中老年HIV/AIDS患者污名化感知与心理健康的关系研究

目的 了解四川省某县中老年HIV/AIDS患者污名化感知与焦虑、抑郁症状的现况及其关系,为提高中老年HIV/AIDS患者的心理健康水平提供科学依据.方法 将截至2019年6月在四川省泸州市泸县符合纳入标准的HIV/AIDS患者作为研究对象,采用面对面问卷调查,线性回归分析中老年HIV/AIDS患者污名化感知与焦虑、抑郁...     

HIV感染者/AIDS病人的小组心理干预模式及效果初步研究

目的 建立艾滋病病毒(HIV)感染者/艾滋病(AIDS)病人的心理支持小组,探讨小组式心理干预对HIV感染者/AIDS病人的影响和效果.方法 山西省夏县某感染者集中的村,自愿参加小组心理辅导和干预的HIV感染者/AIDS病人13人,组成1个小组.对小组成员进行为期6次、每次2-3小时的小组心理干预辅导,采用抑郁自评量表SDS、焦虑自评量表SAS、医学应对量表MCMQ、社会支持量表SSS及自我评价表对干预效果进行评估.结果 干预后小组成员的焦虑、抑郁情绪明显改善,在应对问题的方式和寻求社会支持方面也有显著变化.结论 小组心理干预对改善HIV感染者/AIDS病人的心理问题,提高其社会支持和同伴支持,改善应对策略有一定效果,值得进一步研究和推广.     

老年HIV/AIDS病人自杀意念的调查研究

正随着抗病毒治疗(ART)的发展,艾滋病病毒(HIV)感染者/艾滋病(AIDS)病人(简称HIV/AIDS病人)预期寿命已接近普通人群,病人年龄构成比也逐渐向老龄化倾斜[1]。然而,多数老年病人无法接受HIV感染的事实,易产生消极情绪[2],加之,社会对HIV感染者的污名化较严重,使得老年HIV/AIDS病人易发生自杀行为[3]。因此,早期识别老年HIV/AIDS病人自杀的高危风险因素并进行预防干预具有重要的临床意     

HIV/AIDS病人心理状况测量量表及应用研究进展

目的近年来,艾滋病病毒(HIV)感染者/艾滋病(AIDS)病人(简称HIV/AIDS病人)心理状况的研究逐渐成为热点问题,使用量表对心理状况进行评价是目前最常用的评估方法。文章对HIV/AIDS病人常用的心理测量量表的特点及各量表间的差异进行比较,并对量表在该人群的应用现状进行综述,旨在为AIDS防治提供依据。     

凉山州HIV/AIDS患者抗病毒治疗启动阶段不依从的质性研究

目的 深入了解四川省凉山州艾滋病病毒(HIV)感染者/艾滋病(AIDS)患者(简称HIV/AIDS患者)抗病毒治疗启动阶段不依从原因,为早日启动抗病毒治疗,提高治疗依从性和有效率提供参考.方法 2019年11月至2020年1月,采用现象学研究方法对凉山州23名HIV/AIDS患者进行半结构化深入访谈,运用Colaizz...     

有偿献血而感染HIV/AIDS者心理干预前后焦虑抑郁状况分析

目的 探讨心理干预对有偿献血感染艾滋病病毒（HIV）者和艾滋病（AIDS）病人焦虑、抑郁状况的影响。方法 选择皖北有偿献血感染的HIV／AIDS病人，随机分为干预组和对照组各30名，干预组给予心理干预。采用焦虑自评量表（SAS）、抑郁自评量表（SDS）对患者进行问卷调查。结果 60名HIV／AIDS病人心理干预后，干预组焦虑、抑郁情绪较对照组减轻（t=3．882，P〈0．01；t=3．018，P〈0．05）。结论 心理干预可有效改善有偿献血HIV／AIDS病人的焦虑、抑郁状况。     

HIV/AIDS相关羞辱与歧视测量工具的系统评价

目的通过对国内外艾滋病相关羞辱与歧视测量工具的质量评价,为致力于艾滋病病毒(HIV)感染者/艾滋病(AIDS)相关羞辱的研究者提供量表选择或者新量表开发的参考。方法以PRIS MA2009框架为指南,检索Pubmed数据库、中国期刊全文数据库(CNKI)、中文科技期刊数据库(维普)、万方数据库中,1980-2016年4月期间发表的文献。采用系统评价的方法对纳入的文献进行归纳与分析。结果 HIV/AIDS相关羞辱与歧视的中英文量表共21个。HIV/AIDS相关羞辱与歧视量表的测量人群可分为两种:一是因HIV/AIDS受羞辱与歧视的患者、家庭照顾者、儿童和同性恋;二是羞辱与歧视HIV感染者/AIDS病人的医务人员和普通人群。另外,11个量表报道了框架构建,多以感染HIV相关羞辱理论为框架。心理学测量结果显示了各量表具有良好的信度和效度。结论 HIV/AIDS相关羞辱与歧视量表的发展趋向于专门化和精细化。在量表选择中,需要重视研究的文化背景与量表的相似性、量表的理论框架对研究的指向性、量表心理学测量结果的稳定性、研究样本与量表测量对象的一致性等问题。     

广东省初治HIV/AIDS患者焦虑抑郁状况及其影响因素

目的 了解初治HIV/AIDS患者焦虑、抑郁情绪状况及其影响因素,为提高HIV感染者的心理健康提供理论依据。方法 采用连续性抽样方法,以2019年1月至2020年9月在广州某艾滋病定点医院门诊就诊,拟开展ART的初治HIV/AIDS患者为研究对象,采用焦虑自评量表（HAD-A）和抑郁自评量表（HAD-D）测评其焦虑及抑郁状况,使用多因素Logistic回归分析其影响因素。结果 共入组1 337例初治HIV/AIDS患者,年龄为33.8(26.4,47.2)岁。出现焦虑症状139例（10.4%）,HAD-A量表得分为5(2,8)分;出现抑郁症状140例（10.5%）,HAD-D量表得分为5(2,8)分;同时出现焦虑和抑郁症状53例（4.0%）。多因素分析显示,从事高强度脑力工作（OR=0.552,95CI:0.358～0.851）、有抑郁史（OR=0.204,95CI:0.121～0.343）和睡眠质量差（OR=9.229,95CI:3.072～27.723）是焦虑发生的影响因素;年龄（OR=2.685,95CI:1.260～5.723）、从事高强度脑力工作（OR=1.846,95CI:...     

吸毒成瘾HIV/AIDS患者抗逆转录病毒治疗的初步探讨

目的 评价国产艾滋病抗病毒药物治疗吸毒成瘾艾滋病病毒感染者/病人(HIV/AIDS)的疗效及对治疗时机的探讨. 方法 采用回顾性研究方法,调查随访2004～2007年在北京佑安医院确诊并经抗病毒治疗的吸毒成瘾HIV/AIDS患者114例,按照疾病进展将随访对象分成艾滋病组( AIDS)和HIV感染组(free of AIDS) ,所有患者均用3种抗病毒药物(奈韦拉平 司他夫定 拉米夫定)治疗,疗程48周.常规方法检测患者治疗前后血CD4 T淋巴细胞数,核酸序列扩增技术(NASBA)测定病毒载量. 结果 114例吸毒成瘾HIV/AIDS患者CD4细胞数平均增加(182.39±90.70)个/mm3;其中35例吸毒成瘾HIV/AIDS患者中85.71%病毒载量下降至50 copies/ml以下, 下降2.5个Log数;艾滋病组与HIV感染组治疗后3、6、9和12个月CD4 T淋巴细胞差异有统计学意义(P＜0.05);治疗6个月后,HIV感染组病毒载量下降趋势较艾滋病组明显,但治疗12个月后 HIV感染组病毒载量较艾滋病组有反弹现象. 结论 吸毒成瘾HIV/AIDS患者选用国产艾滋病抗病毒药物奈韦拉平 司他夫定 拉米夫定治疗取得良好效果,并且对艾滋病患者的疗效好于HIV感染者.     

农村有偿献血HIV感染者/AIDS患者的抑郁和焦虑情绪状况分析

目的了解有偿献血艾滋病病毒(HIV)感染者伎滋病(AIDS)患者的抑郁和焦虑情绪状况,探讨影响两种情绪状况的一些因素。方法采用Beck抑郁量表、焦虑自评量表作为工具,测查了185名农村有偿献血HIV感染者／AIDS患者,并收集了他们的人口学资料、症状资料和其它信息。结果92％的患者有中、重度抑郁障碍;患者在抑郁项目上得分表明,“疲劳”得分最高,“自杀”得分最低。患者的焦虑程度分析表明,他们的焦虑程度比神经衰弱者和焦虑症患者显著严重;患者在焦虑项目上得分表明,“睡眠障碍”得分最高,“手足颤抖”得分最低。患者焦虑总分方差分析表明,CD4数量和症状的轻重对焦虑情绪有影响。结论有偿献血HIV感染者／AIDS患者抑郁、焦虑情绪障碍严重,感染HIV给患者造成了严重的影响。     

HIV and depression in Eastern Nigeria: The role of HIV-related stigma

To examine the prevalence of depression among HIV-positive patients in Eastern Nigeria and to explore its association with HIV-related stigma. One hundred and five patients with a diagnosis of HIV attending HIV clinics in Eastern Nigeria completed a questionnaire consisting of demographic and health background, the Patients Health Questionnaire (to measure depression) and the Berger HIV stigma scale. As many as 33.3% of participants were considered depressed. Depression was positively correlated with overall stigma score with further analysis finding a positive correlation with all four subscales of the questionnaire (personalised stigma, disclosure, negative self-image and public attitudes). Individuals experiencing more side effects of HIV treatment were also rated as more depressed. A regression analysis found that negative self-image and number of treatment side effects were significant predictors of depression. Depression is positively associated with HIV-related stigma in this sample in Eastern Nigeria. As both stigma and depression have been shown to have a negative impact on quality of life for those with HIV, health professionals working to support them should be aware of the impact of stigma on risk of depression. Screening for both HIV-related stigma and depression would be an important intervention to promote both physical and psychological well-being amongst HIV-positive patients in Eastern Nigeria.     

Experiences of stigma in older adults living with HIV/AIDS: a mixed-methods analysis

Older adults are increasingly becoming impacted by HIV disease, both as newly infected individuals and as long-term survivors of HIV/AIDS living into older age. HIV-related stigma impacts the quality of life of all persons with HIV/AIDS. However, little is know about HIV-related stigma in older adults because many studies do not include older subjects or ignore age as a variable. This mixed methods study examined the experiences of HIV-related stigma in a sample of 25 older adults with HIV/AIDS from the Pacific Northwest. Quantitative methods measured HIV-stigma and depression, while in-depth qualitative interviews captured the lived experiences of these individuals. Stigma was positively and significantly correlated with depression (r = 0.627, p = 0.001) and stigma was found to be significantly higher in African American, as compared to white informants (chi (2) = 4.16, p = 0.041). Qualitative interviews yielded 11 themes that correspond to the four categories constructed in the stigma instrument. Rejection, disclosure concerns, stereotyping, protective silence and feeling "other" were all common experiences of these individuals. HIV stigma should be routinely assessed when working with older, HIV infected clients and interventions should be tailored to the individual experiences of stigma.     

四川省凉山州受艾滋病影响儿童焦虑情况及影响因素分析

目的 了解凉山州彝族受艾滋病影响儿童(简称受艾影响儿童)焦虑现状及其影响因素.方法 采用问卷调查法对凉山州某两所学校223名受艾影响儿童的焦虑情绪现状进行调查并分析其影响因素.结果 223名受艾影响儿童平均年龄为(15.24±2.79)岁,其中男童120名(53.8％),女童103名(46.2％),使用儿童焦虑性情绪障...     

Association between HIV/AIDS knowledge and stigma towards people living with HIV/AIDS in Botswana

In Botswana, an estimated 350 000 people live with HIV/AIDS. HIV/AIDS testing rates are low, suggesting that many other people remain undiagnosed. Stigma related to HIV/AIDS is prevalent and contributes to low testing rates and under-diagnosis of the virus. Identifying factors that contribute to stigma, such as insufficient or inaccurate knowledge of HIV/AIDS, may be critical in increasing early identification and treatment. This cross-sectional study used nationally representative data from the 2013 Botswana AIDS Impact Survey (BAIS) IV to examine the relationship between HIV/AIDS knowledge and stigmatising attitudes toward people living with HIV/AIDS (PLWHA). The mean (standard error) for stigma towards PLWHA score and HIV/AIDS knowledge score were 0.99 (0.02) and 5.90 (0.03) respectively. HIV/AIDS knowledge score and stigma towards PLWHA score were strongly positively correlated r (4,4045) = 0.415, p < 0.001). After adjusting for potential confounders, HIV/AIDS knowledge score significantly predicted stigma towards PLWHA score [coefficient β (95% CI)] [?0.25 (?0.29, ?0.20), p < 0.001]. These findings imply that programmes and interventions that increase HIV/AIDS knowledge may reduce the pervasive apprehension, blame, and stigmatising attitude held towards PLWHA in Botswana.     

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

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.     

Psychological reactance and HIV-related stigma among women living with HIV

Psychological reactance is defined as the drive to re-establish autonomy after it has been threatened or constrained. People living with HIV may have high levels of psychological reactance due to the restrictions that they may perceive as a result of living with HIV. People living with HIV may also exhibit levels of HIV-related stigma. The relationship between psychological reactance and HIV-related stigma is complex yet understudied. Therefore, the main aim of this study was to examine the association between psychological reactance and HIV-related stigma among women living with HIV. Data were obtained from one time-point (a cross-sectional assessment) of a longitudinal HIV disclosure study. Psychological reactance was measured using the 18-item Questionnaire for the Measurement of Psychological Reactance. HIV-related stigma was measured using the HIV Stigma Scale, which has four domains: personalized, disclosure concerns, negative self-image, and concerns with public attitudes. Principal component analysis was used to derive components of psychological reactance. Linear regression models were used to determine the association between overall psychological reactance and its components, and stigma and its four domains, and depressive and anxiety symptoms. The associations between stigma and mental health were also examined. Three components of psychological reactance were derived: Opposition, Irritability, and Independence. Overall psychological reactance and irritability were associated with all forms of stigma. Opposition was linked to overall and negative self-image stigma. Overall psychological reactance, opposition, and irritability were positively associated with anxiety symptoms while opposition was also associated with Centers for Epidemiologic Studies-Depression depressive symptoms. There were also positive associations between all forms of stigma, and depressive and anxiety symptoms. Health-care providers and counselors for women living with HIV addressing feelings of irritability and opposition toward others may reduce HIV-related stigma. Future research should examine the link between psychological reactance, mental health, and HIV-related stigma among other populations living with HIV.     

HIV symptom distress and anxiety sensitivity in relation to panic, social anxiety, and depression symptoms among HIV-positive adults

Although past work has documented relations between HIV/AIDS and negative affective symptoms and disorders, empirical work has only just begun to address explanatory processes that may underlie these associations. The current investigation sought to test the main and interactive effects of HIV symptom distress and anxiety sensitivity in relation to symptoms of panic disorder (PD), social anxiety disorder (SA), and depression among people with HIV/AIDS. Participants were 164 adults with HIV/AIDS (17.1% women; mean age, 48.40) recruited from AIDS service organizations (ASOs) in Vermont/New Hampshire and New York City. The sample identified as 40.9% white/Caucasian, 31.1% black, 22.0% Hispanic, and 6.1% mixed/other; with more than half (56.7%) reporting an annual income less than or equal to $10,000. Both men and women reported unprotected sex with men as the primary route of HIV transmission (64.4% and 50%, respectively). HIV symptom distress and anxiety sensitivity (AS) were significantly positively related to PD, SA, and depression symptoms. As predicted, there was a significant interaction between HIV symptom distress and anxiety sensitivity in terms of PD and SA symptoms, but not depressive symptoms. Results suggest that anxiety sensitivity and HIV symptom distress are clinically relevant factors to consider in terms of anxiety and depression among people living with HIV/AIDS. It may be important to evaluate these factors among patients with HIV/AIDS to identify individuals who may be at a particularly high risk for anxiety and depression problems. Limitations included recruitment from ASOs, cross-sectional self-report data, and lack of a clinical diagnostic assessment.     

男男性行为人群HIV感染者/AIDS病人耻辱感的影响因素

目的了解北京市男男性行为人群(MSM)艾滋病病毒(HIV)感染者/艾滋病(AIDS)病人耻辱感现状,分析影响因素,探索降低耻辱感的科学方法。方法通过方便抽样选取262名MSM人群HIV感染者/AIDS病人,进行一般情况和耻辱感的问卷调查。结果耻辱量表四个维度得分分别为个人耻辱(53.22±8.13)分、担心公开(33.20±3.73)分、负面自我形象(35.84±6.40)分、关注公众态度(61.31±8.44)分。耻辱感随着感染情况告知家人、好友的人数增多而降低(P<0.05),在婚者的耻辱感低于离异/丧偶者。结论如何获得家人和周围好友的情感支持,是降低HIV感染者/AIDS病人耻辱感的关键因素。     

HIV disclosure patterns, predictors, and psychosocial correlates among HIV positive women in Zimbabwe

Disclosure of positive HIV status in Sub-Saharan Africa has been associated with safer sexual practices and better antiretroviral therapy (ART) adherence, but associations with psychosocial function are unclear. We examined patterns and psychosocial correlates of disclosure in a Zimbabwean community. Two hundred HIV positive women at different stages of initiating ART participated in a cross-sectional study examining actual disclosures, disclosure beliefs, perceived stigma, self-esteem, depression, and quality of life. Ninety-seven percent of the women disclosed to at least one person, 78% disclosed to their current husband/partner, with an average disclosure of four persons per woman. The majority (85-98%) of disclosures occurred in a positive manner and 72-95% of the individuals reacted positively. Factors significantly correlated with HIV disclosure to partners included being married, later age at menses, longer duration of HIV since diagnosis, being on ART, being more symptomatic at baseline, ever having used condoms, and greater number of partners in the last year. In multivariate analysis, being married and age at menses predicted disclosure to partners. Positive disclosure beliefs, but not the total number of disclosures, significantly correlated with lower perceived stigma (ρ = 0.44 for personalized subscale and ρ = 0.51 for public subscale, both p<0.0001), higher self-esteem (ρ = 0.15, p=0.04), and fewer depressive symptoms (ρ = -0.14, p=0.05). In conclusion, disclosure of positive HIV status among Zimbabwean women is common and is frequently met with positive reactions. Moreover, positive disclosure beliefs correlate significantly with psychosocial measures, including lower perceived stigma, higher self-esteem, and lower depression.     

HIV-related stigma and optimism as predictors of anxiety and depression among HIV-positive men who have sex with men in the United Kingdom and Ireland

This study investigated the associations between forms of HIV-related optimism, HIV-related stigma, and anxiety and depression among HIV-positive men who have sex with men (MSM) in the United Kingdom and Ireland. HIV health optimism (HHO) and HIV transmission optimism (HTO) were hypothesised to be protective factors for anxiety and depression, while the components of HIV-related stigma (enacted stigma, disclosure concerns, concern with public attitudes, and internalised stigma) were hypothesised to be risk factors. Data were collected from 278 HIV-positive MSM using an online questionnaire. The prevalence of psychological distress was high, with close to half (48.9%) of all participants reporting symptoms of anxiety, and more than half (57.9%) reporting symptoms of depression. Multiple linear regressions revealed that both anxiety and depression were positively predicted by internalised stigma and enacted stigma, and negatively predicted by HHO. For both anxiety and depression, internalised stigma was the strongest and most significant predictor. The results highlight the continued psychological burden associated with HIV infection among MSM, even as community support services are being defunded across the United Kingdom and Ireland. The results point to the need for clinicians and policy makers to implement stigma reduction interventions among this population.