PL) and people living with HIV/AIDS (PLHA). Respondents were selected from several hospitals, charity projects and during home visits in Vellore district, Tamil Nadu. Our results showed that both PLHA (n = 95) and leprosy-affected respondents (n = 95) faced a substantial burden of internalized and perceived stigma, with the former reporting a significantly higher level of stigma. As a result, PLHA faced more frequent and also more severe participation restrictions than PL. Especially, restrictions in work-related areas were reported by the majority of the respondents. In conclusion, PLHA faced a significantly higher level of stigma and participation restriction than PL. However, the latter also reported a substantial burden of stigma and participation restrictions. The study suggests that it may be possible to develop joint interventions based on the commonalities found. More research is needed to define these more precisely and to test the effectiveness of such joint interventions in reducing stigma and improving social participation.

  6. HIV Stigma and Social Capital in Women Living With HIV.

    Science.gov (United States)

    Cuca, Yvette P; Asher, Alice; Okonsky, Jennifer; Kaihura, Alphoncina; Dawson-Rose, Carol; Webel, Allison

    Women living with HIV (WLWH) continue to experience HIV-related stigma. Social capital is one resource that could mitigate HIV stigma. Our cross-sectional study examined associations between social capital and HIV-related stigma in 135 WLWH in the San Francisco Bay Area. The mean age of study participants was 48 years; 60% were African American; 29% had less than a high school education; and 19% were employed. Age was significantly associated with perceived HIV stigma (p = .001), but total social capital was not. Women with lower Value of Life social capital scores had significantly higher total stigma scores (p = .010) and higher Negative Self-image stigma scores (p = .001). Women who felt less valued in their social worlds may have been more likely to perceive HIV stigma, which could have negative health consequences. This work begins to elucidate the possible relationships between social capital and perceived HIV stigma. Copyright © 2016 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

  7. "My House Is the Hospital": Housing and Health and Wellbeing among Persons Living with HIV/AIDS in Northern Malawi.

    Science.gov (United States)

    Mkandawire, Paul; Arku, Godwin; Atari, Odwa; Madut, Kon; Luginaah, Isaac; Dixon, Jenna

    2015-11-01

    This paper reports findings of a qualitative study and draws on the political ecology of health framework to examine the links between housing and health among people living with HIV/AIDS (PLWAs) in Northern Malawi in a wider context in which the epidemic has overburdened the country's hospitals, thereby transferring the responsibility for care from government to families. The findings suggest that poor housing conditions, rooted in colonial and postcolonial policy failure, may undermine the amount, as well as the quality, of palliative care available to PLWAs. It was also found that the high cost of renting, discrimination, and poor landlord-tenant relationships imposed significant financial and emotional burden on PLWAs, thereby undermining their ability to meet dietary needs, stay healthy, and adhere to treatment. Furthermore, customary norms around property inheritance hampered women's housing security and their ability to cope with the disease. The paper concludes by making relevant policy recommendations.

  8. Perceived stigma and highly active antiretroviral treatment ...

    African Journals Online (AJOL)

    Perceived stigma and highly active antiretroviral treatment adherence among persons living with HIV/AIDS in the University of Port Harcourt Teaching Hospital. ... Data on socio-demographic characteristics, stigma and adherence to drug regimen were collected using a validated self-administered questionnaire. Data were ...

  9. HIV, gender, race, sexual orientation, and sex work: a qualitative study of intersectional stigma experienced by HIV-positive women in Ontario, Canada.

    Science.gov (United States)

    Logie, Carmen H; James, Llana; Tharao, Wangari; Loutfy, Mona R

    2011-11-01

    HIV infection rates are increasing among marginalized women in Ontario, Canada. HIV-related stigma, a principal factor contributing to the global HIV epidemic, interacts with structural inequities such as racism, sexism, and homophobia. The study objective was to explore experiences of stigma and coping strategies among HIV-positive women in Ontario, Canada. We conducted a community-based qualitative investigation using focus groups to understand experiences of stigma and discrimination and coping methods among HIV-positive women from marginalized communities. We conducted 15 focus groups with HIV-positive women in five cities across Ontario, Canada. Data were analyzed using thematic analysis to enhance understanding of the lived experiences of diverse HIV-positive women. Focus group participants (n = 104; mean age = 38 years; 69% ethnic minority; 23% lesbian/bisexual; 22% transgender) described stigma/discrimination and coping across micro (intra/interpersonal), meso (social/community), and macro (organizational/political) realms. Participants across focus groups attributed experiences of stigma and discrimination to: HIV-related stigma, sexism and gender discrimination, racism, homophobia and transphobia, and involvement in sex work. Coping strategies included resilience (micro), social networks and support groups (meso), and challenging stigma (macro). HIV-positive women described interdependent and mutually constitutive relationships between marginalized social identities and inequities such as HIV-related stigma, sexism, racism, and homo/transphobia. These overlapping, multilevel forms of stigma and discrimination are representative of an intersectional model of stigma and discrimination. The present findings also suggest that micro, meso, and macro level factors simultaneously present barriers to health and well being--as well as opportunities for coping--in HIV-positive women's lives. Understanding the deleterious effects of stigma and discrimination

  10. HIV, gender, race, sexual orientation, and sex work: a qualitative study of intersectional stigma experienced by HIV-positive women in Ontario, Canada.

    Directory of Open Access Journals (Sweden)

    Carmen H Logie

    2011-11-01

    Full Text Available HIV infection rates are increasing among marginalized women in Ontario, Canada. HIV-related stigma, a principal factor contributing to the global HIV epidemic, interacts with structural inequities such as racism, sexism, and homophobia. The study objective was to explore experiences of stigma and coping strategies among HIV-positive women in Ontario, Canada.We conducted a community-based qualitative investigation using focus groups to understand experiences of stigma and discrimination and coping methods among HIV-positive women from marginalized communities. We conducted 15 focus groups with HIV-positive women in five cities across Ontario, Canada. Data were analyzed using thematic analysis to enhance understanding of the lived experiences of diverse HIV-positive women. Focus group participants (n = 104; mean age = 38 years; 69% ethnic minority; 23% lesbian/bisexual; 22% transgender described stigma/discrimination and coping across micro (intra/interpersonal, meso (social/community, and macro (organizational/political realms. Participants across focus groups attributed experiences of stigma and discrimination to: HIV-related stigma, sexism and gender discrimination, racism, homophobia and transphobia, and involvement in sex work. Coping strategies included resilience (micro, social networks and support groups (meso, and challenging stigma (macro.HIV-positive women described interdependent and mutually constitutive relationships between marginalized social identities and inequities such as HIV-related stigma, sexism, racism, and homo/transphobia. These overlapping, multilevel forms of stigma and discrimination are representative of an intersectional model of stigma and discrimination. The present findings also suggest that micro, meso, and macro level factors simultaneously present barriers to health and well being--as well as opportunities for coping--in HIV-positive women's lives. Understanding the deleterious effects of stigma and

  11. HIV-related stigma in pregnancy and early postpartum of mothers living with HIV in Ontario, Canada.

    Science.gov (United States)

    Ion, Allyson; Wagner, Anne C; Greene, Saara; Loutfy, Mona R

    2017-02-01

    HIV-related stigma is associated with many psychological challenges; however, minimal research has explored how perceived HIV-related stigma intersects with psychosocial issues that mothers living with HIV may experience including depression, perceived stress and social isolation. The present study aims to describe the correlates and predictors of HIV-related stigma in a cohort of women living with HIV (WLWH) from across Ontario, Canada during pregnancy and early postpartum. From March 2011 to December 2012, WLWH ≥ 18 years (n = 77) completed a study instrument measuring independent variables including sociodemographic characteristics, perceived stress, depression symptoms, social isolation, social support and perceived racism in the third trimester and 3, 6 and 12 months postpartum. Multivariable linear regression was employed to explore the relationship between HIV-related stigma and multiple independent variables. HIV-related stigma generally increased from pregnancy to postpartum; however, there were no significant differences in HIV-related stigma across all study time points. In multivariable regression, depression symptoms and perceived racism were significant predictors of overall HIV-related stigma from pregnancy to postpartum. The present analysis contributes to our understanding of HIV-related stigma throughout the pregnancy-motherhood trajectory for WLWH including the interactional relationship between HIV-related stigma and other psychosocial variables, most notably, depression and racism.

  12. Factors Associated with HIV Related Stigma among College Students in the Midwest

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    Caroline Kingori

    2017-07-01

    Full Text Available In general, U.S. college students have low perceived susceptibility of acquiring HIV infection while 15–25 percent of youth have had negative perceptions towards HIV positive individuals. Factors associated with HIV stigma among college students were examined in a convenience sample of 200 students. Descriptive and inferential statistics were utilized to summarize the data. Only four percent of participants responded correctly to HIV transmission knowledge items. HIV transmission knowledge scores were significantly higher for participants who were single with partner and those who resided outside university residential dorms (p < 0.05. There was a significant negative correlation between composite HIV knowledge scores and stigma scores r = −0.18 (p < 0.05. After adjusting for confounders, a marginal significant negative linear relationship emerged (β = −0.09, p = 0.06 between HIV knowledge and stigma. HIV prevention education among college students needs to be addressed with nuance to minimize HIV knowledge gaps, stigma and student risk perception that impacts HIV prevention and stigma against those living with HIV.

  13. Drivers of young people's attitudes towards HIV/AIDS stigma and discrimination: evidence from Ghana.

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    Amo-Adjei, Joshua; Darteh, Eugene K M

    2013-12-01

    Using data from the 2008 Ghana Demographic and Health Survey, this paper examines the drivers of young people's attitudes towards HIV/AIDS stigma and discrimination in Ghana. Descriptive statistics and binary logistic regression were used to examine these drivers. The odds of low stigma and discrimination attitudes increased with higher education: thus, males [OR = 11.04; 95% CI = 4.59-26.54] and females [OR = 5.12; 95% CI = 2.41-11.28] with higher education were significantly more likely to express positive attitudes towards people living HIV. Controlling for beliefs, myths and knowledge about causes of HIV, the influence of education on HIV-related stigma among males and females reduces considerably but the odds remain statistically significant. Beliefs, myths and knowledge of HIV causes/prevention had varying significant effects on stigma. Ethnic, regional and religious differences also emerged in the results. The findings suggest that people with better and accurate knowledge about HIV, particularly its transmission have lower tendencies of showing HIV-related stigma and discrimination. Both formal and informal education on HIV should be pursued rigorously as part of the larger efforts at reducing HIV.

  14. Metacognitions mediate HIV stigma and depression/anxiety in men who have sex with men living with HIV

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    Esben Strodl

    2015-04-01

    Full Text Available The study examined whether the relationships between HIV stigma and depression and anxiety would be mediated by metacognitive beliefs and thought control strategies in men who have sex with men living with HIV. Men who have sex with men living with HIV completed an online survey that measured 30-item Metacognitions Questionnaire, thought control strategies (Thought Control Questionnaire, as well as symptoms of depression (Patient Health Questionnaire-9 and anxiety (generalized anxiety disorder-7. The relationships between internalised and anticipated HIV stigma with depressive symptoms were mediated by Negative Metacognitive Beliefs and the use of Worry and Social thought control strategies. Negative Metacognitive Beliefs mediated the association between internalised HIV stigma and anxiety symptoms.

  15. Depression among patients attending antiretroviral treatment program in public health facilities in Bahir Dar City, Ethiopia.

    Science.gov (United States)

    Tareke, Minale; Addisu, Fikir; Abate, Andargie

    2018-05-01

    The magnitude of depression is not well investigated among people living with HIV/AIDS. Thus, this research aimed to assess the magnitude of depression and its influencing factors among people living with HIV/AIDS attending government institutions in Bahir Dar City, North West, Ethiopia. institution based-cross-sectional study was done among randomly selected 415 people living with HIV/AIDS attending antiretroviral therapy program in Bahir Dar city, Ethiopia. Socio-demographic data and medical histories for all respondents were collected using interviewer-administered structured questionnaire. We assessed the odds of association of patient characteristics with depression was assessed using multiple logistic regression. The relative effect estimates of the respective factors were presented with odds ratio accompanied by their 95% uncertainty intervals. From 407 people living with HIV/AIDS interviewed, 198(48.6%) of them had depression. Social support, HIV clinical staging, total daily pill burden, treatment regimen and adherence to highly active antiretroviral therapy were significantly associated with depression. The magnitude of depression among people living with HIV/AIDS was found to be high. Early mental health screening should be done for people living with HIV/AIDS. Copyright © 2018 Elsevier B.V. All rights reserved.

  16. Factors associated with high rates of antiretroviral medication adherence among youth living with perinatal HIV in Thailand.

    Science.gov (United States)

    Kang, Ezer; Delzell, Darcie A P; Chhabra, Manik; Oberdorfer, Peninnah

    2015-07-01

    Antiretroviral medication adherence behaviour among Thai youth with perinatal HIV in Thailand has received growing attention. However, few studies have examined individual predictors of antiretroviral adherence using multiple self-reports. A convenience sample of 89 Thai youth (interquartile range 14-16 years) with perinatal HIV at three paediatric programmes in Chiang Mai completed a structured questionnaire and reported their antiretroviral adherence in the past one, seven and 30 days using count-based recall and a visual analog scale. Mean self-reported adherence rates ranged from 83.5% (past 30 days) to 99.8% (yesterday) of the time. One-inflated beta regression models were used to examine the associations between antiretroviral adherence outcomes, treatment self-efficacy, depression, anxiety, social support and beliefs/attitudes about medications. Higher percentage of medications taken in the past 30 days was independently associated with higher treatment self-efficacy and fewer symptoms of depression. Adherence monitoring would benefit from focal assessment of youth depression and perceived capacity to follow their antiretroviral regimen. © The Author(s) 2014.

  17. Thai people living with tuberculosis and how they adhere to treatment: A grounded theory study.

    Science.gov (United States)

    Choowong, Jiraporn; Tillgren, Per; Söderbäck, Maja

    2017-12-01

    To develop a conceptual framework of adherence to treatment among Thai people living with tuberculosis, a grounded theory approach was used. A purposive sample of 20 Thai people living with tuberculosis, aged from 23 to 85 years, was interviewed. From the participants' perspective, a core category of social belonging was highlighted, with three categories of conditions connected: personal barriers, personal resilience, and social facilitation. Personal barriers encompassed fear of stigma, concealing the illness, and lack of knowledge and motivation to complete the treatment regime. Personal resilience encompassed positive thinking and self-awareness. Social facilitation encompassed the ease of access to health services, continuity in the health service's ability to choose a directly-observed therapy observer, and social support. This study contributes a deeper understanding of the perspective of Thai people living with tuberculosis with regards to adherence to tuberculosis treatment. It might improve how local healthcare workers provide tuberculosis care, and inspire them to tailor care to people living with tuberculosis in a local community to increase personal resilience and reduce stigma. © 2017 John Wiley & Sons Australia, Ltd.

  18. EXPERIENCES OF HIV/AIDS STIGMA OF PERSONS LIVING WITH HIV/AIDS AND NURSES INVOLVED IN THEIR CARE FROM FIVE AFRICAN COUNTRIES

    OpenAIRE

    Greeff, Minrie; Uys, Leana R; Holzemer, William L; Makoae, Lucia N; Dlamini, Priscilla S; Kohi, Thecla W; Chirwa, Maureen L; Naidoo, Joanne R; Phetlhu, Rene D.

    2008-01-01

    The concept of stigma has received significant attention in recent years in the HIV/AIDS literature. Although there is some change towards the positive, AIDS still remains a significantly stigmatized condition. AIDS stigma and discrimination continue to influence people living with and affected by HIV (PLWA), as well as their health-care providers. Unless stigma is conquered, the illness will not be defeated. Due to the burden that HIV/AIDS places on people living in Africa, a five-year proje...

  19. Multiple Dimensions of Stigma and Health Related Factors Among Young Black Men Who Have Sex with Men

    Science.gov (United States)

    Quinn, Katherine; Voisin, Dexter R.; Bouris, Alida; Jaffe, Kate; Kuhns, Lisa; Eavou, Rebecca; Schneider, John

    2016-01-01

    This study is among the first to examine the association between multiple domains of HIV-related stigma and health-related correlates including viral load and medication adherence among young Black men who have sex with men (N = 92). Individual logistic regressions were done to examine the hypothesized relationships between HIV-related stigma and various health and psychosocial outcomes. In addition to examining total stigma, we also examined four domains of HIV stigma. Findings revealed the various domains of stigma had differential effects on health-related outcomes. Individuals who reported higher levels of total stigma and personalized stigma were less likely to be virally suppressed (OR 0.96, 95 % CI 0.91–1.00 and OR 0.50, 95 % CI 0.25–1.02, respectively). Concerns about public attitudes toward HIV were positively related to medication adherence (OR 2.18, 95 % CI 1.20–3.94) and psychological distress (OR 5.02, 95 % CI 1.54–16.34). The various domains of HIV stigma differentially affected health and psychosocial outcomes, and our findings suggest that some forms of HIV stigma may significantly affect viral load and medication adherence among this population. Stigma-informed approaches to care and treatment are needed, along with incorporated psychological and social supports. PMID:27233249

  20. Associations between HIV-related stigma, racial discrimination, gender discrimination, and depression among HIV-positive African, Caribbean, and Black women in Ontario, Canada.

    Science.gov (United States)

    Logie, Carmen; James, Llana; Tharao, Wangari; Loutfy, Mona

    2013-02-01

    Abstract African, Caribbean, and Black (ACB) women are greatly overrepresented in new HIV infections in comparison with Canada's general population. Social and structural factors such as HIV-related stigma, gender discrimination, and racial discrimination converge to increase vulnerability to HIV infection among ACB women by reducing access to HIV prevention services. Stigma and discrimination also present barriers to treatment, care, and support and may contribute to mental health problems. We administered a cross-sectional survey to HIV-positive ACB women (n=173) across Ontario in order to examine the relationships between HIV-related stigma, gender discrimination, racial discrimination, and depression. One-third of participants reported moderate/severe depression scores using the Beck Depression Inventory Fast-Screen guidelines. Hierarchical block regression, moderation, and mediation analyses were conducted to measure associations between independent (HIV-related stigma, gender discrimination, racial discrimination), moderator/mediator (social support, resilient coping), and dependent (depression) variables. Findings included: (1) HIV-related stigma was associated with increased depression; (2) resilient coping was associated with reduced depression but did not moderate the influence of HIV-related stigma on depression; and (3) the effects of HIV-related stigma on depression were partially mediated through resilient coping. HIV-related stigma, gender discrimination, and racial discrimination were significantly correlated with one another and with depression, highlighting the salience of examining multiple intersecting forms of stigma. Generalizability of findings may be limited due to nonrandom sampling. Findings emphasize the importance of multi-component interventions, including building resilient coping skills, mental health promotion and assessment, and stigma reduction programs.

  1. Measles Morbidity and Mortality Trend in Nigeria: A 10-Year Hospital-Based Retrospective Study in Lagos State, Nigeria

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    Akeeb O. Bola Oyefolu

    2016-03-01

    Full Text Available Objective: This hospital-based retrospective cohort study was undertaken with a view to determine the epidemiological trend of measles in Lagos State, Nigeria Methods: Medical records of clinically diagnosed measles patients from nine referral public hospitals in Lagos State between 1998 and 2007 were retrieved, transcribed and reviewed. Data were analyzed using standard methods. Results: A total of 35,500 clinically confirmed cases and 835 deaths (case fatality rate = 2.35%/10 years were recorded. The mean incidence was estimated at 19 cases per 100,000 population/year. A consistent seasonality pattern of measles was observed for the study period. The under-fives accounted for the highest reported cases (76.30% while, the under-1 year recorded highest mortality (53.8%. Notable shift of measles vulnerability from under-1year to under-fives was observed. Although there was significant difference between cases and deaths among the age groups (p0.05. Conclusion: This study recorded high incidence and case fatality of measles, which poses serious public health threat. Poor demographic data collection and storage were revealed thus, computerization of medical records for collection, storage and retrieval of data is imperative for adequate planning and control of measles imperil in Nigeria. J Microbiol Infect Dis 2016;6(1:12-18

  2. Post diagnosis reaction, perceived stigma and sexual behaviour of HIV/AIDS patients attending Aminu Kano Teaching Hospital, Northern Nigeria.

    Science.gov (United States)

    Iliyasu, Zubairu; Abubakar, Isa S; Musa, Babashani; Aliyu, Muktar H

    2011-01-01

    The process of becoming aware of one's serostatus, immediate and delayed responses of the individual, family and community have profound implications on health seeking behaviour of PLWHAs especially in developing countries. We investigated post-diagnosis reactions, disclosure, perceived stigmatization and sexual behaviour of PLWHAs in northern Nigeria. A triangulation of methods consisting of structured interviewer questionnaire administered on 205 respondents and two Focus Group Discussions with PLWHAs receiving care at Aminu Kano Teaching Hospital was used. HIV serodiagnosis, immediate and delayed reaction to serostatus and responses of family, friends and community members were elicited in addition to perceived stigma and sexual behaviour. Overall, 111 (54.1%) of the 205 patients were counseled before being tested for HIV infection. Majority of women 59 (51.8%) were tested and informed during antenatal care or 46 (40.4%) following diagnostic workup for symptoms related to AIDS. Most men 69 (75.8%) came to know during diagnostic workup or as part of screening for blood transfusion 5 (5.5%). Up to 37.2% of the respondents had kept their serostatus secret. Disclosures were more likely to mothers (51.9%), sisters (31.0%), brothers (11.0%) and spouses (6.1%). Of all respondents, 149 (72.6%) said they were shocked, afraid, angry and sad while 29 (14.1%) reported being indifferent. A higher proportion of females 68 (59.7%) were shocked, sad and angry than males 36 (39.6%) (Pworkplace and the remaining 17 (37.8%) among friends. Of 85 (41.5%) that were sexually active, 78 (91.8%) reported protecting their partners through use of condoms. The sub-optimal counseling resulted in strong emotional reactions that threatened the strong social support system of PLWHAs. Supportive counseling could improve VCT uptake and well being of PLWHAs in northern Nigeria.

  3. Quality of Life of People Living with HIV/AIDS in the Ho Municipality, Ghana: A Cross-Sectional Study.

    Science.gov (United States)

    Osei-Yeboah, James; Owiredu, William K B A; Norgbe, Gameli Kwame; Lokpo, Sylvester Yao; Obirikorang, Christian; Alote Allotey, Emmanuel; Gameli Deku, John; Akomanin Asiamah, Emmanuel; Manaphraim, Nana Yaw Barimah; Senyo Kwasi Nyamadi, Prince; Yiadom Boakye, Edward; Ntoni, Tibemponi; Avorkliyah, Roseline; Asumbasiya Aduko, Romeo; Tetteh Quarshie, Seyram; Jenkins Gbemu, Maxwell

    2017-01-01

    Quality of life (QoL) is an important component in the evaluation of the wellbeing of people living with HIV/AIDS (PLHIV). This study was aimed at evaluating the QoL of PLHIV attending the antiretroviral clinics in the Ho municipality. A cross-sectional study was conducted from January 2017 to April 2017 involving 158 purposively selected HIV-positive patients who were attending the antiretroviral clinics both in the Volta Regional Hospital and Ho Municipal Hospital. An Interviewer administered standard questionnaire (WHOQOL-HIV Bref) was used to collect information on sociodemography, medical history, and the quality of life (QoL) of the respondents. Among these 158 HIV-positive respondents, 126 (79.75) and 14 (8.86) presented with excellent and good overall QoL, respectively, whilst 18 (11.39) had their life negatively affected by HIV/AIDS. Religious/personal beliefs (19.62%) were the most affected QoL component, followed by the physical (15.82%) and level of independence (15.19%) domains. Patients' occupation, perception of health, sexual activity, and state of the disease were associated with poor overall QoL. In general, being an HIV-infected man, symptomatic patient, not being sexually active, or being ART naïve was also associated with poorer QoL in several HIV/AIDS QoL domains.

  4. Internalized stigma and HIV status disclosure among HIV-positive black men who have sex with men.

    Science.gov (United States)

    Overstreet, Nicole M; Earnshaw, Valerie A; Kalichman, Seth C; Quinn, Diane M

    2013-01-01

    Black men who have sex with men (BMSM) are severely affected by the HIV epidemic, yet research on the relationship between HIV stigma and status disclosure is relatively limited among this population. Within this epidemic, internalized HIV stigma, the extent to which people living with HIV/AIDS endorse the negative beliefs associated with HIV as true of themselves, can negatively shape interpersonal outcomes and have important implications for psychological and physical health. In a sample of HIV-positive BMSM (N=156), the current study examined the effect of internalized stigma on HIV status disclosure to sexual partners, which can inform sexual decision-making in serodiscordant couples, and HIV status disclosure to family members, which can be beneficial in minimizing the psychological distress associated with HIV. Results revealed that greater internalized stigma was associated with less HIV status disclosure to participants' last sexual partner and to family members. Findings from this study provide evidence that internalized negative beliefs about one's HIV status are linked to adverse interpersonal consequences. Implications of these findings are discussed with regard to prevention and intervention efforts to reduce HIV stigmatization.

  5. Self-reported adherence rates in glaucoma patients in Southwest Nigeria

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    Adeola Olukorede Onakoya

    2016-01-01

    Full Text Available Context: Nigerian glaucoma patients have an aversion to surgery and often rely on medical therapy to prevent disease progression. For medical therapy to be effective, the drugs have to be used as prescribed. Compliance has been reported to be low in the previous Nigerian studies. Aims: To evaluate the adherence rates of primary open angle glaucoma (POAG patients on medical therapy using patient self-report. Settings and Design: A hospital-based cross-sectional design was used to assess consecutive POAG patients attending a glaucoma clinic in a Tertiary Hospital in Lagos, Nigeria. Subjects and Methods: Self-reported adherence was evaluated by trained interviewers. Comprehensive clinical assessment including intraocular pressure, gonioscopy, visual field assessment, and dilated binocular funduscopy using the slit lamp and + 78D fundus lens was done. Statistical Analysis Used: Data analysis was done using MedCalc Statistical Software. Results: One hundred and fourteen patients reported adherence rates ranging from 10% to 100% with a mean adherence rate of 82.33% ± 19.25%. Only 31 respondents (27.2% reported 100% adherence. Duration of the disease was the only significant factor on multiple regression analysis. Conclusions: The development of strategies to improve compliance and persistence in glaucoma patients is crucial for the reduction of disease progression and blindness.

  6. Desafios da adesão ao tratamento de pessoas vivendo com HIV/Aids no Brasil Challenges of treatment adherence by people living with HIV/AIDS in Brazil

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    Regina Melchior

    2007-12-01

    content analysis classified the difficulties as follows: related to social factors and life styles, including the stigma; related to beliefs about the use of medication; and directly related to the use of medication. RESULTS: All the interviewees reported having difficulties concerning the stigma of living with HIV/AIDS. The difficulties related to the use of medication were the most important among patients with the best adherence level. Patients with average adherence level presented all three types of difficulties. CONCLUSIONS: Social and cultural factors are more difficult to be overcome in order to achieve treatment adherence than those related to taking medication, thus making the role played by the health sector important, supported by clear public social policies. These dimensions must be faced not only in the health sector, but also on social and political levels.

  7. Examining anxiety sensitivity as an explanatory construct underlying HIV-related stigma: Relations to anxious arousal, social anxiety, and HIV symptoms among persons living with HIV.

    Science.gov (United States)

    Brandt, Charles P; Paulus, Daniel J; Jardin, Charles; Heggeness, Luke; Lemaire, Chad; Zvolensky, Michael J

    2017-05-01

    Persons living with HIV (PLHIV) are a health disparity subgroup of the overall population for mental and physical health problems. HIV-related stigma has been shown to increase anxiety symptoms and HIV symptoms among PLHIV. However, little is known about factors that may impact the relations between HIV-related stigma and anxiety symptoms and HIV symptoms among PLHIV. To address this gap in the literature, the current study examined anxiety sensitivity (i.e., the extent to which individuals believe anxiety and anxiety-related sensations) in the relation between HIV-related stigma, social anxiety, anxious arousal, and HIV symptoms among a sample of 87 PLHIV (60.9% cis gender male, 52.9% Black, non-Hispanic). Results indicated that anxiety sensitivity mediated the relations between HIV-related stigma and the dependent variables, with effect sizes indicating moderate to large effects of anxiety sensitivity on these relations. Findings suggest that anxiety sensitivity be a mechanistic factor in the relations between HIV-related stigma and social anxiety, anxious arousal, and HIV symptoms, and therefore, be important element in efforts to reduce mental/physical health disparity among this population. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. The multidimensional nature of HIV stigma: evidence from Mozambique.

    Science.gov (United States)

    Carrasco, Maria A; Arias, Rosario; Figueroa, Maria E

    2017-03-01

    HIV stigma continues to be a major challenge to addressing HIV/AIDS in various countries in sub-Saharan Africa, including Mozambique. This paper explores the multidimensional nature of HIV stigma through the thematic analysis of five qualitative studies conducted in high HIV prevalence provinces in Mozambique between 2009 and 2012. These studies included 23 interviews with people living with HIV (PLHIV) (10 women and 13 men); 6 focus groups with 32 peer educators (24 women and 8 men) working for community-based organisations (CBOs) providing services to PLHIV; 17 focus groups with community members (72 men and 70 women); 6 interviews (4 women and 2 men) with people who had family members living with HIV/AIDS; 24 focus groups (12 with men and 12 with women) and 6 interviews with couples. Our findings indicate that HIV stigma is a barrier to HIV testing and counselling, status disclosure, partner notification, and antiretroviral therapy (ART) access and adherence, and that moral stigma seems to be more common than physical stigma. Additionally, the findings highlight that HIV stigma is a dynamic social process that is conceptualised as being tied to personal responsibility. To effectively diminish HIV stigma in Mozambique, future interventions should address moral stigma and re-conceptualise HIV as a chronic disease.

  9. Virtual intervention to support self-management of antiretroviral therapy among people living with HIV.

    Science.gov (United States)

    Côté, José; Godin, Gaston; Ramirez-Garcia, Pilar; Rouleau, Geneviève; Bourbonnais, Anne; Guéhéneuc, Yann-Gaël; Tremblay, Cécile; Otis, Joanne

    2015-01-06

    Living with human immunodeficiency virus (HIV) necessitates long-term health care follow-up, particularly with respect to antiretroviral therapy (ART) management. Taking advantage of the enormous possibilities afforded by information and communication technologies (ICT), we developed a virtual nursing intervention (VIH-TAVIE) intended to empower HIV patients to manage their ART and their symptoms optimally. ICT interventions hold great promise across the entire continuum of HIV patient care but further research is needed to properly evaluate their effectiveness. The objective of the study was to compare the effectiveness of two types of follow-up--traditional and virtual--in terms of promoting ART adherence among HIV patients. A quasi-experimental study was conducted. Participants were 179 HIV patients on ART for at least 6 months, of which 99 were recruited at a site offering virtual follow-up and 80 at another site offering only traditional follow-up. The primary outcome was medication adherence and the secondary outcomes were the following cognitive and affective variables: self-efficacy, attitude toward medication intake, symptom-related discomfort, stress, and social support. These were evaluated by self-administered questionnaire at baseline (T0), and 3 (T3) and 6 months (T6) later. On average, participants had been living with HIV for 14 years and had been on ART for 11 years. The groups were highly heterogeneous, differing on a number of sociodemographic dimensions: education, income, marital status, employment status, and living arrangements. Adherence at baseline was high, reaching 80% (59/74) in the traditional follow-up group and 84% (81/97) in the virtual follow-up group. A generalized estimating equations (GEE) analysis was run, controlling for sociodemographic characteristics at baseline. A time effect was detected indicating that both groups improved in adherence over time but did not differ in this regard. Improvement at 6 months was significantly

  10. Testing the efficacy of an HIV stigma reduction intervention with medical students in Puerto Rico: the SPACES project.

    Science.gov (United States)

    Varas-Díaz, Nelson; Neilands, Torsten B; Cintrón-Bou, Francheska; Marzán-Rodríguez, Melissa; Santos-Figueroa, Axel; Santiago-Negrón, Salvador; Marques, Domingo; Rodríguez-Madera, Sheilla

    2013-11-13

    Stigma associated with HIV has been documented as a barrier for accessing quality health-related services. When the stigma manifests in the health care setting, people living with HIV receive substandard services or even be denied care altogether. Although the consequences of HIV stigma have been documented extensively, efforts to reduce these negative attitudes have been scarce. Interventions to reduce HIV stigma should be implemented as part of the formal training of future health care professionals. The interventions that have been tested with health care professionals and published have several limitations that must be surpassed (i.e. lack of comparison groups in research designs and longitudinal follow-up data). Furthermore, Latino health care professionals have been absent from these intervention efforts even though the epidemic has affected this population disproportionately. In this article, we describe an intervention developed to reduce HIV stigma among medical students in Puerto Rico. A total of 507 medical students were randomly introduced into our intervention and control conditions. The results show statistically significant differences between the intervention and control groups; intervention group participants had lower HIV stigma levels than control participants after the intervention. In addition, differences in HIV stigma levels between the groups were sustained for a 12-month period. The results of our study demonstrate the efficacy of the modes of intervention developed by us and serve as a new training tool for future health care professionals with regard to stigma reduction.

  11. Exploring family-centered care for children living with HIV and AIDS in Nigeria.

    Science.gov (United States)

    Achema, Godwin; Ncama, Busisiwe P

    2016-04-01

    To explored the role of family-centered care in supporting children living with HIV and AIDS in Nigeria. A qualitative research design was adopted for this study with a grounded theory approach. Children aged between 11 and 14 years living with HIV and AIDS, their caregivers, and nurse practitioners working in the HIV clinic were engaged in separate focus group discussions in two hospitals in Nigeria. The findings showed that the value African families place on children plays a significant role in identifying their care needs and providing their basic necessities; hence, people around the sick child tend to make him feel better, as attested by nurse practitioners and caregiver participants. Nurse practitioner participants cited unified families as providing care support and love to the children and the support needed to alleviate their sicknesses. Children participants confirmed that family members/relatives were always at their disposal to provide supportive care in terms of administrating antiretroviral medication as well as other psychological care; although a few participants indicated that disruption in family structures in resource-poor settings, isolation and withdrawal, and deprivation of care due to poverty threatened the care rendered to the children. The study highlighted the value attached to children in the African context as helping family members to identify the care needs of children living with HIV and AIDS; thereby providing succor to alleviate their sicknesses and enhance their quality of life. © 2016 Japan Academy of Nursing Science.

  12. Mental Health and Antiretroviral Adherence Among Youth Living With HIV in Rwanda.

    Science.gov (United States)

    Smith Fawzi, Mary C; Ng, Lauren; Kanyanganzi, Fredrick; Kirk, Catherine; Bizimana, Justin; Cyamatare, Felix; Mushashi, Christina; Kim, Taehoon; Kayiteshonga, Yvonne; Binagwaho, Agnes; Betancourt, Theresa S

    2016-10-01

    In Rwanda, significant progress has been made in advancing access to antiretroviral therapy (ART) among youth. As availability of ART increases, adherence is critical for preventing poor clinical outcomes and transmission of HIV. The goals of the study are to (1) describe ART adherence and mental health problems among youth living with HIV aged 10 to 17; and (2) examine the association between these factors among this population in rural Rwanda. A cross-sectional analysis was conducted that examined the association of mental health status and ART adherence among youth (n = 193). ART adherence, mental health status, and related variables were examined based on caregiver and youth report. Nonadherence was defined as ever missing or refusing a dose of ART within the past month. Multivariate modeling was performed to examine the association between mental health status and ART adherence. Approximately 37% of youth missed or refused ART in the past month. In addition, a high level of depressive symptoms (26%) and attempt to hurt or kill oneself (12%) was observed in this population of youth living with HIV in Rwanda. In multivariate analysis, nonadherence was significantly associated with some mental health outcomes, including conduct problems (odds ratio 2.90, 95% confidence interval 1.55-5.43) and depression (odds ratio 1.02, 95% confidence interval 1.01-1.04), according to caregiver report. A marginally significant association was observed for youth report of depressive symptoms. The findings suggest that mental health should be considered among the factors related to ART nonadherence in HIV services for youth, particularly for mental health outcomes, such as conduct problems and depression. Copyright © 2016 by the American Academy of Pediatrics.

  13. HIV/AIDS-related stigma and discrimination among health-care providers in a tertiary health facility

    Directory of Open Access Journals (Sweden)

    Pauline Justin S Doka

    2017-01-01

    Full Text Available Aim: This study was aimed at assessing dispositions, attitudes, and behavioral tendencies for HIV/AIDS-related stigma and discrimination among health-care providers in Specialist Hospital Gombe, Northern Nigeria. Materials and Methods: Out of a total of 397 health personnel of the hospital, a sample of 201 health-care providers of various professional backgrounds was drawn using quota sampling technique. A descriptive exploratory survey method was adopted. Using a structured questionnaire, relevant data were collected from the subjects. Reliability test on key segments of the instrument yielded alpha Cronbach's internal consistency test values of not 0.05. If given the choice, 34 (16.9% of the personnel would not treat a patient with HIV. Conclusion: A prevalence rate of HIV/AIDS-related stigma of 15.4% among the health personnel is quite worrisome. Stigma reduction seminars and workshops would go a long way toward mitigating this trend.

  14. The Vicious Cycle of Stigma and Disclosure in "Self-Management": A Study Among the Dutch HIV Population.

    Science.gov (United States)

    de Vries, Daniel H; Koppen, Luca; Lopez, Adolfo Mejia; Foppen, Reina

    2016-12-01

    Though HIV has become a chronic disease, HIV-related stigma has remained. This article reports on a study that asked how Dutch people living with HIV-AIDS (PLWHA) experienced stigmatization and devised self-management strategies. We used qualitative findings from a survey questionnaire conducted among 468 Dutch HIV-positive people (3% of the population), using a stratified research sample. Findings show how respondents experience relatively high public (30%), self- (26%) and structural (15%) stigma. At the same time, results show the importance of selective disclosure as a self-management strategy. About half the respondents disclose selectively, while 16% does not disclose at all. We conclude that many Dutch PLHWA remain caught up in a vicious cycle of stigma and nondisclosure. To break the cycle, respondents point at the importance of stigma reduction campaigns using actual PLWHA. We highlight the importance of workplace programs and training of medical professionals.

  15. Stigma gets in my way: Factors affecting client-provider communication regarding childbearing among people living with HIV in Uganda.

    Directory of Open Access Journals (Sweden)

    Jolly Beyeza-Kashesya

    Full Text Available Many HIV-affected couples living in sub-Saharan Africa desire to have children, but few quantitative studies have examined support for their childbearing needs. Our study explored client-provider communication about childbearing and safer conception among HIV clients in Uganda.400 Ugandan HIV clients in committed relationships and with intentions to conceive were surveyed. Knowledge, attitudes and practices related to childbearing, and use of safer conception methods were assessed, including communication with providers about childbearing needs, the correlates of which were examined with bivariate statistics and logistic multivariate analysis.75% of the sample was female; 61% were on antiretroviral therapy; and 61% had HIV-negative or unknown status partners. Nearly all (98% reported the desire to discuss childbearing intentions with their HIV provider; however, only 44% reported such discussions, the minority (28% of which was initiated by the provider. Issues discussed with HIV providers included: HIV transmission risk to partner (30%, HIV transmission risk to child (30%, and how to prevent transmission to the child (27%; only 8% discussed safer conception methods. Regression analysis showed that those who had communicated with providers about childbearing were more likely to have been diagnosed with HIV for a longer period [OR (95% CI = 1.09 (1.03, 1.15], while greater internalized childbearing stigma was associated with lower odds of this communication [OR (95% CI = 0.70 (0.49, 0.99], after controlling for all bivariate correlates and basic demographics.Communication between HIV clients and providers about childbearing needs is poor and associated with stigma. Innovations to mitigate stigma among clients as well as training to improve health worker communication and skills related to safer conception counseling is needed.

  16. Internalized HIV and Drug Stigmas: Interacting Forces Threatening Health Status and Health Service Utilization Among People with HIV Who Inject Drugs in St. Petersburg, Russia

    Science.gov (United States)

    Burke, Sara E.; Dovidio, John F.; Levina, Olga S.; Uusküla, Anneli; Niccolai, Linda M.; Heimer, Robert

    2016-01-01

    Marked overlap between the HIV and injection drug use epidemics in St. Petersburg, Russia, puts many people in need of health services at risk for stigmatization based on both characteristics simultaneously. The current study examined the independent and interactive effects of internalized HIV and drug stigmas on health status and health service utilization among 383 people with HIV who inject drugs in St. Petersburg. Participants self-reported internalized HIV stigma, internalized drug stigma, health status (subjective rating and symptom count), health service utilization (HIV care and drug treatment), sociodemographic characteristics, and health/behavioral history. For both forms of internalized stigma, greater stigma was correlated with poorer health and lower likelihood of service utilization. HIV and drug stigmas interacted to predict symptom count, HIV care, and drug treatment such that individuals internalizing high levels of both stigmas were at elevated risk for experiencing poor health and less likely to access health services. PMID:26050155

  17. Perceived stigma and associated factors among people with ...

    African Journals Online (AJOL)

    Background: Epilepsy is the world's most common neurological disorder, affecting approximately 69 million people worldwide. Perceived stigma affects many domains of the lives of people with epilepsy. However, in Ethiopia there is dearth of study on perceived stigma specifically among people with epilepsy. Objective: To ...

  18. The prevalence and risk factors for Trichomonas vaginalis infection amongst human immunodeficiency virus-infected pregnant women attending the antenatal clinics of a university teaching hospital in Lagos, South-Western, Nigeria.

    Science.gov (United States)

    Ijasan, Olaolopin; Okunade, Kehinde Sharafadeen; Oluwole, Ayodeji Ayotunde

    2018-01-01

    Trichomonas vaginalis infection is the most prevalent non-viral sexually transmitted infection worldwide. Interactions between this infection and human immunodeficiency virus (HIV) may cause adverse pregnancy outcomes such as preterm labour, premature rupture of membranes, chorioamnionitis, low birth weight and post-abortal sepsis. This study was aimed to determine the prevalence and risk factors of T. vaginalis infection amongst HIV-positive pregnant women attending antenatal care at the Lagos University Teaching Hospital (LUTH), Lagos, Nigeria. This was an analytical cross-sectional study in which 320 eligible participants which included 160 HIV-positive (case group) and 160 HIV-negative (control group) pregnant women were recruited at the antenatal clinic of LUTH. A structured pro forma was used to collect data from consenting participants after which high vaginal swabs were collected, processed and examined for T. vaginalis. The association between categorical variables was tested using the Chi-square test and Fisher's exact test where applicable. All significances were reported at P women were 10% and 8.1%, respectively (P = 0.559). Significant risk factors for T. vaginalis infection in the HIV-positive pregnant women were early coitarche (P women for T. vaginalis infection as a tool of reducing HIV acquisition, especially in pregnancy, campaign to create better sexual health awareness should be commenced as a way to contributing to the reduction in T. vaginalis infection during pregnancy and perinatal transmission of HIV.

  19. The Impact of Stigma and Social Support on Development of Post-traumatic Growth Among Persons Living with HIV.

    Science.gov (United States)

    Kamen, Charles; Vorasarun, Chaniga; Canning, Ty; Kienitz, Eliza; Weiss, Carolyn; Flores, Sergio; Etter, Darryl; Lee, Susanne; Gore-Felton, Cheryl

    2016-06-01

    Given high rates of trauma in people living with HIV (PLH) and the health benefits of posttraumatic growth (PTG), understanding how to foster PTG in PLH exposed to trauma could be of interest to clinical psychologists working with this population. The current study examined factors theoretically related to development of PTG in PLH, namely HIV-related stigma, disclosure of HIV status, and emotional support. A sample of 334 HIV-positive adults answered a battery of self-report questionnaires. HIV-related stigma, disclosure to sexual partners, and emotional support were significant predictors of PTG: stigma was associated with lower PTG, whereas disclosure and emotional support were associated with higher PTG. Disclosure and emotional support remained significantly associated with PTG in the model including demographic factors and stigma. These findings highlight the need for development of interventions that can aid PLH in disclosing their HIV status to sexual partners and increasing available social support.

  20. A Structural Equation Model of HIV-Related Stigma, Racial Discrimination, Housing Insecurity and Wellbeing among African and Caribbean Black Women Living with HIV in Ontario, Canada.

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    Carmen H Logie

    Full Text Available African and Caribbean Black women in Canada have new HIV infection rates 7 times higher than their white counterparts. This overrepresentation is situated in structural contexts of inequities that result in social, economic and health disparities among African and Caribbean Black populations. Economic insecurity is a distal driver of HIV vulnerability, reducing access to HIV testing, prevention and care. Less is known about how economic insecurity indicators, such as housing security, continue to influence the lives of women living with HIV following HIV-positive diagnoses. The aim of this study was to test a conceptual model of the pathways linking HIV-related stigma, racial discrimination, housing insecurity, and wellbeing (depression, social support, self-rated health. We implemented a cross-sectional survey with African and Caribbean Black women living with HIV in 5 Ontario cities, and included 157 participants with complete data in the analyses. We conducted structural equation modeling using maximum likelihood estimation to evaluate the hypothesized conceptual model. One-fifth (22.5%; n = 39 of participants reported housing insecurity. As hypothesized, racial discrimination had significant direct effects on: HIV-related stigma, depression and social support, and an indirect effect on self-rated health via HIV-related stigma. HIV-related stigma and housing insecurity had direct effects on depression and social support, and HIV-related stigma had a direct effect on self-rated health. The model fit the data well: χ2 (45, n = 154 = 54.28, p = 0.387; CFI = 0.997; TLI = 0.996; RMSEA = 0.016. Findings highlight the need to address housing insecurity and intersecting forms of stigma and discrimination among African and Caribbean Black women living with HIV. Understanding the complex relationships between housing insecurity, HIV-related stigma, racial discrimination, and wellbeing can inform multi-level interventions to reduce stigma and enhance

  1. Anorectal pathology amongst HIV infected patients attending the Douala General Hospital: a cross-sectional study.

    Science.gov (United States)

    Luma, Henry Namme; Eloumou, Servais Albert Fiacre Bagnaka; Fualefeh-Morfaw, Ellis Atemlefeh; Malongue, Agnes; Temfack, Elvis; Lekpa, Fernando Kemta; Donfack-Sontsa, Olivier; Ndip, Lucy; Ditah, Ivo Che

    2017-03-01

    While gastrointestinal disease is common among HIV infected individuals, the prevalence and distribution of ano-rectal pathology has not been well studied in our setting. The objective of this study therefore was to determine the prevalence and determinants of ano-rectal pathology in HIV infected patients attending the Douala General Hospital HIV treatment centre. A hospital-based cross-sectional study was undertaken. We collected socio-demographic, clinical and laboratory data using a structured questionnaire and patients' files. Each study participant had a full physical and ano-rectal examination. We further studied factors associated with having at least one ano-rectal lesion by logistic regression reporting odds ratios (ORs) and their 95% confidence intervals (CI). We included 390 HIV infected patients. The mean age was 41 (SD: 8) years and 48% were men. Median duration since HIV diagnosis was 3 (interquartile range: 2-5) years and median CD4 cell count was 411 (interquartile range: 234-601) cells/mm 3 . Prevalence of ano-rectal pathology was 22.8% (95% CI: 18.7-27.3). Hemorrhoids and proctitis were most common lesions found; each in 10% of patients. From multivariate logistic regression, factors associated with ano-rectal pathology were CD4 HIV infected patients. Care givers should actively investigate and treat them as this will improve the quality of life of people living with HIV/AIDS.

  2. Engagement with Health Care Providers Affects Self- Efficacy, Self-Esteem, Medication Adherence and Quality of Life in People Living with HIV

    Science.gov (United States)

    Chen, Wei-Ti; Wantland, Dean; Reid, Paula; Corless, Inge B; Eller, Lucille S.; Iipinge, Scholastika; Holzemer, William L; Nokes, Kathleen; Sefcik, Elizbeth; Rivero-Mendez, Marta; Voss, Joachim; Nicholas, Patrice; Phillips, J. Craig; Brion, John M.; Rose, Caro Dawson; Portillo, Carmen J; Kirksey, Kenn; Sullivan, Kathleen M; Johnson, Mallory O; Tyer-Viola, Lynda; Webel, Allison R

    2014-01-01

    The engagement of patients with their health care providers (HCP) improves patients’ quality of life (QOL), adherence to antiretroviral therapy, and life satisfaction. Engagement with HCP includes access to HCP as needed, information sharing, involvement of client in decision making and self-care activities, respect and support of the HCP for the client’s choices, and management of client concerns. This study compares country-level differences in patients’ engagement with HCP and assesses statistical associations relative to adherence rates, self-efficacy, self-esteem, QOL, and symptom self-reporting by people living with HIV (PLHIV). A convenience sample of 2,182 PLHIV was enrolled in the United States, Canada, Puerto Rico, Namibia, and China. Cross-sectional data were collected between September 2009 and January 2011. Inclusion criteria were being at least 18 years of age, diagnosed with HIV, able to provide informed consent, and able to communicate in the local language with site researchers. In the HCP scale, a low score indicated greater provider engagement. Country comparisons showed that PLHIV in Namibia had the most HCP engagement (OR 2.80, p < 0.001) and that PLHIV in China had the least engagement (OR −7.03, p < 0.0001) compared to the PLHIV in the Western countries. Individuals having better HCP engagement showed better self-efficacy for adherence (t = −5.22, p < 0.0001), missed fewer medication doses (t = 1.92, p ≤ 0.05), had lower self-esteem ratings (t = 2.67, p < 0.01), fewer self-reported symptoms (t = 3.25, p < 0.0001), and better overall QOL physical condition (t = −3.39, p < 0.001). This study suggests that promoting engagement with the HCP is necessary to facilitate skills that help PLHIV manage their HIV. To improve ART adherence, HCPs should work on strategies to enhance self-efficacy and self-esteem, therefore, exhibiting fewer HIV-related symptoms and missing less medication doses to achieve better QOL. PMID:24575329

  3. Associations between Forced Sexual Initiation, HIV Status, Sexual Risk Behavior, Life Stressors, and Coping Strategies among Adolescents in Nigeria.

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    Morenike Oluwatoyin Folayan

    Full Text Available Some individuals experience their first sexual intercourse through physically forced sex, which affects the way they experience and cope with stress. We examined differences in sexual risk behavior, experience of stressors, and use of stress-coping strategies among adolescents in Nigeria based on their history of forced sexual initiation and HIV status.We analyzed data from 436 sexually active 10-19-year-old adolescents recruited through a population-based survey from 12 Nigerian states. Using Lazarus and Folkman's conceptual framework of stress and coping, we assessed if adolescents who reported forced sexual initiation were more likely to report HIV sexual risk practices, to report as stressors events related to social expectations, medical care and body images, and loss and grief, and to use more avoidance than adaptive coping strategies to manage stress. We also assessed if HIV status affected experience of stressors and use of coping strategies.Eighty-one adolescents (18.6% reported a history of forced sexual initiation; these participants were significantly more likely to report anal sex practices (OR: 5.04; 95% CI: 2.14-11.87, and transactional sex (OR: 2.80; 95% CI: 1.56-4.95. Adolescents with no history of forced sexual initiation were more likely to identify as stressors, life events related to social expectations (OR: 1.03; 95% CI: 0.96-1.11 and loss and grief (OR: 1.34; 95% CI: 0.73-2.65, but not those related to medical care and body images (OR: 0.63; 95% CI: 0.34-1.18. They were also more likely to use adaptive responses (OR: 1.48; 95% CI: 0.62-3.50 than avoidance responses (OR: 0.90; 95% CI: 0.49-1.64 to cope with stress, though these differences were not significant. More adolescents with a history of forced sexual initiation who were HIV positive identified as stressors, life events related to medical care and body images (p = 0.03 and loss and grief (p = 0.009. Adolescents reporting forced sexual initiation and HIV

  4. Development of internalized and personal stigma among patients with and without HIV infection and occupational stigma among health care providers in Southern China

    Directory of Open Access Journals (Sweden)

    Li J

    2016-11-01

    Full Text Available Jing Li,1,2,* Sawitri Assanangkornchai,1,* Lin Lu,3 Manhong Jia,3,* Edward B McNeil,1,* Jing You,4,* Virasakdi Chongsuvivatwong1,* 1Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand; 2School of Public Health, Kunming Medical University, 3Yunnan Center for Disease Prevention and Control, 4Infectious Diseases Department, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, People’s Republic of China *These authors contributed equally to this work Background: HIV/AIDS-related stigma is a major barrier of access to care for those infected with HIV. The aim of this study was to examine, validate, and adapt measuring scales of internalized, personal, and occupational stigma developed in Africa into a Chinese context. Methods: A cross-sectional study was conducted from January to September 2015 in Kunming, People’s Republic of China. Various scales were constructed on the basis of the previous studies with modifications by experts using exploratory and confirmatory factor analyses (EFA + CFA. Validation of the new scales was done using multiple linear regression models and hypothesis testing of the factorial structure invariance. Results: The numbers of subjects recruited for the development/validation samples were 696/667 HIV-positive patients, 699/667 non-HIV patients, and 157/155 health care providers. EFA revealed a two-factor solution for internalized and personal stigma scales (guilt/blaming and being refused/refusing service, which were confirmed by CFA with reliability coefficients (r of 0.869 and 0.853, respectively. The occupational stigma scale was found to have a three-factor structure (blaming, professionalism, and egalitarianism with a reliability coefficient (r of 0.839. Higher correlations of factors in the HIV patients (r=0.537 and non-HIV patients (r=0.703 were observed in contrast to low-level correlations (r=0.231, 0.286, and 0.266 among factors

  5. Risk factors and assessment for cardiovascular disease among HIV ...

    African Journals Online (AJOL)

    Methods: this was a cross-sectional study of HIV-positive patients attending the Lagos University Teaching Hospital, Nigeria. Anthropometric and blood pressure measurements were performed; fasting lipid profile, plasma glucose, homocysteine and hsCRP were determined, as well as prevalences and risk assessments.

  6. My secret: the social meaning of HIV/AIDS stigma.

    Science.gov (United States)

    Judgeo, N; Moalusi, K P

    2014-01-01

    This study uses Goffman's [1963. Stigma: Notes on the Management of Spoiled Identity, New Jersey, Prentice-Hall] theory of stigma as an intellectual scaffold to help understand the social meaning of HIV/AIDS stigma from People Living with HIV/AIDS. The study adopts a qualitative approach because of its appropriateness for unravelling subjective phenomena such as the experiences of HIV/AIDS stigma. In-depth interviews were conducted with 10 HIV-positive employees of a retailing company located in the Western Cape province of South Africa who volunteered to participate in the study. The participants with the discreditable stigma internalised society's prejudice towards those living with the virus. As a result, the participants relied on self-isolation and social withdrawal to cope with enacted stigma. Managing information about one's status and deciding whether, who, when, etc., to tell are crucial questions. The participants feared being devalued by family, friends, co-workers and the community. In concurrence with Goffman [1963], the HIV/AIDS stigma is seen as about relationships.

  7. Can a short film impact HIV-related risk and stigma perceptions? Results from an experiment in Abuja, Nigeria.

    Science.gov (United States)

    Lapinski, Maria Knight; Nwulu, Paul

    2008-09-01

    HIV/AIDS-related stigma is believed to result in negative social consequences for people with the disease and to be a deterrent to HIV serostatus testing. The ability of communicators to change people's stigma perceptions and subsequently impact decisions to test, however, is not well understood. Based on the entertainment-education approach, this article presents the results of a field experiment conducted in Abuja, Nigeria, testing a mediated intervention designed to reduce HIV-related stigma and risk perceptions. The results indicate that the intervention was effective relative to a control in impacting perceptions of the severity of HIV and some stigma-related attitudes, particularly for male participants; and that for this sample, risk and stigma perceptions significantly impact intentions to test for HIV. It also showed that severity perceptions mediated the relationship between viewing the film and testing intent.

  8. AIDS-related stigma and social interaction: Puerto Ricans living with HIV/AIDS.

    Science.gov (United States)

    Varas-Díaz, Nelson; Serrano-García, Irma; Toro-Alfonso, José

    2005-02-01

    People living with HIV/AIDS are stigmatized. Although personal and social consequences of this stigmatization have been documented, research regarding its impact on social interactions is scarce. Latinos, and Puerto Ricans in particular, have voiced concern regarding AIDS stigma. The authors investigated the key role of social interaction in the process of stigmatization through in-depth, semistructured interviews in a sample of 30 Puerto Ricans living with HIV/AIDS. Participants reported instances in which AIDS stigma negatively influenced social interactions with family, friends, sexual partners, coworkers, and health professionals. Some of the consequences they described were loss of social support, persecution, isolation, job loss, and problems accessing health services. Findings support the need for interventions to address AIDS stigma and its consequences.

  9. Association between coping strategies, social support, and depression and anxiety symptoms among rural Ugandan women living with HIV/AIDS.

    Science.gov (United States)

    Seffren, Victoria; Familiar, Itziar; Murray, Sarah M; Augustinavicius, Jura; Boivin, Michael J; Nakasujja, Noeline; Opoka, Robert; Bass, Judith

    2018-02-22

    Poor mental health detrimentally affects quality of life among women living with HIV/AIDS. An improved understanding of how coping and social support relate to depression and anxiety in this population can facilitate the design and implementation of appropriate mental health treatment and support services. Secondary analysis was conducted on baseline data from 288 HIV-positive women enrolled in a parenting intervention in Uganda. Depression and anxiety symptoms, social support, and coping were assessed with the Hopkins Symptom Checklist and adapted versions of the Multidimensional Scale for Perceived Social Support and Ways of Coping Questionnaire. General linear regression models were used to estimate associations between coping and mental health. Based on report of elevated symptoms, approximately 10% of women were categorized as having clinically-relevant depression or anxiety. Emotion-focused (EF: p symptoms while greater family support (EF: p = .002; PF: p = .003) was associated with fewer depression symptoms. More anxiety symptoms were associated with reporting both coping strategies (EF: p symptoms among women living with HIV.

  10. Prevalence and Associated Factors of Suicidal Ideation and Attempt among People Living with HIV/AIDS at Zewditu Memorial Hospital, Addis Ababa, Ethiopia: A Cross-Sectional Study

    Directory of Open Access Journals (Sweden)

    Etsay Hailu Gebremariam

    2017-01-01

    Full Text Available Background. Human Immune Deficiency Virus (HIV/AIDS continues to be an underrecognized risk for suicidal ideation, suicidal attempt, and completion of suicide. Suicidal ideation and attempt in HIV/AIDS is not only a predictor of future attempted suicide and completed suicide. Methods. An institution based cross-sectional study was conducted among HIV-positive patients attending HIV care at Zewditu Memorial Hospital. Systematic random sampling technique was used to recruit 423 participants from April to May 2014. Composite International Diagnostic Interview was used to collect data. Multivariable logistic regression was computed to assess factors associated with suicidal ideation and attempt. Result. Suicidal ideation and suicidal attempt were found to be 22.5% and 13.9%, respectively. WHO clinical stage of HIV, not being on HAART, depression, family history of suicidal attempt, and perceived stigma were associated with suicidal ideation. WHO clinical stage, being female, not being on HAART, use of substance, and depression were associated with suicidal attempt. Conclusion. Early diagnosis and treatment of opportunistic infections, depression, and early initiation of ART need to be encouraged in HIV-positive adults. Furthermore, counseling on substance use and its consequences and early identification of HIV-positive people with family history of suicidal ideation have to be considered.

  11. The intersection of antiretroviral therapy, peer support programmes, and economic empowerment with HIV stigma among HIV-positive women in West Nile Uganda.

    Science.gov (United States)

    Kellett, Nicole Coffey; Gnauck, Katherine

    2016-12-01

    HIV stigma remains a major problem of the AIDS epidemic in sub-Saharan Africa. Women fear impending social stigma including blame, isolation and abuse. HIV infection and HIV stigma interact cyclically, creating and reinforcing economic and social exclusion for individuals living with HIV. Evidence suggests that interventions for people living with HIV infection that include, in combination, antiretroviral therapy (ART), peer support and economic empowerment are likely to be more effective than if used alone. We report a qualitative study in West Nile Uganda that explored perceptions of HIV stigma among fifty-four HIV-positive women who had similar access to ART and HIV peer support programmes, but varying levels of participation (full-time, intermittent, none) in economic empowerment programmes. Our study found that access to ART, peer support groups, and economic empowerment programmes helped to curb perceptions of deep-seated HIV stigma for participants. More expressions of usefulness, hope and psychological well-being prevailed with participants who had increased participation in economic empowerment programmes. Our findings underscore the value of HIV outreach programmes which combine ART, peer support and economic empowerment to alleviate HIV stigma. Further research to quantify the interaction of these factors is warranted.

  12. Self-medication for infants with colic in Lagos, Nigeria

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    Oshikoya Kazeem A

    2009-02-01

    Full Text Available Abstract Background Infantile colic is a self-limiting condition that is distributed worldwide. It is often misdiagnosed as an organic disease for which an infant is admitted to the hospital. Many studies have described the aetiopathogenesis, pharmacologic and non-pharmacologic management of colic but none has evaluated self-medication for infants with colic. The aim of this study was therefore to determine the knowledge of Nigerian mothers about colic, their home-based management, extent of self-medication for the infants with colic and the types of medicines involved. Methods It is a prospective study conducted at the vaccination clinics of 20 primary health care centres, each from different Local Government Areas in Lagos, Nigeria. Eight hundred mothers that brought their infants for vaccination between April and September, 2006 were interviewed with open-and close-ended questionnaire. Results Six hundred and eighty three (85.4% mothers claimed they had a good knowledge of colic. Incessant and excessive cry was the main clinical feature of colic identified by 430(62.9% mothers. Three hundred and seventy eight (67.7% infants were treated by self-medication, 157 (28.1% sought medical intervention and 17 (3.1% were treated at a traditional birth attendant home. Herbal medicines constituted 51.8% of the self-medicated medicines, of which 48 (26.2% were "Ororo Ogiri". Nospamin® (49.5% and Gripe water® (43.0% were the two frequently prescribed and self-medicated medicines for infants with colic. Conclusion Nigerian mothers are deficient in their knowledge of colic. Self-medication was the most frequently used home-based intervention. Health education would appear necessary to improve parental management of this self-limiting condition.

  13. HIV-related stigma, racial discrimination, and gender discrimination: Pathways to physical and mental health-related quality of life among a national cohort of women living with HIV.

    Science.gov (United States)

    Logie, Carmen H; Wang, Ying; Lacombe-Duncan, Ashley; Wagner, Anne C; Kaida, Angela; Conway, Tracey; Webster, Kath; de Pokomandy, Alexandra; Loutfy, Mona R

    2018-02-01

    Social inequities compromise health-related quality of life (HR-QoL) among women living with HIV (WLWH). Little is known about health impacts of intersecting stigma based on HIV status, race and gender among WLWH or potential mechanisms to promote HR-QoL. We tested pathways from multiple types of stigma (HIV-related, racial, gender) to physical and mental HR-QoL utilizing baseline survey data from a national cohort of WLWH in Canada (2013-2015). Structural equation modeling was conducted using maximum likelihood estimation methods to test the direct effects of HIV-related stigma, racial discrimination, and gender discrimination on HR-QoL and indirect effects via social support and economic insecurity, adjusting for socio-demographic factors. Among 1425 WLWH (median age: 43years [IQR=35-50]), HIV-related stigma and gender discrimination had significant direct effects on mental HR-QoL. Social support mediated the relationship between HIV-related stigma and mental HR-QoL, accounting for 22.7% of the effect. Social support accounted for 41.4% of the effect of gender discrimination on mental HR-QoL. Economic insecurity accounted for 14.3% of the effect of HIV-related stigma, and 42.4% of the effect of racial discrimination, on physical HR-QoL. Fit indices suggest good model fit (χ 2 [1]=3.319, p=0.069; CFI=0.998; RMSEA=0.042 (90% CI: 0-0.069); SRMR=0.004). Findings reveal complex relationships between intersecting stigma and HR-QoL. Strategies that address intersecting stigma and economic insecurity among WLWH may prevent the harmful impacts of HIV-related stigma and gender discrimination on physical HR-QoL. Increasing social support may mitigate the impacts of stigma on mental health. Findings can inform multi-level interventions to promote health and wellbeing among WLWH. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Oral manifestations among people living with HIV/AIDS in Tanzania

    DEFF Research Database (Denmark)

    Fabian, F M; Kahabuka, F K; Petersen, P E

    2009-01-01

    BACKGROUND: This study aimed to determine the prevalence of various oral and peri-oral manifestations in people living with HIV/AIDS in Tanzania. METHODS: A cross sectional study. A total of 187 persons with HIV infection were recruited from non-governmental organisations serving people living...... associated with low body mass index (BMI). CONCLUSION: This community survey carried out in an African sub-Saharan country showed that oral lesions are frequent among people living with HIV/AIDS. As emphasised by the World Health Organization Global Oral Health Programme, national HIV/AIDS programmes should...

  15. Health literacy, source of information and impact on adherence to therapy in people living with HIV

    Science.gov (United States)

    Ernst Dorner, Thomas; Schulte-Hermann, Kathrin; Zanini, Matteo; Leichsenring, Birgit; Stefanek, Wiltrut

    2014-01-01

    Introduction Adequate information and health literacy (HL) has a high impact on patients understanding on the causes and consequences of many chronic diseases, including HIV, and is a crucial prerequisite to ensure adherence to therapy regimens. Several Austrian patient organizations developed an online survey together with MSD (the so-called “PAB-test”) aimed to evaluate how people living with HIV perceive the level of care in Austria. Materials and Methods An online survey has been developed to assess HL in people living with HIV and to evaluate the impact of HL on therapy adherence. HL was assessed with seven items regarding the self-rated comprehension of HIV related information, which showed a high reliability (Cronbach's alpha=0.876). A low health literacy was defined by reaching a score below the median of 20 points in the related indicator. Results A total of 303 subjects completed the questionnaire. Women slightly had more often a low HL than men (57.1% vs 44.7%, p=0.335). Heterosexual subjects had more often a low HL compared to homosexual ones (58.3% vs 38.1%, p=0.007). Health literacy slightly increased with age (not significant). An increasing education level correlated with higher HL, (66.7%, 46.2%, and 38.9% of persons showed low HL with primary, secondary and tertiary education, respectively, p=0.037). The number of missed appointments with the HIV physician was significantly higher in the low HL population (30.0% vs 14.4%, p=0.002), which also showed to be more prone to interrupt the therapy without consulting a physician (22.4% vs 9.8%, p=0.006). The low HL population, however, did not report of having forgotten the medication intake more often than the one with high HL (33.1% vs 39.1%, p=0.305). The most important source of information is the treating physician, followed by NGOs/patient organizations and the internet (Figure 1). Conclusions There are significant differences in HL between different sub-groups in the HIV community. Low HL is

  16. “We fear the police, and the police fear us”: Structural and individual barriers and facilitators to HIV medication adherence among injection drug users in Kiev, Ukraine

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    Mimiaga, Matthew J.; Safren, Steven A.; Dvoryak, Sergiy; Reisner, Sari L.; Needle, Richard; Woody, George

    2010-01-01

    Ukraine has one of the most severe HIV/AIDS epidemics in Europe, with an estimated 1.63% of the population living with HIV/AIDS in 2007. Injection drug use (IDU) remains the predominant mode of transmission in Kiev—the capital and largest city. Prior reports suggest that the HIV infection rate among IDUs in Kiev reaches 33%, and many have poor and inequitable access to highly active antiretroviral therapy (HAART). Among those with access to HAART, little is understood about barriers and facilitators to HAART medication adherence. In 5/2009, two semi-structured focus groups were conducted with HIV-infected IDUs seeking treatment at the City AIDS Center, Kiev. The goal was to use this information to adapt and tailor, to Ukrainian culture, an evidence-based intervention for improving adherence to HAART. All 16 participants attributed HIV infection to IDU. Their average age was 31.6 (SD=7.0), average time with HIV 5.7 years (SD=4.0), average time on HAART 2.5 years (SD=1.7), average time as IDU 14.6 years (SD=6.8), and 88% were on opioid substitution therapy. The most salient themes related to adherence barriers included: (1) harassment and discrimination by police; (2) opioid dependence; (3) complexity of drug regimen; (4) side effects; (5) forgetting; (6) co-occurring mental health problems; and (7) HIV stigma. Facilitators of adherence included: (1) cues for pill taking; (2) support and reminders from family, significant other, and friends; (3) opioid substitution therapy; and (4) wanting improved health. Additional factors explored included: 1) knowledge about HAART; (2) storage of medications; and (3) IDU and sexual risk behaviors. Findings highlighted structural and individual barriers to adherence. At the structural level, police discrimination and harassment was reported to be a major barrier to adherence to opioid substitution therapy and HAART. Privacy and stigma were barriers at the individual level. Recommendations for adherence interventions included

  17. HIV stigma, disclosure and psychosocial distress among Thai youth living with HIV.

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    Rongkavilit, C; Wright, K; Chen, X; Naar-King, S; Chuenyam, T; Phanuphak, P

    2010-02-01

    The objective of the present paper is to assess stigma and to create an abbreviated 12-item Stigma Scale based on the 40-item Berger's Stigma Scale for Thai youth living with HIV (TYLH). TYLH aged 16-25 years answered the 40-item Stigma Scale and the questionnaires on mental health, social support, quality of life and alcohol/substance use. Sixty-two (88.6%) of 70 TYLH reported at least one person knowing their serostatus. Men having sex with men were more likely to disclose the diagnosis to friends (43.9% versus 6.1%, P < 0.01) and less likely to disclose to families (47.6% versus 91.8%, P < 0.01). Women were more likely to disclose to families (90.2% versus 62.1%, P < 0.01) and less likely to disclose to friends (7.3% versus 31%, P < 0.05). The 12-item Stigma Scale was reliable (Cronbach's alpha, 0.75) and highly correlated with the 40-item scale (r = 0.846, P < 0.01). Half of TYLH had mental health problems. The 12-item Stigma Scale score was significantly associated with mental health problems (beta = 0.21, P < 0.05). Public attitudes towards HIV were associated with poorer quality of life (beta = -1.41, P < 0.01) and mental health problems (beta = 1.18, P < 0.01). In conclusion, the12-item Stigma Scale was reliable for TYLH. Increasing public understanding and education could reduce stigma and improve mental health and quality of life in TYLH.

  18. Quality of Life of People Living with HIV/AIDS in the Ho Municipality, Ghana: A Cross-Sectional Study

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    James Osei-Yeboah

    2017-01-01

    Full Text Available Quality of life (QoL is an important component in the evaluation of the wellbeing of people living with HIV/AIDS (PLHIV. This study was aimed at evaluating the QoL of PLHIV attending the antiretroviral clinics in the Ho municipality. A cross-sectional study was conducted from January 2017 to April 2017 involving 158 purposively selected HIV-positive patients who were attending the antiretroviral clinics both in the Volta Regional Hospital and Ho Municipal Hospital. An Interviewer administered standard questionnaire (WHOQOL-HIV Bref was used to collect information on sociodemography, medical history, and the quality of life (QoL of the respondents. Among these 158 HIV-positive respondents, 126 (79.75 and 14 (8.86 presented with excellent and good overall QoL, respectively, whilst 18 (11.39 had their life negatively affected by HIV/AIDS. Religious/personal beliefs (19.62% were the most affected QoL component, followed by the physical (15.82% and level of independence (15.19% domains. Patients’ occupation, perception of health, sexual activity, and state of the disease were associated with poor overall QoL. In general, being an HIV-infected man, symptomatic patient, not being sexually active, or being ART naïve was also associated with poorer QoL in several HIV/AIDS QoL domains.

  19. Seroprevalence of Toxoplasma gondii IgG antibody in HIV-infected patients at the Lagos University Teaching Hospital

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    Osunkalu VO

    2011-09-01

    Full Text Available Vincent O Osunkalu1, Sulaimon A Akanmu1, Nkolika J Ofomah1, Igwebuike V Onyiaorah2, Adewumi A Adediran1, Ralph O Akinde3, Ifeanyi A Onwuezobe41Department of Haematology and Blood Transfusion, College of Medicine Idi-Araba, Lagos, Nigeria; 2Department of Histopathology, Nnamdi Azikiwe University, Nnewi Campus, Lagos, Nigeria; 3Department of Morbid Anatomy, College of Medicine Idi-Araba, Lagos, Nigeria; 4Department of Microbiology, University of Calabar, NigeriaBackground: Toxoplasmosis is caused by infection with a ubiquitous intracellular protozoan parasite, Toxoplasma gondii. With the advent of the HIV pandemic in Nigeria, toxoplasmic encephalitis has become one of the more frequent opportunistic infections and the most commonly implicated cause of focal brain lesions complicating the course of AIDS.Objectives: This study was conducted to compare the pattern of seroprevalence of T. gondii (Toxo-IgG antibodies among HIV-infected persons presenting with neurological complications and those without.Materials and methods: Plasma specimens collected from 380 subjects were tested for Toxo-IgG antibodies by enzyme immunoassay technique and CD4 estimation by flow cytometry. Close-ended questionnaires were applied to all respondents to collect relevant data, with ethical approval from the hospital ethical committee. Plasma was obtained from two study groups comprising 300 HIV-positive respondents without neurological presentations, and 80 HIV-positive respondents with neurological complications.Results: Seroprevalence of Toxo-IgG antibodies was 58% in the HIV-positive study group without neurological complications (of these, 79.2% were males and 38.5% were females and 40% in the study group with neurological complications (46.2% of these were males and 28.6% were females. The overall seroprevalence of Toxo-IgG antibodies among the HIV-positive respondents (with and without neurological complications was 54.2% (206 of 380. Seroprevalence of Toxo

  20. Health behaviour change of people living with HIV after a comprehensive community-based HIV stigma reduction intervention in North-West Province in South Africa.

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    Chidrawi, H Christa; Greeff, Minrie; Temane, Q Michael

    2014-01-01

    Abstract All over the world, health behaviour is considered a complex, far reaching and powerful phenomenon. People's lives are influenced by their own or others' health behaviour on a daily basis. Whether it has to do with smoking, drinking, pollution, global warming or HIV management, it touches lives and it challenges personal and community responses. Health behaviour, and health behaviour change, probably holds the key to many a person's immediate or prolonged life or death outcomes. The same can be said about communities, culture groups and nations. This SANPAD-funded study focused on research questions relating to health behaviour change for people living with HIV (PLWH) in the North-West Province in South Africa. It investigated whether a comprehensive community-based HIV stigma reduction intervention caused health behaviour change in PLWH. An quantitative single system research design with one pre- and four repetitive post-tests utilizing purposive sampling was used to test change-over-time in the health behaviour of 18 PLWH. The results of the study indicated statistical and/or practical significant change-over-time. The intervention not only addressed the health behaviour of PLWH, but also their HIV stigma experiences, HIV signs and symptoms and their quality of life in the context of being HIV positive. The recommendations include popularization of the comprehensive community-based HIV stigma reduction intervention and extending it to include a second intervention to strengthen health behaviour and quality of life for PLWH in the community at large.

  1. Factors associated with attendance in 12-step groups (Alcoholics Anonymous/Narcotics Anonymous) among adults with alcohol problems living with HIV/AIDS.

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    Orwat, John; Samet, Jeffrey H; Tompkins, Christopher P; Cheng, Debbie M; Dentato, Michael P; Saitz, Richard

    2011-01-15

    Despite the value of 12-step meetings, few studies have examined factors associated with attendance among those living with HIV/AIDS, such as the impact of HIV disease severity and demographics. This study examines predisposing characteristics, enabling resources and need on attendance at Alcoholic Anonymous (AA) and Narcotics Anonymous (NA) meetings among those living with HIV/AIDS and alcohol problems. Secondary analysis of prospective data from the HIV-Longitudinal Interrelationships of Viruses and Ethanol study, a cohort of 400 adults living with HIV/AIDS and alcohol problems. Factors associated with AA/NA attendance were identified using the Anderson model for vulnerable populations. Generalized estimating equation logistic regression models were fit to identify factors associated with self-reported AA/NA attendance. At study entry, subjects were 75% male, 12% met diagnostic criteria for alcohol dependence, 43% had drug dependence and 56% reported attending one or more AA/NA meetings (past 6 months). In the adjusted model, female gender negatively associated with attendance, as were social support systems that use alcohol and/or drugs, while presence of HCV antibody, drug dependence diagnosis, and homelessness associated with higher odds of attendance. Non-substance abuse related barriers to AA/NA group attendance exist for those living with HIV/AIDS, including females and social support systems that use alcohol and/or drugs. Positive associations of homelessness, HCV infection and current drug dependence were identified. These findings provide implications for policy makers and treatment professionals who wish to encourage attendance at 12-step meetings for those living with HIV/AIDS and alcohol or other substance use problems. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  2. HIV, Gender, Race, Sexual Orientation, and Sex Work: A Qualitative Study of Intersectional Stigma Experienced by HIV-Positive Women in Ontario, Canada

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    Logie, Carmen H.; James, LLana; Tharao, Wangari; Loutfy, Mona R.

    2011-01-01

    Background HIV infection rates are increasing among marginalized women in Ontario, Canada. HIV-related stigma, a principal factor contributing to the global HIV epidemic, interacts with structural inequities such as racism, sexism, and homophobia. The study objective was to explore experiences of stigma and coping strategies among HIV-positive women in Ontario, Canada. Methods and Findings We conducted a community-based qualitative investigation using focus groups to understand experiences of stigma and discrimination and coping methods among HIV-positive women from marginalized communities. We conducted 15 focus groups with HIV-positive women in five cities across Ontario, Canada. Data were analyzed using thematic analysis to enhance understanding of the lived experiences of diverse HIV-positive women. Focus group participants (n = 104; mean age = 38 years; 69% ethnic minority; 23% lesbian/bisexual; 22% transgender) described stigma/discrimination and coping across micro (intra/interpersonal), meso (social/community), and macro (organizational/political) realms. Participants across focus groups attributed experiences of stigma and discrimination to: HIV-related stigma, sexism and gender discrimination, racism, homophobia and transphobia, and involvement in sex work. Coping strategies included resilience (micro), social networks and support groups (meso), and challenging stigma (macro). Conclusions HIV-positive women described interdependent and mutually constitutive relationships between marginalized social identities and inequities such as HIV-related stigma, sexism, racism, and homo/transphobia. These overlapping, multilevel forms of stigma and discrimination are representative of an intersectional model of stigma and discrimination. The present findings also suggest that micro, meso, and macro level factors simultaneously present barriers to health and well being—as well as opportunities for coping—in HIV-positive women's lives. Understanding the

  3. Hospitalization Rates Among People With HIV/AIDS in New York City, 2013.

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    Lazar, Rachael; Kersanske, Laura; Xia, Qiang; Daskalakis, Demetre; Braunstein, Sarah L

    2017-08-01

    Hospitalizations are an important indicator of healthcare quality and access for people with human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS). This study assesses hospitalization rates among people with HIV/AIDS in New York City. We performed a deterministic match between people in the New York City HIV surveillance registry alive as of 1 January 2013 and diagnosed with HIV as of 31 December 2013 and patient-level inpatient hospitalization records during 2013. Event-level data were analyzed to determine characteristics of and reasons for hospitalizations. Primary diagnoses were classified using the International Classification of Diseases, Ninth Revision, Clinical Modification. We estimated hospitalization rates as the number of hospitalizations per 100 person-years for all causes, AIDS-defining illnesses, and non-AIDS-defining infections. Nearly one-fifth of hospitalizations were attributed to non-AIDS-defining infections, whereas AIDS-defining illness diagnoses were infrequent (3.6% of hospitalizations). Other common causes were cardiovascular (10.9%) and substance use (9.8%). The estimated all-cause hospitalization rate was 36.7 per 100 person-years. Higher all-cause hospitalization rates were observed among females (46.8 per 100 person-years), Black and Latino/Hispanic people (41.8 and 39.5 per 100 person-years, respectively), people living in high-poverty neighborhoods (47.4 per 100 person-years), and people with a history of injection drug use (74.9 per 100 person-years). The estimated AIDS-defining illness and non-AIDS-defining infection hospitalization rates were 1.3 and 7.2 per 100 person-years, respectively. People with HIV in New York City were frequently hospitalized. While AIDS-defining illnesses were relatively rare, non-AIDS-defining infection hospitalizations were more common. Disparities in hospitalization rates indicate a need for targeted improved primary care and comorbid disease management. © The Author 2017

  4. Mental illness sexual stigma: Implications for health and recovery.

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    Wainberg, Milton L; Cournos, Francine; Wall, Melanie M; Norcini Pala, Andrea; Mann, Claudio Gruber; Pinto, Diana; Pinho, Veronica; McKinnon, Karen

    2016-06-01

    The majority of people in psychiatric care worldwide are sexually active, and studies have revealed sharply elevated rates of HIV infection in that group compared with the general population. Recovery-oriented treatment does not routinely address sexuality. We examined the relationship between gender, severe mental illness diagnosis, and stigma experiences related to sexuality among people in psychiatric outpatient care. Sexually active adults attending 8 public outpatient psychiatric clinics in Rio de Janeiro (N = 641) were interviewed for psychiatric diagnosis and stigma experiences. Stigma mechanisms well-established in the literature but not previously examined in relation to sexuality were measured with the Mental Illness Sex Stigma Questionnaire, a 27-item interview about stigma in sexual situations and activities. Experiences of stigma were reported by a majority of participants for 48% of questionnaire items. Most people reported supportive attitudes toward their sexuality from providers and family members. Those with severe mental illness diagnoses showed greater stigma on individual discrimination and structural stigma mechanisms than did those with nonsevere mental illness diagnoses, whereas there was no difference on the social psychological processes (internalized stigma) mechanism. Regardless of diagnosis or gender, a majority of participants devalued themselves as sexual partners. Adults in psychiatric outpatient care frequently reported stigma experiences related to aspects of their sexual lives. From the perspectives of both HIV prevention and recovery from mental illness, examinations of the consequences of stigma in the sexual lives of people in psychiatric care and improving their measurement would have wide applicability. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  5. My secret: The social meaning of HIV/AIDS stigma

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    Judgeo, N.; Moalusi, K.P.

    2014-01-01

    Abstract This study uses Goffman's [1963. Stigma: Notes on the Management of Spoiled Identity, New Jersey, Prentice-Hall] theory of stigma as an intellectual scaffold to help understand the social meaning of HIV/AIDS stigma from People Living with HIV/AIDS. The study adopts a qualitative approach because of its appropriateness for unravelling subjective phenomena such as the experiences of HIV/AIDS stigma. In-depth interviews were conducted with 10 HIV-positive employees of a retailing company located in the Western Cape province of South Africa who volunteered to participate in the study. The participants with the discreditable stigma internalised society's prejudice towards those living with the virus. As a result, the participants relied on self-isolation and social withdrawal to cope with enacted stigma. Managing information about one's status and deciding whether, who, when, etc., to tell are crucial questions. The participants feared being devalued by family, friends, co-workers and the community. In concurrence with Goffman [1963. Stigma: Notes on the Management of Spoiled Identity, New Jersey, Prentice-Hall] the HIV/AIDS stigma is seen as about relationships. PMID:24980478

  6. Medicalizing versus psychologizing mental illness: what are the implications for help seeking and stigma? A general population study.

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    Pattyn, E; Verhaeghe, M; Sercu, C; Bracke, P

    2013-10-01

    This study contrasts the medicalized conceptualization of mental illness with psychologizing mental illness and examines what the consequences are of adhering to one model versus the other for help seeking and stigma. The survey "Stigma in a Global Context-Belgian Mental Health Study" (2009) conducted face-to-face interviews among a representative sample of the general Belgian population using the vignette technique to depict schizophrenia (N = 381). Causal attributions, labeling processes, and the disease view are addressed. Help seeking refers to open-ended help-seeking suggestions (general practitioner, psychiatrist, psychologist, family, friends, and self-care options). Stigma refers to social exclusion after treatment. The data are analyzed by means of logistic and linear regression models in SPSS Statistics 19. People who adhere to the biopsychosocial (versus psychosocial) model are more likely to recommend general medical care and people who apply the disease view are more likely to recommend specialized medical care. Regarding informal help, those who prefer the biopsychosocial model are less likely to recommend consulting friends than those who adhere to the psychosocial model. Respondents who apply a medical compared to a non-medical label are less inclined to recommend self-care. As concerns treatment stigma, respondents who apply a medical instead of a non-medical label are more likely to socially exclude someone who has been in psychiatric treatment. Medicalizing mental illness involves a package deal: biopsychosocial causal attributions and applying the disease view facilitate medical treatment recommendations, while labeling seems to trigger stigmatizing attitudes.

  7. Adherence to the cervical cancer screening program in women living with HIV in Denmark: comparison with the general population.

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    Thorsteinsson, Kristina; Ladelund, Steen; Jensen-Fangel, Søren; Katzenstein, Terese L; Johansen, Isik Somuncu; Pedersen, Gitte; Junge, Jette; Helleberg, Marie; Storgaard, Merete; Lebech, Anne-Mette

    2014-05-13

    Women living with HIV (WLWH) are at increased risk of invasive cervical cancer (ICC). International HIV guidelines suggest cervical screening twice the first year after HIV diagnosis and thereafter annually. Adherence to the HIV cervical screening program in Denmark is unknown. We studied women from a population-based, nationwide HIV cohort in Denmark and a cohort of age-matched females from the general population. Screening behaviour was assessed from 1999-2010. Adjusted odds ratios (OR's) for screening attendance in the two cohorts and potential predictors of attendance to guidelines were estimated. Pathology specimens were identified from The Danish Pathology Data Bank. We followed 1143 WLWH and 17,145 controls with no prior history of ICC for 9,509 and 157,362 person-years. The first year after HIV diagnosis 2.6% of WLWH obtained the recommended two cervical cytologies. During the different calendar intervals throughout the study period between 29-46% of WLWH followed the HIV cervical screening guidelines. Adjusted OR's of attendance to the general population screening program for WLWH aged 30, 40 and 50 years, compared to controls, were 0.69 (95% CI: 0.56-0.87), 0.67 (0.55-0.80) and 0.84 (0.61-1.15). Predictors of attendance to the HIV cervical screening program were a CD4 count > 350 cells/μL and HIV RNA < 500 copies/mL. Calendar period after 2002 and HIV RNA < 500 copies/mL predicted attendance to the general population cervical screening program. The majority of WLWH do not follow the HIV guidelines for cervical screening. We support the idea of cytology as part of an annual review and integration of HIV care and cervical screening in a single clinic setting.

  8. Perceived HIV-associated stigma among HIV-seropositive men: psychometric study of HIV stigma scale

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    Adrian eValle

    2015-07-01

    Full Text Available Objectives: To assess the internal consistency and factor structure of the abridged Spanish version of the Berger HIV Stigma Scale (HSS-21, provide evidence for its convergent and discriminant validity, and describe perceived stigma in an urban population from northeast Mexico. Methods: Seventy five HIV-positive men who have sex with men (MSM were recruited. Participants answered the Spanish versions of three Likert-type scales: HSS-21, Robsenberg’s self-esteem scale, and the abbreviated version of the Zung’s Depression Scale.Results: HSS-21 showed high reliability and validity; its factor structure included four components: concern with public attitudes; negative self-image; disclosure concerns; and enacted stigma. The level of stigma was high in 27 out of 75 (36% participants; nevertheless, the score found in the component related to disclosure concerns indicated high level of stigma in 68% of participants. The score of HSS-21 was positively correlated with the score of depression and negatively correlated with the score of self-esteem. Conclusion: Results demonstrated high reliability for the HSS-21; correlations with other scales supported its validity. This scale demonstrated to be a practical tool for assessing stigma among Mexican HIV-positive MSM. High level of stigma was found only in the factor related to disclosure concerns. Policy Implications: Identifying HIV-associated stigma through a short, reliable and validated instrument will allow the development of interventions that cope and manage stigma in HIV-positive MSM. HSS-21 distinguishes between different dimensions of stigma and will contribute to a better understanding of this phenomenon.

  9. Community Cultural Norms, Stigma and Disclosure to Sexual Partners among Women Living with HIV in Thailand, Brazil and Zambia (HPTN 063.

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    Bisola O Ojikutu

    Full Text Available Serostatus disclosure may facilitate decreased HIV transmission between serodiscordant partners by raising risk awareness and heightening the need for prevention. For women living with HIV (WLWH, the decision to disclose may be influenced by culturally determined, community-level stigma and norms. Understanding the impact of community HIV stigma and gender norms on disclosure among WLWH in different countries may inform intervention development.HPTN063 was a longitudinal, observational study of sexually active HIV-infected individuals, including heterosexual women, in care in Zambia, Thailand and Brazil. At baseline, a questionnaire measuring community HIV stigma and gender norms, anticipated stigma, demographic, partner/relationship characteristics, and intimate partner violence was administered. Longitudinal HIV disclosure to sexual partners was determined via audio-computer assisted self-interview (ACASI at the baseline and quarterly during the one year following up. Logistic regression was conducted to identify the predictors of disclosure.Almost half (45% of women living with HIV acknowledged perceived community HIV stigma (the belief that in their community HIV infection among women is associated with sex work and multiple sexual partners. Many women (42.9% also acknowledged perceived community gender norms (the belief that traditional gender norms such as submissiveness to husbands/male sexual partners is necessary and that social status is lost if one does not procreate. HIV disclosure to current sex partners was reported by 67% of women. In multivariate analysis, among all women, those who were older [OR 0.16, 95%CI(0.06,0.48], reported symptoms of severe depression [OR 0.53, 95%CI(0.31, 0.90], endorsed anticipated stigma [OR 0.30, 95%CI(0.18, 0.50], and were unmarried [OR 0.43, 95%CI(0.26,0.71] were less likely to disclose to current partners. In an analysis stratified by marital status and cohabitation, unmarried [OR 0.41, 95%CI(0

  10. Associations between Forced Sexual Initiation, HIV Status, Sexual Risk Behavior, Life Stressors, and Coping Strategies among Adolescents in Nigeria

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    Folayan, Morenike Oluwatoyin

    2016-01-01

    Objectives Some individuals experience their first sexual intercourse through physically forced sex, which affects the way they experience and cope with stress. We examined differences in sexual risk behavior, experience of stressors, and use of stress-coping strategies among adolescents in Nigeria based on their history of forced sexual initiation and HIV status. Methods We analyzed data from 436 sexually active 10–19-year-old adolescents recruited through a population-based survey from 12 Nigerian states. Using Lazarus and Folkman’s conceptual framework of stress and coping, we assessed if adolescents who reported forced sexual initiation were more likely to report HIV sexual risk practices, to report as stressors events related to social expectations, medical care and body images, and loss and grief, and to use more avoidance than adaptive coping strategies to manage stress. We also assessed if HIV status affected experience of stressors and use of coping strategies. Results Eighty-one adolescents (18.6%) reported a history of forced sexual initiation; these participants were significantly more likely to report anal sex practices (OR: 5.04; 95% CI: 2.14–11.87), and transactional sex (OR: 2.80; 95% CI: 1.56–4.95). Adolescents with no history of forced sexual initiation were more likely to identify as stressors, life events related to social expectations (OR: 1.03; 95% CI: 0.96–1.11) and loss and grief (OR: 1.34; 95% CI: 0.73–2.65), but not those related to medical care and body images (OR: 0.63; 95% CI: 0.34–1.18). They were also more likely to use adaptive responses (OR: 1.48; 95% CI: 0.62–3.50) than avoidance responses (OR: 0.90; 95% CI: 0.49–1.64) to cope with stress, though these differences were not significant. More adolescents with a history of forced sexual initiation who were HIV positive identified as stressors, life events related to medical care and body images (p = 0.03) and loss and grief (p = 0.009). Adolescents reporting forced

  11. HIV stigma and associated factors among antiretroviral treatment clients in Jimma town, Southwest Ethiopia

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    Nikus Fido N

    2016-11-01

    Full Text Available Neno Nikus Fido, Mamusha Aman, Zewdie Brihnu Department of Health Education and Behavioral Sciences, Jimma University, Jimma, Ethiopia Background: HIV stigma has an important role in the spread of the AIDS epidemic. It profoundly affects the lives of individuals living with HIV/AIDS. Fear of being identified as having HIV may discourage a person from getting tested, accessing medical services, and obtaining medications. Thus, this study was aimed at assessing HIV-related stigma and associated factors among antiretroviral treatment (ART clients in Jimma town, Oromia region, Southwest Ethiopia. Methods: A facility-based cross-sectional study was conducted from March 11 to April 26, 2015, in ART clinics in Jimma town. Consecutively identified sample was obtained from ART clients who voluntarily participated in the survey after signing written consent. A structured interviewer-administered questionnaire was used to collect the data. Multiple linear regressions were conducted to assess the factors associated with various stigma domains. Results: Out of 349 clients requested, 318 (91.1% respondents voluntarily participated in the study; among them, 204 (64.2% respondents were females and the mean age of the respondents was 32.9 years. The mean score (and possible range of experienced HIV stigma was 41.5±12.6 (20.0–86.7, internalized stigma was 50.5±16.4 (20–96.5, and perceived stigma was 56.2±19.2 (20–100. Conclusion: The study revealed that duration of ART use and provider-initiated and forced HIV testing were significantly associated with the three HIV stigma domains. Despite the lower experienced HIV stigma, there were higher internalized and perceived stigmas. Therefore, HIV counseling services should be strengthened for new ART beginners, including pretest counseling. Keywords: HIV/AIDS, Jimma, stigma, ART clients, PLWHA

  12. Experiences of stigma in healthcare settings among adults living with HIV in the Islamic Republic of Iran.

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    Rahmati-Najarkolaei, Fatemeh; Niknami, Shamsaddin; Aminshokravi, Farkhondeh; Bazargan, Mohsen; Ahmadi, Fazlollah; Hadjizadeh, Ebrahim; Tavafian, Sedigheh S

    2010-07-22

    People living with HIV (PLHIV) sometimes experience discrimination. There is little understanding of the causes, forms and consequences of this stigma in Islamic countries. This qualitative study explored perceptions and experiences of PLHIV regarding both the quality of healthcare and the attitudes and behaviours of their healthcare providers in the Islamic Republic of Iran. In-depth, semi-structured interviews were held with a purposively selected group of 69 PLHIV recruited from two HIV care clinics in Tehran. Data were analyzed using the content analysis approach. Nearly all participants reported experiencing stigma and discrimination by their healthcare providers in a variety of contexts. Participants perceived that their healthcare providers' fear of being infected with HIV, coupled with religious and negative value-based assumptions about PLHIV, led to high levels of stigma. Participants mentioned at least four major forms of stigma: (1) refusal of care; (2) sub-optimal care; (3) excessive precautions and physical distancing; and (4) humiliation and blaming. The participants' healthcare-seeking behavioural reactions to perceived stigma and discrimination included avoiding or delaying seeking care, not disclosing HIV status when seeking healthcare, and using spiritual healing. In addition, emotional responses to perceived acts of stigma included feeling undeserving of care, diminished motivation to stay healthy, feeling angry and vengeful, and experiencing emotional stress. While previous studies demonstrate that most Iranian healthcare providers report fairly positive attitudes towards PLHIV, our participants' experiences tell a different story. Therefore, it is imperative to engage both healthcare providers and PLHIV in designing interventions targeting stigma in healthcare settings. Additionally, specialized training programmes in universal precautions for health providers will lead to stigma reduction. National policies to strengthen medical training and

  13. Do social support, stigma, and social problem-solving skills predict depressive symptoms in people living with HIV? A mediation analysis.

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    White, Worawan; Grant, Joan S; Pryor, Erica R; Keltner, Norman L; Vance, David E; Raper, James L

    2012-01-01

    Social support, stigma, and social problem solving may be mediators of the relationship between sign and symptom severity and depressive symptoms in people living with HIV (PLWH). However, no published studies have examined these individual variables as mediators in PLWH. This cross-sectional, correlational study of 150 PLWH examined whether social support, stigma, and social problem solving were mediators of the relationship between HIV-related sign and symptom severity and depressive symptoms. Participants completed self-report questionnaires during their visits at two HIV outpatient clinics in the Southeastern United States. Using multiple regression analyses as a part of mediation testing, social support, stigma, and social problem solving were found to be partial mediators of the relationship between sign and symptom severity and depressive symptoms, considered individually and as a set.

  14. Coping Strategies Among Brazilian Pregnant Women Living With HIV

    Directory of Open Access Journals (Sweden)

    Evelise Rigoni de Faria

    2014-04-01

    Full Text Available Pregnant women living with HIV (PWLH face tremendous challenges in order to prevent their babies’ infection. Coping is a potential buffer against negative outcomes from these challenges. This study aims to describe coping strategies of PWLH. This cross-sectional survey involved 77 PWLH from a public health care center in Brazil. Coping was measured for three types of strategies: Problem-focused, Emotion-focused, and Relationship support. Multivariate analyses identified some coping predictors. Being employed, reporting religious practice and higher CD4/immunity were associated with Problem-focused coping. Lower educational level was associated with Emotion-focused strategies. Relationship support strategies were more likely to be reported by PWLH who had good social support, who had disclosed HIV status to the baby’s father, and who knew their infection before pregnancy. Findings underline the need for HIV interventions focused on social support and participation by the baby’s father, with particular attention to those PWLH who were recently diagnosed and economically vulnerable.

  15. Barriers to and determinants of medication adherence among hypertensive patients attended National Health Service Hospital, Sunderland

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    Muhammad Umair Khan

    2014-01-01

    Full Text Available Background: Hypertension is a silent killer, a time bomb in both the developed and developing nations of the world. It is one of the most significant risk factors for cardiovascular morbidity and mortality resulting from target-organ damage to blood vessels in the heart, brain, kidney and eyes. Adherence to long-term therapy for chronic illnesses like hypertension is an important tool to enhance the effectiveness of pharmacotherapy. Objective: The two objectives of this study were to evaluate the extent and reasons of non-adherence in patients attended National Health Service (NHS Hospital, Sunderland. Materials and Methods: The study was conducted for 4 months in the out-patient department of NHS Hospital. A total of 200 patients were selected randomly for this study. Morisky′s Medication Adherence Scale was used to assess the adherence rate and the reason of non-adherence. Data were entered and analyzed using Microsoft Excel 2010. Results: The overall adherence rate was found to be 79% (n = 158. Adherence rate in females were low was compared with their male counterparts (74.7% vs. 85.7%. The higher rate of adherence was found in age group of 30-40 years (82%, n = 64. The major intentional and non-intentional reason of non-adherence was side-effects and forgetfulness respectively. Conclusion: Overall, more than three-fourth of the hypertensive participants were found to be adherent to their treatment. On the basis of factors associated with non-adherence, it is analyzed that suitable therapy must be designed for patients individually to increase medication adherence and its effectiveness.

  16. Challenging mental health related stigma in China: Systematic review and meta-analysis. II. Interventions among people with mental illness.

    Science.gov (United States)

    Xu, Ziyan; Huang, Fangfang; Kösters, Markus; Rüsch, Nicolas

    2017-09-01

    People with mental illness often face different types of mental illness stigma that may affect their lives, including perceived stigma, self-stigma, harmful coping strategies and poor quality of life. Although anti-stigma interventions for people with mental illness from Western countries have been identified by recent systematic reviews, their efficacy in China is unknown. This review evaluates the efficacy of anti-stigma interventions among people with mental illness in Mainland China, Hong Kong, Taiwan and Macau. A systematic search of 8 electronic databases in English and Chinese yielded 17 randomized and non-randomized controlled trials. Standardized mean differences (SMDs) were calculated wherever possible. Psychoeducation was the most commonly used intervention. SMDs were large and significant for perceived/experienced/anticipated stigma, self-prejudice and coping with stigma, as well as for depression and anxiety symptoms and quality of life. Both Cognitive Behavioral Therapy and psychoeducation had positive effects on perceived/experienced/anticipated stigma. The quality of studies was modest and heterogeneity across studies was high. Anti-stigma interventions demonstrated promise to reduce stigma's negative impact on people with mental illness in China, but more high-quality intervention research is needed. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  17. "A life of living death": the experiences of people living with chronic low back pain in rural Nigeria.

    Science.gov (United States)

    Igwesi-Chidobe, Chinonso N; Kitchen, Sheila; Sorinola, Isaac O; Godfrey, Emma L

    2017-04-01

    This study explored the experiences of people living with non-specific chronic low back pain (CLBP) in a rural Nigerian community. Qualitative in-depth semi-structured face-to-face interviews were conducted with purposively sampled participants until data saturation. Questions explored back pain beliefs, coping/management strategies and daily activities. Thematic analysis of transcripts was performed using the Framework approach. Themes showed that back pain beliefs were related to manual labour/deprivation, infection/degeneration, spiritual/cultural beliefs and rural-urban divide. These beliefs impacted on gender roles resulting in adaptive or maladaptive coping. Adaptive coping was facilitated by positive beliefs, such as not regarding CLBP as an illness, whereas viewing CLBP as illness stimulated maladaptive coping strategies. Spirituality was associated with both adaptive and maladaptive coping. Maladaptive coping strategies led to dissatisfaction with health care in this community. CLBP-related disability in rural Nigeria is strongly influenced by beliefs that facilitate coping strategies that either enhance or inhibit recovery. Interventions should therefore target maladaptive beliefs while emphasizing behavioural modification. Implications for Rehabilitation Non-specific chronic low back pain (CLBP) is highly prevalent and responsible for much pain and disability in rural Nigeria. No qualitative study has investigated the experiences of people living with CLBP in rural Nigeria or any other rural African context. Qualitative study of peoples' experiences of living with CLBP in rural Nigeria has the potential of exposing complex socio-cultural and psychological factors associated with CLBP which has potential implications for designing effective interventions. The results of this study may inform the development of complex interventions for reducing the disability associated with CLBP in rural Nigeria and other rural African contexts.

  18. Network support, technology use, depression, and ART adherence among HIV-positive MSM of color.

    Science.gov (United States)

    Holloway, I W; Tan, D; Dunlap, S L; Palmer, L; Beougher, S; Cederbaum, J A

    2017-09-01

    Depression is associated with poor antiretroviral therapy (ART) adherence among people living with HIV/AIDS. This relationship may be moderated by an individual's social network characteristics. Our study sought to examine social network correlates of treatment adherence among HIV-positive men recruited from social service agencies throughout Los Angeles County (N = 150) to inform technology-driven social support interventions for this population. We administered egocentric social network and computer-assisted survey interviews focused on demographic characteristics, health history, depressive symptoms, and ART adherence, where adherence was assessed by the number of reasons participants missed taking their medication, if ever. Significant univariate correlates of adherence were included in a multivariable regression analysis, where the moderating effect of having a network member who reminds participants to take their HIV medication on the relationship between depression and adherence was tested. Over 60% of participants reported clinically significant depressive symptoms; this was significantly associated with lower adherence among those without someone in their social network to remind them about taking their HIV medication, even after adjusting for covariates in an ordinary least squares regression (adjusted mean difference b = -1.61, SE = 0.42, p = 0.0003). Having a network member who reminds participants to take their ART medication significantly ameliorated the negative association between depression and treatment adherence, especially for those reporting greater depressive symptoms (p = 0.0394). Additionally, participants demonstrated high rates of technology use to communicate with social network members. In order to achieve the aims of the National HIV/AIDS Strategy, innovative interventions addressing mental health to improve ART adherence are needed. Network strategies that leverage technology may be helpful for improving ART

  19. Longitudinal relationships between antiretroviral treatment adherence and discrimination due to HIV-serostatus, race, and sexual orientation among African-American men with HIV.

    Science.gov (United States)

    Bogart, Laura M; Wagner, Glenn J; Galvan, Frank H; Klein, David J

    2010-10-01

    African-Americans show worse HIV disease outcomes compared to Whites. Health disparities may be aggravated by discrimination, which is associated with worse health and maladaptive health behaviors. We examined longitudinal effects of discrimination on antiretroviral treatment adherence among 152 HIV-positive Black men who have sex with men. We measured adherence and discrimination due to HIV-serostatus, race/ethnicity, and sexual orientation at baseline and monthly for 6 months. Hierarchical repeated-measures models tested longitudinal effects of each discrimination type on adherence. Over 6 months, participants took 60% of prescribed medications on average; substantial percentages experienced discrimination (HIV-serostatus, 38%; race/ethnicity, 40%; and sexual orientation, 33%). Greater discrimination due to all three characteristics was significantly bivariately associated with lower adherence (all p's discrimination was significant (p < 0.05). Efforts to improve HIV treatment adherence should consider the context of multiple stigmas, especially racism.

  20. Exploring intentions to discriminate against patients living with HIV/AIDS among future healthcare providers in Malaysia.

    Science.gov (United States)

    Earnshaw, Valerie A; Jin, Harry; Wickersham, Jeffrey; Kamarulzaman, Adeeba; John, Jacob; Altice, Frederick L

    2014-06-01

    Stigma towards people living with HIV/AIDS (PLWHA) is strong in Malaysia. Although stigma has been understudied, it may be a barrier to treating the approximately 81 000 Malaysian PLWHA. The current study explores correlates of intentions to discriminate against PLWHA among medical and dental students, the future healthcare providers of Malaysia. An online, cross-sectional survey of 1296 medical and dental students was conducted in 2012 at seven Malaysian universities; 1165 (89.9%) completed the survey and were analysed. Socio-demographic characteristics, stigma-related constructs and intentions to discriminate against PLWHA were measured. Linear mixed models were conducted, controlling for clustering by university. The final multivariate model demonstrated that students who intended to discriminate more against PLWHA were female, less advanced in their training, and studying dentistry. They further endorsed more negative attitudes towards PLWHA, internalised greater HIV-related shame, reported more HIV-related fear and disagreed more strongly that PLWHA deserve good care. The final model accounted for 38% of the variance in discrimination intent, with 10% accounted for by socio-demographic characteristics and 28% accounted for by stigma-related constructs. It is critical to reduce stigma among medical and dental students to eliminate intentions to discriminate and achieve equitable care for Malaysian PLWHA. Stigma-reduction interventions should be multipronged, addressing attitudes, internalised shame, fear and perceptions of deservingness of care. © 2014 John Wiley & Sons Ltd.

  1. Prevalence of HIV among Aboriginal and Torres Strait Islander Australians: a systematic review and meta-analysis.

    Science.gov (United States)

    Graham, Simon; O'Connor, Catherine C; Morgan, Stephen; Chamberlain, Catherine; Hocking, Jane

    2017-06-01

    Background Aboriginal and Torres Strait Islanders (Aboriginal) are Australia's first peoples. Between 2006 and 2015, HIV notifications increased among Aboriginal people; however, among non-Aboriginal people, notifications remained relatively stable. This systematic review and meta-analysis aims to examine the prevalence of HIV among Aboriginal people overall and by subgroups. In November 2015, a search of PubMed and Web of Science, grey literature and abstracts from conferences was conducted. A study was included if it reported the number of Aboriginal people tested and those who tested positive for HIV. The following variables were extracted: gender; Aboriginal status; population group (men who have sex with men, people who inject drugs, adults, youth in detention and pregnant females) and geographical location. An assessment of between study heterogeneity (I 2 test) and within study bias (selection, measurement and sample size) was also conducted. Seven studies were included; all were cross-sectional study designs. The overall sample size was 3772 and the prevalence of HIV was 0.1% (I 2 =38.3%, P=0.136). Five studies included convenient samples of people attending Australian Needle and Syringe Program Centres, clinics, hospitals and a youth detention centre, increasing the potential of selection bias. Four studies had a sample size, thus decreasing the ability to report pooled estimates. The prevalence of HIV among Aboriginal people in Australia is low. Community-based programs that include both prevention messages for those at risk of infection and culturally appropriate clinical management and support for Aboriginal people living with HIV are needed to prevent HIV increasing among Aboriginal people.

  2. Adherence to antiretroviral treatment and associated factors in people living with HIV/AIDS in Quindío, Colombia

    OpenAIRE

    Deisy Viviana Cardona-Duque; Oscar Adolfo Medina-Pérez; Sandra Milena Herrera-Castaño; Paula Andrea Orozco-Gómez

    2017-01-01

    Introduction: HIV/AIDS is a chronic disease; therefore, recognizing which factors favor adherence to antiretroviral treatment is necessary. Objective: To determine the association between adherence to antiretroviral treatment and depression, anxiety, perception of social support and sociodemographic variables in people living with HIV/AIDS in Quindío, Colombia. Materials and methods: An observational, cross-sectional study was performed in an intentional sample of 70 adults, who were ap...

  3. Advancing Behavioral HIV Prevention: Adapting an Evidence-Based Intervention for People Living with HIV and Alcohol Use Disorders

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    M. L. Armstrong

    2015-01-01

    Full Text Available Alcohol use disorders (AUDs are highly prevalent among people living with HIV/AIDS (PLWHA and are associated with increased HIV risk behaviors, suboptimal treatment adherence, and greater risk for disease progression. We used the ADAPT-ITT strategy to adapt an evidence-based intervention (EBI, the Holistic Health Recovery Program (HHRP+, that focuses on secondary HIV prevention and antiretroviral therapy (ART adherence and apply it to PLWHA with problematic drinking. Focus groups (FGs were conducted with PLWHA who consume alcohol and with treatment providers at the largest HIV primary care clinic in New Orleans, LA. Overall themes that emerged from the FGs included the following: (1 negative mood states contribute to heavy alcohol consumption in PLWHA; (2 high levels of psychosocial stress, paired with few adaptive coping strategies, perpetuate the use of harmful alcohol consumption in PLWHA; (3 local cultural norms are related to the permissiveness and pervasiveness of drinking and contribute to heavy alcohol use; (4 healthcare providers unanimously stated that outpatient options for AUD intervention are scarce, (5 misperceptions about the relationships between alcohol and HIV are common; (6 PLWHA are interested in learning about alcohol’s impact on ART and HIV disease progression. These data were used to design the adapted EBI.

  4. Experiences of work among people with disabilities who are HIV-positive in Zambia.

    Science.gov (United States)

    Njelesani, Janet; Nixon, Stephanie; Cameron, Deb; Parsons, Janet; Menon, Anitha

    2015-01-01

    This paper focuses on accounts of how having a disability and being HIV-positive influences experiences of work among 21 people (12 women, 9 men) in Lusaka, Zambia. In-depth semi-structured interviews were conducted in English, Bemba, Nyanja, or Zambian sign language. Descriptive and thematic analyses were conducted. Three major themes were generated. The first, a triple burden, describes the burden of having a disability, being HIV-positive, and being unemployed. The second theme, disability and HIV is not inability, describes participants' desire for work and their resistance to being regarded as objects of charity. Finally, how work influences HIV management, describes the practicalities of working and living with HIV. Together these themes highlight the limited options available to persons with disabilities with HIV in Lusaka, not only secondary to the effects of HIV influencing their physical capacity to work, but also because of the attendant social stigma of being a person with a disability and HIV-positive.

  5. Social Stigma in the Care Service of People with Hiv/Aids for Students and Professionals of the Areas of Health, Medellin, Colombia

    Directory of Open Access Journals (Sweden)

    Byron Tamayo-Zuluaga

    2015-01-01

    Full Text Available Abstract Introduction: The social stigma in people with HIV/AIDS by students and health professionals hinders early diagnosis, timely treatment and increases the spread risk of the pandemic. Objective: To describe the social stigma in the care of people with HIV/AIDS by socioeconomic, demographic and academic conditions. Materials and methods: A cross-sectional study in 1,253 individuals. The scale of social stigma was validated with criteria of appearance, content, construct, internal consistency, reliability and usefulness. The analyzes included Pearson correlations, Cronbach,factor analysis, frequencies, summary measures, Mann Whitney U, Anova and multivariate linear regression in SPSS 21.0 R. Results: The highest frequencies for stigma were related to the differential treatment delivered to people with HIV/AIDS (57.2 %, accounting necessary to create exclusive hospitals for this group (52.5 %, the attention of these patients increases the risk of infection (49.7 %, and the need to isolate HIV-positive (43.3 %. The main predictors of social stigma were the academic program, performing the presumptive test and semester of study. Conclusion: Social stigma attitudes were higher in individuals of the first cycle of formation, without performing the test screening, and medical students; this corroborates the need to improve communication, information and health education strategies to combat stigma.

  6. Self-stigma among caregivers of people with mental illness: toward caregivers’ empowerment

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    Girma E

    2014-01-01

    perceived psychosocial and biological explanations of mental illness (r=0.12, P<0.01. The only independent predictor of caregivers' self-stigma was perceived supernatural explanation of mental illness (standardized β=0.22, P<0.001. Conclusion: The tendency of caregivers to avoid being identified with the patients was observed. Low exposure to mental health information was also reported. Caregivers' self-stigma in this study was significantly correlated with perceived supernatural explanation of mental illness. Since caregivers' self-stigma may negatively influence patients' treatment-seeking, adherence, and rehabilitation processes, programs that enhance coping strategies by strengthening self-esteem and empowerment by health care providers and establish family support groups may be helpful to tackle self-stigma among caregivers of people with mental illness. Keywords: self-stigma, internalized stigma, caregivers, mental illness

  7. "[Drinking is] Like a Rule That You Can't Break": Perceived Barriers and Facilitators to Reduce Alcohol Use and Improve Antiretroviral Treatment Adherence Among People Living with HIV and Alcohol Use Disorder in Vietnam.

    Science.gov (United States)

    Hershow, Rebecca B; Zuskov, Diana S; Vu Tuyet Mai, Nguyen; Chander, Geetanjali; Hutton, Heidi E; Latkin, Carl; Vuong, Nguyen Duc; Sripaipan, Teerada; Lancaster, Kathryn E; Ha, Tran Viet; Go, Vivian F

    2018-03-14

    Alcohol use, a highly normative behavior in Vietnam that is associated with high rates of HIV infection and lower antiretroviral treatment (ART) adherence, has been largely overlooked by HIV prevention efforts. Using the risk environment framework, this qualitative study aims to explore the perceived microenvironmental (community-level) and endogenous (individual-level) barriers and facilitators to alcohol reduction among people living with HIV (PLHIV) with alcohol use disorders (AUDs) in Vietnam. From June-July 2014, semi-structured interviews were conducted with thirty PLHIV (18 men; 12 women) recruited from an outpatient ART clinic in Thai Nguyen province, Vietnam. All participants had scores of ≥8 on the Alcohol Use Disorders Identification Test and ten of the 30 participants were currently using injection drugs. Interviews were transcribed, translated, and analyzed to identify perceived barriers and facilitators to alcohol reduction. Most participants reported a spike in alcohol consumption at the time of HIV diagnosis. Most perceived barriers existed at the microenvironmental level, including perceived inability to refuse alcohol in the context of community-level social norms and lack of alcohol treatment programs. Two commonly mentioned endogenous barriers were compensatory behaviors when reducing injection drug use and using alcohol as a coping strategy for HIV-related sadness. Those who were able to successfully reduce alcohol use and adhere to ART reported having social support to buffer community-level social pressure and cope with sadness. It may be effective to introduce targeted alcohol reduction interventions in health care centers to address individual risk practices and microenvironmental social norms.

  8. An Increase in Religiousness/Spirituality Occurs After HIV Diagnosis and Predicts Slower Disease Progression over 4 Years in People with HIV

    Science.gov (United States)

    Ironson, Gail; Stuetzle, Rick; Fletcher, Mary Ann

    2006-01-01

    BACKGROUND Most studies on religion/spirituality predicting health outcomes have been limited to church attendance as a predictor and have focused on healthy people. However, confronting a major medical crisis may be a time when people turn to the sacred. OBJECTIVE The purpose of this study was to determine the extent to which changes in spirituality/religiousness occur after HIV diagnosis and whether changes predict disease progression. DESIGN/PARTICIPANTS This longitudinal study examined the relationship between changes in spirituality/religiousness from before with after the diagnosis of HIV, and disease progression (CD4 and viral load [VL] every 6 months) over 4 years in 100 people with HIV. Measures included change in religiousness/spirituality after diagnosis of HIV, religiousness/spirituality at various times in one’s life, church attendance, depression, hopelessness, optimism, coping (avoidant, proactive), social support, CD4/VL, and health behaviors. RESULTS Forty-five percent of the sample showed an increase in religiousness/spirituality after the diagnosis of HIV, 42% remained the same, and 13% decreased. People reporting an increase in spirituality/religiousness after the diagnosis had significantly greater preservation of CD4 cells over the 4-year period, as well as significantly better control of VL. Results were independent of (i.e., held even after controlling for) church attendance and initial disease status (CD4/VL), medication at every time point, age, gender, race, education, health behaviors (adherence, risky sex, alcohol, cocaine), depression, hopelessness, optimism, coping (avoidant, proactive), and social support. CONCLUSIONS There is an increase in spirituality/religiousness after HIV diagnosis, and this increase predicts slower disease progression; medical personnel should be aware of its potential importance. PMID:17083503

  9. Barriers to uptake of prevention of mother-to-child transmission of HIV services among mothers of vertically infected HIV-seropositive infants in Makurdi, Nigeria

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    Anígilájé EA

    2016-01-01

    Full Text Available Emmanuel Ademola Anígilájé,1 Bem Ruben Ageda,2 Nnamdi Okechukwu Nweke1 1Department of Paediatrics, 2Department of Obstetrics and Gynaecology, Federal Medical Centre, Makurdi, Nigeria Background: Perinatal transmission of human immunodeficiency virus (HIV continues in Nigeria because of the poor use of prevention of mother-to-child transmission of HIV (PMTCT services. This study reports on the barriers preventing mothers of vertically infected HIV-seropositive infants to use the PMTCT services at the Federal Medical Centre, Makurdi, Nigeria.Methods: This is a descriptive study conducted between January and April, 2014. A quantitative survey was applied to detect barriers along the PMTCT services cascade among 52 mothers of vertically infected HIV-seropositive infants. This includes 22 women who attended antenatal care at the Federal Medical Centre (designated as Group A mothers and 30 women who did not receive any form of PMTCT service (Group B mothers. The study was supplemented with a focused group discussion involving 12 discussants from the two groups.Results: In the quantitative assessment: among the Group A mothers, falling asleep was the most common reason (n=22, 100% for missing therapeutic/prophylactic antiretroviral medicine; financial constraint (n=22, 100% was the most common reason for antenatal care visit defaults; and a lot of the mothers (n=11, 50.0% did not give nevirapine to their newborns because they delivered at home. Among Group B mothers, unawareness of HIV-seropositive status was the most common reason (n=28, 93.3% given for not accessing PMTCT services. In the qualitative study: noninvolvement of male partners, stigma and discrimination experienced by HIV-seropositive mothers, financial constraints in couples, involvement of traditional birth attendants in antenatal care and delivery of HIV-infected women, unawareness of HIV-seropositive status by pregnant women, poor health system, and the lack of funding for PMTCT

  10. Medication adherence and its determinants among psychiatric patients in an Ethiopian referral hospital

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    Demoz Z

    2014-09-01

    Full Text Available Zaid Demoz,1 Befikadu Legesse,1 Gebrehiwot Teklay,1 Birhanu Demeke,1 Tewodros Eyob,2 Zewdneh Shewamene,3 Mubarek Abera4 1Department of Pharmacy, College of Health Sciences, Mekelle University, Mekelle, 2Department of Pharmacy, College of Public Health and Medical Sciences, Jimma University, Jimma, 3Department of Pharmacology, School of Pharmacy, University of Gondar, Gondar, 4Department of Psychiatry, College of Public Health and Medical Sciences, Jimma University, Jimma, Ethiopia Background: The degree to which an individual follows medical advice is a major concern in every medical specialty. Non-adherence to psychiatric treatment regimens has a pro­found impact on the disease course, relapse, future recovery, cost of health care, and the outcome for the patient. The aim of this study was to assess medication adherence and its correlates among psychiatric patients at Ayder Referral Hospital, Northern Ethiopia.Methods: A cross-sectional study was conducted from June to September 2013 at Ayder Referral Hospital, where 423 patients were selected by a systematic random sampling technique from all patients attending the psychiatric clinic at the hospital. Data were collected by trained data collectors through interview of the patients using a structured questionnaire. The collected data were entered into Epi Info version 7 and analyzed by Statistical Package for the Social Sciences version 16 software. Logistic regression was used to assess independent predictors of adherence. Results: A total of 387 patients completed the interview. Two hundred and sixteen (55.8% and 113 (29.2% were patients with a diagnosis of schizophrenia and mood disorder, respectively, while 35 (9% and 23 (5.9% had a diagnosis of drug addiction and autistic disorder. Two hundred and seven (71.6% patients were found to be adherent to their medication. When adherence rates were observed according to type of disorder, 60 (53.1%, 24 (68.6%, 149 (69%, and 18 (78.3% of patients

  11. Predictors of medication adherence in high risk youth of color living with HIV.

    Science.gov (United States)

    Macdonell, Karen E; Naar-King, Sylvie; Murphy, Debra A; Parsons, Jeffrey T; Harper, Gary W

    2010-07-01

    To test predictors of medication adherence in high-risk racial or ethnic minority youth living with HIV (YLH) using a conceptual model of social cognitive predictors including a continuous measure of motivational readiness. Youth were participants in a multi-site clinical trial examining the efficacy of a motivational intervention. Racial-minority YLH (primarily African American) who were prescribed antiretroviral medication were included (N = 104). Data were collected using computer-assisted personal interviewing method via an Internet-based application and questionnaires. Using path analysis with bootstrapping, most youth reported suboptimal adherence, which predicted higher viral load. Higher motivational readiness predicted optimal adherence, and higher social support predicted readiness. Decisional balance was indirectly related to adherence. The model provided a plausible framework for understanding adherence in this population. Culturally competent interventions focused on readiness and social support may be helpful for improving adherence in YLH.

  12. Sexual practices of people living with HIV in South Eastern Nigeria.

    Science.gov (United States)

    Ikechebelu, J; Mbamara, S U; Joe-Ikechebebelu, N N; Ezenwabachili, A O

    2009-12-01

    Couples could be in serodiscordant or seroconcordant sexual relationship. The seroconcordant could be seroconcrdant positive or negative in a heterosexual or homosexual or bisexual relationship. The various sexual practices include vaginal sex; anal sex fisting; oral sex fellatio, cunnilingus; masturbation mutual or exclusive and a host of others. These sexual practices outside safer sex guidelines will lead to HIV transmission among couples. The study is set to determine the sexual practices of people living with HIV (PLWHA) in Southeast Nigeria. This is an analytical epidemiological study. A total of 300 subjects were studied using interviewer administered questionnaires. Data is presented in tables and figures. Analysis was done using SPSS 11.0 statistical package. Most respondents were in heterosexual relationship (97%). The married couples in serodiscordant relationship were 25.3% while the singles in serodiscordant relationship were 20%. About 56% do not use condom for the adopted sexual practice although 65% believe that condom use would protect against HIV transmission. Couples in seroconcordant seronegative relationship have it as a challenge to remain so. This study suggests that the PLWHA are very important in the spread of HIV infection as they are still sexually active, in non-cohabiting conjugal unstable relationship, and they do not use the condom consistently. There is an urgent need to target this population with effective behavioural change communications that will translate to safer sexual behaviour. The practice of safer sex should be taught in every health care center, in schools and in village gatherings by qualified health care workers. This will help curb the transmission of HIV.

  13. Applying the information-motivation-behavioral skills model in medication adherence among Thai youth living with HIV: a qualitative study.

    Science.gov (United States)

    Rongkavilit, Chokechai; Naar-King, Sylvie; Kaljee, Linda M; Panthong, Apirudee; Koken, Juline A; Bunupuradah, Torsak; Parsons, Jeffrey T

    2010-12-01

    With disproportionately higher rates of HIV/AIDS among youth and increasing access to antiretroviral therapy (ART) in Thailand, there is a growing urgency in understanding the challenges to medication adherence confronting this population and in developing theory-based interventions to address these challenges. One potentially relevant model, the information-motivation-behavioral skills (IMB) model of adherence, was developed in Western settings characterized by a more individualistic culture in contrast to the more collectivistic culture of Thailand. We explored the application and adaptability of IMB on ART adherence among HIV-positive Thai youth through the analysis of qualitative data from a pilot motivational interviewing study. Twenty-two interview sessions from 10 HIV-positive Thai youth (17-24 years) were analyzed; 6 youth were on ART. Data support the utility of IMB as a potential framework for understanding ART adherence in this population. However, data indicate a consideration to expand the motivation construct of IMB to incorporate youths' perceived familial and social responsibilities and the need to adhere to medications for short- and long-term well-being of self, family, and society in a context of Buddhist values. These modifications to IMB could be relevant in other cultural settings with more collectivistic worldviews.

  14. Applying the Information-Motivation-Behavioral Skills Model in Medication Adherence Among Thai Youth Living with HIV: A Qualitative Study

    Science.gov (United States)

    Naar-King, Sylvie; Kaljee, Linda M.; Panthong, Apirudee; Koken, Juline A.; Bunupuradah, Torsak; Parsons, Jeffrey T.

    2010-01-01

    Abstract With disproportionately higher rates of HIV/AIDS among youth and increasing access to antiretroviral therapy (ART) in Thailand, there is a growing urgency in understanding the challenges to medication adherence confronting this population and in developing theory-based interventions to address these challenges. One potentially relevant model, the information-motivation-behavioral skills (IMB) model of adherence, was developed in Western settings characterized by a more individualistic culture in contrast to the more collectivistic culture of Thailand. We explored the application and adaptability of IMB on ART adherence among HIV-positive Thai youth through the analysis of qualitative data from a pilot motivational interviewing study. Twenty-two interview sessions from 10 HIV-positive Thai youth (17–24 years) were analyzed; 6 youth were on ART. Data support the utility of IMB as a potential framework for understanding ART adherence in this population. However, data indicate a consideration to expand the motivation construct of IMB to incorporate youths' perceived familial and social responsibilities and the need to adhere to medications for short- and long-term well-being of self, family, and society in a context of Buddhist values. These modifications to IMB could be relevant in other cultural settings with more collectivistic worldviews. PMID:21091238

  15. Understanding HIV-Related Stigma Among Women in the Southern United States: A Literature Review.

    Science.gov (United States)

    Darlington, Caroline K; Hutson, Sadie P

    2017-01-01

    Societal stigmatization of HIV/AIDS due to assumptions about transmission and associated behaviors plays a substantial role in the psychosocial well-being of people living with this chronic illness, particularly for women in traditionally conservative geographic regions. Known for social conservatism, the Southern United States (US) holds the highest incidence rate of HIV infection in the US. A systematic search of four databases was used to identify 27 relevant scientific articles pertaining to HIV-related stigma among women living with HIV/AIDS in the Southern US. These studies revealed a rudimentary understanding of stigma sources, effects, and stigma-reduction interventions in this population. Due to the cultural specificity of stigma, further differentiation of stigma in discrete sectors of the South as well as a dialogue about the moral implications of stigma is necessary to lay the groundwork for patient-centered interventions to mitigate the destructive effects of stigma experienced by women in this region.

  16. Relationship of Stigma and Depression Among Newly HIV-Diagnosed Chinese Men Who Have Sex with Men.

    Science.gov (United States)

    Tao, Jun; Wang, Lijuan; Kipp, Aaron M; Qian, Han-Zhu; Yin, Lu; Ruan, Yuhua; Shao, Yiming; Lu, Hongyan; Vermund, Sten H

    2017-01-01

    Little is known about the relationship between HIV stigma and depression among newly diagnosed HIV-infected men who have sex with men (MSM). We measured HIV-related stigma and current depression using standard scales among 367 Chinese MSM who had been diagnosed very recently with HIV infection, analyzing key associations with multivariable ordinal logistic regression. Current depression prevalence was 36 %. Median scores for felt, vicarious, and internalized stigma were 17, 2, and 5, respectively, each on a 0-30 scale. A one-point increase in the total stigma score was associated with a 4 % increase in the odds of current depression [adjusted odds ratio (aOR) = 1.04, 95 % confidence interval (CI) 1.03-1.05]. Internalized stigma had the strongest association with depression (aOR = 1.09, 95 % CI 1.07-1.12). Effective interventions to address coping with HIV-related stigma immediately following HIV-diagnosis might help reduce depression, improve long-term mental health, and improve engagement in their care.

  17. Antihypertensive Medications Adherence Among Nigerian ...

    African Journals Online (AJOL)

    Hospital, Ogbomosho, 2Goshen Heart Clinic, Osogbo, 3Department of Economics, Osun State University, Osogbo, Nigeria ... significant impact of antihypertensive medication adherence.[13]. The level of information provided to patients may also impact ..... Muntner P. New medication adherence scale versus pharmacy.

  18. HIV Stigma: Perspectives from Kenyan Child Caregivers and Adolescents Living with HIV

    Science.gov (United States)

    McHenry, Megan Song; Nyandiko, Winstone M.; Scanlon, Michael L.; Fischer, Lydia J.; McAteer, Carole I.; Aluoch, Josephine; Naanyu, Violet; Vreeman, Rachel C.

    2017-01-01

    Stigma shapes all aspects of HIV prevention and treatment, yet there are limited data on how HIV-infected youth and their families are affected by stigma in sub-Saharan Africa. The authors conducted a qualitative study using focus group discussions among 39 HIV-infected adolescents receiving care at HIV clinics in western Kenya and 53 caregivers of HIV-infected children. Participants felt that while knowledge and access to treatment were increasing, many community members still held negative and inaccurate views about HIV, including associating it with immorality and believing in transmission by casual interactions. Stigma was closely related to a loss of social and economic support but also included internalized negative feelings about oneself. Participants identified treatment-related impacts of stigma, including nonadherence, nondisclosure of status to child or others, and increased mental health problems. Qualitative inquiry also provided insights into how to measure and reduce stigma among affected individuals and families. PMID:27655835

  19. HIV Stigma: Perspectives from Kenyan Child Caregivers and Adolescents Living with HIV.

    Science.gov (United States)

    McHenry, Megan Song; Nyandiko, Winstone M; Scanlon, Michael L; Fischer, Lydia J; McAteer, Carole I; Aluoch, Josephine; Naanyu, Violet; Vreeman, Rachel C

    Stigma shapes all aspects of HIV prevention and treatment, yet there are limited data on how HIV-infected youth and their families are affected by stigma in sub-Saharan Africa. The authors conducted a qualitative study using focus group discussions among 39 HIV-infected adolescents receiving care at HIV clinics in western Kenya and 53 caregivers of HIV-infected children. Participants felt that while knowledge and access to treatment were increasing, many community members still held negative and inaccurate views about HIV, including associating it with immorality and believing in transmission by casual interactions. Stigma was closely related to a loss of social and economic support but also included internalized negative feelings about oneself. Participants identified treatment-related impacts of stigma, including nonadherence, nondisclosure of status to child or others, and increased mental health problems. Qualitative inquiry also provided insights into how to measure and reduce stigma among affected individuals and families.

  20. Psychological pathway to suicidal ideation among people living with HIV/AIDS in China: A structural equation model.

    Science.gov (United States)

    Wang, Wei; Wang, Yuanyuan; Xiao, Chenchang; Yao, Xing; Yang, Yinmei; Yan, Hong; Li, Shiyue

    2017-11-29

    People living with HIV/AIDS (PLWHA) have higher rates of suicide than does the general population. It is critical to interpret the intricate relationships among various psychological variables that increase the risk of suicidal ideation among PLWHA in China. An institutional based cross-sectional study was conducted from Jul to Aug 2016 in Nanjing, China, using a self-reporting questionnaire. A total of 465 PLWHA participated. Sociodemographic, psychological variables and suicide information about the participants were collected. Structural equation modeling (SEM)-path analysis was used to analyze the cross-sectional data. The final structural equation model had a highly satisfactory fit. Among PLWHA, perceived stigma had the greatest accumulated total effect on suicidal ideation, with both a direct effect and indirect effect through self-esteem and depression. Additionally, self-esteem had the second greatest total effect on suicidal ideation and was influenced by social support. Depression contributed directly to suicidal ideation and partly mediated the association of perceived stigma and self-esteem with suicidal ideation. These findings suggest that self-esteem and depression, particularly perceived stigma, play important roles in suicidal ideation among PLWHA. Enhancing personal self-esteem or social support might also reduce perceived stigma and may be an important target for intervention to decrease suicidal ideation among PLWHA. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. People living with AIDS/HIV in Botswana: a needs assessment

    Directory of Open Access Journals (Sweden)

    A. Zuyderduin

    2007-09-01

    Full Text Available A deficit in information and knowledge regarding people living with AIDS in Botswana, hampering health care planning and satisfactory health care delivery to these people, necessitated the needs assessment reported on in this paper. Not only did self-imposed alienation and societal levels of stigma surrounding HIV and AIDS force many people living with AIDS/HIV (PLWAH into silence and denial of their HIV+ve diagnosis, thereby creating knowledge and information deficits. These same factors also pose challenges for conducting a needs assessment among these persons. Consequently, a 73 item questionnaire was administered to a convenience sample of 39 male and 77 female PLWAH in Botswana. Maslow’s Hierarchy of Human Needs served as a general theoretical point of departure for the needs analysis and the 73 items represented needs at all levels of this hierarchy. Analysis of the data indicates that 65% of the respondents lived in urban areas. The majority of individuals (42% were tested for HIV because they became ill, while 28% did so voluntarily. Other reasons for testing were: child becoming ill, partner becoming ill, being pregnant and having been raped. Only 7% indicated that their HIV status had been disclosed to other persons. With regards to love and belongingness 70% of the respondents indicated that they were not in an intimate relationship, nearly one third experienced multiple deaths within their families due to AIDS, 61% had access to a support group, and 48% had not informed their parents about their HIV+ve status. Stigmatisation weighed down self-esteem. Despite the deficiencies in the fulfilment of safety, belonging

  2. Increase in Unemployment over the 2000's: Comparison between People Living with HIV and the French General Population.

    Science.gov (United States)

    Annequin, Margot; Lert, France; Spire, Bruno; Dray-Spira, Rosemary

    2016-01-01

    Despite improved health, unemployment has increased among people living with HIV (PlwHIV) over the last decade. However, since the economic recession of 2008, unemployment also increased in the French general population. This paper aimed to determine if the increase in the unemployment rate in the HIV population was higher than that in the French general population. We used data from the ANRS-Vespa study, a repeated cross-sectional survey among two national representative samples of PlwHIV followed at hospitals in France in 2003 and 2011. We compared employment and unemployment rates between HIV-infected people (overall and according to period of HIV diagnosis) and the French general population in 2003 and 2011, using multivariate Poisson regressions adjusted for individual sociodemographic characteristics. The employment rate among PlwHIV was consistently lower than that in the general population in 2003 and 2011. In contrast, there was a trend of an increasing unemployment rate difference between PlwHIV and the general population: PlwHIV's unemployment rate was 1.48 (95% confidence interval [CI]: 1.16-1.90) times higher than that of the general population in 2003, versus 1.62 (95% CI: 1.34-1.96) times higher in 2011. This unemployment rate difference was the highest for PlwHIV diagnosed in or after 2008 (adjusted prevalence rate ratio: 2.06; 95% CI: 1.59-2.67). These results suggest that in time of economic recession, an increasing proportion of PlwHIV may be excluded from the labor market although they are willing to re-enter it. This constitutes a major issue relative to social consequences of chronic disease.

  3. Linkage to HIV care, postpartum depression, and HIV-related stigma in newly diagnosed pregnant women living with HIV in Kenya: a longitudinal observational study

    OpenAIRE

    Turan, Bulent; Stringer, Kristi L; Onono, Maricianah; Bukusi, Elizabeth A; Weiser, Sheri D; Cohen, Craig R; Turan, Janet M

    2014-01-01

    Background While studies have suggested that depression and HIV-related stigma may impede access to care, a growing body of literature also suggests that access to HIV care itself may help to decrease internalized HIV-related stigma and symptoms of depression in the general population of persons living with HIV. However, this has not been investigated in postpartum women living with HIV. Furthermore, linkage to care itself may have additional impacts on postpartum depression beyond the effect...

  4. A HIV stigma reduction intervention for people living with HIV and ...

    African Journals Online (AJOL)

    Johanna Beatrix Pretorius

    stigma as conceptualised by Alonzo and Reynolds (1995) is used for this ... to access healthcare as it inhibits HIV testing and disclosure of. HIV status ... 2007; Rao et al., 2012) indicates that few effective pro- ..... stress-related mental illness.

  5. Adherence to the cervical cancer screening program in women living with HIV in Denmark

    DEFF Research Database (Denmark)

    Thorsteinsson, Kristina; Ladelund, Steen; Jensen-Fangel, Søren

    2014-01-01

    BACKGROUND: Women living with HIV (WLWH) are at increased risk of invasive cervical cancer (ICC). International HIV guidelines suggest cervical screening twice the first year after HIV diagnosis and thereafter annually. Adherence to the HIV cervical screening program in Denmark is unknown. METHODS......: We studied women from a population-based, nationwide HIV cohort in Denmark and a cohort of age-matched females from the general population. Screening behaviour was assessed from 1999-2010. Adjusted odds ratios (OR's) for screening attendance in the two cohorts and potential predictors of attendance....... CONCLUSIONS: The majority of WLWH do not follow the HIV guidelines for cervical screening. We support the idea of cytology as part of an annual review and integration of HIV care and cervical screening in a single clinic setting....

  6. Personal contact with HIV-positive persons is associated with reduced HIV-related stigma: cross-sectional analysis of general population surveys from 26 countries in sub-Saharan Africa.

    Science.gov (United States)

    Chan, Brian T; Tsai, Alexander C

    2017-01-11

    HIV-related stigma hampers treatment and prevention efforts worldwide. Effective interventions to counter HIV-related stigma are greatly needed. Although the "contact hypothesis" suggests that personal contact with persons living with HIV (PLHIV) may reduce stigmatizing attitudes in the general population, empirical evidence in support of this hypothesis is lacking. Our aim was to estimate the association between personal contact with PLHIV and HIV-related stigma among the general population of sub-Saharan Africa. Social distance and anticipated stigma were operationalized using standard HIV-related stigma questions contained in the Demographic and Health Surveys and AIDS Indicator Surveys of 26 African countries between 2003 and 2008. We fitted multivariable logistic regression models with country-level fixed effects, specifying social distance as the dependent variable and personal contact with PLHIV as the primary explanatory variable of interest. We analyzed data from 206,717 women and 91,549 men living in 26 sub-Saharan African countries. We estimated a statistically significant negative association between personal contact with PLHIV and desires for social distance (adjusted odds ratio [AOR] = 0.80; p  interventions should be developed and tested to reduce the stigma of HIV.

  7. Differential predictors of ART adherence among HIV-monoinfected versus HIV/HCV-coinfected individuals.

    Science.gov (United States)

    Shuper, Paul A; Joharchi, Narges; Irving, Hyacinth; Fletcher, David; Kovacs, Colin; Loutfy, Mona; Walmsley, Sharon L; Wong, David K H; Rehm, Jürgen

    2016-08-01

    Although adherence is an important key to the efficacy of antiretroviral therapy (ART), many people living with HIV (PLWH) fail to maintain optimal levels of ART adherence over time. PLWH with the added burden of Hepatitis C virus (HCV) coinfection possess unique challenges that potentially impact their motivation and ability to adhere to ART. The present investigation sought to (1) compare ART adherence levels among a sample of HIV/HCV-coinfected versus HIV-monoinfected patients, and (2) identify whether ART-related clinical and psychosocial correlates differ by HCV status. PLWH receiving ART (N = 215: 105 HIV/HCV-coinfected, 110 HIV-monoinfected) completed a comprehensive survey assessing ART adherence and its potential correlates. Medical chart extraction identified clinical factors, including liver enzymes. Results demonstrated that ART adherence did not differ by HCV status, with 83.7% of coinfected patients and 82.4% of monoinfected patients reporting optimal (i.e., ≥95%) adherence during a four-day recall period (p = .809). Multivariable logistic regression demonstrated that regardless of HCV status, optimal ART adherence was associated with experiencing fewer adherence-related behavioral skills barriers (AOR = 0.56; 95%CI = 0.43-0.73), lower likelihood of problematic drinking (AOR = 0.15; 95%CI = 0.04-0.67), and lower likelihood of methamphetamine use (AOR = 0.14; 95%CI = 0.03-0.69). However, among HIV/HCV-coinfected patients, optimal adherence was additionally associated with experiencing fewer ART adherence-related motivational barriers (AOR = 0.23; 95%CI = 0.08-0.62) and lower likelihood of depression (AOR = 0.06; 95%CI = 0.00-0.84). Findings suggest that although HIV/HCV-coinfected patients may face additional, distinct barriers to ART adherence, levels of adherence commensurate with those demonstrated by HIV-monoinfected patients might be achievable if these barriers are addressed.

  8. From 'half-dead' to being 'free': resistance to HIV stigma, self-disclosure and support for PMTCT/HIV care among couples living with HIV in Kenya.

    Science.gov (United States)

    Spangler, Sydney A; Abuogi, Lisa L; Akama, Eliud; Bukusi, Elizabeth A; Helova, Anna; Musoke, Pamela; Nalwa, Wafula Z; Odeny, Thomas A; Onono, Maricianah; Wanga, Iris; Turan, Janet M

    2018-05-01

    In sub-Saharan Africa, self-disclosure of HIV-positive status may be a pivotal action for improving access to prevention of mother-to-child transmission services. However, understanding of HIV stigma and disclosure, and their effects on demand for care remains incomplete - particularly in the current context of new antiretroviral therapy guidelines. The purpose of this study was to explore these issues among self-disclosed couples living in southwest Kenya. We conducted 38 in-depth interviews with HIV-positive pregnant or postpartum women and their male partners. Of the 19 couples, 10 were HIV seroconcordant and 9 were serodiscordant. The textual analysis showed that HIV stigma continues to restrict full participation in community life and limit access to care by promoting fear, isolation and self-censorship. Against this backdrop, however, participants' narratives revealed varying forms and degrees of resistance to HIV stigma, which appeared to both produce and emerge from acts of self-disclosure. Such disclosure enabled participants to overcome fears and gain critical support for engaging in HIV care while further resisting HIV stigma. These findings suggest that programme interventions designed explicitly to stimulate and support processes of HIV stigma resistance and safe self-disclosure may be key to improving demand for and retention in HIV services.

  9. Self-Reported Bothersome Symptoms Across Different Socioepidemiological Groups of People Living With HIV Attending French Hospitals: Results From the ANRS-VESPA2 Survey.

    Science.gov (United States)

    Boyer, Véronique; Vilotitch, Antoine; Marcellin, Fabienne; Demoulin, Baptiste; Dray-Spira, Rosemary; Spire, Bruno

    2017-07-01

    Twenty years after the advent of combined antiretroviral therapies (ARTs), there is a growing need for up-to-date information about the daily experience of people living with HIV (PLWH). This study aimed to investigate the relationship between socioepidemiological groups and the types of bothersome symptoms reported by PLWH participating in a national survey in France. We analyzed self-reported bothersome symptoms in a representative sample of PLWH (ANRS-VESPA2 survey), most of whom were receiving ART treatment. PLWH (N = 2505) were grouped into three clusters according to the number of bothersome symptoms reported: Cluster A (low number, n = 1848), Cluster B (moderate number, n = 271), and Cluster C (high number, n = 386). Individuals in Cluster A (low number of bothersome symptoms) were less likely to report all the symptom types investigated. Psychological, sexual, and general symptoms were more likely to be reported in Cluster B (moderate number), whereas gastric-, pain-, and appearance-related symptoms were more likely in Cluster C (high number). In multivariate analyses, women not natives of Sub-Saharan Africa and former/active female injecting drug users were more likely to report a medium or high number of symptoms, and lower adherence to ART. Combining new biomedical strategies with coping mechanisms and providing better support to socially vulnerable PLWH may improve this population's quality of health and daily life. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  10. Suicidal Behavior Among People Living with HIV (PLHIV) in Medical Care in Estonia and Factors Associated with Receiving Psychological Treatment.

    Science.gov (United States)

    Lemsalu, Liis; Rüütel, Kristi; Laisaar, Kaja-Triin; Lõhmus, Liilia; Raidvee, Aire; Uusküla, Anneli

    2017-06-01

    People living with HIV (PLHIV) have higher rates of suicidal behavior than the general population. This study assessed suicidal behavior (ideation and/or attempts, ever and in the past 12 months) among PLHIV receiving outpatient HIV medical care in Estonia and associations between suicidal behavior and psychological treatment. The cross-sectional study collected data from January to November 2013 using a self-report questionnaire. Eight hundred PLHIV participated, 39 % (n = 306) of whom had been suicidal. Lifetime prevalence was 36 % for suicidal ideation and 20 % for attempts. Younger age, incarceration, having ever abused alcohol and also injected drugs, having lived with HIV for more than 10 years, and being depressed were associated with lifetime suicidal behavior. Suicidal behavior within the past 12 months was reported by 20 % (n = 156) of respondents. Of these, 27 % received psychological treatment (counseling and/or psychotherapy), 20 % had taken antidepressants, and 49 % sedatives. Individuals perceiving a need for treatment were significantly more likely to receive psychological treatment when experiencing suicidal behavior (OR 25.65, 95 % CI 2.92-225.47). In conclusion, suicidal behavior is frequent among PLHIV but psychological treatment is not often received. One of the barriers to treatment is patients' lack of perceived need for help.

  11. Depressive Symptoms, Disclosure, HIV-Related Stigma, and Coping Following HIV Testing Among Outpatients in Uganda: A Daily Process Analysis.

    Science.gov (United States)

    Kiene, Susan M; Dove, Meredith; Wanyenze, Rhoda K

    2018-05-01

    As efforts to end the HIV epidemic accelerate there is emphasis on reaching those living with undiagnosed HIV infection. Newly diagnosed individuals face a number of psychosocial challenges, yet we know little about depressive symptoms in the weeks immediately following diagnosis and how disclosure, coping, and other factors may affect short and longer-term depressive symptoms. Purposively sampled Ugandan outpatients completed structured interviews immediately prior to testing for HIV, daily for 28 days after receiving their test results, and at 3 and 6 months post-test. The sample included a total of 244 participants: 20 who tested HIV positive at baseline and who provided 342 daily data points, and 224 who tested HIV negative at baseline and who provided 4388 daily data points. We used linear mixed effects modeling to examine changes in depressive symptom scores over the 28 day daily interview period and predictors of depressive symptom scores and changes over time. Results from the mixed modeling revealed that while those diagnosed with HIV showed initially high depressive symptoms following diagnosis, their symptoms decreased significantly and on average fell below the cutoff for possible depression approximately 15 days after diagnosis. Among those who tested HIV-negative, on average their depressive symptoms were below the cutoff for possible depression and did not change over time. Among those diagnosed with HIV, disclosure, especially to a partner, on a particular day was associated with higher depressive symptoms that day. However, those who disclosed to their partner during the 28 days after diagnosis had significantly lower depression scores by the end of the 28 days as well as lower depression scores 3 and 6 months after diagnosis than did those who did not disclose to their partner during the 28 days after diagnosis. Scoring higher on HIV-related stigma on a particular day was associated with higher depressive symptoms that day and engaging

  12. Factors contributing to food insecurity among women living with HIV in the Dominican Republic: A qualitative study

    Science.gov (United States)

    Payán, Denise D.; Fulcar, María Altagracia; Terrero, Sergio; Acevedo, Ramón; Farías, Hugo; Palar, Kartika

    2017-01-01

    Background Food insecurity contributes to poor health outcomes among people living with HIV. In Latin America and the Caribbean, structural factors such as poverty, stigma, and inequality disproportionately affect women and may fuel both the HIV epidemic and food insecurity. Methods We examined factors contributing to food insecurity among women living with HIV (WLHIV) in the Dominican Republic (DR). Data collection included in-depth, semi-structured interviews in 2013 with 30 WLHIV with indications of food insecurity who resided in urban or peri-urban areas and were recruited from local HIV clinics. In-person interviews were conducted in Spanish. Transcripts were coded using content analysis methods and an inductive approach to identify principal and emergent themes. Results Respondents identified economic instability as the primary driver of food insecurity, precipitated by enacted stigma in the labor and social domains. Women described experiences of HIV-related labor discrimination in formal and informal sectors. Women commonly reported illegal HIV testing by employers, and subsequent dismissal if HIV-positive, especially in tourism and free trade zones. Enacted stigma in the social domain manifested as gossip and rejection by family, friends, and neighbors and physical, verbal, and sexual abuse by intimate partners, distancing women from sources of economic and food support. These experiences with discrimination and abuse contributed to internalized stigma among respondents who, as a result, were fearful and hesitant to disclose their HIV status; some participants reported leaving spouses and/or families, resulting in further isolation from economic resources, food and other support. A minority of participants described social support by friends, spouses, families and support groups, which helped to ameliorate food insecurity and emotional distress. Conclusions Addressing food insecurity among WLHIV requires policy and programmatic interventions to enforce

  13. Factors contributing to food insecurity among women living with HIV in the Dominican Republic: A qualitative study.

    Science.gov (United States)

    Derose, Kathryn P; Payán, Denise D; Fulcar, María Altagracia; Terrero, Sergio; Acevedo, Ramón; Farías, Hugo; Palar, Kartika

    2017-01-01

    Food insecurity contributes to poor health outcomes among people living with HIV. In Latin America and the Caribbean, structural factors such as poverty, stigma, and inequality disproportionately affect women and may fuel both the HIV epidemic and food insecurity. We examined factors contributing to food insecurity among women living with HIV (WLHIV) in the Dominican Republic (DR). Data collection included in-depth, semi-structured interviews in 2013 with 30 WLHIV with indications of food insecurity who resided in urban or peri-urban areas and were recruited from local HIV clinics. In-person interviews were conducted in Spanish. Transcripts were coded using content analysis methods and an inductive approach to identify principal and emergent themes. Respondents identified economic instability as the primary driver of food insecurity, precipitated by enacted stigma in the labor and social domains. Women described experiences of HIV-related labor discrimination in formal and informal sectors. Women commonly reported illegal HIV testing by employers, and subsequent dismissal if HIV-positive, especially in tourism and free trade zones. Enacted stigma in the social domain manifested as gossip and rejection by family, friends, and neighbors and physical, verbal, and sexual abuse by intimate partners, distancing women from sources of economic and food support. These experiences with discrimination and abuse contributed to internalized stigma among respondents who, as a result, were fearful and hesitant to disclose their HIV status; some participants reported leaving spouses and/or families, resulting in further isolation from economic resources, food and other support. A minority of participants described social support by friends, spouses, families and support groups, which helped to ameliorate food insecurity and emotional distress. Addressing food insecurity among WLHIV requires policy and programmatic interventions to enforce existing laws designed to protect the

  14. Factors contributing to food insecurity among women living with HIV in the Dominican Republic: A qualitative study.

    Directory of Open Access Journals (Sweden)

    Kathryn P Derose

    Full Text Available Food insecurity contributes to poor health outcomes among people living with HIV. In Latin America and the Caribbean, structural factors such as poverty, stigma, and inequality disproportionately affect women and may fuel both the HIV epidemic and food insecurity.We examined factors contributing to food insecurity among women living with HIV (WLHIV in the Dominican Republic (DR. Data collection included in-depth, semi-structured interviews in 2013 with 30 WLHIV with indications of food insecurity who resided in urban or peri-urban areas and were recruited from local HIV clinics. In-person interviews were conducted in Spanish. Transcripts were coded using content analysis methods and an inductive approach to identify principal and emergent themes.Respondents identified economic instability as the primary driver of food insecurity, precipitated by enacted stigma in the labor and social domains. Women described experiences of HIV-related labor discrimination in formal and informal sectors. Women commonly reported illegal HIV testing by employers, and subsequent dismissal if HIV-positive, especially in tourism and free trade zones. Enacted stigma in the social domain manifested as gossip and rejection by family, friends, and neighbors and physical, verbal, and sexual abuse by intimate partners, distancing women from sources of economic and food support. These experiences with discrimination and abuse contributed to internalized stigma among respondents who, as a result, were fearful and hesitant to disclose their HIV status; some participants reported leaving spouses and/or families, resulting in further isolation from economic resources, food and other support. A minority of participants described social support by friends, spouses, families and support groups, which helped to ameliorate food insecurity and emotional distress.Addressing food insecurity among WLHIV requires policy and programmatic interventions to enforce existing laws designed to

  15. Correlates of Adherence among Rural Indian Women Living with HIV/AIDS.

    Science.gov (United States)

    Nyamathi, Adeline; Salem, Benissa; Ernst, E J; Keenan, Colleen; Suresh, P; Sinha, Sanjeev; Ganguly, Kalyan; Ramakrishnan, Padma; Liu, Yihang

    2012-01-01

    In this prospective, randomized clinical trial, correlates of adherence to antiretroviral therapy (ART) were assessed using a baseline questionnaire among 68 rural women living with AIDS (WLA) in India. Unadjusted analyses revealed positive relationships of ART adherence with Hindu religion, and support from spouses and parents, whereas negative associations were found with depression, poor quality of life, and having ten or more HIV symptoms. Multiple linear regression analysis also revealed that WLA who were Hindu, not depressed, had ART support from spouses and parents, and perceived some benefit from ART were more adherent to ART than their respective counterparts. This study reveals the unique challenges which rural WLA experience and the need to mitigate these challenges early in ART treatment. Further, the findings enable the refinement of an intervention program which will focus on strengthening ART adherence among rural WLA.

  16. Situating experiences of HIV-related stigma in Swaziland.

    Science.gov (United States)

    Root, R

    2010-01-01

    With the world's highest antenatal HIV prevalence rate (39.2%), Swaziland has also been described as among the most stigmatising. Yet, only recently was an anti-HIV stigma and discrimination (S&D) platform included in the government's National Multisectoral HIV and AIDS Policy. This study draws on a medical anthropological project in rural Swaziland to examine experiences of stigma among people living with HIV/AIDS (PLWH). Qualitative methods included a semi-structured questionnaire and interviews (n=40) to identify patterns of stigma across three domains: verbal, physical and social. Key informant interviews (n=5) were conducted with health personnel and support group leaders. Descriptive statistics were situated within a thematic analysis of open-ended content. Among the findings, participants reported extensive HIV-related rumouring (36.4%) and pejorative name-calling (37.5%). Nearly one in five (18.2%) could no longer partake of family meals. Homesteads, which are an organising principle of Swazi life, were often markedly stigmatising environments. In contrast to documented discrimination in health care settings, the health centre emerged as a space where PLWH could share information and support. Given the UNAIDS call for national partners to 'know your epidemic' by tracking the prevalence of HIV-related S&D, results from this study suggested that unless 'knowing your epidemic' includes the lived experiences of HIV stigma that blister into discernible patterns, effectiveness of national initiatives is likely to be limited. Multidisciplinary and locale-specific studies are especially well suited in examining the cultural dynamics of HIV stigma and in providing grounded data that deepen the impact of comprehensive HIV/AIDS policies and programming.

  17. Job stress, satisfaction, and coping strategies among medical interns in a South Indian tertiary hospital.

    Science.gov (United States)

    Chandramouleeswaran, Susmita; Edwin, Natasha C; Braganza, Deepa

    2014-07-01

    It has previously been demonstrated that there is a significant drop in all domains of quality of life among interns during internship. A modified version of the health consultant's job stress and satisfaction questionnaire (HCJSSQ) was used to assess and quantify aspects of internship that were perceived as stressful and satisfying. Methods used to cope with work place stress were explored. A prospective cohort study was undertaken among 93 medical interns doing a rotating internship at the Christian Medical College and Hospital, a tertiary-care hospital in southern India. After completion of 6 months of internship, the modified version of the HCJSSQ was administered to all participants. The data were entered into Statistical Package for the Social Sciences (SPSS) Version 9 by double data entry technique. Percentages of interns reporting high levels of stress, satisfaction were calculated. While 63.4% of interns reported high levels of satisfaction, 45.2% of the interns experienced high levels of stress, 17.6% coped with work stress by using alcohol and nicotine, and 37% coped through unhealthy eating habits. More people found internship satisfying than stressful. However, a high proportion found it stressful, and many reported unhealthy coping mechanisms.

  18. Influence of Spirituality and Religion on Adherence to Highly Active Antiretroviral Therapy in Adult HIV/AIDS Patients in Calabar, Nigeria

    Directory of Open Access Journals (Sweden)

    Agam Ebaji Ayuk

    2017-07-01

    Full Text Available The emergence of a chronic medical illness such as Human Immune Deficiency Virus and Acquired Immunodeficiency Syndrome (HIV/AIDS may be the time when people turn to the Sacred through spirituality and religion. HIV is a chronic illness that requires strict adherence to medication regimens that may be influenced by spirituality/religion. This study was aimed at finding the association between spirituality/religion and adherence to highly active antiretroviral therapy (HAART in adult HIV/AIDS patients. This is a cross-sectional descriptive study of 370 patients. Adherence was measured using an adapted adult AIDS clinical trial group (AACTG and visual analogue scale (VAS tools. Spirituality was assessed using Functional Assessment of Chronic Illness Therapy-Spirituality Expanded (FACIT-Sp-Ex scale, religiosity with Duke University Religion index (DUREL, and religious coping with Brief Religious Coping (RCOPE scale. Adherence rates were 86.2 and 43.8% using AACTG and VAS tools, respectively. Statistical significant correlation was found between spirituality and adherence to HAART (r = 0.265; p = 0.00. Also, significant correlation was found between positive religious coping and adherence (r = 0.15, p = 0.003. Odds ratio indicated that female respondents were 1.6 times more likely to be adherent, compared with males. Similarly, every unit rise in spirituality score yielded a 1.3 times increased likelihood of adherence to HAART on multiple logistic regression of adherence to HAART with relevant predictors. Both spirituality and positive religious coping have positive influence on optimal adherence. Therefore, the training of health care personnel to assess and provide spiritual care and involvement of chaplains/religious leaders is advocated for improved adherence.

  19. Adherence to antiretroviral treatment and associated factors in people living with HIV/AIDS in Quindío, Colombia

    Directory of Open Access Journals (Sweden)

    Deisy Viviana Cardona-Duque

    2017-07-01

    Conclusion: Depression and self-report on compliance were associated with adherence to antiretroviral therapy. A comprehensive study on the perception of social support and cognitive variables, such as self-efficacy and risk perception, is highly recommended for people living with HIV/AIDS.

  20. Longitudinal spiritual coping with trauma in people with HIV: implications for health care.

    Science.gov (United States)

    Kremer, Heidemarie; Ironson, Gail

    2014-03-01

    This 10-year study (N=177) examines how people with HIV use spirituality to cope with life's trauma on top of HIV-related stress (e.g., facing death, stigma, poverty, limited healthcare) usual events. Spirituality, defined as a connection to a higher presence, is independent from religion (institutionalized spirituality). As a dynamic adaptive process, coping requires longitudinal studying. Qualitative content-analysis of interviews/essays yielded a coding of specific aspects and a longitudinal rating of overall spiritual coping. Most participants were rated as spiritual, using spiritual practices, about half experienced comfort, empowerment, growth/transformation, gratitude, less than one-third meaning, community, and positive reframing. Up to one-fifth perceived spiritual conflict, struggle, or anger, triggering post-traumatic stress, which sometimes converted into positive growth/transformation later. Over time, 65% used spiritual coping positively, 7% negatively, and 28% had no significant use. Spirituality was mainly beneficial for women, heterosexuals, and African Americans (pspirituality is a major source of positive and occasionally negative coping (e.g., viewing HIV as sin). We discuss how clinicians can recognize and prevent when spirituality is creating distress and barriers to HIV treatment, adding a literature review on ways of effective spiritual assessment. Spirituality may be a beneficial component of coping with trauma, considering socio-cultural contexts.

  1. Substance Use to Cope with Stigma in Healthcare Among U.S. Female-to-Male Trans Masculine Adults.

    Science.gov (United States)

    Reisner, Sari L; Pardo, Seth T; Gamarel, Kristi E; White Hughto, Jaclyn M; Pardee, Dana J; Keo-Meier, Colton L

    2015-12-01

    Enacted and anticipated stigma exist within healthcare settings for transgender people, but research has yet to examine the effects of these forms of stigma on the substance use behaviors of female-to-male (FTM) trans masculine people. Data were analyzed from the cross-sectional U.S. National Transgender Discrimination Survey, a convenience sample of transgender adults purposively sampled in 2008. Trans masculine respondents (n=2,578) were identified using a two-step method: Step 1, Assigned birth sex; Step 2, Current gender identity. A gender minority stress model of substance use was tested to examine the relation of enacted and anticipated stigma with substance use to cope with mistreatment. Overall, 14.1% of the sample reported having been refused care by a provider (enacted stigma), 32.8% reported delaying needed medical care when sick/injured, and 39.1% delayed routine preventive care (anticipated stigma). Having been refused care was significantly associated with avoidance of healthcare, including delaying needed medical care when sick/injured and delaying routine preventive medical care. Substance use to cope with mistreatment was self-reported by 27.6% of the sample. Enacted stigma by providers was associated with self-reported substance use to cope. Delays in both needed and preventive care (anticipated stigma) were highly associated with substance use, and attenuated the effect of enacted stigma. Gender minority-related stressors, particularly enacted and anticipated stigma in healthcare, should be integrated into substance use and abuse prevention and intervention efforts with this underserved population.

  2. Measuring quality of life among people living with HIV: a systematic review of reviews.

    Science.gov (United States)

    Cooper, Vanessa; Clatworthy, Jane; Harding, Richard; Whetham, Jennifer

    2017-11-15

    A systematic review of reviews was conducted to identify and appraise brief measures of health-related quality of life (HRQoL) that have been used in peer-reviewed research with people living with HIV. The review was conducted in two stages: 1) search of electronic databases to identify systematic reviews of tools used to measure HRQoL in adults living with HIV, published since the year 2000; 2) selection of HRQol scales from those identified in the reviews. Inclusion criteria included scales that could be self-administered in 10 min or less, covering at least 3 domains of quality of life (physical function, social/role function and mental/emotional function). For generic scales, inclusion criteria included the availability of normative data while for HIV-specific scales, patient input into the development of the scale was required. Ten reviews met the inclusion criteria. Nine generic scales met the inclusion criteria: the EuroQol five dimensions questionnaire (EQ-5D); Health Utilities Index; McGill Quality of Life questionnaire; Medical Outcomes Study (MOS) Short Form (SF)-12; SF-36; World Health Organisation Quality of Life (WHOQOL- BREF), Questions of Life Satisfaction (FLZM) and SF-20. Available psychometric data supported the EQ-5D and SF-36. Seven HIV-specific scales met the inclusion criteria: the AIDS Clinical Trials Group (ACTG)-21; HIV-QL-31; MOS-HIV; Multidimensional Quality of Life Questionnaire for Persons with HIV/AIDS (MQOL-HIV), PROQOL-HIV, Symptom Quality of Life Adherence (HIV-SQUAD) and the WHOQOL-HIV BREF. Of the HIV -specific measures, the MOS-HIV was considered to have the most well-established psychometric properties, however limitations identified in the reviews included insufficient input from people living with HIV in the development of the scale, cross-cultural relevance and continued applicability. Two relatively new measures, the WHOQOL-HIV BREF and PROQOL-HIV, were considered to have promising psychometric properties and may have

  3. Knowledge, attitude and practice towards child adoption amongst women attending infertility clinics in Lagos State, Nigeria

    Directory of Open Access Journals (Sweden)

    Adenike O. Omosun

    2011-10-01

    Full Text Available Background: Child adoption is a recommended alternative form of infertility management. Infertility is of public health importance in Nigeria and many other developing nations. This is a result of its high prevalence and especially because of its serious social implications as the African society places a passionate premium on procreation in any family setting. Objectives: The aim of this study was to determine the knowledge, attitude and practice of child adoption amongst women attending infertility clinics in teaching hospitals in Lagos State and to determine the factors that influence their attitude and practice towards it. Method: A cross-sectional descriptive design was used. Data were collected by using a structured questionnaire which was interviewer-administered. The study was conducted in the two teaching hospitals in Lagos State (LUTH [Lagos University Teaching Hospital] and LASUTH [Lagos State University Teaching Hospital] from amongst 350 women attending the gynaecological clinics. All the patients under management for infertility at the gynaecology clinics during the period of the study were interviewed. Results: Many respondents (85.7% had heard of child adoption and 59.3% of them knew the correct meaning of the term. More than half of the respondents (68.3% said that they could love an adopted child but less than half of them (33.7% were willing to consider adoption. Only 13.9% has ever adopted a child. The major reason given for their unwillingness to adopt was their desire to have their own biological child. Factors that were favourable towards child adoption were Igbo tribe identity, an age above 40 years, duration of infertility above 15 years, and knowing the correct meaning of child adoption. Conclusion: There is a poor attitude to adoption even amongst infertile couples. Interventions need to be implemented to educate the public on child adoption, to improve their attitude towards adoption and to make it more acceptable.

  4. Stigma by association and family burden among family members of people with mental illness: the mediating role of coping.

    Science.gov (United States)

    van der Sanden, Remko L M; Pryor, John B; Stutterheim, Sarah E; Kok, Gerjo; Bos, Arjan E R

    2016-09-01

    When someone has a mental illness, family members may share the experience of stigma. Past research has established that family members' experiences of stigma by association predict psychological distress and lower quality-of-life. The present study, conducted with 503 family members of people with mental illness examined the prevalence of 14 different coping strategies. Of greater importance, we examined the role of these coping strategies as mediators of the relationships between stigma by association and family burden, on the one hand, and outcomes, such as psychological distress and quality-of-life, on the other. The results showed that both perceived stigma by association and family burden are associated with greater psychological distress and lower quality-of-life, and that most coping strategies mediate these relationships. Adaptive coping strategies were related to reduced negative outcomes, while most maladaptive coping strategies were related to enhanced negative outcomes. Implications for intervention development are discussed.

  5. Stigma, HIV and health: a qualitative synthesis

    OpenAIRE

    Chambers, Lori A.; Rueda, Sergio; Baker, D. Nico; Wilson, Michael G.; Deutsch, Rachel; Raeifar, Elmira; Rourke, Sean B.; Team, The Stigma Review

    2015-01-01

    Background HIV-related stigma continues to negatively impact the health and well-being of people living with HIV, with deleterious effects on their care, treatment and quality of life. A growing body of qualitative research has documented the relationship between HIV-related stigma and health. This review aims to synthesize qualitative evidence that explored the intersections of stigma and health for people with HIV. Methods A thematic summary was conducted that was guided by the qualitative ...

  6. Knowledge and psychosocial wellbeing of nurses caring for people living with HIV/AIDS (PLWH

    Directory of Open Access Journals (Sweden)

    Lufuno Makhado

    2016-10-01

    Full Text Available The challenges of caring for people living with HIV (PLWH in a low-resource setting has had a negative impact on the nursing profession, resulting in a shortage of skilled nurses. In response to this shortage and perceived negative impact, we conducted a descriptive, cross-sectional study to describe the level of knowledge and psychosocial wellbeing of nurses caring for PLWH at a regional hospital in Limpopo Province, South Africa. A total of 233 nurses, the majority being female, participated and were stratified into professional nurses (n =108, enrolled nurses (n = 58 and enrolled nursing auxiliaries (n = 66. Data were collected using HIV/AIDS knowledge questionnaire, Maslach Burnout Inventory; AIDS Impact Scale and Beck's Depression Inventory. The total knowledge score obtained by all the participants ranged from 2 to 16, with an average of 12.93 (SD = 1.92 on HIV/AIDS knowledge. Depersonalization (D (83.7% and emotional exhaustion (EE (53.2% were reported among participating nurses caring for PLWH. Burnout was higher among professional nurses as compared to both enrolled nurses and enrolled nursing auxiliaries. There was a moderate negative significant correlation between HIV knowledge with the nurses' emotional exhaustion (r = 0.592, depression (r = 0.584 and stigma and discrimination (r = 0.637. A moderate to high level of burnout was evident among all levels of nurses. These findings lead to the recommendations for support of nurses caring for PLWH that include structured nursing educational support, organisational support with respect to employee wellness programmes that address depression and work burnout, as well as social support. The provision of these support mechanisms has the potential of creating a positive practice environment for nurses in the Vhembe District of the Limpopo Province in particular, and South Africa in general, and in improved care for PLWH.

  7. Correlates of HIV stigma in HIV-positive women.

    Science.gov (United States)

    Wagner, Anne C; Hart, Trevor A; Mohammed, Saira; Ivanova, Elena; Wong, Joanna; Loutfy, Mona R

    2010-06-01

    We examined the variables associated with HIV stigma in HIV-positive women currently living in Ontario, Canada. Based on previous literature, we predicted that variables of social marginalization (e.g., ethnicity, income, education), medical variables (e.g., higher CD4 count, lower viral load), and increased psychological distress would be associated with higher perceived HIV stigma among HIV-positive women. One hundred fifty-nine HIV-positive women between the ages of 18 and 52 in Ontario completed self-report measures of the aforementioned variables. Women were recruited through 28 AIDS service organizations, eight HIV clinics, and two community health centers. In multiple regression analyses, for women born in Canada, lower educational level and higher anxiety were associated with higher HIV stigma. For women born outside of Canada, having been judged by a physician in Canada for trying to become pregnant was associated with higher HIV stigma. For HIV-positive women born outside of Canada, negative judgment by a physician regarding intentions to become pregnant should be addressed to reduce perceived HIV stigma and vice versa. Health care providers should be trained in the provision of sensitive and effective health care for women living with HIV, especially when providing reproductive health care.

  8. Nasal colonization with Staphylococcus aureus in individuals with HIV/ AIDS attended in a Brazilian teaching hospital.

    Science.gov (United States)

    Reinato, Lilian Andreia Fleck; Pio, Daiana Patrícia Marchetti; Lopes, Letícia Pimenta; Pereira, Fernanda Maria Vieira; Lopes, Ana Elisa Ricci; Gir, Elucir

    2013-01-01

    to evaluate the prevalence of nasal colonization with Staphylococcus aureus in individuals with HIV/AIDS under inpatient treatment in a teaching hospital in the state of São Paulo (Brazil). a cross-sectional study undertaken in two units specialized in attending people living with HIV/AIDS, in the period August 2011 - July 2012. Socio-demographic and clinical data was collected through individual interviews and from the medical records; samples of nasal secretion were collected with Stuart swabs on the first day of inpatient treatment. Ethical aspects were respected. of the 229 individuals with HIV/AIDS hospitalized in this period, 169 participated in the study, with Staphylococcus aureus being identified in the culture tests of 46 (27.2%) of the individuals, resistance to oxacillin being evidenced in 10 (21.8%) participants. the results of the research indicate that the prevalence of colonization with Staphylococcus aureus in individuals with HIV/AIDS in the specialized units was considered relevant, possibly contributing to future investigations and, moreover, to the implementation of measures to prevent and control this pathogen in this population.

  9. Factors associated with late Human Immunodeficiency Virus (HIV) diagnosis among peoples living with it, Northwest Ethiopia: hospital based unmatched case-control study.

    Science.gov (United States)

    Aniley, Abebayehu Bitew; Ayele, Tadesse Awoke; Zeleke, Ejigu Gebeye; Kassa, Assefa Andargie

    2016-10-12

    Early HIV diagnosis and access to treatment is one of the most effective ways to prevent its further spread and to protect the health of those living with the virus. However, delay in diagnosis is the major risk factor for uptake of and response to antiretroviral therapy. Institution-based unmatched case-control study design was used in the study. The study was conducted in Debre-Markos and Finote-Selam Hospitals, Northwest Ethiopia. Cases were people living with HIV who had CD4 count study as World Health Organization recommended. A total of 392 respondents (196 cases and 196 controls) were recruited and selected systematically. The data were collected by trained nurses using chart review and interviewer administered structured questionnaire. Binary Logistic Regression Model was used to identify the factors associated with late HIV diagnosis. About 95.9 % of study participants provided complete response. Having no understanding, compared to having understanding, about HIV/AIDS (AOR = 1.7, 95 %CI = 1.08-2.79) and ART (AOR = 2.1, 95 %CI: 1.25-3.72), being tested as a result of symptoms/ illness, compared to being tested for risk exposure (inverted AOR =2.5, 95 %CI: 1.64-4.76), and acquiring HIV through sexual contact, compared to acquiring it through other modes (AOR = 2.5, 95 %CI = 1.52-4.76) were positively and independently associated with late HIV diagnosis. Unlike perceived HIV stigma, having no understanding about HIV and ART, being tested for presence of symptoms/illness, and acquiring HIV through sexual contact were independent and significant factors for late HIV diagnosis.

  10. Increase in Unemployment over the 2000’s: Comparison between People Living with HIV and the French General Population

    Science.gov (United States)

    Annequin, Margot; Lert, France; Spire, Bruno; Dray-Spira, Rosemary

    2016-01-01

    Background Despite improved health, unemployment has increased among people living with HIV (PlwHIV) over the last decade. However, since the economic recession of 2008, unemployment also increased in the French general population. This paper aimed to determine if the increase in the unemployment rate in the HIV population was higher than that in the French general population. Methods We used data from the ANRS-Vespa study, a repeated cross-sectional survey among two national representative samples of PlwHIV followed at hospitals in France in 2003 and 2011. We compared employment and unemployment rates between HIV-infected people (overall and according to period of HIV diagnosis) and the French general population in 2003 and 2011, using multivariate Poisson regressions adjusted for individual sociodemographic characteristics. Results The employment rate among PlwHIV was consistently lower than that in the general population in 2003 and 2011. In contrast, there was a trend of an increasing unemployment rate difference between PlwHIV and the general population: PlwHIV’s unemployment rate was 1.48 (95% confidence interval [CI]: 1.16–1.90) times higher than that of the general population in 2003, versus 1.62 (95% CI: 1.34–1.96) times higher in 2011. This unemployment rate difference was the highest for PlwHIV diagnosed in or after 2008 (adjusted prevalence rate ratio: 2.06; 95% CI: 1.59–2.67). Conclusions These results suggest that in time of economic recession, an increasing proportion of PlwHIV may be excluded from the labor market although they are willing to re-enter it. This constitutes a major issue relative to social consequences of chronic disease. PMID:27814374

  11. Knowledge and Acceptability of Human Papillomavirus Vaccination among Women Attending the Gynaecological Outpatient Clinics of a University Teaching Hospital in Lagos, Nigeria.

    Science.gov (United States)

    Okunade, Kehinde S; Sunmonu, Oyebola; Osanyin, Gbemisola E; Oluwole, Ayodeji A

    2017-01-01

    This study was aimed at determining the knowledge and acceptability of HPV vaccine among women attending the gynaecology clinics of the Lagos University Teaching Hospital (LUTH). This was a descriptive cross-sectional study involving 148 consecutively selected women attending the gynaecology clinic of LUTH. Relevant information was obtained from these women using an interviewer-administered questionnaire. The data was analysed and then presented by simple descriptive statistics using tables and charts. Chi-square statistics were used to test the association between the sociodemographical variables and acceptance of HPV vaccination. All significance values were reported at P < 0.05. The mean age of the respondents was 35.7 ± 9.7 years. The study showed that 36.5% of the respondents had heard about HPV infection while only 18.9% had knowledge about the existence of HPV vaccines. Overall, 81.8% of the respondents accepted that the vaccines could be administered to their teenage girls with the level of education of the mothers being the major determinant of their acceptability ( P = 0.013). Awareness of HPV infections and existence of HPV vaccines is low. However, the acceptance of HPV vaccines is generally high. Efforts should be made to increase the awareness about cervical cancer, its aetiologies, and prevention via HPV vaccination.

  12. Perceived Visual Deterioration among a Selected Group of Dental ...

    African Journals Online (AJOL)

    To assess the perceived visual deterioration and the determinants among selected dental surgeons in Nigeria. A cross-sectional survey of Resident doctors attending the Revision course of Faculty of Dental Surgery of the National Postgraduate Medical College of Nigeria in Lagos University Teaching Hospital, Lagos, ...

  13. The Art of Resilience: Photo-stories of Inspiration and Strength among People with HIV/AIDS.

    Science.gov (United States)

    Kabel, Allison; Teti, Michelle; Zhang, Ni

    2016-01-01

    Using the visual arts to aid healing is a common therapy for people with critical illness, yet the use of art to improve the lives of people with HIV is under-utilized. Eight male and 20 female participants living with HIV in urban areas of the Midwest, U.S. participated in three group photovoice photo-sharing and discussion sessions, post-project individual interviews and a community photo exhibit. We used a grounded theory approach to analyze interview data, and identified three key themes: (1) health and wellness, (2) fear and stigma, and (3) restoring a threatened identity. Participants identified how taking photos, reflecting on and sharing them in focus groups helped them express themselves while living with and coping with HIV. Offering photography as form of expression is a way to foster strength and consequently, improve the lives of people living with HIV. Our participants benefitted from the process of telling their story with images. They were able to express positive aspects of their lives which could be a healthy form of catharsis in and of itself. Future research should continue to investigate how participants in participatory approaches like photovoice, actually do benefit from the research. Although we focused this analysis on resilience, photovoice is flexible and participants' responses to it are varied. Additional outcomes such as impact on mental and physical health, are worthy of additional exploration.

  14. Are people living with HIV less productive at work?

    NARCIS (Netherlands)

    K. Verbooy (Kaya); M.N. Wagener (Marlies); M. Kaddouri (Meriam); P.D.D.M. Roelofs (Pepijn); H.S. Miedema (Harald); E.C.M. van Gorp (Eric); W.B.F. Brouwer (Werner); N.J.A. van Exel (Job)

    2018-01-01

    textabstractHealth problems may cause decreased productivity among working people. It is unclear if this also applies for people living with HIV (PLWH). This cross-sectional study compares data of PLWH of one of the main HIV treatment centres in the Netherlands (n = 298) to data of the general

  15. HIV/AIDS - Related Stigma and Discrimination in Nigeria: Review of ...

    African Journals Online (AJOL)

    Erah

    2009-09-03

    Sep 3, 2009 ... KEYWORDS: HIV/AIDS, Stigma, discrimination, Nigeria. *Institute ... except South Africa and India. 1. The ... defined as a form of exclusion, or ... S&D like gender, age and background ..... levels of socio-economic development.

  16. HIV serostatus disclosure: Experiences and perceptions of people living with HIV/AIDS and their service providers in Gujarat, India

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    Sangita V Patel

    2012-01-01

    Full Text Available Background: Human immunodeficiency virus (HIV disclosure offers important benefits to people living with HIV/AIDS. However, fear of discrimination, blame, and disruption of family relationships can make disclosure a difficult decision. Barriers to HIV disclosure are influenced by the particular culture within which the individuals live. Although many studies have assessed such barriers in the U.S., very few studies have explored the factors that facilitate or prevent HIV disclosure in India. Understanding these factors is critical to the refinement, development, and implementation of a counseling intervention to facilitate disclosure. Materials and Methods: To explore these factors, we conducted 30 in-depth interviews in the local language with HIV- positive individuals from the Integrated Counselling and Testing Centre in Gujarat, India, assessing the experiences, perceived barriers, and facilitators to disclosure. To triangulate the findings, we conducted two focus group discussions with HIV medical and non-medical service providers, respectively. Results: Perceived HIV-associated stigma, fear of discrimination, and fear of family breakdown acted as barriers to HIV disclosure. Most people living with HIV/AIDS came to know of their HIV status due to poor physical health, spousal HIV-positive status, or a positive HIV test during pregnancy. Some wives only learned of their husbands′ HIV positive status after their husbands died. The focus group participants confirmed similar findings. Disclosure had serious implications for individuals living with HIV, such as divorce, maltreatment, ostracism, and decisions regarding child bearing. Interpretation and Conclusion: The identified barriers and facilitators in the present study can be used to augment training of HIV service providers working in voluntary counseling and testing centers in India.

  17. Relationship of race-, sexual orientation-, and HIV-related discrimination with adherence to HIV treatment: a pilot study.

    Science.gov (United States)

    Boarts, Jessica M; Bogart, Laura M; Tabak, Melanie A; Armelie, Aaron P; Delahanty, Douglas L

    2008-10-01

    Adherence to highly active antiretroviral therapy (HAART) must be close to perfect in order to maintain suppression of HIV viral load, and to prevent the development of drug resistant strains of HIV. People living with HIV (PLWH) often report low levels of adherence. One variable that has been linked to poor adherence is perceived discrimination; however, research has generally not considered the possible unique effects of different types of discrimination on adherence. The present pilot study aimed to examine the association of three types of discrimination (due to HIV+ status, race, or sexual orientation) with adherence among 57 PLWH. Logistic regression analyses were conducted to demonstrate the relationships between each type of discrimination and self-reported adherence. Racial discrimination significantly predicted lower adherence levels, whereas sexual orientation- and HIV-related discrimination did not. Results underscore the importance of addressing discrimination issues, specifically racial, when designing interventions to improve adherence to HAART.

  18. Depressive symptoms and social support among people living with HIV in Hunan, China.

    Science.gov (United States)

    Wang, Honghong; Zhang, Caihong; Ruan, Ye; Li, Xianhong; Fennie, Kristopher; Williams, Ann B

    2014-01-01

    Depressive symptoms are common among people living with HIV (PLWH) and are associated with poor adherence to antiretroviral treatment and poor treatment outcomes. Our study investigated the prevalence of and factors associated with depressive symptoms in PLWH in one Chinese province. Data were collected from 496 PLWH between July 2009 and July 2010 at two HIV treatment sites in Hunan Province, China. Sixty-two percent (n = 309) of participants scored 16 or more on the Center for Epidemiological Studies of Depression scale, indicating moderate to high levels of depressive symptoms. Independent predictors of depressive symptoms included active heroin use, lack of a stable job, female gender, and limited social support. These data suggest that interventions addressing depressive symptoms should be included in HIV care programs provided by the Chinese government, with a special focus on PLWH who are heroin users, female, unemployed, or socially isolated. Copyright © 2014 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

  19. Factors associated with access to antiretroviral therapy among people living with hiv in vientiane capital, lao pdr.

    Science.gov (United States)

    Chanvilay, Thammachak; Yoshida, Yoshitoku; Reyer, Joshua A; Hamajima, Nobuyuki

    2015-02-01

    Since 2001, antiretroviral therapy (ART) has been available for people living with HIV (PLHIV) in Lao People's Democratic Republic (PDR). Over 10 years of the ART program many HIV patients were found with advanced-stage AIDS in health care service facilities. This study aimed to examine factors associated with delayed access to ART among PLHIV in the capital of Vientiane. A cross-sectional study was conducted with 283 respondents (131 males and 152 females) aged 15 years or over. In this study, delayed access to ART was defined by a CD4 cell count of less than 350 cells/mm(3) at the first screening, or those who presented with advanced AIDS-related symptoms. The odds ratios (ORs) and 95% confidence intervals (CIs) were estimated by a logistic model. After adjustment, young people (OR=2.17; 95% CI: 1.00-4.68; p=0.049), low education (OR=0.23; 95% CI: 0.10-0.55; p=0.001) and duration between risk behavior and HIV test (OR=3.83; 95% CI: 1.22-12.00; p=0.021) were significantly associated with delayed access to ART. Low perception of high risk behaviors was one of the obstacles leading to delayed testing and inability to access ART. Almost all reported feeling self-stigma, and only 30.5% of men and 23.7% of women disclosed the HIV status to his/her partner/spouse. In conclusion, delayed access to ART was associated with individual factors and exposure to health care facility. In order to improve early detection HIV infection following access to ART, an improvement in perceptional knowledge of HIV, as well as reduction of HIV/AIDS-related stigma, might be needed.

  20. A tale of two cities: stigma and health outcomes among people with HIV who inject drugs in St. Petersburg, Russia and Kohtla-Järve, Estonia.

    Science.gov (United States)

    Burke, Sara E; Calabrese, Sarah K; Dovidio, John F; Levina, Olga S; Uusküla, Anneli; Niccolai, Linda M; Abel-Ollo, Katri; Heimer, Robert

    2015-04-01

    Experiences of stigma are often associated with negative mental and physical health outcomes. The present work tested the associations between stigma and health-related outcomes among people with HIV who inject drugs in Kohtla-Järve, Estonia and St. Petersburg, Russia. These two cities share some of the highest rates of HIV outside of sub-Saharan Africa, largely driven by injection drug use, but Estonia has implemented harm reduction services more comprehensively. People who inject drugs were recruited using respondent-driven sampling; those who indicated being HIV-positive were included in the present sample (n = 381 in St. Petersburg; n = 288 in Kohtla-Järve). Participants reported their health information and completed measures of internalized HIV stigma, anticipated HIV stigma, internalized drug stigma, and anticipated drug stigma. Participants in both locations indicated similarly high levels of all four forms of stigma. However, stigma variables were more strongly associated with health outcomes in Russia than in Estonia. The St. Petersburg results were consistent with prior work linking stigma and health. Lower barriers to care in Kohtla-Järve may help explain why social stigma was not closely tied to negative health outcomes there. Implications for interventions and health policy are discussed. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. A Tale of Two Cities: Stigma and Health Outcomes Among People with HIV who Inject Drugs in St. Petersburg, Russia and Kohtla-Järve, Estonia

    Science.gov (United States)

    Burke, Sara E.; Calabrese, Sarah K.; Dovidio, John F.; Levina, Olga S.; Uusküla, Anneli; Niccolai, Linda M.; Abel-Ollo, Katri; Heimer, Robert

    2015-01-01

    Experiences of stigma are often associated with negative mental and physical health outcomes. The present work tested the associations between stigma and health-related outcomes among people with HIV who inject drugs in Kohtla-Järve, Estonia and St. Petersburg, Russia. These two cities share some of the highest rates of HIV outside of sub-Saharan Africa, largely driven by injection drug use, but Estonia has implemented harm reduction services more comprehensively. People who inject drugs were recruited using respondent-driven sampling; those who indicated being HIV-positive were included in the present sample (n=381 in St. Petersburg; n=288 in Kohtla-Järve). Participants reported their health information and completed measures of internalized HIV stigma, anticipated HIV stigma, internalized drug stigma, and anticipated drug stigma. Participants in both locations indicated similarly high levels of all four forms of stigma. However, stigma variables were more strongly associated with health outcomes in Russia than in Estonia. The St. Petersburg results were consistent with prior work linking stigma and health. Lower barriers to care in Kohtla-Järve may help explain why social stigma was not closely tied to negative health outcomes there. Implications for interventions and health policy are discussed. PMID:25703668

  2. Sexual activity and condom use among people living with HIV in ...

    African Journals Online (AJOL)

    However, the extent to which knowledge of one's HIV status contributes to behavioural change among people living with HIV (PLHIV) has not been comprehensively documented. Drawing on an analysis of 37 in-depth interviews and five focus group discussions with PLHIV, this paper examines the nature of sexual activity ...

  3. Perceived barriers to the implementation of Isoniazid preventive therapy for people living with HIV in resource constrained settings: a qualitative study.

    Science.gov (United States)

    Mindachew, Mesele; Deribew, Amare; Memiah, Peter; Biadgilign, Sibhatu

    2014-01-01

    Isoniazid preventive therapy (IPT) reduces the risk of active TB. IPT is a key public health intervention for the prevention of TB among people living with HIV and has been recommended as part of a comprehensive HIV and AIDS care strategy. However, its implementation has been very slow and has been impeded by several barriers. The Objective of the study is to assess the perceived barriers to the implementation of Isoniazid preventive therapy for people living with HIV in resource constrained settings in Addis Ababa, Ethiopia in 2010. A qualitative study using a semi-structured interviewed guide was used for the in-depth interview. A total of 12 key informants including ART Nurse, counselors and coordinators found in four hospitals were included in the interview. Each session of the in-depth interview was recorded via audio tape and detailed notes. The interview was transcribed verbatim. The data was analyzed manually. The findings revealed that poor patient adherence was a major factor; with the following issues cited as the reasons for poor adherence; forgetfulness; lack of understanding of condition and patient non- disclosure of HIV sero-status leading to insubstantial social support; underlying mental health issues resulting in missed or irregular patient appointments; weak patient/healthcare provider relationship due to limited quality interaction; lack of patient information, patient empowerment and proper counseling on IPT; and the deficient reinforcement by health officials and other stakeholders on the significance of IPT medication adherence as a critical for positive health outcomes. Uptake of the implementation of IPT is facing a challenge in resource limited settings. This recalled provision of training/capacity building and awareness creation mechanism for the health workers, facilitating disclosure and social support for the patients is recommended.

  4. Indicators of adherence to physiotherapy attendance among Saudi female patients with mechanical low back pain: a clinical audit

    Directory of Open Access Journals (Sweden)

    Al-Eisa Einas

    2010-06-01

    Full Text Available Abstract Background Among current musculoskeletal interventions used to treat low back pain (LBP, physiotherapy exercise has the highest evidence of effectiveness in avoiding recurrence and chronic disability. However, effectiveness of physiotherapy is thought to be directly related to the patients' adherence to physiotherapy. Since adherence is reported to be directly influenced by socio-cultural factors, this study was conducted to investigate factors related to patients' adherence in a group of Saudi female patients with LBP. Methods A retrospective chart review was conducted on female LBP patients referred to the department of physiotherapy at a local tertiary hospital over a 12 month period. A total of 98 charts were reviewed. Two physiotherapists specialized in musculoskeletal rehabilitation collected information from the medical files. Data were classified in three categories: patients' personal demographics, patients' medical condition and history, and type of physiotherapy administered. Contingency tables and chi-square test were computed to test for differences in proportions. Spearman rank correlation coefficient was calculated to examine relationships among variables. Results Subjects who attended their scheduled appointments were classified as adherent (40%, and those who failed to attend 2 consecutive scheduled appointments and got discharged were classified as non-adherent (60%. Factors that significantly correlated with adherence included: age (r = 0.7, p Conclusion This study reveals an alarming level of non-adherence to physiotherapy among patients with LBP. It remains unclear as to what level of adherence is required to achieve beneficial effect of treatment. It is quite evident however, that early withdrawal from treatment would not allow the therapeutic benefits of the treatment to be realized. Future research should be directed toward developing strategies to improve adherence.

  5. Community Norms about Suppression of HIV/AIDS Prejudice and Perceptions of Stigma by People with HIV/AIDS

    Science.gov (United States)

    Miller, Carol T.; Grover, Kristin W.; Bunn, Janice Yanushka; Solomon, Sondra E.

    2012-01-01

    We investigated the relationship between reports by 203 people with HIV/AIDS in New England communities about their experiences with stigma and reports by 2,444 randomly selected residents of those same communities about their motivation to control HIV/AIDS prejudice. Multi-level regression analyses revealed that the disclosure concerns of participants with HIV/AIDS were lower in communities in which residents were motivated by personal values to control HIV/AIDS prejudice, and were higher in communities in which residents were motivated by social pressure to control HIV/AIDS prejudice. Reported experiences with discrimination and exclusion were unrelated to these community motivations. These results suggest that the realities of the communities in which stigmatized people live shape their perceptions of stigmatization. PMID:21478473

  6. Reducing medical students' stigmatization of people with chronic mental illness: a field intervention at the "living museum" state hospital art studio.

    Science.gov (United States)

    Cutler, Janis L; Harding, Kelli J; Hutner, Lucy A; Cortland, Clarissa; Graham, Mark J

    2012-05-01

    The authors designed an intervention to reduce beginning medical students' stigmatization of people with chronic mental illness (CMI). Pre-clinical medical students visited a state psychiatric facility's "Living Museum," a combination patient art studio/display space, as the intervention. During the visit, students interacted with artist-guides who showed their work and discussed their experiences creating art. Students completed a self-assessment survey developed to measure attitudes and feelings toward people with CMI after half of the class visited the Living Museum, constituting a Visit/No-Visit cross-sectional comparison. Students who visited the Living Museum (N=64), as compared with those who did not visit (N=110), endorsed more positive attitudes toward people with CMI. Among the students who visited, however, those who reported having spoken individually with a patient-artist (N=44), paradoxically, indicated less-positive feelings toward people with CMI. An intervention in which pre-clinical medical students visited patient-artist guides in an art-studio setting generally improved students' attitudes toward people with CMI. Thus, nontraditional psychiatric settings offer a valuable adjunct to more traditional clinical settings to reduce stigma when introducing medical students to the field of psychiatry.

  7. Barriers to ART adherence & follow ups among patients attending ART centres in Maharashtra, India.

    Science.gov (United States)

    Joglekar, N; Paranjape, R; Jain, R; Rahane, G; Potdar, R; Reddy, K S; Sahay, S

    2011-12-01

    Adherence to ART is a patient specific issue influenced by a variety of situations that a patient may encounter, especially in resource-limited settings. A study was conducted to understand factors and influencers of adherence to ART and their follow ups among patients attending ART centres in Maharashtra, India. Between January and March 2009, barriers to ART adherence among 32 patients at three selected ART centres functioning under national ART roll-out programme in Maharashtra, India, were studied using qualitative methods. Consenting patients were interviewed to assess barriers to ART adherence. Constant comparison method was used to identify grounded codes. Patients reported multiple barriers to ART adherence and follow up as (i) Financial barriers where the contributing factors were unemployment, economic dependency, and debt, (ii) social norm of attending family rituals, and fulfilling social obligations emerged as socio-cultural barriers, (iii) patients' belief, attitude and behaviour towards medication and self-perceived stigma were the reasons for sub-optimal adherence, and (iv) long waiting period, doctor-patient relationship and less time devoted in counselling at the center contributed to missed visits. Mainstreaming ART can facilitate access and address 'missed doses' due to travel and migration. A 'morning' and 'evening' ART centre/s hours may reduce work absenteeism and help in time management. Proactive 'adherence probing' and probing on internalized stigma might optimize adherence. Adherence probing to prevent transitioning to suboptimal adherence among patients stable on ART is recommended.

  8. Dietary diversity and associated factors among HIV positive adults attending antiretroviral therapy clinics at Hiwot Fana and Dilchora Hospitals, eastern Ethiopia

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    Weldegebreal F

    2018-05-01

    Full Text Available Fitsum Weldegebreal,1 Tesfaye Digaffe,1 Frehiwot Mesfin,2 Habtamu Mitiku1 1Department of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 2Department of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia Background: Nutritional care is considered a crucial component of comprehensive care for people living with HIV/AIDS (PLWHA, particularly in resource-limited settings where malnutrition and food insecurity are endemic problems, and low quality monotonous diets are the norm. The findings of this study provide baseline information on dietary diversity and related factors for health care providers so that they will be able to improve nutritional care and support activity. Therefore, the aim of this study was to assess dietary diversity and associated factors among HIV positive adults (18–65 years old attending antiretroviral therapy (ART clinics at Hiwot Fana and Dilchora Hospitals, eastern Ethiopia. Patients and methods: An institution-based cross-sectional study was conducted from November 2015 to February 2016 at the ART clinics of Hiwot Fana and Dilchora Hospitals. Using a systematic random sampling technique, a total of 303 patients were selected from all adults attending the ART clinics. The data were collected with a 95% CI used to show association between dietary diversity and independent factors. Results: A total of 303 adult HIV positive individuals on ART participated in the study and 62.4% were females. The largest numbers of participants (49.5% were 30–40 years of age. Eighty-seven (28.7% participants had low dietary diversity (≤4 food groups. Duration of antiretroviral treatment was the factor significantly associated with dietary diversity: respondents with a duration of antiretroviral treatment of more than 2 years were almost two times more likely to have high dietary diversity compared with those with less than a year of

  9. Prevalence and Predictors of Food Insecurity among People Living with HIV Enrolled in Antiretroviral Therapy and Livelihood Programs in Two Rural Zambian Hospitals

    Science.gov (United States)

    Masa, Rainier; Chowa, Gina; Nyirenda, Victor

    2018-01-01

    The objective of this study was to examine the prevalence and predictors of food insecurity among people living with HIV (PLHIV) in two rural communities in Zambia. A cross-sectional sample of 101 PLHIV was surveyed using the Household Food Insecurity Access Scale. In multivariable linear regression models, income, household possessions, and perceived coping strategies were significantly associated with decreased food insecurity. Debt and perceived mental distress were significantly associated with increased food insecurity. Programs that tackle economic disadvantage and its adverse effect on stress may be an appropriate strategy to improve food security of PLHIV in low-resource communities. PMID:28418728

  10. Emergency distress call system for automobiles in Lagos state, Nigeria

    African Journals Online (AJOL)

    Emergency distress call system for automobiles in Lagos state, Nigeria. ... PROMOTING ACCESS TO AFRICAN RESEARCH ... and communications technology capabilities to transportation and the medical care system in order to save lives, ...

  11. Sociodemographic profile and predictors of outpatient clinic attendance among HIV-positive patients initiating antiretroviral therapy in Selangor, Malaysia

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    Abdulrahman SA

    2017-07-01

    Full Text Available Surajudeen Abiola Abdulrahman,1,2 Lekhraj Rampal,1 Norlijah Othman,3 Faisal Ibrahim,1 Kadir Shahar Hayati,1 Anuradha P Radhakrishnan4 1Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, 2Department of Public Health Medicine, Penang Medical College, George Town, Penang, 3Department of Paediatrics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, 4Infectious Disease Clinic, Hospital Sungai Buloh, Sungai Buloh, Selangor, MalaysiaBackground: Inconsistent literature evidence suggests that sociodemographic, economic, and system- and patient-related factors are associated with clinic attendance among the HIV-positive population receiving antiretroviral therapy (ART around the world. We examined the factors that predict outpatient clinic attendance among a cohort of HIV-positive patients initiating ART in Selangor, Malaysia.Patients and methods: This cross-sectional study analyzed secondary data on outpatient clinic attendance and sociodemographic, economic, psychosocial, and patient-related factors among 242 adult Malaysian patients initiating ART in Selangor, Malaysia. Study cohort was enrolled in a parent randomized controlled trial (RCT in Hospital Sungai Buloh Malaysia between January and December 2014, during which peer counseling, medication, and clinic appointment reminders were provided to the intervention group through short message service (SMS and telephone calls for 24 consecutive weeks. Data on outpatient clinic attendance were extracted from the hospital electronic medical records system, while other patient-level data were extracted from pre-validated Adult AIDS Clinical Trial Group (AACTG adherence questionnaires in which primary data were collected. Outpatient clinic attendance was categorized into binary outcome – regular attendee and defaulter categories – based on the number of missed scheduled outpatient clinic appointments within a 6-month

  12. Assessment of medical waste management in seven hospitals in Lagos, Nigeria

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    Olufunsho Awodele

    2016-03-01

    Full Text Available Abstract Background Medical waste (MW can be generated in hospitals, clinics and places where diagnosis and treatment are conducted. The management of these wastes is an issue of great concern and importance in view of potential public health risks associated with such wastes. The study assessed the medical waste management practices in selected hospitals and also determined the impact of Lagos Waste Management Authority (LAWMA intervention programs. A descriptive cross-sectional survey method was used. Methods Data were collected using three instrument (questionnaire, site visitation and in –depth interview. Two public (hospital A, B and five private (hospital C, D, E, F and G which provide services for low, middle and high income earners were used. Data analysis was done with SPSS version 20. Chi-squared test was used to determine level of significance at p < 0.05. Results The majority 56 (53.3 % of the respondents were females with mean age of 35.46 (±1.66 years. The hospital surveyed, except hospital D, disposes both general and medical waste separately. All the facilities have the same process of managing their waste which is segregation, collection/on-site transportation, on-site storage and off–site transportation. Staff responsible for collecting medical waste uses mainly hand gloves as personal protective equipment. The intervention programs helped to ensure compliance and safety of the processes; all the hospitals employ the services of LAWMA for final waste disposal and treatment. Only hospital B offered on-site treatment of its waste (sharps only with an incinerator while LAWMA uses hydroclave to treat its wastes. There are no policies or guidelines in all investigated hospitals for managing waste. Conclusions An awareness of proper waste management amongst health workers has been created in most hospitals through the initiative of LAWMA. However, hospital D still mixes municipal and hazardous wastes. The treatment of waste

  13. The meaning and effect of HIV/AIDS stigma for people living with AIDS and nurses involved in their care in the North West Province, South Africa

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    M. Greeff

    2007-09-01

    Full Text Available The five countries with the highest HIV prevalence rates in the world are situated in southern Africa, and South Africa, with an estimated 4,7 million people living with HIV (PLWA, has more cases of HIV/AIDS than any other country. AIDS stigma and discrimination continue to impact on those living with and affected by the HIV disease and their health-care providers, particularly in southern Africa, where the burden of AIDS is so significant. Stigma has become a major problem in the provision o f care for PLWA in Africa. A five-year multinational African study on perceived AIDS stigma was undertaken. The North West Province in South Africa formed part of this study. The first phase focused on exploring and describing the meaning and effect o f stigma for PLWA and nurses involved in their care. This article focuses on the data for the North West Province, South Africa. An exploratory descriptive qualitative research design was used. Through focus groups the critical incident method was applied to gain respondents’ emic and etic views. The study was conducted in the Potchefstroom district and the Kayakulu area. Purposive voluntary sampling was utilised. The open coding technique was used for data analysis. Three types of stigma (received, internal and associated stigma and several dimensions for each type o f stigma were identified. Recommendations for interventions, a measuring scale and the formulation of a conceptual model were formulated.

  14. Nasal colonization with Staphylococcus aureus in individuals with HIV/ AIDS attended in a Brazilian Teaching Hospital

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    Lilian Andreia Fleck Reinato

    2013-12-01

    Full Text Available OBJECTIVE: to evaluate the prevalence of nasal colonization with Staphylococcus aureus in individuals with HIV/AIDS under inpatient treatment in a teaching hospital in the state of São Paulo (Brazil. METHOD: a cross-sectional study undertaken in two units specialized in attending people living with HIV/AIDS, in the period August 2011 - July 2012. Socio-demographic and clinical data was collected through individual interviews and from the medical records; samples of nasal secretion were collected with Stuart swabs on the first day of inpatient treatment. Ethical aspects were respected. RESULT: of the 229 individuals with HIV/AIDS hospitalized in this period, 169 participated in the study, with Staphylococcus aureus being identified in the culture tests of 46 (27.2% of the individuals, resistance to oxacillin being evidenced in 10 (21.8% participants. CONCLUSION: the results of the research indicate that the prevalence of colonization with Staphylococcus aureus in individuals with HIV/AIDS in the specialized units was considered relevant, possibly contributing to future investigations and, moreover, to the implementation of measures to prevent and control this pathogen in this population.

  15. Physiotherapy intervention as a complementary treatment for people living with HIV/AIDS

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    Pullen SD

    2014-06-01

    Full Text Available Sara D Pullen,1 Nnenna Nina Chigbo,2 Emmanuel Chukwudi Nwigwe,2 Chinwe J Chukwuka,3 Christopher Chim Amah,4 Stanley C Idu21Department of Rehabilitation Medicine, Division of Physical Therapy, Emory University, Atlanta, GA, USA; 2Department of Physiotherapy, 3Department of Medicine, 4Paediatric Surgery Division, Department of Surgery, College of Medicine, University of Nigeria Teaching Hospital, Enugu, NigeriaBackground: The advent of highly active antiretroviral therapy has dramatically extended the life expectancy of people living with human immunodeficiency virus (HIV/acquired immunodeficiency syndrome. Despite this increased longevity, HIV disease and its pharmacological treatment can cause long-term and acute health complications, many of which can be treated successfully by physiotherapy. The purpose of this paper is to report the effect of a 12-week rehabilitation program on several health-related markers in a 43-year-old woman living with HIV.Methods: This case study examined the effect of a 12-week exercise and manual therapy intervention on morphology, pain, cardiopulmonary fitness, strength, neurological balance, immune markers (CD4 cell count, and quality of life in a 43-year-old woman living with HIV.Results: The results showed complete elimination of pain and shortness of breath on exertion. There was also a reduction in resting heart rate, waist circumference, exercise duration, muscle strength, and endurance. The patient showed an increase in peak expiratory flow rate, maximal heart rate attained, upper arm, forearm, and thigh circumference, and CD4+ cell count. The patient also showed improvements in the quality of life domains of general health, pain, energy/fatigue, social and physical functioning, and emotional well-being.Conclusion: Physiotherapy interventions consisting of exercise and manual therapy appear beneficial in several areas as an adjunct therapy in HIV management.Keywords: exercise, manual therapy, quality of life

  16. Prevalence and predictors of food insecurity among people living with HIV affiliated with AIDS service organizations in Ontario, Canada.

    Science.gov (United States)

    Bekele, Tsegaye; Globerman, Jason; Watson, James; Jose-Boebridge, Murray; Kennedy, Richard; Hambly, Keith; Anema, Aranka; Hogg, Robert S; Rourke, Sean B

    2018-05-01

    Up to half of people living with HIV in resource-rich settings experience moderate to severe food insecurity. Food insecurity, in turn, has been linked to adverse health outcomes including poor antiretroviral adherence, poor HIV viral suppression, frailty, and mortality. We estimated the prevalence of food insecurity among 649 adults living with HIV and recruited from community-based AIDS service organizations in Ontario, Canada. Food security was assessed using the Canadian Household Food Security module. We used logistic regression modeling to identify demographic, socioeconomic, and psychosocial factors independently associated with food insecurity. Almost three-fourths of participants (70.3%) were food insecure and a third (31%) reported experiencing hunger. The prevalence of food insecurity in this sample is approximately six times higher than that of the general population. Factors independently associated with food insecurity were: having dependent children at home, residing in large urban areas, low annual household income (<$40,000), difficulty meeting housing-related expenses, cigarette smoking, harmful drug use, and depression. Broad, multisector interventions that address income, housing affordability, substance use and mental health issues are needed and could offset future public health expenditures.

  17. A Moderated Mediation Model of HIV-Related Stigma, Depression, and Social Support on Health-Related Quality of Life among Incarcerated Malaysian Men with HIV and Opioid Dependence.

    Science.gov (United States)

    Shrestha, Roman; Copenhaver, Michael; Bazazi, Alexander R; Huedo-Medina, Tania B; Krishnan, Archana; Altice, Frederick L

    2017-04-01

    Although it is well established that HIV-related stigma, depression, and lack of social support are negatively associated with health-related quality of life (HRQoL) among people living with HIV (PLH), no studies to date have examined how these psychosocial factors interact with each other and affect HRQoL among incarcerated PLH. We, therefore, incorporated a moderated mediation model (MMM) to explore whether depression mediates the effect of HIV-related stigma on HRQoL as a function of the underlying level of social support. Incarcerated HIV-infected men with opioid dependence (N = 301) were recruited from the HIV units in Kajang prison in Malaysia. Participants completed surveys assessing demographic characteristics, HIV-related stigma, depression, social support, and HRQoL. Results showed that the effect of HIV-related stigma on HRQoL was mediated via depression (a1:β = 0.1463, p depression was negatively associated with HRQOL (β = -0.0317, p = 0.0133). This indicated that the predicted influence of HIV-related stigma on HRQoL via depression had negative effect on HRQoL for individuals with low social support. The results suggest that social support can buffer the negative impact of depression on HRQoL and highlights the need for future interventions to target these psychosocial factors in order to improve HRQoL among incarcerated PLH.

  18. Psychoactive Substance use among People living with HIV/AIDS in ...

    African Journals Online (AJOL)

    Background: There is a wide opinion on pattern of use of psychoactive substances especially parenteral psychoactive substances which have been indicted as one of the major mode of transmission of HIV among people living with HIV/AIDS (PLWHA) in the western world. However, there is regional variability especially in ...

  19. Differences in labour participation between people living with HIV and the general population: Results from Spain along the business cycle.

    Science.gov (United States)

    Peña Longobardo, Luz María; Oliva-Moreno, Juan

    2018-01-01

    HIV/AIDS (Human immunodeficiency virus/Acquired immune deficiency syndrome) not only has a strong impact on the health of the worldwide population but also affects the labour status of HIV-positive people. The primary aim of this paper is to compare the labour participation of people living with HIV (PlwHIV) with the labour participation of the general population along the last business cycle in Spain. The data used are from the Hospital Survey on HIV-AIDS, with a total sample size of 4,651 PlwHIV and the Labour Force Survey from 2001 to 2010, with a total sample size of 660,674 individuals as general population. Propensity Score Matching method was used to analyse the differences between the labour participation of PlwHIV and the general population. Additionally, several specific models categorised into different subgroups (gender, education, source of infection and level of defences) were also performed. We identified a convergence in labour participation across the period in the two populations considered: PlwHIV was 23% less likely to have a job than the general population during 2001-2002 and 14% less likely during 2009-2010. This convergence is mainly explained by two facts: first, the positive evolution of people infected by sex; second, the change in the PlwHIV population composition with a decreasing weight of people infected by drug use throughout the decade. Thereby, at the end of period, there was no statistical difference in the employment rate between PlwHIV infected through sex and the general population but there was strongly difference in PlwHIV infected through drugs. Inmunological status, source of infection and level of education play a relevant role among the PlwHIV population when comparing their labour participation with the general population. In spite of this positive result, the likelihood of being employed in HIV-positive people continues to be different from that of non-carriers. Our study shows that institutional features of labour

  20. HIV/AIDS stigma: Measurement and relationships to psycho-behavioral factors in Latino gay/bisexual men and transgender women

    OpenAIRE

    Molina, Y.; Ramirez-Valles, J.

    2013-01-01

    Despite the increased interest in HIV/AIDS stigma and its negative effects on the health and social support of people living with HIV/AIDS (PLWHA), little attention has been given to its assessment among Latino gay/bisexual men and transgender women (GBT) living with HIV/AIDS. The purpose of this paper is twofold: to develop a multidimensional assessment of HIV/AIDS stigma for Latino GBT living with HIV/AIDS, and to test whether such stigma is related to self-esteem, safe sex self-efficacy, s...

  1. Exchange sex among people receiving medical care for HIV in the United States - medical monitoring project 2009-2013.

    Science.gov (United States)

    Olaiya, Oluwatosin; Nerlander, Lina; Mattson, Christine L; Beer, Linda

    2018-04-20

    Many studies of persons who exchange sex for money or drugs have focused on their HIV acquisition risk, and are often limited to select populations and/or geographical locations. National estimates of exchange sex among people living with HIV (PLWH) who are in medical care, and its correlates, are lacking. To address these gaps, we analyzed data from the Medical Monitoring Project, a surveillance system that produces nationally representative estimates of behavioral and clinical characteristics of PLWH receiving medical care in the United States, to estimate the weighted prevalence of exchange sex overall, and by selected socio-demographic, behavioral and clinical characteristics. We found 3.6% of sexually active adults reported exchange sex in the past 12 months. We found a higher prevalence of exchange sex among transgender persons, those who experienced homelessness, and those with unmet needs for social and medical services. Persons who exchanged sex were more likely to report depression and substance use than those who did not exchange sex. We found a higher prevalence of sexual behaviors that increase the risk of HIV transmission and lower viral suppression among persons who exchanged sex. PLWH who exchanged sex had a higher prevalence of not being prescribed ART, and not being ART adherent than those who did not exchange sex. We identify several areas for intervention, including: provision of or referral to services for unmet needs (such as housing or shelter), enhanced delivery of mental health and substance abuse screening and treatment, risk-reduction counseling, and ART prescription and adherence support services.

  2. Diabetes treatment satisfaction, medication adherence, and glycemic control among ambulatory type 2 diabetic nigerians in a primary care clinic of a tertiary hospital situated in a resource-limited environment of Southeast Nigeria

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    Iloh Gabriel Uche Pascal

    2016-01-01

    Full Text Available Background: Diabetic treatment satisfaction, medication adherence, and glycemic control are widely recognized as the cornerstones for successful management of diabetes and proxy indicators of quality of care. However, in Nigeria, nothing is known on the role of diabetic treatment satisfaction on medication adherence and blood glucose control. Aim: The study was aimed at determining the role of diabetes treatment satisfaction in medication adherence and glycemic control among ambulatory type 2 diabetic Nigerians in a primary care clinic in Southeast Nigeria. Materials and Methods: This was a descriptive study that was carried out on 120 type 2 diabetic Nigerians who were on treatment for at least 3 months at the primary care clinic of a tertiary hospital in Nigeria. Diabetes treatment satisfaction and medication adherence were assessed in the previous 30 days using pretested, interviewer-administered questionnaire on self-reported satisfaction and adherence to therapy, respectively. Glycemic control was assessed in the previous 1 month. A patient was defined to have goal glycemic control if the fasting blood glucose at the end of the study, visit was between 70 and 130 mg/dL. Results: Diabetic treatment satisfaction, medication adherence, and glycemic control rates were 85.8%, 72.5%, and 61.7%, respectively. Diabetic treatment satisfaction was significantly associated with medication adherence (P = 0.025 and glycemic control (P = 0.04. Conclusion: Diabetic treatment satisfaction was significantly associated with medication adherence and glycemic control. However, treatment satisfaction did not translate marginally to higher medication and glycemic control. Diabetic treatment satisfaction should be integrated into a standard care package for diabetic patients in primary care settings.

  3. Persisting stigma reduces the utilisation of HIV-related care and support services in Viet Nam

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    Thanh Duong Cong

    2012-11-01

    Full Text Available Abstract Background Seeking and utilisation of HIV prevention, treatment, care, and support services for people living with HIV is often hampered by HIV-related stigma. The study aimed to explore the perceptions and experiences regarding treatment, care, and support amongst people living with HIV in Viet Nam, where the HIV epidemic is concentrated among injecting drug users, sex workers, and men who have sex with men. Methods In-depth interviews and focus group discussions were conducted during September 2007 in 6 districts in Hai Phong with a very high HIV prevalence among injecting drug users. The information obtained was analysed and merged within topic areas. Illustrative quotes were selected. Results Stigma and discrimination against people living with HIV in the community and healthcare settings was commonly reported, and substantially hampered the seeking and the utilisation of HIV-related services. The informants related the high level of stigma to the way the national HIV preventive campaigns played on fear, by employing a “scare tactic” mainly focusing on drug users and sex workers, who were defined as “social evils” in the anti-drug and anti-prostitution policy. There was a strong exclusion effect caused by the stigma, with serious implications, such as loss of job opportunities and isolation. The support and care provided by family members was experienced as vital for the spirit and hope for the future among people living with HIV. Conclusions A comprehensive care and support programme is needed. The very high levels of stigma experienced seem largely to have been created by an HIV preventive scare tactic closely linked to the “social evil“ approach in the national policy on drug and prostitution. In order to reduce the stigma and create more effective interventions, this tactic will have to be replaced with approaches that create better legal and policy environments for drug users and sex workers.

  4. Factors That Affect Quality of Life among People Living with HIV Attending an Urban Clinic in Uganda: A Cohort Study.

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    Doris Mutabazi-Mwesigire

    Full Text Available With the availability of antiretroviral therapy (ART and primary general care for people living with HIV (PLHIV in resource limited settings, PLHIV are living longer, and HIV has been transformed into a chronic illness. People are diagnosed and started on treatment when they are relatively well. Although ART results in clinical improvement, the ultimate goal of treatment is full physical functioning and general well-being, with a focus on quality of life rather than clinical outcomes. However, there has been little research on the relationship of specific factors to quality of life in PLHIV. The objective of this study was to investigate factors associated with quality of life among PLHIV in Uganda receiving basic care and those on ART.We enrolled 1274 patients attending an HIV outpatient clinic into a prospective cohort study. Of these, 640 received ART. All were followed up at 3 and 6 months. Health related quality of life was assessed with the MOS-HIV Health Survey and the Global Person Generated Index (GPGI. Multivariate linear regression and logistic regression with generalized estimating equations were used to examine the relationship of social behavioral and disease factors with Physical Health Summary (PHS score, Mental Health Summary (MHS score, and GPGI.Among PLHIV receiving basic care, PHS was associated with: sex (p=0.045 - females had lower PHS; age in years at enrollment (p=0.0001 - older patients had lower PHS; and depression (p<0.001 - depressed patients had lower PHS. MHS was only associated with opportunistic infection (p=0.01 - presence of an opportunistic infection was associated with lower MHS. For the GPG the associated variables were age (p=0.03 - older patients had lower GPGI; education (p=0.01 - higher education associated with higher GPGI; and depression - patients with depression had a lower GPGI (p<0.001. Among patients on ART, PHS was associated with: study visit (p=0.01, with increase in time there was better PHS

  5. Factors influencing CD4 cell count in HIV-positive pregnant women in a secondary health center in Lagos, Nigeria

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    Akinbami AA

    2015-04-01

    Full Text Available Akinsegun A Akinbami,1 Abidoye Gbadegesin,2 Sarah O Ajibola,3 Ebele I Uche,1 Adedoyin O Dosunmu,1 Adewumi Adediran,4 Adekunle Sobande2 1Department of Haematology and Blood Transfusion, 2Department Of Obstetrics and Gynaecology, College of Medicine, Lagos State University, Ikeja, Lagos, Nigeria; 3Department of Haematology and Immunology, Ben-Carson School of Medicine, Babcock University, Ilisan, Ogun State, Nigeria; 4Department of Haematology and Blood Transfusion, Faculty of Clinical Sciences, College of Medicine, University of Lagos, Lagos, Nigeria Background: Immunity in pregnancy is physiologically compromised, and this may affect CD4 count levels. It is well-established that several factors affect CD4 count level in pregnancy. This study aimed to determine the mean and reference range of CD4 count in human immunodeficiency virus (HIV-positive pregnant women in Lagos, Nigeria. Methods: A retrospective study was carried out at antenatal clinics of the Maternal and Child Center of a secondary health center in Lagos State, Nigeria. Records of HIV-positive pregnant women at various gestational ages, including CD4+ cell count at booking, packed cell volume (PCV at booking and labor, gestational age at delivery, and infant weight and sex were retrieved. The descriptive data was given as mean ± standard deviation (SD. Pearson's chi-squared test and correlation were used for analytical assessment. Results: Data were retrieved for a total of 143 patients. The mean age was 31.15±3.78 years. The mean PCV was 31.01%±3.79% at booking and 30.49%±4.80% during labor. The mean CD4 count was 413.87±212.09 cells/µL, with a range of 40 to 1,252 cells/µL. The mean infant weight was 3.05±0.45 kg, with a range of 2 to 5 kg. Age of the mother, gestational age, and PCV at booking were not statistically significantly associated with CD4 count. Conclusion: Maternal age, gestational age, and PCV at booking had no significant effects on CD4+ cell count levels in

  6. Religion and HIV in Tanzania: influence of religious beliefs on HIV stigma, disclosure, and treatment attitudes

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    Ostermann Jan

    2009-03-01

    Full Text Available Abstract Background Religion shapes everyday beliefs and activities, but few studies have examined its associations with attitudes about HIV. This exploratory study in Tanzania probed associations between religious beliefs and HIV stigma, disclosure, and attitudes toward antiretroviral (ARV treatment. Methods A self-administered survey was distributed to a convenience sample of parishioners (n = 438 attending Catholic, Lutheran, and Pentecostal churches in both urban and rural areas. The survey included questions about religious beliefs, opinions about HIV, and knowledge and attitudes about ARVs. Multivariate logistic regression analysis was performed to assess how religion was associated with perceptions about HIV, HIV treatment, and people living with HIV/AIDS. Results Results indicate that shame-related HIV stigma is strongly associated with religious beliefs such as the belief that HIV is a punishment from God (p Conclusion The decision to start ARVs hinged primarily on education-level and knowledge about ARVs rather than on religious factors. Research results highlight the influence of religious beliefs on HIV-related stigma and willingness to disclose, and should help to inform HIV-education outreach for religious groups.

  7. Osteopenia and osteoporosis in people living with HIV: multiprofessional approach

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    Lima AL

    2011-12-01

    Full Text Available Ana Lucia Lei Munhoz Lima, Priscila Rosalba D de Oliveira, Perola Grimberg Plapler, Flora Maria D Andrea Marcolino, Eduardo de Souza Meirelles, André Sugawara, Riccardo Gomes Gobbi, Alexandre Leme Godoy dos Santos , Gilberto Luis CamanhoInstitute of Orthopedics and Traumatology, Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo, BrazilAbstract: Increasing bone mineralization abnormalities observed among people living with HIV (PLWHIV result from various factors relating to the host, the virus, and the antiretrovirals used. Today, HIV infection is considered to be a risk factor for bone mineralization disorders. The test most recommended for diagnosing osteoporosis is measurement of bone mineral density by means of dual energy X-ray absorptiometry at two sites. Osteoporosis treatment has the aims of bone mass improvement and fracture control. A combination of calcium and vitamin D supplementation may reduce the risk of fractures. Antiresorptive drugs act by blocking osteoclastic activity and reducing bone remodeling. On the other hand, bone-forming drugs stimulate osteoblastogenesis, thereby stimulating the formation of bone matrix. Mixed-action medications are those that are capable of both stimulating bone formation and inhibiting reabsorption. Antiresorptive drugs form the group of medications with the greatest quantity of scientific evidence confirming their efficacy in osteoporosis treatment. Physical activity is a health promotion strategy for the general population, but only preliminary data on its real value and benefit among PLWHIV are available, especially in relation to osteoporosis.Keywords: osteoporosis, HIV/AIDS, diagnosis, treatment, exercise

  8. Depressive Symptoms and Associated Factors among People Living with HIV/AIDS.

    Science.gov (United States)

    Dal-Bó, Márcio José; Manoel, André Luciano; Filho, Arthur Onofre Beltram; Silva, Bibiana Quatrin Tiellet da; Cardoso, Yuri Souza; Cortez, Josué; Tramujas, Lucas; Silva, Rosemeri Maurici da

    2015-01-01

    The purpose of this study was to evaluate the prevalence of depressive symptoms and associated variables among people living with HIV/AIDS (PLWHA) in a specialized treatment center in a city located in southern Brazil. A cross-sectional study was conducted using the Beck Depression Inventory to assess the presence of depressive symptoms. The prevalence of depressive symptoms was 53.5% among the surveyed population, which supports the idea that depressive symptoms are more common among PLWHA, mainly if compared with the general population. It was observed that 57.7% of the study participants were with depressive symptoms and did not take any psychiatric medication and 100% did not undergo psychotherapy, which indicates undertreatment. There was no statistically significant difference in the mean CD4 count between patients with depressive symptoms (484.1  ±  353) and patients without depressive symptoms (528.4  ±  263). Further actions should be taken to improve the care for PLWHA. The interface between psychology, psychiatry, and internal medicine is of utmost importance to provide a more humanized care, in which the psychosocial, psychological, and psychiatric aspects are not neglected. © The Author(s) 2013.

  9. The Information and Motivation and Behavioral Skills Model of ART Adherence among HIV-Positive Adults in Mexico.

    Science.gov (United States)

    Santillán Torres Torija, Carolina; Villagrán Vázquez, Gabina; Robles Montijo, Silvia Susana; de Lourdes Eguiluz Romo, Luz

    2015-01-01

    Middle-income countries are in need of research that uses theoretical-based models to assess factors that predict adherence to antiretroviral therapy (ART) and help in the design, implementation, and evaluation of interventions for nonadherent populations. In Mexico, the Information and Motivation and Behavioral Skills (IMB) Model of ART Adherence constructs is useful in describing and predicting adherence behaviors in various samples but has not been articulated to people living with HIV (PLWH) on ART. The aim of this was to characterize the IMB core constructs and identify correlates of ART adherence in an HIV-positive clinic sample in Mexico. A convenience sample of 109 HIV-positive patients attending their monthly visits at a local public hospital were interviewed with the Spanish version of the LifeWindows IMB ART Adherence Questionnaire (LW-IMB-AAQ) as well as a sociodemographic questionnaire. All participants were recruited from a hospital-based outpatient clinical care site. Partial confirmation of the relationships proposed by the IMB Model of ART Adherence was found. As predicted by the model, only behavioral skills had direct association with all measures of self-reported adherence, and motivation was associated with behavioral skills. Information did not demonstrate significant relations to either motivation or behavioral skills, nor did it directly associate with adherence. Self-reported adherence did not associate with CD4 counts, nor did any of the IMB model core constructs. Applicability of the IMB Model of ART Adherence in this setting is discussed. The IMB Model of ART Adherence offered promise in this population and could help tailor population-specific interventions to promote high rates of ART adherence. © The Author(s) 2015.

  10. The role of emotions in the reduction of HIV/AIDS stigma among physicians in training.

    Science.gov (United States)

    Varas-Díaz, Nelson; Neilands, Torsten B; Rodríguez-Madera, Sheilla L; Padilla, Mark

    2016-01-01

    Scientific literature has systematically documented the negative effects of social stigma for people living with HIV/AIDS (PLWHA). HIV/AIDS stigma has the potential to negatively impact self-care strategies for those already affected, and simultaneously hinder prevention efforts to deter the emergence of new infections. When health professionals manifest these negative attitudes access to quality health-care and prevention strategies can be seriously affected. Scientifically tested interventions to reduce HIV/AIDS stigma among health professionals are still scarce. Although the number of tested interventions has increased over the past decade, few of them target Latino health professionals or Spanish-speaking populations. Furthermore, although some of those interventions have been reported as effective for stigma reduction, more work is needed to better understand the underlying variables that account for the reduction of stigma attitudes in those efforts. The SPACES intervention has been documented as an effective HIV/AIDS stigma-reduction intervention focusing on health-care professionals in training. The intervention, which is delivered in Spanish, has been previously tested with medical students in Puerto Rico and shown significant results in addressing negative attitudes toward PLWHA. The main objective of this study was to document the underlying variables that fostered reduction of HIV/AIDS stigma due to participation in the SPACES intervention. Results evidence that health professionals in training who participated in the intervention (n = 507) had less stigmatizing attitudes toward PLWHA due to an increase in their positive emotions toward this population. In light of these results, we discuss the importance of engaging health professionals in HIV/AIDS stigma-reduction interventions that go beyond the provision of information and skills for interacting with PLWHA, and address the emotional component of HIV/AIDS stigma.

  11. Predictors and Evolution of Antiretroviral Therapy Adherence Among Perinatally HIV-Infected Adolescents in Brazil.

    Science.gov (United States)

    Côté, José; Delmas, Philippe; de Menezes Succi, Regina Célia; Galano, Eliana; Auger, Patricia; Sylvain, Hélène; Colson, Sebastien; Machado, Daisy Maria

    2016-09-01

    Antiretroviral therapy medication adherence is a complex phenomenon influenced by multiple factors. This study examines its evolution and predictors among perinatally HIV-infected youths in São Paulo, Brazil. During a 1-year longitudinal cohort study, perinatally HIV-infected youths aged 13-21 years taking antiretroviral therapy were recruited in hospitals and HIV/AIDS reference centers. Data were collected at baseline and after 12 months. Variables assessed were adherence, self-efficacy regarding medication intake, social support, stress level, depression, CD4 cell count, viral load, and symptoms. Adherence was defined as taking ≥95% of prescribed HIV medication in the past 7 days. Generalized estimating equation and analysis of variance methods were used. A total of 268 adolescents participated in the study (59% female; mean age of 16 years). At baseline, 63.06% of the sample was adherent to their HIV medication, and 52.99% had an undetectable viral load. All participants, regardless of adherence, reported: low levels of stress and symptoms of depression; high perception of medication self-efficacy and social support; and a mean of 6.8 symptoms related to their HIV medication. Predictors of adherence were: high perception of medication self-efficacy (odds ratio = 2.81; 95% confidence interval: 1.94-4.05) and low number of reported medication side effects (odds ratio = .97; 95% confidence interval: .95-.99]. Between baseline and follow-up, 49.6% remained adherent, 22.3% remained nonadherent, and the adherence level changed over time for 28.2%. These findings suggest the need to develop interventions to enhance self-efficacy toward medication and to help youth better manage HIV medication symptoms. Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.

  12. What helps or undermines adolescents' anticipated capacity to cope with mental illness stigma following psychiatric hospitalization.

    Science.gov (United States)

    Moses, Tally

    2015-05-01

    Better understanding of the individual and environmental factors that promote adolescents' use of more or less adaptive coping strategies with mental illness stigma would inform interventions designed to bolster youth resilience. This cross-sectional study draws on data from research on adolescents' well-being after discharge from a first psychiatric hospitalization to explore the relationships between anticipated coping in reaction to a hypothetical social stigma scenario, and various factors conceptualized as 'coping resource' and 'coping vulnerability' factors. Focusing on coping strategies also identified in the companion article, we hypothesize that primary and secondary control engagement coping would relate to more coping resource and less coping vulnerability factors, and the opposite would be true for disengagement, aggression/confrontation and efforts to disconfirm stereotypes. Data were elicited from interviews with 102 adolescents within 7 days of discharge. Hypothesized coping resource factors included social resources, optimistic illness perceptions, better hospital experiences and higher self-esteem. Vulnerability factors included more previous stigma experiences, desire for concealment of treatment, more contingent self-worth, higher symptom levels and higher anticipated stress. Multivariate ordinary least squares (OLS) regression was used to analyze associations between coping strategy endorsement and correlates. Although some coping correlates 'behaved' contrary to expectations, for the most part, our hypotheses were confirmed. As expected, youth anticipating reacting to the stigmatizing situation with greater disengagement, aggression/confrontation or efforts to disconfirm stenotypes rated significantly lower on 'coping resources' such as self-esteem and higher on vulnerability factors such as symptom severity. The opposite was true for youth who anticipated exercising more primary and secondary control engagement coping. This study begins to

  13. Social, Psychological and Health Concerns of People Living with HIV/AIDS in Mysore District, Karnataka.

    Science.gov (United States)

    Sebastian, Shibu Thomas; Siddanna, Sunitha

    2016-03-01

    One of the significant health and social problem the world facing today is Acquired immune deficiency syndrome (AiDS). The patients affected with HIV and their family may face various psychosocial problems during diagnosis and treatment due to the stigma associated with this disease. The objective of the study was to identify social, psychological and health concerns of people living with HIV/AIDS (PLWHA) and its association with the demographic factors in Mysore District, Karnataka, India. A questionnaire based study was conducted among 194 participants in Mysore District, Karnataka state who were receiving care and support services. A 22-item questionnaire provided information regarding social, psychological and health concerns of PLWHA in Mysore district. A general linear regression model was used for assessing the predictors of social, psychological and health concerns. The main social concern was that of "Fear of Losing a loved one" whereas the main psychological concern was "Too much worry", "No cure for AIDS" was the highly rated health concern. Males had more social, psychological and health concerns when compared to females but was not statistically significant. Employed people were having fewer psychological concerns when compared to unemployed people. Unemployed people were having fewer health concerns than employed people. For every unit increase in age there were fewer social and health concerns and both these findings were statistically significant. PLWHA in the present study reported that they were concerned about social, psychological and health issues in spite of the fact they were attending counseling. Health care workers, including those in public health sector should be educated about the importance of these factors that influence the health of the population they are caring for.

  14. Stigma and Discrimination in HIV/AIDS; The greatest Challenge to ...

    African Journals Online (AJOL)

    The greatest challenge to the efforts of the various agencies and governments in the care, support and treatment of people living with HIV/AIDS, appears to be stigma and discrimination. Stigma and discrimination has to be addressed through public education, legislation to protect people living with HIV/AIDS and also by ...

  15. Surviving Surveillance: How Pregnant Women and Mothers Living With HIV Respond to Medical and Social Surveillance.

    Science.gov (United States)

    Greene, Saara; Ion, Allyson; Kwaramba, Gladys; Lazarus, Lisa; Loutfy, Mona

    2017-12-01

    Pregnant women and mothers living with HIV are under surveillance of service providers, family members, and the community at large. Surveillance occurs throughout the medical management of their HIV during pregnancy, preventing HIV transmission to their baby, infant feeding practices, and as part of assessments related to their ability to mother. Enacted and anticipatory HIV-related stigma can exacerbate the negative impact that being under surveillance has on mothers living with HIV as they move through their pregnancy, birthing, and mothering experiences. In response, women living with HIV find ways to manage their experiences of surveillance through engaging in acts of distancing, planning, and resisting at different points in time, and sometimes enacting all three practices at once. Positioning the narratives of pregnant women and mothers living with HIV in relation to their experiences of surveillance illuminates the relationship between the surveillance of mothers living with HIV and HIV-related stigma.

  16. HIV Stigma and Depressive Symptoms are Related to Adherence and Virological Response to Antiretroviral Treatment Among Immigrant and Indigenous HIV Infected Patients

    NARCIS (Netherlands)

    Sumari-de Boer, I. Marion; Sprangers, Mirjam A. G.; Prins, Jan M.; Nieuwkerk, Pythia T.

    2012-01-01

    We compared adherence to cART and viro-logical response between indigenous and immigrant HIV-infected patients in the Netherlands, and investigated if a possible difference was related to a difference in the psychosocial variables: HIV-stigma, quality-of-life, depression and beliefs about

  17. Long stay patients in a psychiatric hospital in Lagos, Nigeria | Taiwo ...

    African Journals Online (AJOL)

    Objective: In the face of recently introduced government health reform and the dwindling number of available beds for acutely ill patients, a cross sectional study was carried out on long-stay patients at the 100 years old psychiatric hospital Yaba, Lagos, Nigeria with a view to discharging most of them. Method: Necessary ...

  18. Knowledge and psychosocial wellbeing of nurses caring for people living with HIV/AIDS (PLWH

    Directory of Open Access Journals (Sweden)

    Lufuno Makhado

    2016-12-01

    Full Text Available The challenges of caring for people living with HIV (PLWH in a low-resource setting has had a negative impact on the nursing profession, resulting in a shortage of skilled nurses. In response to this shortage and perceived negative impact, we conducted a descriptive, cross-sectional study to describe the level of knowledge and psychosocial wellbeing of nurses caring for PLWH at a regional hospital in Limpopo Province, South Africa. A total of 233 nurses, the majority being female, participated and were stratified into professional nurses (n = 108, enrolled nurses (n = 58 and enrolled nursing auxiliaries (n = 66. Data were collected using HIV/AIDS knowledge questionnaire, Maslach Burnout Inventory; AIDS Impact Scale and Beck's Depression Inventory. The total knowledge score obtained by all the participants ranged from 2 to 16, with an average of 12.93 (SD = 1.92 on HIV/AIDS knowledge. Depersonalization (D (83.7% and emotional exhaustion (EE (53.2% were reported among participating nurses caring for PLWH. Burnout was higher among professional nurses as compared to both enrolled nurses and enrolled nursing auxiliaries. There was a moderate negative significant correlation between HIV knowledge with the nurses' emotional exhaustion (r = −0.592, depression (r = −0.584 and stigma and discrimination (r = −0.637. A moderate to high level of burnout was evident among all levels of nurses. These findings lead to the recommendations for support of nurses caring for PLWH that include structured nursing educational support, organisational support with respect to employee wellness programmes that address depression and work burnout, as well as social support. The provision of these support mechanisms has the potential of creating a positive practice environment for nurses in the Vhembe District of the Limpopo Province in particular, and South Africa in general, and in improved care for PLWH.

  19. An evaluation of quality of life and its determinants among people living with HIV/AIDS from Southern Brazil

    Directory of Open Access Journals (Sweden)

    Susane Müller Klug Passos

    2015-04-01

    Full Text Available This cross-sectional study evaluated the quality of life and its associated factors among people living with HIV/AIDS at a regional reference center for the treatment of HIV/AIDS in southern Brazil. WHOQOL-HIV Bref, ASSIST 2.0, HAD Scale, and a questionnaire were used to assess 625 participants on quality of life, clinical and sociodemographic characteristics, drug use, depression and anxiety. Multivariate analysis was performed through linear regression. The lowest results for quality of life were associated with being female, age (< 47 years, low education levels, low socioeconomic class, unemployment, not having a stable relationship, signs of anxiety and depression, abuse or addiction of psychoactive substances, lack of perceived social support, never taking antiretroviral medication, lipodystrophy, comorbidities, HIV related hospitalizations and a CD4+ cell count less than 350. Psychosocial factors should be included in the physical and clinical evaluation given their strong association with quality of life domains.

  20. Psychological and behavioral barriers to ART adherence among PLWH in China: role of self-efficacy.

    Science.gov (United States)

    Zhou, Guangyu; Li, Xiaoming; Qiao, Shan; Zhou, Yuejiao; Shen, Zhiyong

    2017-12-01

    Globally, optimal adherence to antiretroviral therapy (ART) is insufficient despite it is critical for maximum clinical benefits and treatment success among people living with HIV (PLWH). Many factors have been evidenced to influence medication adherence, including perceived barriers and self-efficacy. However, limited data are available regarding to psychological and behavioral barriers to ART adherence in China. Moreover, few studies have examined the mechanism of these two factors underlying HIV medication adherence. The aim of the current study is to examine the mediating role of adherence self-efficacy between perceived barriers and ART adherence among PLWH. Cross-sectional data were obtained from 2095 PLWH in Guangxi China who provided data on ART adherence. Participants reported their medication adherence, self-efficacy, barriers to ART adherence, as well as background characteristics. Results indicated a significant indirect effect from perceived barriers to medication adherence through adherence self-efficacy. Higher perceived psychological and behavioral barriers to ART adherence were related to lower adherence self-efficacy, which in turn was related to lower ART adherence. Self-efficacy could buffer the negative effects of perceived barriers on ART adherence. Future interventions to promote HIV medication adherence are recommended to focus on eliminating psychological and behavioral barriers, as well as increasing adherence self-efficacy.

  1. 6. Disability and Quality Of Life among People Living With HIV AIDS ...

    African Journals Online (AJOL)

    user

    Disability and Quality of Life among People Living. With HIV/AIDS in Ibadan, ... activities of daily living as well as challenges with. 7,8 ... infected individuals, their family and the society at large. ... Independence, Social Relationships, Environment ..... efavirenz on neuropsychological performance .... Acta paul. enferm. 2015 ...

  2. Adherence to oral anti-diabetic drugs among patients attending a Ghanaian teaching hospital

    Directory of Open Access Journals (Sweden)

    Bruce SP

    2015-03-01

    Full Text Available Background: The burden of diabetes mellitus, especially Type-2, continues to increase across the world. Medication adherence is considered an integral component in its management. Poor glycemic controls due to medication nonadherence accelerates the development of long-term complications which consequently leads to increased hospitalization and mortality. Objective: This study examined the level of adherence to oral antidiabetic drugs among patients who visited the teaching hospital and explored the probable contributory factors to non-adherence. Methods: A cross-sectional descriptive study using systematic sampling to collect quantitative data was undertaken. Questionnaires were administered to out-patients of the medical department of a teaching hospital in Ghana. Logistic regression was performed with statistical significance determined at p<0.05. Results: A total of 200 diabetic patients participated in the study. Using the Morisky Medication Adherence scale, the level of adherence determined was 38.5%. There were significant correlations between level of adherence and educational level [(OR=1.508; (CI 0.805- 2.825, P=0.019, and mode of payment [(OR=1.631; (CI 0.997- 2.669, P=0.05. Conclusion: Adherence in diabetic patients was low among respondents and this can be improved through education, counseling and reinforcement of self-care. There were several possible factors that contributed to the low adherence rate which could benefit from further studies.

  3. Experiences of work among people with disabilities who are HIV ...

    African Journals Online (AJOL)

    Experiences of work among people with disabilities who are HIV-positive in Zambia. ... HIV in Lusaka, not only secondary to the effects of HIV influencing their physical capacity to work ... Keywords: qualitative, disability, stigma, Southern Africa ...

  4. Measuring HIV stigma at the family level: psychometric assessment of the Chinese Courtesy Stigma Scales (CCSSs).

    Science.gov (United States)

    Liu, Hongjie; Xu, Yongfang; Sun, Yehuan; Dumenci, Levent

    2014-01-01

    Courtesy stigma is the stigmatization a person perceives or experiences due to their association with a stigmatized individual or group. Most HIV-related stigma scales have been developed for people living with HIV/AIDS (PLWHAs), but not for their HIV-uninfected family members. To date, few measurement scales have been designed to measure the degree of stigma among both PLWHAs and their HIV-uninfected family members at the family level. We developed a set of courtesy stigma scales and estimated their reliability and validity from 256 PLWHAs and 256 of their HIV-uninfected family members. Exploratory and confirmatory factor analyses were performed in two independent samples: a development sample (N = 216) and a validation sample (N = 296), respectively. Two factors ("public stigma" and "self-perceived stigma") had high internal consistency reliability (Cronbach's alpha coefficient between 0.83-0.90) and good construct validity (standardized factor loading range: 0.37-0.95) in both samples. These findings document that the newly developed brief instrument is a psychometrically sound measure of HIV-related stigma among both PLWHAs and their HIV-uninfected family members.

  5. Stigma, violence and HIV vulnerability among transgender persons in sex work in Maharashtra, India.

    Science.gov (United States)

    Ganju, Deepika; Saggurti, Niranjan

    2017-08-01

    Among marginalised groups in India, HIV prevalence is highest among transgender persons; however, little is known about their HIV vulnerability. This study describes transgender sex workers' experiences of stigma and violence, a key driver of the HIV epidemic, and explores their coping responses. In-depth interviews were conducted with 68 respondents in Maharashtra state, India. Findings show that respondents face pervasive stigma and violence due to multiple marginalised social identities (transgender status, sex work, gender non-conformity), which reinforce and intersect with social inequities (economic and housing insecurity, employment discrimination, poverty), fuelling HIV vulnerability at the micro, meso and macro levels. Several factors, such as felt and internalised stigma associated with psycho-social distress and low self-efficacy to challenge abuse and negotiate condom use; clients' power in sexual transactions; establishing trust in regular partnerships through condomless sex; norms condoning violence against gender non-conforming persons; lack of community support; police harassment; health provider discrimination and the sex work environment create a context for HIV vulnerability. In the face of such adversity, respondents adopt coping strategies to shift power relations and mobilise against abuse. Community mobilisation interventions, as discussed in the paper, offer a promising vulnerability reduction strategy to safeguard transgender sex workers' rights and reduce HIV vulnerability.

  6. Factors associated with late Human Immunodeficiency Virus (HIV diagnosis among peoples living with it, Northwest Ethiopia: hospital based unmatched case-control study

    Directory of Open Access Journals (Sweden)

    Abebayehu Bitew Aniley

    2016-10-01

    Full Text Available Abstract Background Early HIV diagnosis and access to treatment is one of the most effective ways to prevent its further spread and to protect the health of those living with the virus. However, delay in diagnosis is the major risk factor for uptake of and response to antiretroviral therapy. Methods Institution-based unmatched case-control study design was used in the study. The study was conducted in Debre-Markos and Finote-Selam Hospitals, Northwest Ethiopia. Cases were people living with HIV who had CD4 count <350cells/mm3 or WHO clinical stage III and IV regardless of the CD4 count at first presentation and controls were those who had CD4 count ≥350cells/mm3 or WHO clinical stage I and II. If both criteria were available, the CD4 count was used in the study as World Health Organization recommended. A total of 392 respondents (196 cases and 196 controls were recruited and selected systematically. The data were collected by trained nurses using chart review and interviewer administered structured questionnaire. Binary Logistic Regression Model was used to identify the factors associated with late HIV diagnosis. Results About 95.9 % of study participants provided complete response. Having no understanding, compared to having understanding, about HIV/AIDS (AOR = 1.7, 95 %CI = 1.08–2.79 and ART (AOR = 2.1, 95 %CI: 1.25–3.72, being tested as a result of symptoms/ illness, compared to being tested for risk exposure (inverted AOR =2.5, 95 %CI: 1.64–4.76, and acquiring HIV through sexual contact, compared to acquiring it through other modes (AOR = 2.5, 95 %CI = 1.52–4.76 were positively and independently associated with late HIV diagnosis. Conclusions Unlike perceived HIV stigma, having no understanding about HIV and ART, being tested for presence of symptoms/illness, and acquiring HIV through sexual contact were independent and significant factors for late HIV diagnosis.

  7. Perspectives of HIV-related stigma in a community in Vietnam: a qualitative study.

    Science.gov (United States)

    Gaudine, Alice; Gien, Lan; Thuan, Tran T; Dung, Do V

    2010-01-01

    While HIV/AIDS is increasing in Vietnam, very few published studies focus on HIV-related stigma in Vietnam. This study reports on findings from a community development project to reduce HIV-related stigma within one community in Vietnam. The purpose of this qualitative study is to describe HIV-related stigma from the perspective of three groups within one community in Vietnam: people living with HIV, their family members, and community members and leaders, including health care professionals. SETTING, PARTICIPANTS AND METHODS: Fifty-eight individuals from a poor, industrial district on the outskirts of a large city participated in the study and were asked to describe HIV-related stigma. Interviews were conducted with 10 people living with HIV, 10 family members of a person living with HIV, and 10 community members and 5 community leaders including health care professionals. We also conducted three focus groups, one with people living with HIV (n=8), one with family members of people living with HIV (n=8), and one with community leaders including health care professionals (n=7). Stigma across the three groups is characterized by four dimensions of HIV-related stigma: feeling shamed and scorned, behaving differently, stigma due to association, and fear of transmission. The manifestation of these dimensions differs for each group. Four themes of HIV-related stigma as described by people living with HIV are: being avoided, experiencing anger and rejection, being viewed as a social ill, and hiding the illness. Seven themes of HIV-related stigma as described by family members are: shunned by neighbors, viewed as poor parents, discriminated by health professionals, overhearing discussions about people with HIV, maintaining the secret, financial hardship for family, and fear of contracting HIV. Four themes of HIV-related stigma as described by community members and leaders including health professionals are: stigma as a fair reward, avoidance and shunning by neighbors

  8. Socio-demographic and clinical factors affecting adherence to ...

    African Journals Online (AJOL)

    Socio-demographic and clinical factors affecting adherence to antihypertensive medications and blood pressure control among patients attending the family practice clinic in a tertiary hospital in northern Nigeria.

  9. Prevalence and socioeconomic factors associated with smoking in people living with HIV by sex, in Recife, Brazil

    Directory of Open Access Journals (Sweden)

    Joanna d’Arc Lyra Batista

    2013-06-01

    Full Text Available Introduction: Smoking is the leading cause of preventable death in the world. The prevalence of smoking is higher in people infected with HIV than in the general population. Although it is biologically plausible that smoking increases the morbidity and mortality of people living with HIV/AIDS, few studies in developing countries have analyzed the determinants and consequences of smoking in HIV infected people. Objective: To estimate the prevalence of smoking and identify the socioeconomic factors associated with smoking and smoking cessation in patients with HIV by sex. Methods: A cross-sectional study was conducted with baseline data, obtained from an ongoing prospective cohort study of patients with HIV attending two referral centers in Recife, Northeast Region of Brazil, between July 2007 and October 2009. Results: The prevalence of current smoking was 28.9%. For both sexes, smoking was independently associated with heavy alcohol drinking and marijuana use. Among women, smoking was associated with living alone, not being married and illiteracy; and among men, being 40 years or older, low income and using crack. Compared with ex-smokers, current smokers were younger and more likely to be unmarried, heavy drinkers and marijuana users. Conclusions: It is important to incorporate smoking cessation interventions for the treatment of heavy alcohol drinkers and marijuana users with HIV/AIDS, which may increase life expectancy and quality of life, as smoking is related to risk of death, relapse of tuberculosis, and non communicable diseases.

  10. Facilitators and barriers to medication adherence in an HIV prevention study among men who have sex with men in the iPrEx study in Chiang Mai, Thailand.

    Science.gov (United States)

    Tangmunkongvorakul, Arunrat; Chariyalertsak, Suwat; Amico, K Rivet; Saokhieo, Pongpun; Wannalak, Vorawan; Sangangamsakun, Thirayut; Goicochea, Pedro; Grant, Robert

    2013-08-01

    In 2008, the Pre-exposure Prophylaxis Initiative (iPrEx) study expanded to include men who have sex with men (MSM) in Chiang Mai, Thailand. In full, 114 participants from Chiang Mai joined this international double-blinded trial of daily FTC-TDF (Truvada®) or placebo as a pre-exposure prophylaxis (PrEP) HIV prevention strategy. To better understand the characteristics of iPrEx participants specifically from this underserved population in Thailand, and gain insights into their experiences of trying to take a daily tablet as part of this blinded PrEP trial, we conducted a qualitative study. In 2010, 32 MSM iPrEx participants provided in-depth interviews and an additional 14 joined focus group discussions. Results of the qualitative analyzes suggested that participants held generally positive attitudes toward the iPrEx study and study medication and related this to high rates of adherence to the daily regimen. Participants also reflected on the provision of quality health care as part of participation in the trial, as well as support from clinical research staff, family and friends as helpful in supporting high rates of study medication adherence. Discourse concerning challenges to adherence included medication taking behavior, which was contextualized by lifestyle, living arrangement, social life, social stigma in terms of being mistakenly identified as HIV positive or unintentional disclosure of sexual identity to family and friends, and relationship conflicts with partners. The results provide broader perspectives of participant experiences of the study medication and daily adherence in the larger contexts of the MSM community, close relationships, and the study climate, and can be leveraged in constructing PrEP adherence support approaches within these communities.

  11. Individual-level socioeconomic status and community-level inequality as determinants of stigma towards persons living with HIV who inject drugs in Thai Nguyen, Vietnam.

    Science.gov (United States)

    Lim, Travis; Zelaya, Carla; Latkin, Carl; Quan, Vu Minh; Frangakis, Constantine; Ha, Tran Viet; Minh, Nguyen Le; Go, Vivian

    2013-11-13

    HIV infection may be affected by multiple complex socioeconomic status (SES) factors, especially individual socioeconomic disadvantage and community-level inequality. At the same time, stigma towards HIV and marginalized groups has exacerbated persistent concentrated epidemics among key populations, such as persons who inject drugs (PWID) in Vietnam. Stigma researchers argue that stigma fundamentally depends on the existence of economic power differences in a community. In rapidly growing economies like Vietnam, the increasing gap in income and education levels, as well as an individual's absolute income and education, may create social conditions that facilitate stigma related to injecting drug use and HIV. A cross-sectional baseline survey assessing different types of stigma and key socioeconomic characteristics was administered to 1674 PWID and 1349 community members living in physical proximity throughout the 32 communes in Thai Nguyen province, Vietnam. We created four stigma scales, including HIV-related and drug-related stigma reported by both PWID and community members. We then used ecologic Spearman's correlation, ordinary least-squares regression and multi-level generalized estimating equations to examine community-level inequality associations, individual-level SES associations and multi-level SES associations with different types of stigma, respectively. There was little urban-rural difference in stigma among communes. Higher income inequality was marginally associated with drug-related stigma reported by community members (p=0.087), and higher education inequality was significantly associated with higher HIV-related stigma reported by both PWID and community members (pinequality and HIV-related stigma is superseded by the effect of individual-level education. The results of the study confirm that socioeconomic factors at both the individual level and community level affect different types of stigma in different ways. Attention should be paid to these

  12. Linkage to HIV care, postpartum depression, and HIV-related stigma in newly diagnosed pregnant women living with HIV in Kenya: a longitudinal observational study.

    Science.gov (United States)

    Turan, Bulent; Stringer, Kristi L; Onono, Maricianah; Bukusi, Elizabeth A; Weiser, Sheri D; Cohen, Craig R; Turan, Janet M

    2014-12-03

    While studies have suggested that depression and HIV-related stigma may impede access to care, a growing body of literature also suggests that access to HIV care itself may help to decrease internalized HIV-related stigma and symptoms of depression in the general population of persons living with HIV. However, this has not been investigated in postpartum women living with HIV. Furthermore, linkage to care itself may have additional impacts on postpartum depression beyond the effects of antiretroviral therapy. We examined associations between linkage to HIV care, postpartum depression, and internalized stigma in a population with a high risk of depression: newly diagnosed HIV-positive pregnant women. In this prospective observational study, data were obtained from 135 HIV-positive women from eight antenatal clinics in the rural Nyanza Province of Kenya at their first antenatal visit (prior to testing HIV-positive for the first time) and subsequently at 6 weeks after giving birth. At 6 weeks postpartum, women who had not linked to HIV care after testing positive at their first antenatal visit had higher levels of depression and internalized stigma, compared to women who had linked to care. Internalized stigma mediated the effect of linkage to care on depression. Furthermore, participants who had both linked to HIV care and initiated antiretroviral therapy reported the lowest levels of depressive symptoms. These results provide further support for current efforts to ensure that women who are newly diagnosed with HIV during pregnancy become linked to HIV care as early as possible, with important benefits for both physical and mental health.

  13. Mental illness stigma among medical students and teachers.

    Science.gov (United States)

    Janoušková, Miroslava; Weissová, Aneta; Formánek, Tomáš; Pasz, Jiří; Bankovská Motlová, Lucie

    2017-12-01

    Medical school curriculum contributes to future doctors' attitude formation towards people with mental illness. The purpose of this study was to compare stigmatizing attitudes between medical students and faculty, analyse stigmatizing attitudes among students from different years of study and identify factors predicting stigma. A cross-sectional study with the use of scales measuring attitudes and social distance was designed. Online questionnaires were distributed to all students and teachers at a medical faculty in the Czech Republic. The response rate was 32.1% ( n = 308) among students and 26.7% ( n = 149) among teachers. Teachers had a greater prevalence of stigmatizing attitudes than students. Increased tolerant attitudes in students were detected after the fourth year, that is, following introduction to psychiatry. Preferred specialization in psychiatry and attending two psychiatry courses predicted more tolerant attitudes. Among both students and teachers, men possessed more stigmatizing attitudes towards people with mental illness. Age was an important predictor of stigmatizing attitudes among teachers. Educators should pay closer attention to the role of medical psychology and communication training implementation, which may be beneficial to improving skills and increasing medical students' self-esteem and feeling of competence throughout their psychiatry rotation.

  14. Social networks and mental health among people living with human immunodeficiency virus (HIV) in Johannesburg, South Africa.

    Science.gov (United States)

    Odek, Willis Omondi

    2014-01-01

    People living with human immunodeficiency virus (PLHIV) in developing countries can live longer due to improved treatment access, and a deeper understanding of determinants of their quality of life is critical. This study assessed the link between social capital, operationally defined in terms of social networks (group-based and personal social networks) and access to network resources (access to material and non-material resources and social support) and health-related quality of life (HRQoL) among 554 (55% female) adults on HIV treatment through South Africa's public health system. Female study participants were involved with more group-based social networks but had fewer personal social networks in comparison to males. Access to network resources was higher among females and those from larger households but lower among older study participants. Experience of social support significantly increased with household economic status and duration at current residence. Social capital indicators were unrelated to HIV disease status indicators, including duration since diagnosis, CD4 count and viral load. Only a minority (13%) of study participants took part in groups formed by and for predominantly PLHIV (HIV support groups), and participation in such groups was unrelated to their mental or physical health. Personal rather than group-linked social networks and access to network resources were significantly associated with mental but not physical health, after controlling for sociodemographic characteristics. The findings of limited participation in HIV support groups and that the participation in such groups was not significantly associated with physical or mental health may suggest efforts among PLHIV in South Africa to normalise HIV as a chronic illness through broad-based rather than HIV-status bounded social participation, as a strategy for deflecting stigma. Further research is required to examine the effects of HIV treatment on social networking and participation

  15. Prevalence of Internalized HIV-Related Stigma Among HIV-Infected Adults in Care, United States, 2011-2013.

    Science.gov (United States)

    Baugher, Amy R; Beer, Linda; Fagan, Jennifer L; Mattson, Christine L; Freedman, Mark; Skarbinski, Jacek; Shouse, R Luke

    2017-09-01

    HIV-infected U.S. adults have reported internalized HIV-related stigma; however, the national prevalence of stigma is unknown. We sought to determine HIV-related stigma prevalence among adults in care, describe which socio-demographic groups bear the greatest stigma burden, and assess the association between stigma and sustained HIV viral suppression. The Medical Monitoring Project measures characteristics of U.S. HIV-infected adults receiving care using a national probability sample. We used weighted data collected from June 2011 to May 2014 and assessed self-reported internalized stigma based on agreement with six statements. Overall, 79.1% endorsed ≥1 HIV-related stigma statements (n = 13,841). The average stigma score was 2.4 (out of a possible high score of six). White males had the lowest stigma scores while Hispanic/Latina females and transgender persons who were multiracial or other race had the highest. Although stigma was associated with viral suppression, it was no longer associated after adjusting for age. Stigma was common among HIV-infected adults in care. Results suggest individual and community stigma interventions may be needed, particularly among those who are Stigma was not independently associated with viral suppression; however, this sample was limited to adults in care. Examining HIV-infected persons not in care may elucidate stigma's association with viral suppression.

  16. Risk factors for non-adherence to cART in immigrants with HIV living in the Netherlands: Results from the Rotterdam ADherence (ROAD) project

    NARCIS (Netherlands)

    S.K. Been; D.A.M.C. van de Vijver (David); P.T. Nieuwkerk (Pythia); Brito, I. (Inês); J. Stutterheim (Janine); A.E.R. Bos (Arjan); M.E.G. Wolfers (Mireille); K. Pogány (Katalin); A. Verbon (Annelies)

    2016-01-01

    textabstractIn the Netherlands, immigrant people living with HIV (PLWH) have poorer psychological and treatment outcomes than Dutch PLWH. This cross-sectional field study examined risk factors for non-adherence to combination Antiretroviral Therapy (cART) among immigrant PLWH. First and second

  17. Risk Factors for Non-Adherence to cART in Immigrants with HIV Living in the Netherlands: Results from the ROtterdam ADherence (ROAD) Project

    NARCIS (Netherlands)

    Been, Sabrina K.; van de Vijver, David A. M. C.; Nieuwkerk, Pythia T.; Brito, Inês; Stutterheim, Sarah E.; Bos, Arjan E. R.; Wolfers, Mireille E. G.; Pogány, Katalin; Verbon, Annelies

    2016-01-01

    In the Netherlands, immigrant people living with HIV (PLWH) have poorer psychological and treatment outcomes than Dutch PLWH. This cross-sectional field study examined risk factors for non-adherence to combination Antiretroviral Therapy (cART) among immigrant PLWH. First and second generation

  18. A qualitative exploration of parental experiences of stigma while living with HIV in Bangladesh.

    Science.gov (United States)

    Islam, Md Shahidul; Scott, John; Minichiello, Victor

    2016-01-01

    With much of the focus on the "risk" groups, families have often been less studied in HIV research. Further, because of a focus on the aetiology and epidemiology of HIV, the social impacts associated with HIV on families and neighbours are sometimes overlooked. This study examined parental experiences of stigma and discrimination while living with HIV within a family context in Bangladesh. A qualitative research design using a grounded theory approach was used for this research. Data was collected through in-depth interviews with 19 HIV-positive parents, recruited with the support of two self-help groups of HIV-positive people, in two settings namely Khulna and Dhaka in Bangladesh. The findings indicate that HIV-positive parents held the view that they continue to experience significant stigma and their narratives clearly show how this affected them and their children. A range of informal practices were enacted in everyday contexts by extended family and community members to identify, demarcate and limit the social interaction of HIV-positive parents. Parents highlighted a number of factors including negative thoughts and behaviours, rejection, isolation and derogatory remarks as manifestations of stigma and discrimination, impacting upon them and their children because of their association with HIV.

  19. A Theoretical Perspective on Coping with Stigma.

    Science.gov (United States)

    Miller, Carol T.; Kaiser, Cheryl R.

    2001-01-01

    Uses existing theory and research on general stress and coping responses to describe responses to stigma-related stressors and discuss the adaptiveness of these responses. Research suggests that different stressors evoke different responses from different individuals. Stigmatized people have different life experiences than nonstigmatized people,…

  20. Non-adherence to anti-retroviral therapy among HIV infected adults in Mon State of Myanmar

    Directory of Open Access Journals (Sweden)

    Win Lei Aye

    2017-05-01

    Full Text Available Abstract Background The provision of Anti-Retroviral Therapy (ART was started in Myanmar in 2005 in collaboration with the National AIDS Program and the private sector. Successful clinical management of HIV-infected patients is subject to optimal adherence. The aim of the study was to determine the prevalence of adherence to ART and identify factors associated with non-adherence to ART among HIV infected adults registered in a private sector setting in Mon State, Myanmar. Methods This cross-sectional study was conducted with adults living with HIV receiving ART at an HIV outpatient clinic between April and May 2016. A total of three hundred People Living with HIV(PLHIV were interviewed using a pretested and structured questionnaire. The 30 days Visual Analog Scale (VAS adherence instrument was used to assess the level of adherence. Multivariable logistic regression analysis was used to determine factors associated with non-adherence to ART. Results Among 300 patients (male 37.7% and female 62.3%, with a mean age of 41.3 years, standard deviation 8.7, 84% reported ≥95% adherence to ART in the past month. Among 16% of those reporting non-adherence, major reasons for skipping the medication were being busy (23%, being away from home (17.7% and being forgetful (12.3%. In multivariable logistic rgeression, low behavioural skills on ART adherence (OR = 0.31, 95% CI: 0.10-0.94, tobacco use (OR = 3.22, 95% CI:1.28-8.12, having disclosed their HIV status (OR = 0.07, 95% CI: 0.01-0.69, having a partner who was not on ART (OR = 4.25, 95% CI: 1.70-10.64 and among men, having erectile dysfunction (OR = 15.14, 95% CI: 1.41-162.66 were significant associated with ART non-adherence. Conclusion Non-adherence to ART was associated with individual moderating factors and behavioral skills. Priority measures such as addressing risk behaviour and behavioural change communication tailored to individual patients’ lifestyles requires comprehensive

  1. Non-adherence to anti-retroviral therapy among HIV infected adults in Mon State of Myanmar.

    Science.gov (United States)

    Aye, Win Lei; Puckpinyo, Apa; Peltzer, Karl

    2017-05-05

    The provision of Anti-Retroviral Therapy (ART) was started in Myanmar in 2005 in collaboration with the National AIDS Program and the private sector. Successful clinical management of HIV-infected patients is subject to optimal adherence. The aim of the study was to determine the prevalence of adherence to ART and identify factors associated with non-adherence to ART among HIV infected adults registered in a private sector setting in Mon State, Myanmar. This cross-sectional study was conducted with adults living with HIV receiving ART at an HIV outpatient clinic between April and May 2016. A total of three hundred People Living with HIV(PLHIV) were interviewed using a pretested and structured questionnaire. The 30 days Visual Analog Scale (VAS) adherence instrument was used to assess the level of adherence. Multivariable logistic regression analysis was used to determine factors associated with non-adherence to ART. Among 300 patients (male 37.7% and female 62.3%, with a mean age of 41.3 years, standard deviation 8.7), 84% reported ≥95% adherence to ART in the past month. Among 16% of those reporting non-adherence, major reasons for skipping the medication were being busy (23%), being away from home (17.7%) and being forgetful (12.3%). In multivariable logistic rgeression, low behavioural skills on ART adherence (OR = 0.31, 95% CI: 0.10-0.94), tobacco use (OR = 3.22, 95% CI:1.28-8.12), having disclosed their HIV status (OR = 0.07, 95% CI: 0.01-0.69), having a partner who was not on ART (OR = 4.25, 95% CI: 1.70-10.64) and among men, having erectile dysfunction (OR = 15.14, 95% CI: 1.41-162.66) were significant associated with ART non-adherence. Non-adherence to ART was associated with individual moderating factors and behavioral skills. Priority measures such as addressing risk behaviour and behavioural change communication tailored to individual patients' lifestyles requires comprehensive interventions to improve adherence.

  2. Conspiracy Beliefs Are Not Necessarily a Barrier to Engagement in HIV Care Among Urban, Low-Income People of Color Living with HIV.

    Science.gov (United States)

    Jaiswal, J; Singer, S N; Griffin Tomas, M; Lekas, H-M

    2018-02-27

    HIV-related "conspiracy beliefs" include ideas about the genocidal origin of HIV to target minority people, and the notion that a cure for HIV is being deliberately withheld. Previous literature suggests that these beliefs may negatively affect engagement in HIV care and ART adherence, but little is known about how people who are disengaged from care may think about these ideas. Twenty-seven semi-structured interviews were conducted with low-income Black and Latinx people living with HIV in NYC who were currently disengaged from, or recently re-engaged in, HIV care. The data suggest that HIV-related "conspiracy beliefs" are not necessarily a barrier to care. Regardless of whether or not people endorsed these ideas, participants were largely dismissive, and prioritized focusing on managing their HIV and overall health and life challenges. Interventions aiming to improve ART adherence and retention in HIV care should focus on building trust between clinicians and populations that have experienced historical, as well as ongoing, marginalization. HIV care providers should ask patients open-ended questions specifically about their beliefs about HIV and ART in order to address potential suspicion. Moving away from the phrase "conspiracy beliefs" in favor of more neutral language, such as "HIV-related beliefs," can enable us to better understand these ideas in the context of people's daily lives. Further research is needed to better understand how structural inequality may shape how people experience mistrust, and how mistrust may factor into the constellation of barriers to consistent engagement in HIV care.

  3. Risk sexual behavior among people living with HIV/AIDS and receiving antiretroviral therapy in Piura, Peru

    OpenAIRE

    Juarez-Vílchez, José P.; Subregión de Salud “Luciano Castillo Colonna” Sullana, Perú. Licenciado en Obstetricia, Candidato a Magister en Género, Sexualidad y Salud Reproductiva.; Pozo, Edwar J.; Subregión de Salud “Luciano Castillo Colonna” Sullana, Perú. Biólogo-Microbiólogo, Candidato a Magister en Control de Enfermedades Infecciosas y Tropicales.

    2010-01-01

    Objetive. To explore opinions and beliefs about risky sexual behavior and HIH transmission in tow hospital of Piura. Material y methods. Qualitative study based on extensive interviews and focus groups of people over 15 years old of age living with HIV. Interviews were recorded as audio, and then transcribed as text in MS Word. Information was analyzed with AtlasTi. Results. Results indicate that people living with HIV and receive antiretrovirals practice risky sexual behavior. Those resu...

  4. Condom use, risk perception, and HIV knowledge: a comparison across sexes in Nigeria

    Directory of Open Access Journals (Sweden)

    Lammers J

    2013-10-01

    Full Text Available Judith Lammers,1 Sweder JG van Wijnbergen,2 Daan Willebrands3 1Academic Medical Center, 2Faculty of Economics and Business, University of Amsterdam, 3Atradius Credit Insurance, Amsterdam, The Netherlands Background: This paper analyzes how different types of Human immunodeficiency virus (HIV knowledge influences condom use across the sexes. Methods: The empirical work was based on a household survey conducted among 1979 households of a representative group of stallholders in Lagos, Nigeria in 2008. Condom use during last sexual intercourse was analyzed using a multivariate model corrected for clustering effects. The data included questions on socioeconomic characteristics, knowledge of the existence of HIV, HIV prevention, HIV stigma, intended pregnancy, and risk perceptions of engaging in unprotected sex. Results: A large HIV knowledge gap between males and females was observed. Across the sexes, different types of knowledge are important in condom use. Low-risk perceptions of engaging in unprotected sex and not knowing that condoms prevent HIV infection appear to be the best predictors for risky sexual behavior among men. For females, stigma leads to lower condom use. Obviously, lack of knowledge on where condoms are available (9.4% and 29.1% of male and female respondents, respectively reduced condom use in both males and females. Conclusion: The results call for programmatic approaches to differentiate between males and females in the focus of HIV prevention campaigns. Moreover, the high predictive power of high-risk perceptions of engaging in unprotected sex (while correcting for other HIV knowledge indicators calls for further exploration on how to influence these risk perceptions in HIV prevention programs. Keywords: Africa, condom, males, females, HIV/AIDS, knowledge, prevention, risk perception

  5. The dynamics of the production of AIDS-related stigma among pregnant women living with HIV/AIDS in Rio de Janeiro, Brazil

    Directory of Open Access Journals (Sweden)

    Simone Monteiro

    Full Text Available The study analyses the relationship between AIDS-related stigma and the processes of discrimination prior to diagnosis among pregnant women living with HIV/AIDS. The fieldwork involved interviews about the life trajectories of 29 pregnant women living with HIV/AIDS, recruited at two AIDS services in Rio de Janeiro, Brazil. The analysis revealed that before HIV diagnosis, social and gender inequalities experienced by these women reduced their access to material and symbolic goods that could have enhanced educational and career prospects and their ability and autonomy to exercise sexual and reproductive rights. Being diagnosed with HIV triggered fear of moral judgment and of breakdown in social and family support networks. Given these fears, pregnant women living with HIV/AIDS opt for concealment of the diagnosis. It is necessary for health services, NGOs and government agencies to work together to face the factors that fuel stigma, such as socioeconomic and gender inequalities, taboos and prejudices related to sexuality, and also develop actions to enable women to redefine the meaning of the disease.

  6. Disentangling the stigma of HIV/AIDS from the stigmas of drugs use, commercial sex and commercial blood donation – a factorial survey of medical students in China

    Directory of Open Access Journals (Sweden)

    Zhang Kong-Lai

    2007-10-01

    Full Text Available Abstract Background HIV/AIDS related stigma interferes with the provision of appropriate care and support for people living with HIV/AIDS. Currently, programs to address the stigma approach it as if it occurs in isolation, separate from the co-stigmas related to the various modes of disease transmission including injection drug use (IDU and commercial sex (CS. In order to develop better programs to address HIV/AIDS related stigma, the inter-relationship (or 'layering' between HIV/AIDS stigma and the co-stigmas needs to be better understood. This paper describes an experimental study for disentangling the layering of HIV/AIDS related stigmas. Methods The study used a factorial survey design. 352 medical students from Guangzhou were presented with four random vignettes each describing a hypothetical male. The vignettes were identical except for the presence of a disease diagnosis (AIDS, leukaemia, or no disease and a co-characteristic (IDU, CS, commercial blood donation (CBD, blood transfusion or no co-characteristic. After reading each vignette, participants completed a measure of social distance that assessed the level of stigmatising attitudes. Results Bivariate and multivariable analyses revealed statistically significant levels of stigma associated with AIDS, IDU, CS and CBD. The layering of stigma was explored using a recently developed technique. Strong interactions between the stigmas of AIDS and the co-characteristics were also found. AIDS was significantly less stigmatising than IDU or CS. Critically, the stigma of AIDS in combination with either the stigmas of IDU or CS was significantly less than the stigma of IDU alone or CS alone. Conclusion The findings pose several surprising challenges to conventional beliefs about HIV/AIDS related stigma and stigma interventions that have focused exclusively on the disease stigma. Contrary to the belief that having a co-stigma would add to the intensity of stigma attached to people with HIV

  7. Food insecurity, sexual risk behavior, and adherence to antiretroviral therapy among women living with HIV: A systematic review.

    Science.gov (United States)

    Chop, Elisabeth; Duggaraju, Avani; Malley, Angela; Burke, Virginia; Caldas, Stephanie; Yeh, Ping Teresa; Narasimhan, Manjulaa; Amin, Avni; Kennedy, Caitlin E

    2017-09-01

    Gender inequalities shape the experience of food insecurity among women living with HIV (WLHIV). We systematically reviewed the impact of food insecurity on sexual risk behaviors and antiretroviral therapy (ART) adherence among WLHIV. We included qualitative or quantitative peer-reviewed articles, extracted data in duplicate, and assessed rigor. Seven studies, from sub-Saharan Africa, North America, and Europe, met inclusion criteria. Food insecurity was associated with increased sexual risk through transactional sex and inability to negotiate safer sex. Hunger and food insecurity were barriers to ART initiation/adherence. Multidimensional programming and policies should simultaneously address poverty, gender inequality, food insecurity, and HIV.

  8. Caring for caregivers of people living with HIV in the family: a response to the HIV pandemic from two urban slum communities in Pune, India.

    Science.gov (United States)

    Kohli, Rewa; Purohit, Vidula; Karve, Latika; Bhalerao, Vinod; Karvande, Shilpa; Rangan, Sheela; Reddy, Srikanth; Paranjape, Ramesh; Sahay, Seema

    2012-01-01

    In low resource settings, the vast majority of 'Person/people Living with HIV' (PLHIV/s) and inadequate healthcare delivery systems to meet their treatment and care needs, caregivers play a vital role. Home based caregivers are often unrecognized with limited AIDS policies and programs focusing on them. We explored the perceptions and norms regarding care being provided by family caregivers of PLHIVs in India. A community based qualitative study to understand the issues pertaining to home based care for PLHIV was conducted in urban settings of Pune city, in Maharashtra, India. Eight Focus Group Discussions (FGDs) among men, women and peer educators were carried out. A total of 44 in-depth Interviews (IDIs) with PLHIVs (20) and their caregivers (24), were conducted using separate guides respectively. Data was analyzed thematically. Home based care was perceived as economically viable option available for PLHIVs. 'Care' comprised of emotional, adherence, nursing and financial support to PLHIV. Home based care was preferred over hospital based care as it ensured confidentiality and patient care without hampering routine work at home. Women emerged as more vital primary caregivers compared to men. Home based care for men was almost unconditional while women had no such support. The natal family of women also abandoned. Their marital families seemed to provide support. Caregivers voiced the need for respite care and training. Gender related stigma and discrimination existed irrespective of women being the primary family caregivers. The support from marital families indicates a need to explore care and support issues at natal and marital homes of the women living with HIV respectively. Home based care training and respite care for the caregivers is recommended. Gender sensitive interventions addressing gender inequity and HIV related stigma should be modeled while designing interventions for PLHIVs and their family caregivers.

  9. Caring for caregivers of people living with HIV in the family: a response to the HIV pandemic from two urban slum communities in Pune, India.

    Directory of Open Access Journals (Sweden)

    Rewa Kohli

    Full Text Available INTRODUCTION: In low resource settings, the vast majority of 'Person/people Living with HIV' (PLHIV/s and inadequate healthcare delivery systems to meet their treatment and care needs, caregivers play a vital role. Home based caregivers are often unrecognized with limited AIDS policies and programs focusing on them. We explored the perceptions and norms regarding care being provided by family caregivers of PLHIVs in India. METHODOLOGY: A community based qualitative study to understand the issues pertaining to home based care for PLHIV was conducted in urban settings of Pune city, in Maharashtra, India. Eight Focus Group Discussions (FGDs among men, women and peer educators were carried out. A total of 44 in-depth Interviews (IDIs with PLHIVs (20 and their caregivers (24, were conducted using separate guides respectively. Data was analyzed thematically. RESULTS: Home based care was perceived as economically viable option available for PLHIVs. 'Care' comprised of emotional, adherence, nursing and financial support to PLHIV. Home based care was preferred over hospital based care as it ensured confidentiality and patient care without hampering routine work at home. Women emerged as more vital primary caregivers compared to men. Home based care for men was almost unconditional while women had no such support. The natal family of women also abandoned. Their marital families seemed to provide support. Caregivers voiced the need for respite care and training. DISCUSSION: Gender related stigma and discrimination existed irrespective of women being the primary family caregivers. The support from marital families indicates a need to explore care and support issues at natal and marital homes of the women living with HIV respectively. Home based care training and respite care for the caregivers is recommended. Gender sensitive interventions addressing gender inequity and HIV related stigma should be modeled while designing interventions for PLHIVs and their

  10. Manifestations of HIV stigma and their impact on retention in care for people transitioning from prisons to communities

    OpenAIRE

    Kemnitz, Rebecca; Kuehl, Theresa C.; Hochstatter, Karli R.; Barker, Emily; Corey, Anna; Jacobs, Elizabeth A.; Repplinger, Michael D.; Ehlenbach, William J.; Seal, David W.; Sosman, James M.; Westergaard, Ryan P.

    2017-01-01

    Background While most people living with HIV who are incarcerated in United States receive appropriate HIV care while they are in prison, interruptions in antiretroviral therapy and virologic failure are extremely common after they are released. The purpose of this study was to describe whether and how HIV stigma influences continuity of care for people living with HIV while they transition from prison to community settings. Methods We conducted semi-structured, telephone-based interviews wit...

  11. 'They Say HIV is a Punishment from God or from Ancestors': Cross-Cultural Adaptation and Psychometric Assessment of an HIV Stigma Scale for South African Adolescents Living with HIV (ALHIV-SS).

    Science.gov (United States)

    Pantelic, Marija; Boyes, Mark; Cluver, Lucie; Thabeng, Mildred

    2018-01-01

    Sub-Saharan Africa is home to 90 % of the world's adolescents living with HIV (ALHIV). HIV-stigma and the resultant fear of being identified as HIV-positive can compromise the survival of these youth by undermining anti-retroviral treatment initiation and adherence. To date, no HIV-stigma measures have been validated for use with ALHIV in Sub-Saharan Africa. This paper reports on a two-stage study in the Eastern Cape, South Africa. Firstly, we conducted a cross-cultural adaptation of an HIV stigma scale, previously used with US ALHIV. One-on-one semi-structured cognitive interviews were conducted with 9 urban and rural ALHIV. Three main themes emerged: 1) participants spoke about experiences of HIV stigma specific to a Southern African context, such as anticipating stigma from community members due to 'punishment from God or ancestors'; 2) participants' responses uncovered discrepancies between what the items intended to capture and how they understood them and 3) participants' interpretation of wording uncovered redundant items. Items were revised or removed in consultation with participants. Secondly, we psychometrically assessed and validated this adapted ALHIV stigma scale (ALHIV-SS). We used total population sampling in 53 public healthcare facilities with community tracing. 721 ALHIV who were fully aware of their status were identified and interviewed for the psychometric assessment. Confirmatory factor analysis confirmed a 3-factor structure of enacted, anticipated and internalized stigma. The removal of 3 items resulted in a significant improvement in model fit ( Chi 2 (df)  = 189.83 (33), p  < .001) and the restricted model fitted the data well (RMSEA = .017; CFI/TLI = .985/.980; SRMR = .032). Standardized factor loadings of indicators onto the latent variable were acceptable for all three measures (.41-.96). Concurrent criterion validity confirmed hypothesized relationships. Enacted stigma was associated with higher AIDS

  12. Family interaction and social stigmatization of people leaving with HIV and AIDS in Puerto Rico

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    Marinilda Rivera-Díaz

    2017-12-01

    Full Text Available This article aims to describe the manifestation of HIV stigma in the family context and how this could impact the life of people living with HIV (PLWH. The data derive from a larger phenomenological study addressing manifestations of stigma in the lives of PLWH when interacting with the health sector. Nine focus groups were carried out in 2011 with PLWH  (N=67. Eight themes emerged from the qualitative analysis. For the purpose of this article, we focus on the categories related to family dynamics: the negotiation of disclosure and non-disclosure, fear of the HIV virus and family dynamics, and life as a couple.  Socio demographic information showed that 53% were between 44 to 54 years old, 80% were single, 51% were male, 42% did not complete a high school diploma, 82% were unemployed. Also, 82% described themselves as religious persons and 41% had lived with HIV for 10 years or less. Qualitative results show stigma is still present in the family context. PLWH experience fear of disclosure, discrimination, avoid initiating families or couple relationships, experience physical and verbal abuse from relatives, and even separation from other family members. After more than 30 years of the ongoing HIV epidemic, stigma is still manifested by family members with detrimental social and medical implications for PLWH. Research and educational efforts should continue addressing manifestations of stigma among family members of PLWH.

  13. Individual-level socioeconomic status and community-level inequality as determinants of stigma towards persons living with HIV who inject drugs in Thai Nguyen, Vietnam

    Science.gov (United States)

    Lim, Travis; Zelaya, Carla; Latkin, Carl; Quan, Vu Minh; Frangakis, Constantine; Ha, Tran Viet; Minh, Nguyen Le; Go, Vivian

    2013-01-01

    Introduction HIV infection may be affected by multiple complex socioeconomic status (SES) factors, especially individual socioeconomic disadvantage and community-level inequality. At the same time, stigma towards HIV and marginalized groups has exacerbated persistent concentrated epidemics among key populations, such as persons who inject drugs (PWID) in Vietnam. Stigma researchers argue that stigma fundamentally depends on the existence of economic power differences in a community. In rapidly growing economies like Vietnam, the increasing gap in income and education levels, as well as an individual's absolute income and education, may create social conditions that facilitate stigma related to injecting drug use and HIV. Methods A cross-sectional baseline survey assessing different types of stigma and key socioeconomic characteristics was administered to 1674 PWID and 1349 community members living in physical proximity throughout the 32 communes in Thai Nguyen province, Vietnam. We created four stigma scales, including HIV-related and drug-related stigma reported by both PWID and community members. We then used ecologic Spearman's correlation, ordinary least-squares regression and multi-level generalized estimating equations to examine community-level inequality associations, individual-level SES associations and multi-level SES associations with different types of stigma, respectively. Results There was little urban–rural difference in stigma among communes. Higher income inequality was marginally associated with drug-related stigma reported by community members (p=0.087), and higher education inequality was significantly associated with higher HIV-related stigma reported by both PWID and community members (pstigma (HIV and drug related) reported by both PWID and community members. Part-time employed PWID reported more experiences and perceptions of drug-related stigma, while conversely unemployed community members reported enacting lower drug-related stigma

  14. Condom use among people living with HIV/AIDS attending ...

    African Journals Online (AJOL)

    repeated sexual contact among HIV-discordant couples, 98-100% of those who used latex condoms correctly and ... Quick Response Code: ... Human immunodeficiency virus (HIV) ..... en/wpraids2001.pdf [Last accessed on 2009 Apr 20]. 2.

  15. HIV stigma experiences and stigmatisation before and after an intervention

    Directory of Open Access Journals (Sweden)

    H. C. Chidrawi

    2016-10-01

    Full Text Available This study focuses on one aspect of a more extensive SANPAD-funded HIV stigma reduction research project. The study addresses not only the continuous burden of HIV stigma, but more specifically on the low rate of participation in healthcare opportunities and HIV stigma reduction interventions by people living with HIV (PLWH This study tested both change-over-time in HIV stigma experiences of PLWH and change-over-time in the HIV stigmatisation behaviour of people living close to them (PLC in an urban and rural setting in the North-West in South Africa. These aspects were measured before and after the comprehensive community-based HIV stigma reduction intervention. A quantitative single system research design, with a pre-test and four repetitive post-tests, and purposive voluntary and snowball sampling were used. Findings did not indicate significant differences between urban and rural settings, but demonstrated some significance in change-over-time in the HIV stigma experiences of PLWH as well as the HIV stigmatisationbehaviour of PLC after the intervention. Recommendations include the continuation of this intervention, following the same guidelines that were implemented during the study.

  16. HIV stigma experiences and stigmatisation before and after an intervention

    Directory of Open Access Journals (Sweden)

    H. Christa Chidrawi

    2016-12-01

    Full Text Available This study focuses on one aspect of a more extensive SANPAD-funded HIV stigma reduction research project. The study addresses not only the continuous burden of HIV stigma, but more specifically on the low rate of participation in healthcare opportunities and HIV stigma reduction interventions by people living with HIV (PLWH This study tested both change-over-time in HIV stigma experiences of PLWH and change-over-time in the HIV stigmatisation behaviour of people living close to them (PLC in an urban and rural setting in the North-West in South Africa. These aspects were measured before and after the comprehensive community-based HIV stigma reduction intervention. A quantitative single system research design, with a pre-test and four repetitive post-tests, and purposive voluntary and snowball sampling were used. Findings did not indicate significant differences between urban and rural settings, but demonstrated some significance in change-over-time in the HIV stigma experiences of PLWH as well as the HIV stigmatisation behaviour of PLC after the intervention. Recommendations include the continuation of this intervention, following the same guidelines that were implemented during the study.

  17. Osteopenia and osteoporosis in people living with HIV: multiprofessional approach.

    Science.gov (United States)

    Lima, Ana Lucia Lei Munhoz; de Oliveira, Priscila Rosalba D; Plapler, Perola Grimberg; Marcolino, Flora Maria D Andrea; de Souza Meirelles, Eduardo; Sugawara, André; Gobbi, Riccardo Gomes; Dos Santos, Alexandre Leme Godoy; Camanho, Gilberto Luis

    2011-01-01

    Increasing bone mineralization abnormalities observed among people living with HIV (PLWHIV) result from various factors relating to the host, the virus, and the antiretrovirals used. Today, HIV infection is considered to be a risk factor for bone mineralization disorders. The test most recommended for diagnosing osteoporosis is measurement of bone mineral density by means of dual energy X-ray absorptiometry at two sites. Osteoporosis treatment has the aims of bone mass improvement and fracture control. A combination of calcium and vitamin D supplementation may reduce the risk of fractures. Antiresorptive drugs act by blocking osteoclastic activity and reducing bone remodeling. On the other hand, bone-forming drugs stimulate osteoblastogenesis, thereby stimulating the formation of bone matrix. Mixed-action medications are those that are capable of both stimulating bone formation and inhibiting reabsorption. Antiresorptive drugs form the group of medications with the greatest quantity of scientific evidence confirming their efficacy in osteoporosis treatment. Physical activity is a health promotion strategy for the general population, but only preliminary data on its real value and benefit among PLWHIV are available, especially in relation to osteoporosis.

  18. Coping with information style and family burden: Possible roles of self-stigma and hope among parents of children in a psychiatric inpatient unit.

    Science.gov (United States)

    Hasson-Ohayon, I; Pijnenborg, G H M; Ben-Pazi, A; Taitel, S; Goldzweig, G

    2017-05-01

    Parents of children who are hospitalized in inpatient psychiatric units must cope with significant challenges. One of these challenges relates to the way in which they cope with illness-related information. The current study examined the relationship between two such coping styles - monitoring and blunting - and family burden among parents of children in a psychiatric inpatient unit. Moreover, the possible moderating roles played by hope and self-stigma in these associations were also examined. Questionnaires regarding coping with information style, self-stigma, hope and family burden were administered to 70 parents. A main positive effect of hope and a main negative effect of self-stigma were uncovered. An interaction between self-stigma and monitoring was also revealed, suggesting that for parents with high self-stigma, compared to those with low self-stigma, more monitoring was related to more burden. Tailoring family interventions according to coping style and self-stigma is highly recommended as a mean to reduce the family burden of parents whose child is hospitalized in a psychiatric inpatient unit. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  19. HIV-related stigma, social norms, and HIV testing in Soweto and Vulindlela, South Africa: National Institutes of Mental Health Project Accept (HPTN 043).

    Science.gov (United States)

    Young, Sean D; Hlavka, Zdenek; Modiba, Precious; Gray, Glenda; Van Rooyen, Heidi; Richter, Linda; Szekeres, Greg; Coates, Thomas

    2010-12-15

    HIV testing is necessary to curb the increasing epidemic. However, HIV-related stigma and perceptions of low likelihood of societal HIV testing may reduce testing rates. This study aimed to explore this association in South Africa, where HIV rates are extraordinarily high. Data were taken from the Soweto and Vulindlela, South African sites of Project Accept, a multinational HIV prevention trial. Self-reported HIV testing, stigma, and social norms items were used to study the relationship between HIV testing, stigma, and perceptions about societal testing rates. The stigma items were broken into 3 factors: negative attitudes, negative perceptions about people living with HIV, and perceptions of fair treatment for people living with HIV (equity). Results from a univariate logistic regression suggest that history of HIV testing was associated with decreased negative attitudes about people living with HIV/AIDS, increased perceptions that people living with HIV/AIDS experience discrimination, and increased perceptions that people with HIV should be treated equitably. Results from a multivariate logistic regression confirm these effects and suggest that these differences vary according to sex and age. Compared with people who had never tested for HIV, those who had previously tested were more likely to believe that the majority of people have tested for HIV. Data suggest that interventions designed to increase HIV testing in South Africa should address stigma and perceptions of societal testing.

  20. Identification and characterization of microsporidia from fecal samples of HIV-positive patients from Lagos, Nigeria.

    Directory of Open Access Journals (Sweden)

    Oladele Teslim Ojuromi

    Full Text Available BACKGROUND: Microsporidia are obligate intracellular parasites that infect a broad range of vertebrates and invertebrates. They have been increasingly recognized as human pathogens in AIDS patients, mainly associated with a life-threatening chronic diarrhea and systemic disease. However, to date the global epidemiology of human microsporidiosis is poorly understood, and recent data suggest that the incidence of these pathogens is much higher than previously reported and may represent a neglected etiological agent of more common diseases indeed in immunocompetent individuals. To contribute to the knowledge of microsporidia molecular epidemiology in HIV-positive patients in Nigeria, the authors tested stool samples proceeding from patients with and without diarrhea. METHODOLOGY/PRINCIPAL FINDINGS: Stool samples from 193 HIV-positive patients with and without diarrhea (67 and 126 respectively from Lagos (Nigeria were investigated for the presence of microsporidia and Cryptosporidium using Weber's Chromotrope-based stain, Kinyoun stain, IFAT and PCR. The Weber stain showed 45 fecal samples (23.3% with characteristic microsporidia spores, and a significant association of microsporidia with diarrhea was observed (O.R. = 18.2; CI: 95%. A similar result was obtained using Kinyoun stain, showing 44 (31,8% positive samples with structures morphologically compatible with Cryptosporidium sp, 14 (31.8% of them with infection mixed with microsporidia. The characterization of microsporidia species by IFAT and PCR allowed identification of Enterocytozoon bieneusi, Encephalitozoon intestinalis and E. cuniculi in 5, 2 and 1 samples respectively. The partial sequencing of the ITS region of the rRNA genes showed that the three isolates of E.bieneusi studied are included in Group I, one of which bears the genotype B. CONCLUSIONS/SIGNIFICANCE: To our knowledge, this is the first report of microsporidia characterization in fecal samples from HIV-positive patients from

  1. The Affordable Care Act and the Burden of High Cost Sharing and Utilization Management Restrictions on Access to HIV Medications for People Living with HIV/AIDS.

    Science.gov (United States)

    Zamani-Hank, Yasamean

    2016-08-01

    The HIV/AIDS epidemic continues to be a critical public health issue in the United States, where an estimated 1.2 million individuals live with HIV infection. Viral suppression is one of the primary public health goals for People Living with HIV/AIDS (PLWHA). A crucial component of this goal involves adequate access to health care, specifically anti-retroviral HIV medications. The enactment of the Affordable Care Act (ACA) in 2010 raised hopes for millions of PLWHA without access to health care coverage. High cost-sharing requirements enacted by health plans place a financial burden on PLWHA who need ongoing access to these life-saving medications. Plighted with poverty, Detroit, Michigan, is a center of attention for examining the financial burden of HIV medications on PLWHA under the new health plans. From November 2014 to January 2015, monthly out-of-pocket costs and medication utilization requirements for 31 HIV medications were examined for the top 12 insurance carriers offering Qualified Health Plans on Michigan's Health Insurance Marketplace Exchange. The percentage of medications requiring quantity limits and prior authorization were calculated. The average monthly out-of-pocket cost per person ranged from $12 to $667 per medication. Three insurance carriers placed all 31 HIV medications on the highest cost-sharing tier, charging 50% coinsurance. High out-of-pocket costs and medication utilization restrictions discourage PLWHA from enrolling in health plans and threaten interrupted medication adherence, drug resistance, and increased risk of viral transmission. Health plans inflicting high costs and medication restrictions violate provisions of the ACA and undermine health care quality for PLWHA. (Population Health Management 2016;19:272-278).

  2. Preexposure prophylaxis-related stigma: strategies to improve uptake and adherence - a narrative review.

    Science.gov (United States)

    Haire, Bridget G

    2015-01-01

    Despite high levels of efficacy, the implementation of preexposure prophylaxis (PrEP) as a strategy to prevent new HIV infection has been slow. Studies show that PrEP works so long as it is taken, making adherence one of the great challenges of effective PrEP implementation alongside issues of access and uptake. Given that effective PrEP use requires ongoing self-administration of pills by people at high risk of HIV acquisition, it is a strategy best understood not as simply biomedical, but as biobehavioral or biopsychosocial, meaning that that social, psychological, cultural, and structural factors all contribute to the success or failure of the intervention. The willingness of people at risk of HIV to take up and adhere to PrEP depends greatly upon social understandings - whether it is seen as effective, as a healthy option, and a socially acceptable strategy for preventing HIV. Stigma - unfavorable associations - can negatively influence the implementation of PrEP. Because it is associated with high-risk sexual activity, PrEP risks multiple stigmas that can differ according to specific cultural conditions. This includes the stigma of being related to HIV (which may also relate to other stigmas, such as homosexuality, sex work, and/or drug use) and the stigma of PrEP being an alternative to condoms (as condom use is associated with responsible sexual activity). PrEP-related stigma has emerged as a significant social harm that can arise from PrEP research participation, reported by trial participants from a range of different trial sites, different trial populations, and spanning different continents. Social marketing needs to redress PrEP-related stigmas through health promotion campaigns aimed at clinicians, HIV-affected communities, and people at high risk of HIV who might benefit from PrEP access. PrEP access needs to be reframed as a positive and responsible option to help people remain HIV-negative.

  3. Financial situation of people living with HIV in Europe

    NARCIS (Netherlands)

    Schrooten, W.; Dreezen, C.; Borleffs, J.; Dijkgraaf, M.; Borchert, M.; de Graeve, D.; Hemmer, R.; Fleerackers, Y.; Colebunders, R.

    2002-01-01

    The objective was to investigate the financial situation of people living with HIV in Europe. Two surveys using an anonymous questionnaire were organized in Europe among people living with HIV, the first in 1996-97 and the second in 1998-99. One thousand one hundred and sixty-one people from the

  4. HIV-Related Stigma and Discriminatory Attitudes among a Semi-Urban Population.

    Science.gov (United States)

    Lugova, Halyna; Mon, Aye Aye; Daher, Aqil Mohammad; Suleiman, Adlina

    2015-09-01

    Stigma and discriminatory attitudes (SDAs) have a negative impact on human immunodeficiency virus (HIV) prevention, testing, and treatment as well as on family and social networks. There is a lack of understanding about HIV-related SDAs among people living outside large cities. This study is aimed to determine the level of HIV-related SDAs among a semi-urban population in Malaysia and to compare the SDA results among people with different sociodemographic characteristics. A sample of 106 respondents was generated by convenience sampling during the screening campaign in Alor Gajah, Malaysia. Data collection was carried out based on a pre-tested questionnaire via face-to-face interviews. More than half of the respondents (62.3%) thought that an HIV-positive teacher should not be allowed to continue teaching at school; 81.1% were unsure or were unwilling to care for their family member with AIDS at home; 81.2% thought children with HIV/AIDS should not continue to be raised in families; and 77.3% thought they would not reveal if a family member had HIV/AIDS. Priority should be given to evidence-based interventions to reduce HIV-related SDAs. This study did not reveal any significant relationship between sociodemographic profiles and HIV-related SDAs. Therefore, further research with a larger sample size is needed to investigate the underlying causes of HIV-related SDAs.

  5. Prevalence and Factors Associated with Fixed-Dose Combination Antiretroviral Drugs Adherence among HIV-Positive Pregnant Women on Option B Treatment in Mpumalanga Province, South Africa

    Directory of Open Access Journals (Sweden)

    Shandir Ramlagan

    2018-01-01

    Full Text Available The possibility for all babies to be born and remain HIV-negative for the first year of life is achievable in South Africa. HIV-positive mothers’ adherence to their antiretroviral medication is one of the crucial factors to achieve this target. Cross-sectional data were collected at 12 community health centres, over 12 months (2014–2015, from 673 HIV-positive women, less than 6 months pregnant, attending antenatal care, and on Option B treatment. Adherence measures included the Adults AIDS Clinical Trials Group (AACTG four-day measure, as well as the Visual Analog Scale (VAS seven-day measure. Bivariate analyses and multivariate logistic regressions are presented. 78.8% of respondents were adherent on AACTG, while 68.8% reported VAS adherence. Bivariate analyses for increased adherence show significant associations with older age, less/no alcohol usage, disclosure of HIV status, higher HIV knowledge, no desire to avoid ARV side effects, low stigma, and low depression. AACTG showed a negative association with intimate partner violence. Multivariable logistic regression on AACTG and VAS adherence rates resulted in unique contributions to increased adherence of older age, less/no alcohol usage, higher HIV knowledge, lack of depression, and non-disclosure. Programs targeting closer side effect monitoring, HIV disclosure, pre-natal depression, alcohol intake, and HIV knowledge need consideration.

  6. Young peoples awareness and support for tobacco control legislation: A study among in-school youth in Lagos, Nigeria.

    Science.gov (United States)

    Odukoya, Oluwakemi Ololade; Chife, Jacob Obi; Odeyemi, Kofoworola A; Nwangwu, Genevieve I

    2015-01-01

    The increasing awareness of the health risks associated with tobacco use has led many countries to enact tobacco control legislation to protect citizens from the harmful effects of tobacco use. Young people are important stakeholders in many aspects of tobacco control legislation. This study.aims to assess the awareness of existing tobacco control laws among young people, their attitudes towards these laws and the factors associated with youth awareness and support for tobacco control legislation in Nigeria. A descriptive cross-sectional survey was carried out among 950 students enrolled in six randomly selected public and private schools in the, Mushin local government area of Lagos state using a multi stage sampling method. The respondents completed a pre-tested self-administered questionnaire eliciting information on their awareness and support for tobacco control laws in selected thematicareas Data was analysed using SPSS 17.0 and presented as frequency tables and cross tabulations. Most of the participants were between 14-18 years of age (55.8%) with a mean age of 14.1 +/- 2.2 years. There were slightly more male than female respondents. About two-thirds of the respondents were aware that laws exist to regulate tobacco use in Nigeria. Specifically, more than 60% of the students knew that tobacco smoking was outlawed in schools, medical establishment, public vehicles and offices. Many were aware of the advert bans on tobacco products on television, newspapers, radio, magazines and cinemas. The respondents were however less informed of the penalties for violating tobacco restriction laws. Majority supported the law prohibiting cigarette smoking in health facilities (84.3%), schools (83.7%), public transportation (79.5%) and cinemas (76.3%). Relatively fewer (49.6%) respondents felt that smoking should be prohibited in bars, restaurants and nightclubs. A significant proportion believed that young people in Nigeria should not be allowed to buy (76.4%) or sell (76

  7. Food insecurity, mental health and quality of life among people living with HIV commencing antiretroviral treatment in Ethiopia

    DEFF Research Database (Denmark)

    Tesfaye, Markos; Kæstel, Pernille; Olsen, Mette Frahm

    2016-01-01

    BACKGROUND: Studies from high-income settings show that both food insecurity and common mental disorders (CMDs) are associated with lower quality of life among people living with HIV (PLHIV). However, there is limited research among PLHIV in sub-Saharan Africa. In this study we tested the hypothe......BACKGROUND: Studies from high-income settings show that both food insecurity and common mental disorders (CMDs) are associated with lower quality of life among people living with HIV (PLHIV). However, there is limited research among PLHIV in sub-Saharan Africa. In this study we tested...... the hypothesis that food insecurity and CMDs would be associated with poorer quality of life of PLHIV in Ethiopia. METHODS: A cross-sectional study was carried out with 348 PLHIV who were initiating antiretroviral therapy recruited from two primary care centers and a tertiary Hospital in southwest Ethiopia. Food...... insecurity, CMD, and quality of life were measured using instruments adapted and validated in Ethiopia (Household Food Insecurity Access Scale, Kessler-6, and WHOQOL-HIV-BREF-ETH, respectively). Multiple linear regression analysis was used to identify factors associated with quality of life after adjusting...

  8. Self-reported adherence and associated factors to isoniazid preventive therapy for latent tuberculosis among people living with HIV/AIDS at health centers in Gondar town, North West Ethiopia.

    Science.gov (United States)

    Ayele, Asnakew Achaw; Asrade Atnafie, Seyfe; Balcha, Demis Driba; Weredekal, Asegedech Tsegaw; Woldegiorgis, Birhanu Alemayehu; Wotte, Mulgeta Melaku; Gebresillasie, Begashaw Melaku

    2017-01-01

    This study aimed to assess self-reported adherence and associated factors to isoniazid preventive therapy (IPT) for latent tuberculosis among people living with HIV/AIDS (PLWHA) at health centers in Gondar town, North West Ethiopia. An institution-based prospective cross-sectional study was conducted from March 10 to June 11, 2016. A total of 154 eligible participants were included in the study, using the simple random sampling method, from the available four health centers and one teaching referral hospital that provided antiretroviral therapy (ART) for HIV/AIDS patients. Adherence was measured by self-report of isoniazid (INH) tablets taken for the preceding 7 days. Participants were recruited through in-depth interviews. The collected data were entered and analyzed using the statistical packages for social sciences (SPSS) version 20. The adherence level to IPT was 90.3% for the last 7 days of the study. ART was initiated for 84.4%, and all of them were on a first-line regimen. Isoniazid-related side effects were reported by 48 (31.2%) participants, of which the most commonly identified were abdominal pain, vomiting, skin rash, jaundice, and numbness. Only 3 (2%) participants discontinued from the study. In the bivariate logistic regression analysis, respondents who had received an explanation about IPT were 83% times more likely to be adherent compared to those who had not received it (95% CI, AOR: 0.266 [0.23-3.127]). Respondents who had taken IPT for ≥5 months were more likely to be adherent than those who had taken it for 1-2 months [95% CI, COR: 1.484]. On the other hand, respondents who experienced side effects were 36% less likely to be adherent compared to those who did not experience any. The level of adherence to IPT among PLWHA was high. Among the predictors reported, carelessness and/or forgetfulness, side effects, and absence from home were the major factors identified for being nonadherent. Health professionals and the Ministry of Health should

  9. Ageing and healthy sexuality among women living with HIV.

    Science.gov (United States)

    Narasimhan, Manjulaa; Payne, Caitlin; Caldas, Stephanie; Beard, John R; Kennedy, Caitlin E

    2016-11-01

    Populations around the world are rapidly ageing and effective treatment for HIV means women living with HIV (WLHIV) can live longer, healthier lives. HIV testing and screening programmes and safer sex initiatives often exclude older sexually active WLHIV. Systematically reviewing the literature to inform World Health Organization guidelines on the sexual and reproductive health and rights (SRHR) of WLHIV, identified four studies examining healthy sexuality among older WLHIV. In Uganda, WLHIV reported lower rates of sexual activity and rated sex as less important than men. In the United States, HIV stigma, disclosure, and body image concerns, among other issues, were described as inhibiting relationship formation and safer sexual practices. Sexual activity declined similarly over time for all women, including for WLHIV who reported more protected sex, while a significant minority of WLHIV reported unprotected sex. A single intervention, the "ROADMAP" intervention, demonstrated significant increases in HIV knowledge and decreases in HIV stigma and high risk sexual behaviour. WLHIV face ageist discrimination and other barriers to remaining sexually active and maintaining healthy sexual relationships, including challenges procuring condoms and seeking advice on safe sex practices, reduced ability to negotiate safer sex, physical and social changes associated with menopause, and sexual health challenges due to disability and comorbidities. Normative guidance does not adequately address the SRHR of older WLHIV, and while this systematic review highlights the paucity of data, it also calls for additional research and attention to this important area. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Using a clinic based creativity initiative to reduce HIV related stigma at the Infectious Diseases Institute, Mulago National Referral Hospital, Uganda.

    Science.gov (United States)

    Neema, S; Atuyambe, L M; Otolok-Tanga, E; Twijukye, C; Kambugu, A; Thayer, L; McAdam, K

    2012-06-01

    Stigma has been associated with chronic health conditions such as HIV/AIDS, leprosy, tuberculosis, Mental illness and Epilepsy. Different forms of stigma have been identified: enacted stigma, perceived stigma, and self stigma. Stigma is increasingly regarded as a key driver of the HIV/AIDS epidemic and has a major impact on public health interventions. The initiative was to provide activities in the clinic while patients waited to be seen by healthcare professionals. It was envisaged this would contribute to reduction of clinic based stigma felt by clients. This was a repeated cross-sectional survey (October-November 2005 and March-April 2007) that was conducted at the Infectious Diseases Institute clinic (IDC) at Mulago, the national referral hospital in Uganda. We utilized quantitative (survey) and qualitative (key informants, focus group discussions) methods to collect the data. Data were collected on stigma before the creativity initiative intervention was implemented, and a second phase survey was conducted to assess effectiveness of the interventions. Clients who attended the IDC before the creativity intervention were about twice as likely to fear catching an infection as those who came after the intervention. The proportion that had fears to be seen by a friend or relative at the clinic decreased. Thus during the implementation of the Creativity intervention, HIV related stigma was reduced in this clinic setting. The creativity intervention helped to build self esteem and improved communication among those attending the clinic; there was observed ambiance at the clinic and clients became empowered, with creative, communication and networking skills. Improved knowledge and communication are key in addressing self stigma among HIV positive individuals.

  11. Self-compassion and Risk Behavior among People Living with HIV/AIDS

    OpenAIRE

    Dawson Rose, Carol; Webel, Allison; Sullivan, Kathleen M.; Cuca, Yvette P.; Wantland, Dean; Johnson, Mallory O.; Brion, John; Portillo, Carmen J.; Corless, Inge B.; Voss, Joachim; Chen, Wei-Ti; Phillips, J. Craig; Tyer-Viola, Lynda; Rivero-Méndez, Marta; Nicholas, Patrice K.

    2014-01-01

    Sexual risk behavior and illicit drug use among people living with HIV/AIDS (PLWHA) contribute to poor health and onward transmission of HIV. The aim of this collaborative multi-site nursing research study was to explore the association between self-compassion and risk behaviors in PLWHA. Nurse researchers in Canada, China, Namibia, Puerto Rico, Thailand and the U.S. enrolled 2,182 PLWHA using convenience sampling. Over half of study participants were sexually active in the past three months....

  12. Factors associated with undernourishment among people 20 years old or over with HIV/AIDS, attending public health services in the São Paulo municipality, Brazil.

    Science.gov (United States)

    Bassichetto, Katia Cristina; Bergamaschi, Denise Pimentel; Garcia, Vania Regina Salles; Veras, Maria Amélia de Sousa Mascena

    2014-12-01

    The study evaluated the nutritional status of 629 people living with HIV/AIDS attended at 12 specialized services of São Paulo's Municipal Health Department, Brazil. Data were obtained from medical records and through interviews during nutritional consultation. We used the classification criteria established by World Health Organization to assess malnourished individuals, a BMI health care of individuals at nutritional risk.

  13. Caregiving to persons living with HIV/AIDS: experiences of Vietnamese family members.

    Science.gov (United States)

    Lundberg, Pranee C; Doan, Thoa Thi Kim; Dinh, Thu Thi Xuan; Oach, Nhung Kim; Le, Phong Hoang

    2016-03-01

    To examine the experiences of caregiving among Vietnamese family members of persons living with HIV/AIDS. As the number of persons living with HIV/AIDS increases, the need of family caregivers who can take responsibility for the home care of these persons increases. Vietnam has one of the fastest growing HIV epidemics in Asia. A descriptive cross-sectional study with quantitative and qualitative methods was used. A purposive sample of 104 family caregivers, both male and female, participated voluntarily by answering a questionnaire of caregiver burden, and 20 of them participated in in-depth interview. Female caregivers were mainly mothers and wives while male caregivers were mainly husbands, fathers and siblings. The largest group of family caregivers reported moderate to severe burden. There was no difference between genders in total caregiver burden, but there were several differences between older and younger caregivers in some items of caregiver burden. Five categories of experiences emerged: Different types of caregiving to persons living with HIV/AIDS, cultural and religious issues associated with caregiving, keeping secret to avoid stigma and discrimination, lack of knowledge about disease and provision of care, and fear, anxiety and frustration. Stigma and discrimination should be decreased by providing knowledge to the general public about HIV/AIDS, in particular about ways of transmission and protection. Special knowledge should be given to family caregivers to enable them to give care to persons living with HIV/AIDS at home. This could be done through culturally appropriate training/intervention programmes in which coping methods should be included. Support group interventions should also be carried through. The results obtained can be used as baseline information. Health care providers should consider gender, age and culture of family members of persons living with HIV/AIDS. Knowledge about HIV/AIDS, provision of care at home and in hospital, and

  14. 'I was thinking too much': experiences of HIV-positive adults with common mental disorders and poor adherence to antiretroviral therapy in Zimbabwe.

    Science.gov (United States)

    Kidia, Khameer; Machando, Debra; Bere, Tarisai; Macpherson, Kirsty; Nyamayaro, Primrose; Potter, Lucy; Makadzange, Tariro; Munjoma, Ronald; Marufu, Marshall; Araya, Ricardo; Safren, Steven; O'Cleirigh, Conall; Chibanda, Dixon; Abas, Melanie

    2015-07-01

    To document the lived experiences of people with both poor mental health and suboptimal adherence to antiretroviral therapy in high HIV prevalence settings. In-depth qualitative interviews were conducted with 47 (female = 31) HIV-positive adults who scored above the cut-point on a locally validated scale for common mental disorders (CMDs). Purposive sampling was used to recruit participants with evidence of poor adherence. Six additional key informant interviews (female = 6) were conducted with healthcare workers. Data were collected and analysed inductively by an interdisciplinary coding team. The major challenges faced by participants were stressors (poverty, stigma, marital problems) and symptoms of CMDs ('thinking too much', changes to appetite and sleep, 'burdened heart' and low energy levels). Thinking too much, which appears closely related to rumination, was the symptom with the greatest negative impact on adherence to antiretroviral therapy among HIV-positive adults with CMDs. In turn, thinking too much was commonly triggered by the stressors faced by people living with HIV/AIDS, especially poverty. Finally, participants desired private counselling, access to income-generating activities and family engagement in mental health care. Better understanding of the local expression of mental disorders and of underlying stressors can inform the development of culturally sensitive interventions to reduce CMDs and poor adherence to antiretroviral therapy. © 2015 John Wiley & Sons Ltd.

  15. Clinic Attendance for Antiretroviral Pills Pick-Up among HIV-Positive People in Nepal: Roles of Perceived Family Support and Associated Factors.

    Science.gov (United States)

    Ayer, Rakesh; Kikuchi, Kimiyo; Ghimire, Mamata; Shibanuma, Akira; Pant, Madhab Raj; Poudel, Krishna C; Jimba, Masamine

    2016-01-01

    HIV-positive people's clinic attendance for medication pick-up is critical for successful HIV treatment. However, limited evidence exists on it especially in low-income settings such as Nepal. Moreover, the role of family support in clinic attendance remains under-explored. Therefore, this study was conducted to examine the association between perceived family support and regular clinic attendance and to assess factors associated with regular clinic attendance for antiretroviral pills pick-up among HIV-positive individuals in Nepal. A cross-sectional study was conducted among 423 HIV-positive people in three districts of Nepal. Clinic attendance was assessed retrospectively for the period of 12 months. To assess the factors associated, an interview survey was conducted using a semi-structured questionnaire from July to August, 2015. Multiple logistic regression models were used to assess the factors associated with regular clinic attendance. Of 423 HIV-positive people, only 32.6% attended the clinics regularly. They were more likely to attend them regularly when they received high family support (AOR = 3.98, 95% CI = 2.29, 6.92), participated in support programs (AOR = 1.68, 95% CI = 1.00, 2.82), and had knowledge on the benefits of antiretroviral therapy (AOR = 2.62, 95% CI = 1.15, 5.99). In contrast, they were less likely to attend them regularly when they commuted more than 60 minutes to the clinics (AOR = 0.53, 95% CI = 0.30, 0.93), when they self-rated their health status as being very good (AOR = 0.13, 95% CI = 0.04, 0.44), good (AOR = 0.14, 95% CI = 0.04, 0.46), and fair (AOR = 0.21, 95% CI = 0.06, 0.70). HIV-positive individuals are more likely to attend the clinics regularly when they receive high family support, know the benefits of antiretroviral therapy, and participate in support programs. To improve clinic attendance, family support should be incorporated with HIV care programs in resource limited settings. Service providers should also consider

  16. Predictors of quality of life among Chinese people with schizophrenia.

    Science.gov (United States)

    Wang, Xiao Qin; Petrini, Marcia A; Morisky, Donald E

    2017-06-01

    This study was designed to investigate the association of quality of life, perceived stigma, and medication adherence among Chinese patients with schizophrenia, and to ascertain the predictors of quality of life. A cross-sectional correlation study was conducted with 146 participants. All participants completed self-report scales: the Schizophrenia Quality of Life Scale, Link's Stigma Scale, and the Morisky Medication Adherence Scale. Pearson parametric correlations and stepwise multiple regressions were performed. The total quality of life score and psychosocial subscale was significantly positively correlated with perceived stigma, coping orientation of withdrawal, and feelings of stigma, and negatively correlated with age and medication adherence. The means of all subscale scores except perceived devaluation-discrimination and different/guilty feelings were significantly higher than the midpoint of 2.5. The best predictors of quality of life and psychosocial domains were stigma-related feelings: feeling misunderstood, feeling different/shame, and age. Our findings suggest that an individual's negative emotional response may strengthen internalized stigma and decrease quality of life. As the best predictor, age indicated that adaptation to mental illness may relieve perceived stigma and achieve favorable quality of life. © 2016 John Wiley & Sons Australia, Ltd.

  17. A Qualitative Study of Providers’ Perception of Adherence of Women Living with HIV/AIDS in Puerto Rico

    OpenAIRE

    Rivero-Méndez, Marta; Dawson-Rose, Carol S.; Solís-Báez, Solymar S.

    2010-01-01

    This study examines healthcare providers’ perceptions regarding experiences and factors that contribute to adherent and non-adherent behaviors to HIV treatment among women living with HIV infection in Puerto Rico and describes strategies implemented to improve adherence. Providers’ accounts revealed that women with HIV infection are living “beyond their strengths” attempting to reconcile the burden of the illness and keep adherent. Factors putting women beyond their strengths and influencing ...

  18. Stigma reduction in adolescents and young adults newly diagnosed with HIV: findings from the Project ACCEPT intervention.

    Science.gov (United States)

    Harper, Gary W; Lemos, Diana; Hosek, Sybil G

    2014-10-01

    This article describes the influence of a group-based behavioral intervention for adolescents and young adults newly diagnosed with HIV (Project ACCEPT) on four dimensions of HIV-related stigma-personalized stigma, disclosure concerns, negative self-image, and concern with public attitudes about people with HIV-as measured by the Berger HIV Stigma Scale. Stigma was addressed in a holistic manner during the intervention by providing HIV/AIDS-related information, facilitating the acquisition of coping skills, and providing contact with other youth living with HIV in order to improve social support. Fifty youth (28 male, 22 female; mean age=19.24 years) newly diagnosed with HIV from four geographically diverse clinics participated in a one-group pretest-posttest design study whereby they received the intervention over a 12-week period, and completed assessments at baseline, post-intervention, and 3-month follow-up. Results from the combined sample (males and females) revealed overall reductions in stigma in three dimensions: personalized stigma, disclosure concerns, and negative self-image, although only the combined-sample effects for negative self-image were maintained at 3-month follow-up. Gender-specific analyses revealed that the intervention reduced stigma for males across all four dimensions of stigma, with all effects being maintained to some degree at the 3-month follow-up. Only personalized stigma demonstrated a decrease for females, although this effect was not maintained at the 3-month follow-up; while the other three types of stigma increased at post-intervention and 3-month follow-up. Findings are discussed in terms of gender specific outcomes and the need for a different type of intervention to reduce stigma for young women.

  19. Resources to cope with stigma related to HIV status, gender identity, and sexual orientation in gay men and transgender women.

    Science.gov (United States)

    Arístegui, Inés; Radusky, Pablo D; Zalazar, Virginia; Lucas, Mar; Sued, Omar

    2018-02-01

    The stigma related to HIV status, gender identity, and sexual orientation has negative implications for the quality of life of individuals. A qualitative study was conducted to explore the resources that these stigmatized groups recognize as tools to cope with stigma and maintain their psychological well-being. Four focus groups were conducted with gay men and transgender women divided by HIV status. A thematic analysis revealed that individual, interpersonal, and institutional resources are commonly recognized as coping resources. This article discusses the importance of enhancing self-acceptance, social support, and a legal framework that legitimizes these groups as right holders.

  20. Incident and prevalence of HIV/AIDS among patients attending a ...

    African Journals Online (AJOL)

    Young people, ages 15–24, account for approximately 40% of new HIV infections (among those 15 and over). Globally, young women are twice as likely to become infected with HIV than their male counterparts. As at 2012, UNAIDS revealed that the HIV/AIDS prevalence rate among adults of ages 15-49 in Nigeria was ...

  1. Experiences of HIV-related stigma among HIV-positive older ...

    African Journals Online (AJOL)

    Monica O. Kuteesa

    2014-07-23

    Jul 23, 2014 ... This is an open-access article distributed under the terms of the Creative Commons Attribution License ..... high because HIV testing services are available at both sites. ..... expressed denial as a means of coping with stigma.

  2. Predictors of fertility desire among people living with HIV attending anti-retroviral clinic in a tertiary health facility in Sokoto, Northern Nigeria

    Directory of Open Access Journals (Sweden)

    A U Kaoje

    2015-01-01

    Full Text Available Introduction: The pressure on couples and particularly women to have children is strong in developing countries where a childless woman is considered a social pariah. This study aimed to determine the predictors of fertility desire among people living with HIV. Materials and Methods : This is a descriptive cross-sectional study conducted among 400 HIV-positive clients receiving follow-up care at anti-retroviral (ART clinic in a tertiary health facility in Sokoto. A list of clients that came to the clinic was compiled and served as sampling frame. A two stage sampling method was used to select study respondents from the sampling frame. Interviewer- administered closed-ended questionnaire was used to collect the required data from the respondents. Ethical approval was granted for the conduct of the study and informed consent was obtained from the respondents. Descriptive, bivariate and multivariate analyses were carried out. Results : Majority (56.2% of the respondents were females. The overall mean age was 34.5 ± 0.4 years (male 38.4 ± 0.5 years, and (females, 31.4 ± 0.4 years. A large proportion of the respondents (67.7% reported desire to have children in future. Using logistic regression analysis, younger age (adjusted odd ratio [aOR] = 2.0, P = 0.023, marital status (aOR = 1.9, P < 0.001 and number of living children (aOR = 0.7, P < 0.001 were the key factors influencing respondents desire for children. Conclusion : Many HIV-positive clients in the clinic reported desire to have children. It is recommended that full reproductive health services be provided in the clinic to help them achieve their reproductive goal without risk to their partners and new born.

  3. HIV-Related Stigma Among Spanish-speaking Latinos in an Emerging Immigrant Receiving City.

    Science.gov (United States)

    Dolwick Grieb, Suzanne M; Shah, Harita; Flores-Miller, Alejandra; Zelaya, Carla; Page, Kathleen R

    2017-08-01

    HIV-related stigma has been associated with a reluctance to test for HIV among Latinos. This study assessed community HIV-related stigma within an emerging Latino immigrant receiving city. We conducted a brief survey among a convenience sample of 312 Spanish-speaking Latinos in Baltimore, Maryland. HIV-related stigma was assessed through six items. Associations between stigma items, socio-demographic characteristics, and HIV testing history were considered. Gender, education, and religiosity were significantly associated with stigmatizing HIV-related beliefs. For example, men were 3.4 times more likely to hold more than three stigmatizing beliefs than women, and were also twice as likely as women to report feeling hesitant to test for HIV for fear of people's reaction if the test is positive. These findings can help inform future stigma interventions in this community. In particular, we were able to distinguish between drivers of stigma such as fear and moralistic attitudes, highlighting specific actionable items.

  4. Food insecurity and coping strategies among people living with HIV ...

    African Journals Online (AJOL)

    2011-10-04

    Oct 4, 2011 ... 2Clinton Health Access Initiative, P.O. Box 7727, Dar es Salaam, Tanzania ... Food insecurity raises risks of HIV infection as people adopt behaviours to ..... Relatives. Friends. Neighbours. CBO/NGO/FBO. Others. 238. 210.

  5. Social position, gender role, and treatment adherence among Colombian women living with HIV/AIDS: social determinants of health approach.

    Science.gov (United States)

    Arrivillaga, Marcela; Ross, Michael; Useche, Bernardo; Alzate, Martha Lucia; Correa, Diego

    2009-12-01

    To assess and analyze the associations between adherence to treatment and social position in women living with HIV/AIDS. A cross-sectional, descriptive, correlational study among 269 Colombian women was conducted. Participants completed three questionnaires: a socio-demographic and clinical characteristics survey, a treatment adherence scale, and a social position survey. Women of low social position had a significantly higher probability of low treatment adherence (OR = 5.651, P effect on adherence. A general model considering the variables 'type of national health care plan' ('contributive,' 'subsidized,' or, in the case of vinculadas or the uninsured, 'none'); 'having HIV-positive children'; and 'level of viral load' was statistically reliable in predicting study participants' treatment adherence. Membership in the subsidized plan or being uninsured had a greater effect on the probability of low adherence than membership in the contributive plan (OR = 3.478, P 400 copies/ml were more likely to have low adherence than women without those characteristics (OR = 2.395, P = 0.0274 and OR = 2.178, P = 0.0050, respectively). Improving women's adherence to HIV/AIDS treatment in Colombia would require eliminating barriers to national health care system and comprehensive health care services and implementing programs that take into account women's role as maternal caregivers The findings underscore the need to integrate variables related to gender inequality and social position in treatment adherence analysis, as advocated in the social determinants of health approach.

  6. Psychological factors, sociodemographic characteristics, and coping mechanisms associated with the self-stigma of problem gambling.

    Science.gov (United States)

    Hing, Nerilee; Russell, Alex M T

    2017-09-01

    Background and aims Few studies have examined the stigma of problem gambling and little is known about those who internalize this prejudice as damaging self-stigma. This paper aimed to identify psychological factors, sociodemographic characteristics, and coping mechanisms associated with the self-stigma of problem gambling. Methods An online survey was conducted on 177 Australian adults with a current gambling problem to measure self-stigma, self-esteem, social anxiety, self-consciousness, psychological distress, symptom severity, most problematic gambling form, stigma coping mechanisms, and sociodemographic characteristics. Results All variables significantly correlated with self-stigma were considered for inclusion in a regression model. A multivariate linear regression indicated that higher levels of self-stigma were associated with: being female, being older, lower self-esteem, higher problem gambling severity score, and greater use of secrecy (standardized coefficients: 0.16, 0.14, -0.33, 0.23, and 0.15, respectively). Strongest predictors in the model were self-esteem, followed by symptom severity score. Together, predictors in the model accounted for 38.9% of the variance in self-stigma. Discussion and conclusions These results suggest that the self-stigma of problem gambling may be driven by similar mechanisms as the self-stigma of other mental health disorders, and impact similarly on self-esteem and coping. Thus, self-stigma reduction initiatives used for other mental health conditions may be effective for problem gambling. In contrast, however, the self-stigma of problem gambling increased with female gender and older age, which are associated with gaming machine problems. This group should, therefore, be a target population for efforts to reduce or better cope with the self-stigma of problem gambling.

  7. Road Traffic Injury in Lagos, Nigeria: Assessing Prehospital Care.

    Science.gov (United States)

    Ibrahim, Nasiru A; Ajani, Abdul Wahab O; Mustafa, Ibrahim A; Balogun, Rufai A; Oludara, Mobolaji A; Idowu, Olufemi E; Solagberu, Babatunde A

    2017-08-01

    Introduction Injuries are the third most important cause of overall deaths globally with one-quarter resulting from road traffic crashes. Majority of these deaths occur before arrival in the hospital and can be reduced with prompt and efficient prehospital care. The aim of this study was to highlight the burden of road traffic injury (RTI) in Lagos, Nigeria and assess the effectiveness of prehospital care, especially the role of Lagos State Ambulance Service (LASAMBUS) in providing initial care and transportation of the injured to the hospital. A three-year, retrospective review of road traffic injured patients seen at the Surgical Emergency Room (SER) of the Lagos State University Teaching Hospital (LASUTH), Ikeja, Nigeria, from January 1, 2012 to December 31, 2014 was conducted. Parameters extracted from the Institution Trauma Registry included bio-data, date and time of injury, date and time of arrival in SER, host status, type of vehicle involved, and region(s) injured. Information on how patients came to the hospital and outcome in SER also were recorded. Results were analyzed using Statistical Package for Social Sciences (SPSS; IBM Corporation; Armonk, New York USA) version 16. A total of 23,537 patients were seen during the study period. Among them, 16,024 (68.1%) had trauma. Road traffic crashes were responsible in 5,629 (35.0%) of trauma cases. Passengers constituted 42.0% of the injured, followed by pedestrians (34.0%). Four wheelers were the most frequent vehicle type involved (54.0%), followed by motor cycles (30.0%). Regions mainly affected were head and neck (40.0%) and lower limb (29.0%). Less than one-quarter (24.0%) presented to the emergency room within an hour, while one-third arrived between one and six hours following injury. Relatives brought 55.4%, followed by bystanders (21.4%). Only 2.3% had formal prehospital care and were brought to the hospital by LASAMBUS. They also had significantly shorter arrival time. One hundred and nine patients

  8. HIV-related stigma and symptoms of post-traumatic stress disorder and depression in HIV-infected individuals: does social support play a mediating or moderating role?

    Science.gov (United States)

    Breet, Elsie; Kagee, Ashraf; Seedat, Soraya

    2014-01-01

    HIV stigma plays a major role in the etiology of psychological distress among persons living with HIV, but may be ameliorated by social support. This cross-sectional study examined whether social support mediates or moderates the relationship between HIV stigma and psychological symptoms. We recruited a convenience sample of 210 individuals living with HIV in three peri-urban communities in the Western Cape, South Africa. People living with HIV and AIDS (PLWHA) completed self-report questionnaires that assessed HIV-related stigma, social support, post-traumatic stress disorder (PTSD) and depression. Product-term regression analyses showed that social support played a mediating role in the relationship between HIV-related stigma and symptoms of PTSD (not depression). Social support did not, however, moderate the relationship between HIV-related stigma and PTSD or depression. The results indicate that perceived HIV-related stigma may decrease PLWHA's perceived level of social support, which in turn may increase PTSD symptoms. Moreover, these findings suggest that despite the protective role of social support, there are other factors that affect the relationship between HIV-related stigma and mental health that hinder the buffering role of social support in this relationship. These findings may have implications for designing and implementing interventions that increase perceived social support and decrease perceived HIV-related stigma, which in turn may decrease symptoms of PTSD among PLWHA.

  9. Self-reported adherence and associated factors to isoniazid preventive therapy for latent tuberculosis among people living with HIV/AIDS at health centers in Gondar town, North West Ethiopia

    Directory of Open Access Journals (Sweden)

    Ayele AA

    2017-04-01

    Full Text Available Asnakew Achaw Ayele,1 Seyfe Asrade Atnafie,2 Demis Driba Balcha,1 Asegedech Tsegaw Weredekal,2 Birhanu Alemayehu Woldegiorgis,1 Mulgeta Melaku Wotte,1 Begashaw Melaku Gebresillasie1 1Department of Clinical Pharmacy, 2Department of Pharmacology, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia Purpose: This study aimed to assess self-reported adherence and associated factors to isoniazid preventive therapy (IPT for latent tuberculosis among people living with HIV/AIDS (PLWHA at health centers in Gondar town, North West Ethiopia.Patients and methods: An institution-based prospective cross-sectional study was conducted from March 10 to June 11, 2016. A total of 154 eligible participants were included in the study, using the simple random sampling method, from the available four health centers and one teaching referral hospital that provided antiretroviral therapy (ART for HIV/AIDS patients. Adherence was measured by self-report of isoniazid (INH tablets taken for the preceding 7 days. Participants were recruited through in-depth interviews. The collected data were entered and analyzed using the statistical packages for social sciences (SPSS version 20.Results: The adherence level to IPT was 90.3% for the last 7 days of the study. ART was initiated for 84.4%, and all of them were on a first-line regimen. Isoniazid-related side effects were reported by 48 (31.2% participants, of which the most commonly identified were abdominal pain, vomiting, skin rash, jaundice, and numbness. Only 3 (2% participants discontinued from the study. In the bivariate logistic regression analysis, respondents who had received an explanation about IPT were 83% times more likely to be adherent compared to those who had not received it (95% CI, AOR: 0.266 [0.23–3.127]. Respondents who had taken IPT for ≥5 months were more likely to be adherent than those who had taken it for 1–2 months [95% CI, COR: 1.484]. On the

  10. Quality of life of elderly people living with HIV/AIDS in outpatient follow-up

    Directory of Open Access Journals (Sweden)

    Juliano de Souza Caliari

    Full Text Available ABSTRACT Objective: To analyze factors related to the quality of life of elderly people living with HIV/AIDS. Method: A cross-sectional study was carried out with people aged 50 years or more in a specialized outpatient clinic. The data collection was by means of an interview. For the analysis of data and characterization of the sample, descriptive statistics and comparison tests were used. The project met the ethical requirements. Results: Participants were 81 users aged 50 to 75 years, mean age was 57.8 (± 6.1 years, 71.6% of whom were men. There was a statistically significant relationship with the quality of life, the following variables: gender, children, occupation, religion, diagnosis time, HIV exposure, adverse effects, treatment interruption, viral load counts, hospitalization, dependence for daily activities and use of drugs. Conclusion: The results suggest that the quality of life deficit is related not only to physical changes, but to the anguish and stigma related to HIV/AIDS.

  11. Assessing medication adherence and healthcare utilization and cost patterns among hospital-discharged patients with schizoaffective disorder.

    Science.gov (United States)

    Karve, Sudeep; Markowitz, Michael; Fu, Dong-Jing; Lindenmayer, Jean-Pierre; Wang, Chi-Chuan; Candrilli, Sean D; Alphs, Larry

    2014-06-01

    Hospital-discharged patients with schizoaffective disorder have a high risk of re-hospitalization. However, limited data exist evaluating critical post-discharge periods during which the risk of re-hospitalization is significant. Among hospital-discharged patients with schizoaffective disorder, we assessed pharmacotherapy adherence and healthcare utilization and costs during sequential 60-day clinical periods before schizoaffective disorder-related hospitalization and post-hospital discharge. From the MarketScan(®) Medicaid database (2004-2008), we identified patients (≥18 years) with a schizoaffective disorder-related inpatient admission. Study measures including medication adherence and healthcare utilization and costs were assessed during sequential preadmission and post-discharge periods. We conducted univariate and multivariable regression analyses to compare schizoaffective disorder-related and all-cause healthcare utilization and costs (in 2010 US dollars) between each adjacent 60-day post-discharge periods. No adjustment was made for multiplicity. We identified 1,193 hospital-discharged patients with a mean age of 41 years. The mean medication adherence rate was 46% during the 60-day period prior to index inpatient admission, which improved to 80% during the 60-day post-discharge period. Following hospital discharge, schizoaffective disorder-related healthcare costs were significantly greater during the initial 60-day period compared with the 61- to 120-day post-discharge period (mean US$2,370 vs US$1,765; p schizoaffective disorder-related costs declined during the 61- to 120-day post-discharge period and remained stable for the remaining post-discharge periods (days 121-365). We observed considerably lower (46%) adherence during 60 days prior to the inpatient admission; in comparison, adherence for the overall 6-month period was 8% (54%) higher. Our study findings suggest that both short-term (e.g., 60 days) and long-term (e.g., 6-12 months) medication

  12. Deportation history among HIV-positive Latinos in two US-Mexico border communities.

    Science.gov (United States)

    Muñoz, Fátima A; Servin, Argentina E; Garfein, Richard S; Ojeda, Victoria D; Rangel, Gudelia; Zúñiga, María Luisa

    2015-02-01

    Health-related vulnerabilities associated with deportation are understudied. We conducted a cross-sectional study to identify factors associated with history of deportation from the US to Mexico among HIV-positive Latinos. From 2009 to 2010, we recruited a convenience sample from HIV clinics in San Diego, US and Tijuana, Mexico. Of 283 participants, 25% reported a prior deportation. Factors independently associated with increased odds of deportation history were being male [adjusted odds ratio (AOR) 2.77; 95% CI 1.18-6.48], having ≤high-school education (AOR 3.87; 95% CI 1.84-8.14), ever using cocaine (AOR 2.46; 95% CI 1.33-4.57), and reporting personalized HIV-stigma: "some have told me HIV is what I deserve for how I lived" (AOR 2.23; 95% CI 1.14-4.37). Lower self-reported antiretroviral medication adherence (AOR 0.35; 95% CI 0.12-0.96) and perceiving HIV-stigma: "most people believe a person who has HIV is dirty" (AOR 0.49; 95% CI 0.25-0.94) were associated with decreased odds of deportation history. Deportation is associated with specific socioeconomic indicators that are known to impact the health of individuals living with HIV.

  13. Factors that can influence feelings towards and interactions with people living with HIV/AIDS in rural Central Kenya.

    Science.gov (United States)

    Kingori, Caroline; Haile, Zelalem T; Ngatia, Peter; Nderitu, Ruth

    2017-08-01

    Background In Kenya, HIV incidence and prevalence have declined. HIV rates are lower in rural areas than in urban areas. However, HIV infection is reported higher in men in rural areas (4.5%) compared to those in urban areas (3.7%). Objectives This study examined HIV knowledge, feelings, and interactions towards HIV-infected from 302 participants in rural Central Kenya. Methods Chi square tests and multivariable logistic regression analyzed variables of interest. Results Most participants exhibited positive feelings in their interaction with people living with HIV and AIDS (PLWHA). Association between HIV knowledge and socio-demographic characteristics revealed that the proportion of participants with a correct response differed by gender, age, level of education, and marital status ( p risk populations from the general population is needed to reduce stigma.

  14. Changing forms of HIV-related stigma along the HIV care and treatment continuum in sub-Saharan Africa: a temporal analysis.

    Science.gov (United States)

    Bonnington, O; Wamoyi, J; Ddaaki, W; Bukenya, D; Ondenge, K; Skovdal, M; Renju, J; Moshabela, M; Wringe, A

    2017-07-01

    Stigma remains pervasive for people living with HIV (PLHIV) in sub-Saharan Africa, undermining care engagement. Using everyday , biographical and epochal temporalities, we explored the manifestation of stigma at different stages of the HIV care continuum in seven health and demographic surveillance sites in Eastern and Southern Africa. Between 2015 and 2016, we conducted qualitative in-depth interviews with 264 PLHIV, 54 health providers and 48 family members of people who had died from HIV. Topic guides explored experiences of HIV testing, care and treatment services. Data were analysed thematically, aided by NVivo 10. In everyday time across these communities, stigma was evident in the presence of gossiping and the relative absence of supportive interpersonal discourse, which fuelled judicious disclosure. This was especially disruptive at testing, counselling and early antiretroviral therapy adherence stages of care. Biographical time framed everyday stigma events, highlighting the dilemma of disclosure in relation to sexual relationship norms, as well as the interfacing of age and healthcare continuum points. Epochal patriarchal relations gave a structural context to everyday and biographical stigma dynamics. Historical shifts to social acceptance of PLHIV within these communities, while positive, were complicated by stigma in everyday life and in respect of biographical goals like having a family. Moreover, low community-level resistance to HIV-related stigma jeopardised stigma reduction strategies. Despite improvements to HIV care services, stigma remains pervasive across the HIV care continuum in these sites. Context-specific interventions are needed to address stigma and discrimination of PLHIV within the community and in health services, and greater reflection is required to ensure policies aiming to expand HIV treatment do not exacerbate stigma and result in negative HIV outcomes. Published by the BMJ Publishing Group Limited. For permission to use (where

  15. HIV Medication Adherence

    Science.gov (United States)

    ... AIDS Drugs Clinical Trials Apps skip to content HIV Treatment Home Understanding HIV/AIDS Fact Sheets HIV ... 4 p.m. ET) Send us an email HIV Medication Adherence Last Reviewed: January 17, 2018 Key ...

  16. The value of reducing HIV stigma.

    Science.gov (United States)

    Brent, Robert J

    2016-02-01

    HIV-stigma is a major reason why HIV continues to be a global epidemic. Interventions targeting HIV-stigma are therefore necessary. To find an intervention that is worthwhile, a Cost-Benefit Analysis is needed which compares costs and benefits. There are many documented costs of HIV-stigma. What is missing is a valuation of the benefits of reducing HIV-stigma. The purpose of this paper is to present a general method that can be used to value the benefits of stigma reduction programs. The method involves estimating the marginal rate of substitution (MRS) between stigma and income in the utility function of older people with HIV. To illustrate how our framework can be used, we applied it to a sample of just over 900 people coming from the 2005-06 ROAH study (Research on Older Adults with HIV) in New York City. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. Access to oral health care for HIV patients in Nigeria: Role of ...

    African Journals Online (AJOL)

    Objective: To assess the knowledge of attending physicians on oral manifestations of HIV infection and their attitude and practice towards dental referral for HIV patients. Method: A self-administered questionnaire survey of attending physicians in outpatient clinics of two teaching hospitals in Lagos and the National hospital, ...

  18. The dynamic relationship between social support and HIV-related stigma in rural Uganda.

    Science.gov (United States)

    Takada, Sae; Weiser, Sheri D; Kumbakumba, Elias; Muzoora, Conrad; Martin, Jeffrey N; Hunt, Peter W; Haberer, Jessica E; Kawuma, Annet; Bangsberg, David R; Tsai, Alexander C

    2014-08-01

    Cross-sectional studies show that human immunodeficiency virus (HIV) stigma is negatively correlated with social support. The purpose of this study is to examine the bidirectional relationship between social support and HIV stigma. We collected quarterly data from a cohort of 422 people living with HIV in Uganda, followed for a median of 2.1 years. We used multilevel regression to model the contemporaneous and 3-month-lagged associations between social support and both enacted and internalized stigma. Lagged enacted stigma was negatively correlated with emotional and instrumental social support, and lagged instrumental social support was negatively correlated with enacted stigma. Internalized stigma and emotional social support had reciprocal lagged associations. Interventions to reduce enacted stigma may strengthen social support for people living with HIV. Improved social support may in turn have a protective influence against future enacted and internalized stigma.

  19. A Qualitative Study of Providers' Perception of Adherence of Women Living with HIV/AIDS in Puerto Rico

    Science.gov (United States)

    Rivero-Mendez, Marta; Dawson-Rose, Carol S.; Solis-Baez, Solymar S.

    2010-01-01

    This study examines healthcare providers' perceptions regarding experiences and factors that contribute to adherent and non-adherent behaviors to HIV treatment among women living with HIV infection in Puerto Rico and describes strategies implemented to improve adherence. Providers' accounts revealed that women with HIV infection are living…

  20. Opening communication channels with people living with HIV using mobile phone text messaging: insights from the CAMPS trial.

    Science.gov (United States)

    Mbuagbaw, Lawrence; Thabane, Lehana; Ongolo-Zogo, Pierre

    2013-04-04

    Using two-way mobile phone text messages to improve adherence to antiretroviral medication enhances communication between patients and health workers. We describe the implications of participants' responses to text messages in the Cameroon Mobile Phone SMS (CAMPS) trial. This is a cross-sectional analysis of data from the intervention arm of the CAMPS trial. CAMPS was a randomized controlled trial of motivational text messaging versus usual care to improve adherence to antiretroviral medication among people living with HIV in Yaounde, Cameroon (n = 200) over a 6 month period. Participants in the intervention arm (n = 101) were given a contact phone number, but were not required to respond to their reminder messages. If they did, their responses were noted and reported as counts and percentages. We received 99 phone calls and 55 text messages (154 responses) from 48 participants during the study period. The median number of responses was 1 (first quartile [Q1]: 1; third quartile [Q3]: 3). Half (n = 79, 51.1%) of them were expressions of gratitude. The rest included requests for logistical (n = 21, 13.6%), medical (n = 20, 12.9%) and financial (n = 11, 7.1%) support. Initiating two-way mobile communication opens more channels for people living with HIV to express unmet needs. Researchers, policy makers and clinicians should be ready to respond to the needs expressed by patients who respond to text messages. Pan-African Clinical Trials Registry: PACTR201011000261458;

  1. Profile of medical waste management in two healthcare facilities in Lagos, Nigeria: a case study.

    Science.gov (United States)

    Idowu, Ibijoke; Alo, Babajide; Atherton, William; Al Khaddar, Rafid

    2013-05-01

    Proper management and safe disposal of medical waste (MW) is vital in the reduction of infection or illness through contact with discarded material and in the prevention of environmental contamination in hospital facilities. The management practices for MW in selected healthcare facilities in Lagos, Nigeria were assessed. The cross-sectional study involved the use of questionnaires, in-depth interviews, focused group discussions and participant observation strategies. It also involved the collection, segregation, identification and weighing of waste types from wards and units in the representative facilities in Lagos, Nigeria, for qualitative and quantitative analysis of the MW streams. The findings indicated that the selected Nigerian healthcare facilities were lacking in the adoption of sound MW management (MWM) practices. The average MW ranged from 0.01 kg/bed/day to 3.98 kg/bed/day. Moreover, about 30% of the domestic waste from the healthcare facilities consisted of MW due to inappropriate co-disposal practices. Multiple linear regression was applied to predict the volume of waste generated giving a correlation coefficient (R(2)) value of 0.99 confirming a good fit of the data. This study revealed that the current MWM practices and strategies in Lagos are weak, and suggests an urgent need for review to achieve vital reversals in the current trends.

  2. Stigma Reduction in Adolescents and Young Adults Newly Diagnosed with HIV: Findings from the Project ACCEPT Intervention

    Science.gov (United States)

    Lemos, Diana; Hosek, Sybil G.

    2014-01-01

    Abstract This article describes the influence of a group-based behavioral intervention for adolescents and young adults newly diagnosed with HIV (Project ACCEPT) on four dimensions of HIV-related stigma—personalized stigma, disclosure concerns, negative self-image, and concern with public attitudes about people with HIV—as measured by the Berger HIV Stigma Scale. Stigma was addressed in a holistic manner during the intervention by providing HIV/AIDS-related information, facilitating the acquisition of coping skills, and providing contact with other youth living with HIV in order to improve social support. Fifty youth (28 male, 22 female; mean age=19.24 years) newly diagnosed with HIV from four geographically diverse clinics participated in a one-group pretest-posttest design study whereby they received the intervention over a 12-week period, and completed assessments at baseline, post-intervention, and 3-month follow-up. Results from the combined sample (males and females) revealed overall reductions in stigma in three dimensions: personalized stigma, disclosure concerns, and negative self-image, although only the combined-sample effects for negative self-image were maintained at 3-month follow-up. Gender-specific analyses revealed that the intervention reduced stigma for males across all four dimensions of stigma, with all effects being maintained to some degree at the 3-month follow-up. Only personalized stigma demonstrated a decrease for females, although this effect was not maintained at the 3-month follow-up; while the other three types of stigma increased at post-intervention and 3-month follow-up. Findings are discussed in terms of gender specific outcomes and the need for a different type of intervention to reduce stigma for young women. PMID:25216106

  3. STIGMA AND DISCRIMINATION AMONG THE PERSONS LIVING WITH HIV/AIDS: PUBLIC SECTOR AND COMMUNITY PERSPECTIVE’S IN BITUNG MUNICIPALITY NORTH SULAWESI

    Directory of Open Access Journals (Sweden)

    Roy G.A. Massie

    2013-03-01

    Full Text Available ABSTRACT Background: Stigma and discrimination persist resulting many people living with HIV hide their status for fear of losing their jobs, social status, and the support of their families and communities. Methods: This case study presents collecting evidence and reviews factors relate to HIVIAIDS programme provided by public in Bitung Municipality, North Sulawesi Province, lndonesia. The objectives of this ca se study are to identify policy of HIVIAIDS program in local con text and to leam the collaboration of local public services' activities relate to health particularly to lessen the stigma and discrimination of HIVIAIDS. Results: Stigma and discrimination may be reduced through structural intervention at local level, community intervention and individual intervention. The interventions should be understood by health providers relate to HIVIAIDS prevention and control program at all stages. To reduce stigma at the community level can be integrated into HIVIAIDS programs by facilitating the participation of people living with HIVIAIDS. Key words: stigma, discrimination, HIVIAIDS ABSTRAK Adanya stigma dan diskriminasi terhadap penderita penyakit HIVIAIDS dimasyarakat menyebabkan penderita menyembunyikan keberadaaan mereka. Hal tersebut dikarenakan mereka merasa akan kehilangan pekerjaan, status sosial yang direndahkan dan berkurangnya dukungan dari keluarga dan masyarakat. Studi kasus ini mempresentasikan hasil pengumpulan data yang berbasis bukti, dan mengkaji faktor-faktor yang berhubungan dengan program penanggulangan HIVIAIDS dari sektor publik, terutama pada konteks lokal serta mempelajari kolaborasi sektor-sektor publik yang terkait dengan kebijakan program penanggulanggan HIVIAID, khususnya mempelajari stigma dan diskriminasi dari penyakit ini pada masyarakat. Stigma dan diskriminasi dapat ditanggulangi melalui beberapa struktur intervensi di tingkat nasional dan khususnya tingkat lokal. Demikian juga intervensi terhadap masyarakat

  4. Stigma and self-esteem: A case of HIV-positive sex-workers.

    Science.gov (United States)

    Kalemi, G; Gkioka, S; Tsapatsari, P; Tzeferakos, G; Kandri, T; Psarra, M L; Konstantopoulou, F; Douzenis, A

    2017-01-01

    Stigma associated with sex work and HIV can be easily recognized in public reactions towards the members of discriminated groups. Nevertheless, there are only a few studies examining the impact of discrimination to the self-esteem of individuals who suffer the coexistence of multiple stigmatizing conditions. In our case, the unprecedented stigmatization of sex workers through the media as a menace of public health as well as criminals due to their seropositivity should be examined with respect and scientificity. The sample consisted of the 27 women found to be HIV positive. The small number of subject and the uniqueness of the situation made necessary the use of qualitative research method. Data were collected of through a semi-structured interview during which personal and medical history was taken and Rosenberg self-esteem scale was completed. Information for each domain of interest was systematically collected from multiple interview guide items. Interpretive Phenomenological Analysis was used to analyze data derived from qualitative interview (IPA). Four main categories emerged from the horizontal analysis of the interviews referring to the mechanism used by those women in order to cope with stigma and protect their self-esteem, a description of their felt stigma and feelings about seropositivity, as well as the existence of self-destructive behaviors. The existence of a normal self-esteem on the majority of those women is well explained by the use of certain coping strategies in order to confront the enacted stigma, such as the avoidance of self-blame for their condition (HIV-positive), the disregard of public's discriminating comments and behaviors, the acknowledge of their competence in specific issues they have to deal with in their everyday life, in common with the existence of a strongly supportive network. Despite those women's felt stigma, structured by community's discriminating approach of their families and their feelings of helplessness and

  5. Depressive symptoms and hazardous/harmful alcohol use are prevalent and correlate with stigma among TB-HIV patients in Lesotho.

    Science.gov (United States)

    Hayes-Larson, E; Hirsch-Moverman, Y; Saito, S; Frederix, K; Pitt, B; Maama-Maime, L; Howard, A A

    2017-11-01

    Limited data exist on the prevalence and correlates, including stigma, of mental health conditions, including depressive symptoms and alcohol use, among patients co-infected with tuberculosis (TB) and the human immunodeficiency virus (HIV) in sub-Saharan Africa, despite their negative impact on health outcomes. To assess the prevalence and correlates of depressive symptoms and hazardous/harmful alcohol use among TB-HIV patients in the Start TB patients on ART and Retain on Treatment (START) study. START, a mixed-methods cluster-randomized trial, evaluated a combination intervention package vs. standard of care (SOC) to improve treatment outcomes in TB-HIV co-infected patients in Lesotho. Moderate/severe depressive symptoms and hazardous/harmful alcohol use were measured using baseline questionnaire data collected from April 2013 to March 2015. Demographic, psychosocial, and TB- and HIV-related knowledge and attitudes, including stigma, were assessed for association with both conditions using generalized linear mixed models. Among 371 participants, 29.8% reported moderate/severe depressive symptoms, and 24.7% reported hazardous/harmful alcohol use; 7% reported both. Depressive symptoms were significantly associated with less education, more difficulty understanding written medical information, non-disclosure of TB, greater TB stigma, and the SOC study arm. Hazardous/harmful alcohol use was significantly associated with male sex, as well as greater TB and external HIV stigma. Prevalence of depressive symptoms and hazardous/harmful alcohol use were high, suggesting a need for routine screening for, and treatment of, mental health disorders in TB-HIV patients.

  6. Raising awareness of HIV-related stigma and its associated ...

    African Journals Online (AJOL)

    HIV Aids will remain a problem for a long time. Many people with HIV/AIDS still live in fear of discovery because of the prevalent stigma and its associated prejudice and discrimination. This article examines how HIV-related stigma and its associated prejudice and discrimination can be addressed in a classroom ± in the field ...

  7. Barriers and facilitators of the HIV care continuum in Southern New England for people with drug or alcohol use and living with HIV/AIDS: perspectives of HIV surveillance experts and service providers.

    Science.gov (United States)

    Grau, Lauretta E; Griffiths-Kundishora, Abbie; Heimer, Robert; Hutcheson, Marguerite; Nunn, Amy; Towey, Caitlin; Stopka, Thomas J

    2017-10-02

    Contemporary studies about HIV care continuum (HCC) outcomes within substance using populations primarily focus on individual risk factors rather than provider- or systems-level influences. Over 25% of people living with HIV (PLWH) have substance use disorders that can alter their path through the HCC. As part of a study of HCC outcomes in nine small cities in Southern New England (population 100,000-200,000 and relatively high HIV prevalence particularly among substance users), this qualitative analysis sought to understand public health staff and HIV service providers' perspectives on how substance use may influence HCC outcomes. Interviews with 49 participants, collected between November 2015 and June 2016, were analyzed thematically using a modified social ecological model as the conceptual framework and codes for substance use, HCC barriers and facilitators, successes and failures of initiatives targeting the HCC, and criminal justice issues. Eight themes were identified concerning the impact of substance use on HCC outcomes. At the individual level, these included coping and satisfying basic needs and could influence all HCC steps (i.e., testing, treatment linkage, adherence, and retention, and viral load suppression). The interpersonal level themes included stigma issues and providers' cultural competence and treatment attitudes and primarily influenced treatment linkage, retention, and viral load suppression. These same HCC steps were influenced at the health care systems level by organizations' physical environment and resources as well as intra-/inter-agency communication. Testing and retention were the most likely steps to affect at the policy/society level, and the themes included opposition within an organization or community, and activities with unintended consequences. The most substantial HCC challenges for PLWH with substance use problems included linking and retaining in treatment those with multiple co-morbidities and meeting their basic living

  8. Community voices: barriers and opportunities for programmes to successfully prevent vertical transmission of HIV identified through consultations among people living with HIV.

    Science.gov (United States)

    Anderson, Ginna; Caswell, Georgina; Edwards, Olive; Hsieh, Amy; Hull, Beri; Mallouris, Christoforos; Mason, Naisiadet; Nöstlinger, Christiana

    2012-07-11

    In 2010, two global networks of people living with HIV, the International Community of Women Living with HIV (ICW Global) and the Global Network of People living with HIV (GNP+) were invited to review a draft strategic framework for the global scale up of prevention of vertical transmission (PVT) through the primary prevention of HIV and the prevention of unintended pregnancies among women living with HIV. In order to ensure recommendations were based on expressed needs of people living with HIV, GNP+ and ICW Global undertook a consultation amongst people living with HIV which highlighted both facilitators and barriers to prevention services. This commentary summarizes the results of that consultation. The consultation was comprised of an online consultation (moderated chat-forum with 36 participants from 16 countries), an anonymous online e-survey (601 respondents from 58 countries), and focus-group discussions with people living with HIV in Jamaica (27 participants). The consultation highlighted the discrepancies across regions with respect to access to essential packages of PVT services. However, the consultation participants also identified common barriers to access, including a lack of trustworthy sources of information, service providers' attitudes, and gender-based violence. In addition, participant responses revealed common facilitators of access, including quality counselling on reproductive choices, male involvement, and decentralized services. The consultation provided some understanding and insight into the participants' experiences with and recommendations for PVT strategies. Participants agreed that successful, comprehensive PVT programming require greater efforts to both prevent primary HIV infection among young women and girls and, in particular, targeted efforts to ensure that women living with HIV and their partners are supported to avoid unintended pregnancies and to have safe, healthy pregnancies instead. In addition to providing the insights

  9. High levels of unprotected anal intercourse and never testing for HIV among men who have sex with men in Nigeria: evidence from a cross-sectional survey for the need for innovative approaches to HIV prevention.

    Science.gov (United States)

    Vu, Lung; Andrinopoulos, Katherine; Tun, Waimar; Adebajo, Sylvia

    2013-12-01

    To describe sexual risk behaviour, correlates of unprotected anal intercourse (UAI) and never testing for HIV and its implications for HIV prevention interventions among men who have sex with men (MSM) in Nigeria and other similar contexts. A cross-sectional survey was administered to 712 MSM in Abuja, Ibadan and Lagos, recruited through respondent-driven sampling (RDS). Levels of sexual risk behaviour and never having tested for HIV prior to the survey were calculated using weighted data for each city and unweighted data for the pooled sample. Correlates of UAI and never testing for HIV were determined using multiple logistic regression. The risk for HIV and STI among MSM in Nigeria is high, with 43.4% reporting UAI at last sex, 45.1% never having been tested for HIV and 53.9% reporting exchange of sex for resources in the past 6 months. Correlates of UAI in multivariate analysis included living in Ibadan, marriage or cohabitation with a woman, identification as bisexual, not having tested for HIV and being HIV-positive. Correlates of not having tested for HIV in multivariate analysis included living in Ibadan, young age, less education, unemployment and report of UAI. HIV testing is low and associated with UAI. Findings merit targeted and innovative approaches for HIV prevention for MSM, especially access to HIV self-testing. Attention to social and structural determinants of health-seeking and sexual risk behaviour is also needed, including the criminalisation of homosexuality and social marginalisation of MSM.

  10. Brief Report: Stigma and HIV Care Continuum Outcomes Among Ethiopian Adults Initiating ART.

    Science.gov (United States)

    Hoffman, Susie; Tymejczyk, Olga; Kulkarni, Sarah; Lahuerta, Maria; Gadisa, Tsigereda; Remien, Robert H; Melaku, Zenebe; Nash, Denis; Elul, Batya

    2017-12-01

    Stigma harms the mental health of HIV-positive individuals and reduces adherence to antiretroviral therapy (ART), but less is known about stigma and other outcomes across the HIV care continuum. Among 1180 Ethiopian adults initiating ART at 6 urban HIV clinics, we examined the relationship of internalized, anticipated, and enacted stigma to HIV care-related outcomes ascertained by interview (repeat HIV-positive testing, provider vs. self-referred testing, missed clinic visit before ART initiation, eagerness to begin ART), and by abstraction of routinely collected clinical data (late ART initiation, 3-month gap in care following ART initiation). Logistic regression was used to assess the association of each type of stigma with each outcome, adjusting for potential confounders. Scoring higher on each stigma domain was associated with 50%-90% higher odds of repeat HIV-positive testing. High internalized stigma was associated with higher odds of provider vs. self-referred test [adjusted odds ratio (aOR)high vs. low: 1.7; 95% confidence interval (CI): 1.3 to 2.2]. Higher anticipated stigma was associated with lower eagerness to begin ART (aORhigh vs. low: 0.55; 0.35-0.87; aORmedium vs. low: 0.45; 95% CI: 0.30 to 0.69). Any enacted stigma was associated with higher odds of a missed visit (aORany vs. none 1.8; 1.2-2.8). Stigma was not associated with late ART-initiation or with a subsequent gap in care. These findings provide further evidence of the importance of measuring and addressing stigma across the entire care continuum. Future work should test hypotheses about specific stigma domains and outcomes in prospective intervention or observational studies.

  11. Risk Factors of Active Tuberculosis in People Living with HIV/AIDS ...

    African Journals Online (AJOL)

    BACKGROUND: Determinants of active tuberculosis among People Living with HIV/AIDS (PLHA) are not well elucidated in countries with limited resources. The objective of this study was to assess distal and proximate determinants of active tuberculosis among people living with HIV/AIDS in southwest. Ethiopia.

  12. Medication adherence among ambulatory patients with type 2 diabetes in a tertiary healthcare setting in Southwestern Nigeria

    Directory of Open Access Journals (Sweden)

    Adisa R

    2011-06-01

    Full Text Available Objective: To assess adherence to medication among ambulatory patients with type 2 diabetes, ascertain the level of glycemic control, and evaluate patients’ opinions on probable reasons for non-adherence with a view to identify areas of intervention to improve adherence.Methods: A prospective cross-sectional study was carried out at a 900-bed tertiary teaching hospital in Ibadan, Southwestern Nigeria between June and August, 2009. Out of 140 consented patients, 114 (81.4% properly responded to the validated and pre-tested data collection tool and these were subsequently considered for analysis. Descriptive statistics were used to summarize the data. Means and proportions were compared using student t-test and chi-square or Kruskal-Wallis test as appropriate, with p<0.05 considered statistical significant.Results: Approximately sixty percent of the patients were adjudged adherent with prescribed medication. Out of 58.8% of the cohort who gave their recent fasting plasma glucose (FPG values, 59.7% had FPG above 110mg/dL. The mean FPG for patients was 139.05 (SD=70.5mg/dL, males and females significantly differed in their mean FPG, 146.55 (SD=85.0mg/dL versus 133.33 (SD=57.6mg/dL respectively (p=0.032. Also, the mean FPG values for adherent patients, 137.09 (SD=59.3mg/dL was lower than their non-adherent counterparts, 143.92 (SD=87.6 mg/dL, but the difference was not statistically significant (p=0.095. Financial constraint (34.4% was the major barrier to optimal adherence with medication. A significant association exist between genders and opinions on physician’s mode of approach during patient-physician interaction as a contributory factor for non-adherence (p=0.038.Conclusion: Medication adherence of ambulatory type 2 diabetes patients is considerable. However, the relatively high level of adherence did not appear to have significantly impacted on patients’ glycemic status due to a substantial number who had plasma glucose above the

  13. Overlapping HIV and sex-work stigma among female sex workers recruited to 14 respondent-driven sampling surveys across Zimbabwe, 2013.

    Science.gov (United States)

    Hargreaves, J R; Busza, J; Mushati, P; Fearon, E; Cowan, F M

    2017-06-01

    HIV stigma can inhibit uptake of HIV testing and antiretroviral therapy as well as negatively affect mental health. Efforts to reduce discrimination against people living with HIV (LWH) have contributed to greater acceptance of the infection. Female sex workers (FSW) LWH may experience overlapping stigma due to both their work and HIV status, although this is poorly understood. We examined HIV and sex-work stigma experienced by FSW LWH in Zimbabwe. Using the SAPPH-IRe cluster-randomised trial baseline survey, we analysed the data from 1039 FSW self-reporting HIV. The women were recruited in 14 sites using respondent-driven sampling. We asked five questions to assess internalised and experienced stigma related to working as a sex worker, and the same questions were asked in reference to HIV. Among all FSW, 91% reported some form of sex-work stigma. This was not associated with sociodemographic or sex-work characteristics. Rates of sex-work stigma were higher than those of HIV-related stigma. For example, 38% reported being "talked badly about" for LWH compared with 77% for their involvement in sex work. Those who reported any sex-work stigma also reported experiencing more HIV stigma compared to those who did not report sex-work stigma, suggesting a layering effect. FSW in Zimbabwe experience stigma for their role as "immoral" women and this appears more prevalent than HIV stigma. As HIV stigma attenuates, other forms of social stigma associated with the disease may persist and continue to pose barriers to effective care.

  14. How important are human immunodeficiency virus (HIV) clinical markers to the long-term formal employment among people living with HIV in developing countries? A study in South Africa.

    Science.gov (United States)

    Odek, W O; Glendinning, A; Charalambous, S

    2014-01-01

    To examine the relationship of Human Immunodeficiency Virus (HIV) clinical markers and socio-demographic characteristics with long-term formal employment among people living with HIV (PLHIV). 554 adults, 55% females, on HIV treatment for at least two years at two public hospitals in Johannesburg, South Africa. A retrospective cohort design, tracing changes in study participants' formal employment status since the first HIV-positive diagnosis. Data collection included historical medical records review and interviewer-administered questionnaires. 44% of all study participants (39% and 49% among males and females, respectively) were formally employed at the time of the study, primarily in low-skilled jobs in the private sector. The majority (83%) of males and 60% of females remained in formal employment since being diagnosed as HIV-positive. Female gender, education to grade 12 or higher, a smaller household size and being married were significantly associated with current formal employment. Formal employment was unrelated to HIV treatment indicators (CD4 count, viral load and duration since diagnosis). Of those in formal employment, 68 (28%) were aware of HIV policies at their workplaces, which was also positively associated with the duration in their current employment. PLHIV in developing country contexts can enter into and maintain formal employment, especially when treatment and workplace support are available. Thus, employer organisations should implement effective workplace HIV policies to enhance employment experiences of their workforce living with HIV. Care and support services for people on HIV treatment should also address their career development needs.

  15. Conceptualisations of masculinity and self-reported medication adherence among HIV-positive Latino men in Los Angeles, California, USA.

    Science.gov (United States)

    Galvan, Frank H; Bogart, Laura M; Wagner, Glenn J; Klein, David J; Chen, Ying-Tung

    2014-06-01

    HIV-positive Latino men have been found to have poorer medication adherence compared to Whites. This study sought to identify how cultural conceptualisations of masculinity are associated with self-reported medication adherence among Latino men. A total of 208 HIV-positive men reported the number of doses of antiretroviral medication missed in the previous seven days (dichotomised at 100% adherence versus less). Conceptualisations of masculinity consisted of traditional machismo (e.g., power and aggressive attitudes, which are normally associated with negative stereotypes of machismo) and caballerismo (e.g., fairness, respect for elders and the importance of family). Multivariate logistic regression was used to identify factors associated with adherence. The mean adherence was 97% (SD = 6.5%; range = 57-100%). In all, 77% of the participants reported 100% adherence in the previous seven days. Caballerismo was associated with a greater likelihood (OR = 1.77; 95% CI: 1.08-2.92; p = 0.03) and machismo with a lower likelihood (OR = 0.60; 95% CI: 0.38-0.95; p = 0.03) of medication adherence. In addition, higher medication side-effects were found to be associated with a lower likelihood (OR = 0.59; 95% CI: 0.43-0.81; p = 0.001) of medication adherence. These findings reinforce the importance of identifying cultural factors that may affect medication adherence among HIV-positive Latino men resident in the USA.

  16. The Dynamic Relationship Between Social Support and HIV-Related Stigma in Rural Uganda

    Science.gov (United States)

    Weiser, Sheri D.; Kumbakumba, Elias; Muzoora, Conrad; Martin, Jeffrey N.; Hunt, Peter W.; Haberer, Jessica E.; Kawuma, Annet; Bangsberg, David R.; Tsai, Alexander C.

    2014-01-01

    Background Cross-sectional studies show that human immunodeficiency virus (HIV) stigma is negatively correlated with social support. Purpose The purpose of this study is to examine the bidirectional relationship between social support and HIV stigma. Methods We collected quarterly data from a cohort of 422 people living with HIV in Uganda, followed for a median of 2.1 years. We used multilevel regression to model the contemporaneous and 3-month-lagged associations between social support and both enacted and internalized stigma. Results Lagged enacted stigma was negatively correlated with emotional and instrumental social support, and lagged instrumental social support was negatively correlated with enacted stigma. Internalized stigma and emotional social support had reciprocal lagged associations. Conclusions Interventions to reduce enacted stigma may strengthen social support for people living with HIV. Improved social support may in turn have a protective influence against future enacted and internalized stigma. PMID:24500077

  17. Men's and women's experiences with HIV and stigma in Swaziland.

    Science.gov (United States)

    Shamos, Sara; Hartwig, Kari A; Zindela, Nomsa

    2009-12-01

    To explore how gender differentially affects the stigma experiences of people living with HIV (PLHIV) in Swaziland, the extent and dimensions of HIV-related felt and enacted stigma and social support were analyzed. Thirty-seven semistructured, face-to-face interviews were conducted with PLHIV in Swaziland between 2004 and 2006. Through the process of conceptual analysis, themes, including felt stigma, information management, enacted stigma, and social support, were explored, coded, and analyzed in the contexts of partner and familial relationships, and workplace and neighborhood settings. Findings revealed that there were high levels of felt stigma in all contexts, yet fewer than anticipated accounts of enacted stigma in family, work, and neighborhood contexts compared to their expressions of felt stigma. The amount and characteristics of felt and enacted stigma and social support differed based on gender, as women often experienced more felt and enacted stigma than men, and had less definite financial or emotional support.

  18. Social support and moment-to-moment changes in treatment self-efficacy in men living with HIV: Psychosocial moderators and clinical outcomes

    Science.gov (United States)

    Turan, Bulent; Fazeli, Pariya; Raper, James L.; Mugavero, Michael J.; Johnson, Mallory O.

    2016-01-01

    Objective For people living with HIV, treatment adherence self-efficacy is an important predictor of treatment adherence and therefore of clinical outcomes. Using experience sampling method (ESM), this study aimed to examine: (1) the within-person association between moment-to-moment changes in social support and HIV treatment self-efficacy; (2) the moderators of this within-person association, (3) the concordance between questionnaire and ESM measurement of treatment self-efficacy; and (4) the utility of each approach (ESM and questionnaire) in predicting adherence to medication, adherence to clinic visits, CD4 counts, and viral load. Methods 109 men living with HIV responded to the same set of ESM questions 3 times a day for 7 days via a smart phone given to them for the study. They also completed cross-sectional questionnaires and their clinic data was extracted from medical records in order to examine predictors and consequences of state and trait treatment self-efficacy. Results In within-person hierarchical linear modeling (HLM) analyses, receipt of recent social support predicted higher current ESM treatment self-efficacy. This association was stronger for individuals reporting higher avoidance coping with HIV. The correlation between ESM and questionnaire measures of treatment self-efficacy was r = .37. ESM measure of average treatment self-efficacy predicted medication adherence, visit adherence, CD4 counts, and viral load, while questionnaire-based self-efficacy did not predict these outcomes. Conclusion Interventions aimed at improving treatment adherence may target social support processes, which may improve treatment self-efficacy and adherence. PMID:27089459

  19. Clinic Attendance for Antiretroviral Pills Pick-Up among HIV-Positive People in Nepal: Roles of Perceived Family Support and Associated Factors

    Science.gov (United States)

    Kikuchi, Kimiyo; Ghimire, Mamata; Shibanuma, Akira; Pant, Madhab Raj; Poudel, Krishna C.; Jimba, Masamine

    2016-01-01

    Introduction HIV-positive people’s clinic attendance for medication pick-up is critical for successful HIV treatment. However, limited evidence exists on it especially in low-income settings such as Nepal. Moreover, the role of family support in clinic attendance remains under-explored. Therefore, this study was conducted to examine the association between perceived family support and regular clinic attendance and to assess factors associated with regular clinic attendance for antiretroviral pills pick-up among HIV-positive individuals in Nepal. Methods A cross-sectional study was conducted among 423 HIV-positive people in three districts of Nepal. Clinic attendance was assessed retrospectively for the period of 12 months. To assess the factors associated, an interview survey was conducted using a semi-structured questionnaire from July to August, 2015. Multiple logistic regression models were used to assess the factors associated with regular clinic attendance. Results Of 423 HIV-positive people, only 32.6% attended the clinics regularly. They were more likely to attend them regularly when they received high family support (AOR = 3.98, 95% CI = 2.29, 6.92), participated in support programs (AOR = 1.68, 95% CI = 1.00, 2.82), and had knowledge on the benefits of antiretroviral therapy (AOR = 2.62, 95% CI = 1.15, 5.99). In contrast, they were less likely to attend them regularly when they commuted more than 60 minutes to the clinics (AOR = 0.53, 95% CI = 0.30, 0.93), when they self-rated their health status as being very good (AOR = 0.13, 95% CI = 0.04, 0.44), good (AOR = 0.14, 95% CI = 0.04, 0.46), and fair (AOR = 0.21, 95% CI = 0.06, 0.70). Conclusion HIV-positive individuals are more likely to attend the clinics regularly when they receive high family support, know the benefits of antiretroviral therapy, and participate in support programs. To improve clinic attendance, family support should be incorporated with HIV care programs in resource limited settings

  20. Experience of stigma in the public life of relatives of people diagnosed with schizophrenia in the Republic of Belarus.

    Science.gov (United States)

    Krupchanka, Dzmitry; Kruk, Nina; Sartorius, Norman; Davey, Silvia; Winkler, Petr; Murray, Joanna

    2017-04-01

    Mental health-related stigma affects people with mental disorders and their families. We aimed to investigate the experience of stigma among relatives of patients with schizophrenia in Belarus and formulate recommendations for anti-stigma interventions. We conducted and thematically analysed 20 interviews with relatives of people diagnosed with schizophrenia. Experience of discrimination, strategies to cope with it, and requests for interventions were examined. A number of themes related to the experience of stigma in the public life of relatives of people with schizophrenia were elicited in relation to: (1) mental health care (difficulties in contacting mental health professionals; in getting appropriate information; lack of alternatives to hospital treatment; absence of appropriate long-term care services); (2) employment of people living with schizophrenia and (3) contact with the police. Analysis of the strategies used to overcome difficulties revealed resignation and passive acceptance, self-reliance, and emotional containment during crises. Despite the passivity and scepticism in expressing needs, participants suggested a number of interventions that could reduce the burden of stigma. With respect to the public domain of life, substantial stigma and discrimination perceived by families of people living with schizophrenia in Belarus is associated with structural issues of the country's mental health care system. To reduce the stigma-related burden, action must be taken to: (1) educate and support families and (2) deal with structural issues, by reorganising mental health services to better meet the needs of the families of people diagnosed with schizophrenia, and by including them in decision making at all levels.

  1. Preexposure prophylaxis-related stigma: strategies to improve uptake and adherence – a narrative review

    Directory of Open Access Journals (Sweden)

    Haire BG

    2015-10-01

    Full Text Available Bridget G Haire Kirby Institute for Infection and Immunity in Society, University of New South Wales, Sydney, NSW, Australia Abstract: Despite high levels of efficacy, the implementation of preexposure prophylaxis (PrEP as a strategy to prevent new HIV infection has been slow. Studies show that PrEP works so long as it is taken, making adherence one of the great challenges of effective PrEP implementation alongside issues of access and uptake. Given that effective PrEP use requires ongoing self-administration of pills by people at high risk of HIV acquisition, it is a strategy best understood not as simply biomedical, but as biobehavioral or biopsychosocial, meaning that that social, psychological, cultural, and structural factors all contribute to the success or failure of the intervention. The willingness of people at risk of HIV to take up and adhere to PrEP depends greatly upon social understandings – whether it is seen as effective, as a healthy option, and a socially acceptable strategy for preventing HIV. Stigma – unfavorable associations – can negatively influence the implementation of PrEP. Because it is associated with high-risk sexual activity, PrEP risks multiple stigmas that can differ according to specific cultural conditions. This includes the stigma of being related to HIV (which may also relate to other stigmas, such as homosexuality, sex work, and/or drug use and the stigma of PrEP being an alternative to condoms (as condom use is associated with responsible sexual activity. PrEP-related stigma has emerged as a significant social harm that can arise from PrEP research participation, reported by trial participants from a range of different trial sites, different trial populations, and spanning different continents. Social marketing needs to redress PrEP-related stigmas through health promotion campaigns aimed at clinicians, HIV-affected communities, and people at high risk of HIV who might benefit from PrEP access. Pr

  2. Living in the shadow of shame and stigma: Lived experience of mothers with deaf children

    Directory of Open Access Journals (Sweden)

    Hossein Ebrahimi

    2016-11-01

    Full Text Available Congenital deafness is one of the most common childhood disorders and every year many children are born with permanent hearing loss. The present study was carried out to understand the experience of mothers with deaf children. This study was conducted with a qualitative approach. The participants were 35 mothers of children with congenital deafness who were selected by purposive sampling. The data was collected through semi structured indepth interviews and analyzed using thematic analysis introduced by Braun and Clarke. Data analysis revealed 3 themes and 9 sub-themes including social stigma (prying eyes, pity aversion, feeling of discrimination, taunt from people, internalized stigma (feeling of inferiority, feeling of shame and embarrassment, and reaction to stigma(turning to concealment, cautious disclosure, and marginalization. Shame and stigma were the major experiences of Iranian mothers of deaf children that shadowed their lives. These experiences lead mainly to ineffective coping mechanisms such as avoidance of using hearing aids and concealment of the child’s hearing loss. In addition, to cope with perceived stigma, mothers isolate and marginalize themselves and pursue secrecy strategies. Therefore, our findings are important for health professionals who are working with families having children with hearing loss. They need to aware of the problems faced by the families and should advocate necessary support.

  3. Community patterns of stigma towards persons living with HIV: A population-based latent class analysis from rural Vietnam

    LENUS (Irish Health Repository)

    Pharris, Anastasia

    2011-09-18

    Abstract Background The negative effects of stigma on persons living with HIV (PLHIV) have been documented in many settings and it is thought that stigma against PLHIV leads to more difficulties for those who need to access HIV testing, treatment and care, as well as to limited community uptake of HIV prevention and testing messages. In order to understand and prevent stigma towards PLHIV, it is important to be able to measure stigma within communities and to understand which factors are associated with higher stigma. Methods To analyze patterns of community stigma and determinants to stigma toward PLHIV, we performed an exploratory population-based survey with 1874 randomly sampled adults within a demographic surveillance site (DSS) in rural Vietnam. Participants were interviewed regarding knowledge of HIV and attitudes towards persons living with HIV. Data were linked to socioeconomic and migration data from the DSS and latent class analysis and multinomial logistic regression were conducted to examine stigma group sub-types and factors associated with stigma group membership. Results We found unexpectedly high and complex patterns of stigma against PLHIV in this rural setting. Women had the greatest odds of belong to the highest stigma group (OR 1.84, 95% CI 1.42-2.37), while those with more education had lower odds of highest stigma group membership (OR 0.45, 95% CI 0.32-0.62 for secondary education; OR 0.19, 95% CI 0.10-0.35 for tertiary education). Long-term migration out of the district (OR 0.61, 95% CI 0.4-0.91), feeling at-risk for HIV (OR 0.42, 95% CI 0.27-0.66), having heard of HIV from more sources (OR 0.44, 95% CI 0.3-0.66), and knowing someone with HIV (OR 0.76, 95% CI 0.58-0.99) were all associated with lower odds of highest stigma group membership. Nearly 20% of the population was highly unsure of their attitudes towards PLHIV and persons in this group had significantly lower odds of feeling at-risk for HIV (OR 0.54, 95% CI 0.33-0.90) or of knowing

  4. Correlates and consequences of internalized stigma for people living with mental illness: a systematic review and meta-analysis.

    Science.gov (United States)

    Livingston, James D; Boyd, Jennifer E

    2010-12-01

    An expansive body of research has investigated the experiences and adverse consequences of internalized stigma for people with mental illness. This article provides a systematic review and meta-analysis of the extant research regarding the empirical relationship between internalized stigma and a range of sociodemographic, psychosocial, and psychiatric variables for people who live with mental illness. An exhaustive review of the research literature was performed on all articles published in English that assessed a statistical relationship between internalized stigma and at least one other variable for adults who live with mental illness. In total, 127 articles met the inclusion criteria for systematic review, of which, data from 45 articles were extracted for meta-analyses. None of the sociodemographic variables that were included in the study were consistently or strongly correlated with levels of internalized stigma. The review uncovered a striking and robust negative relationship between internalized stigma and a range of psychosocial variables (e.g., hope, self-esteem, and empowerment). Regarding psychiatric variables, internalized stigma was positively associated with psychiatric symptom severity and negatively associated with treatment adherence. The review draws attention to the lack of longitudinal research in this area of study which has inhibited the clinical relevance of findings related to internalized stigma. The study also highlights the need for greater attention on disentangling the true nature of the relationship between internalized stigma and other psychosocial variables. Copyright © 2010 Elsevier Ltd. All rights reserved.

  5. Stigma Related Avoidance in People Living with Severe Mental Illness (SMI): Findings of an Integrative Review.

    Science.gov (United States)

    Abiri, Sadat; Oakley, Linda Denise; Hitchcock, Mary E; Hall, Amanda

    2016-04-01

    The purpose of this integrative review is to synthesize primary evidence of the impact of internalized stigma on avoidance in adult community treatment patients living with SMI. A keyword database search of articles published through 2015 yielded 21 papers and a total of 4256 patients. Our analyses found that stigmatizing beliefs associated with avoidance are related to significant loss of self-esteem. Factors generally thought to reduce stigma internalized as self-stigmatizing beliefs, such as improved insight, increased self-awareness, and psycho-education to improve stigma coping skills, do not appear to improve self-esteem.

  6. Socioeconomic factors explain suboptimal adherence to antiretroviral therapy among HIV-infected Australian adults with viral suppression.

    Directory of Open Access Journals (Sweden)

    Krista J Siefried

    Full Text Available Missing more than one tablet of contemporary antiretroviral therapy (ART per month increases the risk of virological failure. Recent studies evaluating a comprehensive range of potential risk factors for suboptimal adherence are not available for high-income settings.Adults on ART with undetectable viral load (UDVL were recruited into a national, multi-centre cohort, completing a comprehensive survey assessing demographics, socio-economic indicators, physical health, well-being, life stressors, social supports, HIV disclosure, HIV-related stigma and discrimination, healthcare access, ART regimen, adherence, side effects, costs and treatment beliefs. Baseline data were assessed, and suboptimal adherence was defined as self-reported missing ≥1 ART dose/month over the previous 3-months; associated factors were identified using bivariate and multivariate binary logistic regression.We assessed 522 participants (494 [94.5%] men, mean age = 50.8 years, median duration UDVL = 3.3 years [IQR = 1.2-6.8] at 17 sexual health, hospital, and general practice clinics across Australia. Seventy-eight participants (14.9% reported missing ≥1 dose/month over the previous three months, which was independently associated with: being Australian-born (AOR [adjusted odds ratio] = 2.4 [95%CI = 1.2-4.9], p = 0.014, not being in a relationship (AOR = 3.3 [95%CI = 1.5-7.3], p = 0.004, reaching the "Medicare safety net" (capping annual medical/pharmaceutical costs (AOR = 2.2 [95%CI = 1.1-4.5], p = 0.024, living in subsidised housing (AOR = 2.5 [95%CI = 1.0-6.2], p = 0.045, receiving home-care services (AOR = 4.4 [95%CI = 1.0-18.8], p = 0.046, HIV community/outreach services linkage (AOR = 2.4 [95%CI = 1.1-5.4], p = 0.033, and starting ART following self-request (AOR = 3.0 [95%CI = 1.3-7.0], p = 0.012.In this population, 15% reported recent suboptimal ART adherence at levels associated in prospective studies with subsequent virological failure, despite all having an

  7. Assessment of the knowledge and attitudes regarding HIV/AIDS among pre-clinical medical students in Israel

    Science.gov (United States)

    2014-01-01

    Background Today’s medical students are the future physicians of people living with HIV/AIDS (PLWHA). It is therefore essential that medical students possess the appropriate knowledge and attitudes regarding PLWHA. This study aims to evaluate knowledge and attitudes of pre-clinical Israeli medical students and to assess whether their knowledge and attitudes change throughout their pre-clinical studies. Methods A cross-sectional study was conducted among all pre-clinical medical students from the four medical schools in Israel during the academic year of 2010/2011 (a total of 1,470 students). A self-administered questionnaire was distributed. The questionnaire sought student responses pertaining to knowledge of HIV transmission and non-transmission routes, basic knowledge of HIV/AIDS treatment and attitudes towards HIV/AIDS. Results The study’s response rate was 62.24 percent. Knowledge among pre-clinical medical students was generally high and showed a statistically significant improvement as students progressed through their pre-clinical studies. However, there were some misconceptions, mostly regarding HIV transmission via breastfeeding and knowledge of HIV prevention after exposure to the virus. Students’ attitudes were found to include stigmatizing notions. Furthermore, the majority of medical students correlated HIV with shame and fear. In addition, students’ attitudes toward HIV testing and providing confidential medical information were contradictory to health laws, protocols and guidelines. Overall, no positive changes in students’ attitudes were observed during the pre-clinical years of medical school. Conclusion The knowledge of pre-clinical medical students in Israel is generally high, although there are some knowledge inadequacies that require more emphasis in the curricula of the medical schools. Contrary to HIV-related knowledge, medical students’ attitudes are unaffected by their progression through medical school. Therefore, medical

  8. Assessing Timely Presentation to Care Among People Diagnosed with HIV During Hospital Admission: A Population-Based Study in Ontario, Canada.

    Science.gov (United States)

    Kendall, Claire E; Shoemaker, Esther S; Raboud, Janet; Mark, Amy E; Bayoumi, Ahmed M; Burchell, Ann N; Loutfy, Mona; Rourke, Sean B; Liddy, Clare E; Rosenes, Ron; Rogers, Timothy; Antoniou, Tony

    2018-03-13

    Timely presentation to care for people newly diagnosed with HIV is critical to optimize health outcomes and reduce onward HIV transmission. Studies describing presentation to care following diagnosis during a hospital admission are lacking. We sought to assess the timeliness of presentation to care and to identify factors associated with delayed presentation. We conducted a population-level study using health administrative databases. Participants were all individuals older than 16 and newly diagnosed with HIV during hospital admission in Ontario, Canada, between April 1, 2007 and March 31, 2015. We used modified Poisson regression models to derive relative risk ratios for the association between sociodemographic and clinical variables and the presentation to out-patient HIV care by 90 days following hospital discharge. Among 372 patients who received a primary HIV diagnosis in hospital, 83.6% presented to care by 90 days. Following multivariable analysis, we did not find associations between patient sociodemographic or clinical characteristics and presentation to care by 90 days. In a secondary analysis of 483 patients diagnosed during hospitalization but for whom HIV was not recorded as the principal reason for admission, 73.1% presented to care by 90 days. Following multivariable adjustment, we found immigrants from countries with generalized HIV epidemics (RR 1.265, 95% CI 1.133-1.413) were more likely to present to care, whereas timely presentation was less likely for people with a mental health diagnosis (RR 0.817, 95% CI 0.742-0.898) and women (RR 0.748, 95% CI 0.559-1.001). Future work should evaluate mechanisms to facilitate presentation to care among these populations.

  9. Perceptions of community and family level IDU and HIV related stigma, disclosure decisions and experiences with layered stigma among HIV positive injection drug users in Vietnam

    OpenAIRE

    Rudolph, A.E.; Davis, W.W.; Quan, V.M.; Ha, T.V.; Minh, N.L.; Gregowski, A.; Salter, Megan; Celentano, D.D.; Go, V.

    2011-01-01

    This paper explores how perceived stigma and layered stigma related to injection drug use and being HIV positive influence the decision to disclose one’s HIV status to family and community and experiences with stigma following disclosure among a population of HIV positive male injection drug users (IDUs) in Thai Nguyen, Vietnam. In qualitative interviews conducted between 2007 and 2008, 25 HIV positive male IDUs described layered stigma in their community but an absence of layered stigma with...

  10. Dietary diversity and associated factors among HIV positive adults attending antiretroviral therapy clinics at Hiwot Fana and Dilchora Hospitals, eastern Ethiopia.

    Science.gov (United States)

    Weldegebreal, Fitsum; Digaffe, Tesfaye; Mesfin, Frehiwot; Mitiku, Habtamu

    2018-01-01

    Nutritional care is considered a crucial component of comprehensive care for people living with HIV/AIDS (PLWHA), particularly in resource-limited settings where malnutrition and food insecurity are endemic problems, and low quality monotonous diets are the norm. The findings of this study provide baseline information on dietary diversity and related factors for health care providers so that they will be able to improve nutritional care and support activity. Therefore, the aim of this study was to assess dietary diversity and associated factors among HIV positive adults (18-65 years old) attending antiretroviral therapy (ART) clinics at Hiwot Fana and Dilchora Hospitals, eastern Ethiopia. An institution-based cross-sectional study was conducted from November 2015 to February 2016 at the ART clinics of Hiwot Fana and Dilchora Hospitals. Using a systematic random sampling technique, a total of 303 patients were selected from all adults attending the ART clinics. The data were collected with a 95% CI used to show association between dietary diversity and independent factors. A total of 303 adult HIV positive individuals on ART participated in the study and 62.4% were females. The largest numbers of participants (49.5%) were 30-40 years of age. Eighty-seven (28.7%) participants had low dietary diversity (≤4 food groups). Duration of anti-retroviral treatment was the factor significantly associated with dietary diversity: respondents with a duration of antiretroviral treatment of more than 2 years were almost two times more likely to have high dietary diversity compared with those with less than a year of antiretroviral treatment (adjusted odds ratio =0.490; 95% CI: 0.091, 0.978). Low dietary diversity was found to be a nutritional problem among HIV positive adults. Duration of antiretroviral treatment was the predictor of low dietary diversity. Therefore, appropriate dietary management of side effects of ART is important.

  11. Applying an expanded social determinant approach to the concept of adherence to treatment: the case of Colombian women living with HIV/AIDS.

    Science.gov (United States)

    Arrivillaga, Marcela; Ross, Michael; Useche, Bernardo; Springer, Andrew; Correa, Diego

    2011-01-01

    The purpose of this study was to explore and analyze social determinants that influence adherence among Colombian women living with HIV/AIDS in poverty conditions. A qualitative, descriptive-interpretative study was developed. Forty-seven women participated in five focus group discussions. Also, in-depth interviews with six women were conducted. Results showed that women with lower adherence sell their antiretroviral medication to satisfy economic needs, and prioritize the care of their HIV-positive children over their own adherence needs. In contrast, women with higher adherence were found to participate in social support groups offered by nongovernmental organizations. These findings underscore the need to understand the social determinants that facilitate and/or hinder adherence among women in poverty-associated conditions. Results indicate the need to facilitate access to treatment on a timely and continual basis; provide economic resources, including support to meet basic needs as well as subsidies for transportation to health care centers; and explore mechanism for supporting the care of their offspring. Copyright © 2011 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  12. Substance use and adherence among people living with HIV/AIDS receiving cART in Latin America

    OpenAIRE

    De Boni, Raquel B.; Shepherd, Bryan E.; Grinsztejn, Beatriz; Cesar, Carina; Cortés, Claudia; Padgett, Denis; Gotuzzo, Eduardo; Belaunzarán-Zamudio, Pablo F.; Rebeiro, Peter F.; Duda, Stephany N.; McGowan, Catherine C.

    2016-01-01

    This cross-sectional study describes substance use prevalence and its association with cART adherence among 3343 individuals receiving care at HIV clinics in Argentina, Brazil, Chile, Honduras, Mexico, and Peru. A rapid screening tool evaluated self-reported 7-day recall of alcohol, marijuana, cocaine, heroin, and methamphetamine use, and missed cART doses. Overall, 29.3% individuals reported having ≥ 1 alcoholic drinks, 5.0% reported any illicit drug use and 17.0% reported missed cART doses....

  13. A Study of Power Relations in Doctor-Patient Interactions in Selected Hospitals in Lagos State, Nigeria

    Science.gov (United States)

    Adam, Qasim

    2014-01-01

    This paper explores power relations in clinical interactions in Nigeria. It seeks to investigate the use of power between doctors and patients during consultations on patient-centred approach to medicine in selected public and private hospitals in Lagos State, Nigeria. The objective is to establish how doctors' projection of power, using the…

  14. Stress, coping and adherence to immunosuppressive medications in kidney transplantation: a comparative study.

    Science.gov (United States)

    Brito, Daniela Cristina Sampaio de; Marsicano, Elisa Oliveira; Grincenkov, Fabiane Rossi Dos Santos; Colugnati, Fernando Antônio Basile; Lucchetti, Giancarlo; Sanders-Pinheiro, Helady

    2016-01-01

    : Adherence to medication is a key issue relating to outcomes from transplantation and it is influenced by several factors, such as stress and coping strategies. However, these factors have been poorly explored. We aimed to compare stress and coping strategies between adherent and nonadherent renal transplant recipients who were receiving immunosuppression. : We conducted a comparative, cross-sectional and observational study at a university-based transplantation clinic in Juiz de Fora, Brazil. :Fifty patients were recruited and classified as adherent or nonadherent following administration of the Basel Assessment of Adherence to Immunosuppressive Medications Scale. Stress was evaluated using the Lipp Stress Symptom Inventory for Adults and coping strategies were assessed using the Ways of Coping Scale. : The study included 25 nonadherent patients and 25 controls with a mean age of 44.1 ± 12.8 years and median post-transplantation time of 71.8 months. Stress was present in 50% of the patients. Through simple logistic regression, nonadherence was correlated with palliative coping (OR 3.4; CI: 1.02-11.47; P transplantation patients and should be considered among the strategies for reducing nonadherence.

  15. Symptom Clusters in People Living with HIV Attending Five Palliative Care Facilities in Two Sub-Saharan African Countries: A Hierarchical Cluster Analysis.

    Science.gov (United States)

    Moens, Katrien; Siegert, Richard J; Taylor, Steve; Namisango, Eve; Harding, Richard

    2015-01-01

    Symptom research across conditions has historically focused on single symptoms, and the burden of multiple symptoms and their interactions has been relatively neglected especially in people living with HIV. Symptom cluster studies are required to set priorities in treatment planning, and to lessen the total symptom burden. This study aimed to identify and compare symptom clusters among people living with HIV attending five palliative care facilities in two sub-Saharan African countries. Data from cross-sectional self-report of seven-day symptom prevalence on the 32-item Memorial Symptom Assessment Scale-Short Form were used. A hierarchical cluster analysis was conducted using Ward's method applying squared Euclidean Distance as the similarity measure to determine the clusters. Contingency tables, X2 tests and ANOVA were used to compare the clusters by patient specific characteristics and distress scores. Among the sample (N=217) the mean age was 36.5 (SD 9.0), 73.2% were female, and 49.1% were on antiretroviral therapy (ART). The cluster analysis produced five symptom clusters identified as: 1) dermatological; 2) generalised anxiety and elimination; 3) social and image; 4) persistently present; and 5) a gastrointestinal-related symptom cluster. The patients in the first three symptom clusters reported the highest physical and psychological distress scores. Patient characteristics varied significantly across the five clusters by functional status (worst functional physical status in cluster one, ppeople living with HIV with longitudinally collected symptom data to test cluster stability and identify common symptom trajectories is recommended.

  16. Determinants of medication adherence in older people with dementia from the caregivers' perspective.

    Science.gov (United States)

    El-Saifi, Najwan; Moyle, Wendy; Jones, Cindy; Alston-Knox, Clair

    2018-05-11

    ABSTRACTBackground:Adherence to treatment is a primary determinant of treatment success. Caregiver support can influence medication adherence in people with cognitive impairment. This study sought to characterize medication adherence in older people with dementia from the caregivers' perspective, and to identify influencing factors. Caregivers caring for a person with dementia and living in the community were eligible to complete the survey. Bayesian profile regression was applied to identify determinants of medication adherence measured using the Adherence to Refills and Medication Scale. Out of the 320 caregivers who participated in the survey, Bayesian profile regression on 221 participants identified two groups: Profile 1 (55 caregivers) with a mean adherence rate of 0.69 (80% Credible Interval (CrI): 0.61-0.77), and Profile 2 (166 caregivers) with a mean adherence rate of 0.80 (80% CrI: 0.77-0.84). Caregivers in Profile 1 were characterized with below data average scores for the following: cognitive functioning, commitment or intention, self-efficacy, and health knowledge, which were all above the data average in Profile 2, except for health knowledge. Caregivers in Profile 1 had a greater proportion of care recipients taking more than five medications and with late-stage dementia. Trade, technical, or vocational training was more common among the caregivers in Profile 1. Profile 2 caregivers had a better patient-provider relationship and less medical problems. Bayesian profile regression was useful in understanding caregiver factors that influence medication adherence. Tailored interventions to the determinants of medication adherence can guide the development of evidence-based interventions.

  17. Prevalence and drivers of HIV stigma among health providers in urban India: implications for interventions

    Science.gov (United States)

    Ekstrand, Maria L; Ramakrishna, Jayashree; Bharat, Shalini; Heylen, Elsa

    2013-01-01

    Introduction HIV stigma inflicts hardship and suffering on people living with HIV (PLHIV) and interferes with both prevention and treatment efforts. Health professionals are often named by PLHIV as an important source of stigma. This study was designed to examine rates and drivers of stigma and discrimination among doctors, nurses and ward staff in different urban healthcare settings in high HIV prevalence states in India. Methods This cross-sectional study enrolled 305 doctors, 369 nurses and 346 ward staff in both governmental and non-governmental healthcare settings in Mumbai and Bengaluru, India. The approximately one-hour long interviews focused on knowledge related to HIV transmission, personal and professional experiences with PLHIV, instrumental and symbolic stigma, endorsement of coercive policies, and intent to discriminate in professional and personal situations that involve high and low risk of fluid exposure. Results High levels of stigma were reported by all groups. This included a willingness to prohibit female PLHIV from having children (55 to 80%), endorsement of mandatory testing for female sex workers (94 to 97%) and surgery patients (90 to 99%), and stating that people who acquired HIV through sex or drugs “got what they deserved” (50 to 83%). In addition, 89% of doctors, 88% of nurses and 73% of ward staff stated that they would discriminate against PLHIV in professional situations that involved high likelihood of fluid exposure, and 57% doctors, 40% nurses and 71% ward staff stated that they would do so in low-risk situations as well. Significant and modifiable drivers of stigma and discrimination included having less frequent contact with PLHIV, and a greater number of transmission misconceptions, blame, instrumental and symbolic stigma. Participants in all three groups reported high rates of endorsement of coercive measures and intent to discriminate against PLHIV. Stigma and discrimination were associated with multiple modifiable

  18. Prevalence and drivers of HIV stigma among health providers in urban India: implications for interventions.

    Science.gov (United States)

    Ekstrand, Maria L; Ramakrishna, Jayashree; Bharat, Shalini; Heylen, Elsa

    2013-11-13

    HIV stigma inflicts hardship and suffering on people living with HIV (PLHIV) and interferes with both prevention and treatment efforts. Health professionals are often named by PLHIV as an important source of stigma. This study was designed to examine rates and drivers of stigma and discrimination among doctors, nurses and ward staff in different urban healthcare settings in high HIV prevalence states in India. This cross-sectional study enrolled 305 doctors, 369 nurses and 346 ward staff in both governmental and non-governmental healthcare settings in Mumbai and Bengaluru, India. The approximately one-hour long interviews focused on knowledge related to HIV transmission, personal and professional experiences with PLHIV, instrumental and symbolic stigma, endorsement of coercive policies, and intent to discriminate in professional and personal situations that involve high and low risk of fluid exposure. High levels of stigma were reported by all groups. This included a willingness to prohibit female PLHIV from having children (55 to 80%), endorsement of mandatory testing for female sex workers (94 to 97%) and surgery patients (90 to 99%), and stating that people who acquired HIV through sex or drugs "got what they deserved" (50 to 83%). In addition, 89% of doctors, 88% of nurses and 73% of ward staff stated that they would discriminate against PLHIV in professional situations that involved high likelihood of fluid exposure, and 57% doctors, 40% nurses and 71% ward staff stated that they would do so in low-risk situations as well. Significant and modifiable drivers of stigma and discrimination included having less frequent contact with PLHIV, and a greater number of transmission misconceptions, blame, instrumental and symbolic stigma. Participants in all three groups reported high rates of endorsement of coercive measures and intent to discriminate against PLHIV. Stigma and discrimination were associated with multiple modifiable drivers, which are consistent with

  19. Psychosocial functioning and depressive symptoms among HIV-positive persons receiving care and treatment in Kenya, Namibia, and Tanzania.

    Science.gov (United States)

    Seth, Puja; Kidder, Daniel; Pals, Sherri; Parent, Julie; Mbatia, Redempta; Chesang, Kipruto; Mbilinyi, Deogratius; Koech, Emily; Nkingwa, Mathias; Katuta, Frieda; Ng'ang'a, Anne; Bachanas, Pamela

    2014-06-01

    In sub-Saharan Africa, the prevalence of depressive symptoms among people living with HIV (PLHIV) is considerably greater than that among members of the general population. It is particularly important to treat depressive symptoms among PLHIV because they have been associated with poorer HIV care-related outcomes. This study describes overall psychosocial functioning and factors associated with depressive symptoms among PLHIV attending HIV care and treatment clinics in Kenya, Namibia, and Tanzania. Eighteen HIV care and treatment clinics (six per country) enrolled approximately 200 HIV-positive patients (for a total of 3,538 participants) and collected data on patients' physical and mental well-being, medical/health status, and psychosocial functioning. Although the majority of participants did not report clinically significant depressive symptoms (72 %), 28 % reported mild to severe depressive symptoms, with 12 % reporting severe depressive symptoms. Regression models indicated that greater levels of depressive symptoms were associated with: (1) being female, (2) younger age, (3) not being completely adherent to HIV medications, (4) likely dependence on alcohol, (5) disclosure to three or more people (versus one person), (6) experiences of recent violence, (7) less social support, and (8) poorer physical functioning. Participants from Kenya and Namibia reported greater depressive symptoms than those from Tanzania. Approximately 28 % of PLHIV reported clinically significant depressive symptoms. The scale-up of care and treatment services in sub-Saharan Africa provides an opportunity to address psychosocial and mental health needs for PLHIV as part of comprehensive care.

  20. Prevalence and public-health significance of HIV infection and anaemia among pregnant women attending antenatal clinics in south-eastern Nigeria.

    Science.gov (United States)

    Uneke, C J; Duhlinska, D D; Igbinedion, E B

    2007-09-01

    HIV infection and anaemia are major public-health problems in Africa and are important factors associated with an increased risk of adverse pregnancy outcomes. The objective of this study was to determine the prevalence of HIV infection and anaemia among pregnant women attending antenatal clinics in southeastern Nigeria. To achieve this, a cross-sectional survey was conducted during July 2005-June 2006 using standard techniques. Of 815 pregnant women studied, 31 (3.8%, 95% confidence interval [CI] 2.5-5.1) were HIV-positive. Maternal age and gestational age were not associated with HIV infection (p > 0.05). The prevalence of anaemia (Hb anaemia (Hb prevalence of anaemia was observed among individuals in their second pregnancy trimester (p anaemia are preventable, antenatal care services could serve as a pivotal entry point for simultaneous delivery of interventions for the prevention and control of HIV infection and anaemia in pregnant women.