Physical activity behaviours of persons living with HIV of low socioeconomic status: domain,intensity and sociodemographic correlates

Physical activity (PA) is healthy for People Living with HIV and AIDS (PLWHA). This study examined the PA profile of 978 PLWHA based on PA domains and PA intensity. The study also sought to determine whether employment status and level of education can predict PA among PLWHA of low SES. PA and sociodemographic data of 978 PLWHA of mean age 35 (8.77) years were collected using the global physical activity questionnaire and a sociodemographic questionnaire. Results showed that, participants engaged more in work-related PA [160.11 (346.95) min/wk], followed by transport related PA [115.21(SD?=?142.04) min/wk], and lastly in leisure related PA [40.84 (SD?=?110.37) min/wk]. Participants also engaged more in moderate PA [265.86 (SD?=?335.45) min/wk], than in vigorous PA [50.29 (SD?=?205.30) min/wk]. Employment was a significant predictor of overall PA controlling for age, CD4 count and education level. The model explained 2.5% of the variance (R^2?=?0.025) on overall PA and tested significant at a 0.01 alpha level (p?<?0.01). PA interventions for this population should be domain- and intensity-specific. Researchers promoting healthy lifestyle behaviour change can benefit from determining the factors that facilitate domain-specific PA.     

The relationship between social support and anxiety amongst children living with HIV in rural northern Namibia

This study examined how HIV-related stigma and social support are related to anxiety among children living with HIV in rural northern Namibia. This is a cross-sectional exploratory study with a sample of 132 caregiver–child dyads. Our study found that higher levels of social support was correlated with lower levels of anxiety among children living with HIV, but higher levels of HIV-related stigma was not correlated with higher levels of anxiety. These findings point to the need for the development of more culturally and age specific interventions that enhance social support among children living with HIV, especially those in high-prevalence and socio-economically deprived settings.     

低收入高结核病负担国家的成人HIV/AIDS,特别是合并结核病者的处置

由于在低收入国家获得HIV抗逆转录病毒(antiretroviralARV)制剂可能性的提高,目前,许多临床医生需要ARV应用方面的培训。现在临床医生在治疗结核病(TB)时,还要进一步考虑到HIV/AIDS的情况。本文概要介绍医生处置HIV感染者时需要解决的关键问题,尤其是HIV/TB双重感染者。初级卫生保健医生要对所有提示HIV感染的症状、体征者和所有结核病患者进行HIV快速检测诊断。本文主要内容为:对HIV检测前和检测后的咨询问题进行探讨。对HIV感染者进行评估,确定临床分期;通过某些实验室检查判断免疫抑制的程度,以便确定应用ARV治疗和结核病预防性治疗的最佳时机。ARV治疗需要良好的依从性,建议劝导和加强依从性。介绍ARV治疗方案和患者随访要求。优先治疗结核病。不管是否合并HIV感染,治疗结核病的原则是相同的。对合并结核病的患者应用ARV提出了建议。必须建立标准化和不断充实的信息系统,以便监控HIV与结核病双重感染者的处置及结核病和HIV联合防治的执行情况。通过对结核病患者进行HIV感染的筛查,发现HIV感染病例,并对其进行诊断和处置,医生能为减少HIV负担做出贡献,同样也为减少结核病负担做出贡献。     

The relationship between stress and clinical outcomes for persons living with HIV/AIDS: a systematic review of the global literature

For persons living with HIV/AIDS, the relationship between stress and clinical outcomes has received little attention in current research, yet represents an important area for future research and intervention. Chronic illness has been theorized to place additional demands on a person that may exceed their ability to cope with daily life, leading to long-term stress, which then increases the risk for negative health outcomes in persons already at risk. This paper reviews the existing global literature to answer two main questions: (1) how is stress conceptualized in research with persons living with HIV/AIDS? and (2) what are the current findings linking stress to clinical outcomes? Twenty-three articles are included in the final review. Findings reveal that researchers conceptualize stress in multiple ways for persons living with HIV/AIDS, including depressive symptomology, post-traumatic stress, life events, emotions linked to stress, and biological markers (such as cortisol levels and autonomic nervous system activity). Further, findings related to the link between stress and clinical outcomes are mixed; however, stress was shown to be related to lower CD4 cell counts, higher viral load, and disease progression. Several studies also showed a link between stress and poorer treatment adherence. Implications and directions for future research are discussed, including further thought into how we conceptualize stress for persons living with HIV, future research that is necessary to elucidate current mixed findings on the link between stress and clinical outcomes, and preliminary suggestions for intervention to prevent and alleviate stress in this population.     

Dropout from physical activity interventions in people living with HIV: a systematic review and meta-analysis

Physical activity (PA) interventions have been shown to improve the health of people living with HIV (PLWH), yet treatment dropout poses an important challenge. We conducted a meta-analysis to investigate the prevalence and predictors of treatment dropout in PA interventions in PLWH. Electronic databases were searched for records up to September 2016. Randomized control trials of PA interventions in PLWH reporting dropout rates were included. Random effects meta-analysis and meta-regression analyses were employed. In 36 studies involving 49 PA intervention arms, 1128 PLWH were included (mean age?=?41.6 years; 79.3% male; 39% White). The trim and fill adjusted treatment dropout rate was 29.3% (95% CI?=?24.5–34.7%). There was a significant lower dropout rate in resistance training interventions compared with aerobic (p?=?0.003) PA interventions, in studies utilizing supervised interventions throughout the study period (p?p?β?=?1.15, standard error (SE)?=?0.49, z?=?2.0, p?=?0.048), a lower body mass index(BMI) (β?=?0.14, SE?=?0.06, z?=?2.16, p?=?0.03), and a lower cardiorespiratory fitness (β?=?0.10, SE?=?0.04, z?=?2.7, p?=?0.006). The dropout from PA interventions is much higher in PLWH than in many other populations with chronic morbidities. Qualified professionals (i.e., exercise physiologists, physical educators, or physical therapists) should be incorporated as key care providers in the multidisciplinary care of HIV/AIDS and should prescribe supervised PA for PLWH in order to enhance adherence and reduce the burden of HIV/AIDS. Special attention should be given men, those with a higher BMI, and those with a lower cardiorespiratory fitness.     

The relationships among social support and quality of life in persons living with HIV/AIDS in Jiangxi and Zhejiang provinces,China

Several empirical studies, particularly those conducted in developed countries, have linked social support to quality of life among persons living with HIV/AIDS (PLWA). However, few studies have been conducted in developing countries, such as China; therefore, the question of any association being present between social support and quality of life in PLWA in China remains unanswered. This retrospective cross-sectional study was conducted to examine the relationships between social support and quality of life among PLWA in the Jiangxi and Zhejiang provinces of China. A total of 377 PLWA participated in this study, and questionnaires used included demographics, the Chinese Medical Outcomes Study Short Form-36, and a Social Support Rating Scale, all of which were collected through face-to-face interviews between 1 March and 15 April 2013 in six different County Centers of Disease Control and Prevention in Jiangxi and Zhejiang provinces, and one hospital in the Jiangxi. The health-related quality of life score was 64.7 ± 13.5 (out of a total score of 100), which was significantly lower than the national norm level of 78.2 ± 15.9. The total score of social support was 29.4 ± 7.8 (full score 66). The canonical correlation between social support and quality of participants' lives was shown to be statistically significant (p < 0.0001). The relationship between subjective support and quality of life among PLWA was also significant (p = 0.004). Subjective support and the use of social support showed a positive correlation with vitality, role-physical, and role-emotional, and a negative correlation with body pain. The current study suggests that PLWA with lower social support have diminished quality of life.     

The role of chronic pain and current substance use in predicting negative social support among disadvantaged persons living with HIV/AIDS

Chronic pain and substance use can strain the supportive relationships of persons with serious chronic illness, which may increase the likelihood of receiving negative, rather than positive, social support from informal caregivers and social network members. To our knowledge, this is the first study to longitudinally examine the effects of chronic pain and substance use on negative social support. The sample (N?=?383) comprised disadvantaged, primarily African-American, persons living with HIV/AIDS with a history of injection drug use, 32.4% of whom reported frequent or constant pain in the prior 6 months. Using factor analysis and structural equation modeling, current substance use and greater levels of chronic pain positively predicted negative social support 12 months later, after controlling for baseline negative support, viral load, age and sex. We also found a significant interaction effect such that among those not using substances, there was a significant positive association between pain and negative support, but no such association among those currently using substances. The findings emphasize the importance of treatment of chronic pain and substance use in the supportive functioning of social networks of a disadvantaged population with serious chronic conditions and persistent health disparities.     

云南省HIV感染者／AIDS病人社会支持度调查分析

目的调查云南省艾滋病病毒（HIV）感染者/艾滋病（AIDS）病人（PLWHA）的社会支持现状,探讨其影响因素。方法采用固定场所连续抽样的方式,在AIDS疫情较为严重的德宏州芒市、瑞丽市和陇川县,抽取2012年5月15日至6月14日期间,接受常规随访服务的PLWHA病人作为调查对象,每个县分别连续抽取100名调查对象,用肖水源制订的社会支持评定量表进行社会支持评价。结果 PLWHA的社会支持总分为（37.90±8.01）分,明显高于国内常模水平（34.56±3.73）,t=7.219,P〈0.001。社会支持总分不仅与民族、职业、婚姻、家庭年收入等一般人口学特征相关,还与亲人知晓病人感染情况、发现感染时间的长短、抗病毒治疗和生活救助服务等因素相关,其中与职业和婚姻的相关性较大。结论云南省PLWHA的社会支持总体处于较高的水平,但是汉族、无业、无配偶和低收入等人群的社会支持度仍相对较低,应该受到更多的关注,抗病毒治疗和生活救助能有效提高其社会支持度。     

HIV/AIDS and family support systems: A situation analysis of people living with HIV/AIDS in Lagos State

Current statistics about the HIV/AIDS epidemic in Nigeria do not reveal the broader social and economic impacts of the disease on the family. The study therefore primarily aimed to address the socio-economic effects of HIV infection on individuals and their families. The study was carried out in Lagos State. In-depth interviews were employed to collect information from 188 people living with HIV/AIDS through support groups in the state, while four focus group discussions were conducted to elicit information from people affected by AIDS about the socio-economic impacts of HIV/AIDS on families in Nigeria. From the survey, among people living with HIV/AIDS, 66% of females and males were in the age group 21–40 years, while 10% were older people above 60 years of age. Findings revealed that as HIV/AIDS strikes at parents, grand parents are assuming responsibility for bringing up the children of the infected persons and the orphans of those killed by the virus. It was striking that some of the older caregivers could not meet the requirement of these children. They are often forced to work more than they would have, or borrow in order to cope with the needs of these extra mouths. Some of the infected people have sold their properties to enable them to cope with the economic effects of the virus, while their children have had to drop out of school, since they could not afford the school fees and other related expenses. It was suggested that PLWHA should be economically empowered with adequate medical treatment, in order to reduce the impact of the disease on the family.     

Patient activation among people living with HIV: a cross-sectional comparative analysis with people living with diabetes mellitus

Standardized self-management supports are an integral part of care delivery for many chronic conditions. We used the validated Patient Activation Measure (PAM®) to assess level of engagement for self-management from a sample of 165 people living with HIV (PLWH) and 163 people with diabetes. We conducted multivariable logistic regression to assess associations between demographics and PAM® scores. PLWH had high levels of activation that were no different from those of people with diabetes (mean score?=?67.2, SD?=?14.2 versus 65.0, SD?=?14.9, p?=?0.183). After adjusting for patient characteristics, only being on disability compared to being employed or a student was associated with being less activated (AOR?=?0.276, 95%CI?=?0.103–0.742). Our findings highlight the potential for the implementation of existing standardized chronic disease self-management programs to enhance the care delivery for PLWH, with people on disability as potential target populations.     

The emerging needs of persons living with haemophilia and HIV/AIDS in British Columbia

The Haemophilia Programme Enhancement Project (HPEP) was initiated in 1991 to assist Haemophilia Programme staff meet the increasing and complex needs of persons living with haemophilia and HIV/AIDS. A review of the HPEP in 1997 revealed that the needs of this population have changed due to the advances in medical treatment, laboratory monitoring and the proliferation of HIV/AIDS expertise and resources. Continued roles for the HPEP include triage and liaison with HIV specialists to ensure appropriate care, given the possible haematological complications that coexist with HIV and/or liver disease. Access to resources remains problematic for those living in remote regions of British Columbia, and a strong advocacy presence is needed. Services to families and children of persons with HIV and haemophilia is required, especially around disclosure and preparation for the stresses incurred during hospitalization. The fact that many long-term survivors are living in relatively good health has sparked renewed optimism amongst this group. Those who continue to do well are in the process of re-evaluating their lives and may need assistance in establishing both short- and long-term goals. Interventions to sustain hope could include individual and family counselling, facilitated support meetings and a commitment to the provision of vocational rehabilitation counselling, re-training and job placement. For the first time in years, many persons living with haemophilia and HIV are facing an opportunity to look forward into the future and devise ventures which will enhance their feelings of productivity.     

艾滋病病毒感染者/艾滋病病人生存质量与社会支持的典型相关分析

目的了解艾滋病病毒感染者/艾滋病病人(HIV/AIDS病人)生存质量和社会支持现状。方法采用世界卫生组织生存质量量表简表(WHOQOL-BREF)中文版和社会支持评定量表,对98名HIV/AIDS病人进行面对面询问式匿名调查。结果 2010年7月至2011年3月共发出调查问卷100份,完成有效调查98份。典型相关分析结果显示:社会支持中影响较大的是主观支持和对支持的利用度2个因素,生存质量中影响较大的是社会关系领域和环境领域。主观支持、对支持的利用度与社会关系领域和环境领域成正相关。第一对典型变量(U1、V1)的典型相关系数分别为0.569(P=0.0001)。结论 HIV/AIDS病人获得的主观支持越多、对支持的利用度越高,其社会关系领域和环境领域得分越高。     

Sexually transmitted infections and infectiousness beliefs among people living with HIV/AIDS: implications for HIV treatment as prevention

Objectives

Sexually transmitted infections (STIs) significantly impact the health of people living with HIV/AIDS, increasing HIV infectiousness and therefore transmissibility. The current study examined STIs in a community sample of 490 HIV‐positive men and women.

Methods

Assessments were performed using confidential computerized interviews in a community research setting.

Results

Fourteen per cent of the people living with HIV/AIDS in this study had been diagnosed with a new STI in a 6‐month period. Individuals with a new STI had significantly more sexual partners in that time period, including non‐HIV‐positive partners. Participants who had contracted an STI were significantly more likely to have detectable viral loads and were less likely to know their viral load than participants who did not contract an STI. Multivariate analysis showed that believing an undetectable viral load leads to lower infectiousness was associated with contracting a new STI.

Conclusions

Individuals who believed that having an undetectable viral load reduces HIV transmission risks were more likely to be infectious because of STI coinfection. Programmes that aim to use HIV treatment for HIV prevention must address infectiousness beliefs and aggressively control STIs among people living with HIV/AIDS.     

Anxiety,depression, and HIV symptoms among persons living with HIV/AIDS: the role of hazardous drinking

Hazardous drinking is common among persons living with HIV/AIDS (PLWHA) and associated with numerous negative health consequences. Despite the well-established negative effects of hazardous drinking among PLWHA, scholarly work has neglected to explore the role of such drinking in regard to anxiety/depressive symptoms and HIV symptom expression. The current study investigated associations between hazardous drinking and anxiety/depressive symptoms and HIV symptoms among PLWHA. Participants (n = 94; 88.3% male; M_age = 48.55; SD = 9.15) included PLWHA recruited from AIDS service organizations in the northeast. Hazardous drinking was significantly associated with anxiety/depressive symptoms and HIV symptom expression above and beyond the variance accounted for by sex, race, recruitment site, and CD4 T-Cell count, as well as other cognitive-affective variables (emotion dysregulation, distress intolerance, and anxiety sensitivity). The present results provide empirical support that hazardous drinking is indeed related to depressive and anxiety symptoms as well as HIV symptom distress and that this effect is not attributable to other factors commonly related to both alcohol use problems and emotional distress among PLWHA. Results highlight the importance of alcohol interventions for excessive drinking specifically tailored for PLWHA to facilitate better mental and physical health adjustment.     

State-level spending on health care and social services for people living with HIV/AIDS in the USA: a systematic review

Every year for the past decade, approximately 50,000 people have been diagnosed with HIV or AIDS in the USA, and the incidence of HIV/AIDS varies considerably from state to state. Studies have shown that health care services, most notably treatment with combination antiretroviral therapy, can help people living with HIV/AIDS (PLWHA) live healthier, longer lives, and prevent the spread of HIV from person to person. In addition, social services, such as housing support and provision of meals, have also shown to be important for helping PLWHA adhere to antiretroviral treatment and maintain contact with health care providers for improved health outcomes. Although spending on health care and social services for PLWHA varies across the USA, the relationship between state-level spending on these services and HIV/AIDS-related outcomes is not clear. We therefore conducted a systematic review of peer-reviewed literature to identify studies that explore state-level spending on health care services and/or social services for PLWHA and HIV/AIDS-related health outcomes in the USA.     

安徽农村地区某项目乡AIDS病人/HIV感染者社会支持状况评价

目的了解安徽农村地区艾滋病(AIDS)病人/艾滋病病毒(HIV)感染者社会支持状况。方法整群抽取安徽农村地区某项目乡AIDS病人/HIV感染者进行横断面研究,社会支持状况采用社会支持量表评定。结果219名AIDS病人/HIV感染者社会支持总分为32.50±7.13,主观支持为17.95±4.15,客观支持为8.90±3.02,支持利用度为5.65±2.42;家庭和政府在AIDS病人/HIV感染者的社会支持网络中起到了决定作用,家庭人口数多及子女孝顺的AIDS病人/HIV感染者社会支持评分较高。结论AIDS病人/HIV感染者社会支持网络建设应充分发挥政府和家庭的主导作用,同时进一步调动其他组织和人员参与其中。     

My secret: The social meaning of HIV/AIDS stigma

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.     

Barriers to social support for persons living with HIV/AIDS

The purpose of this study was to test a barrier theory of perceived social support to HIV-positive gay men. The proposed model was tested for friends and family separately in order to investigate the uniqueness each provided. In both models, it was hypothesized that the presence of barriers to social support (availability, intimacy and disclosure) diminished acquisition of social support. The influence of barriers on the relationship between social support and health outcome (i.e. depression, t-cell count) for both friend and family models was also investigated. In general, data from HIV-positive gay men support barrier theory premises for both family and friends. Implications for helping professionals and researchers are proposed.     

Pain-related anxiety in relation to anxiety and depression among persons living with HIV/AIDS

Persons living with HIV/AIDS (PLHA) experience clinically significant pain as a result of HIV and such pain is often related to increased levels of anxiety/depression. Pain-related anxiety has been identified as a mechanism in the onset and progression of pain experience and associated affective distress. However, there has not been empirical study of pain-related anxiety in relation to affective processes among PLHA. To address this gap, hierarchical multiple regressions were conducted using SPSS v.21 to examine pain-related anxiety (as measured using the Pain Anxiety Symptoms Scale) in relation to anxiety and depressive symptoms (as measured using the Mood and Anxiety Symptoms Questionnaire) among 93 PLHA (10.8% female; Mean age?=?49.63, SD?=?8.89). Pain-related anxiety was significantly related to anxious arousal symptoms (β?=?.43) and anhedonic depressive symptoms (β?=?.25); effects were evident beyond the variance accounted for by CD4 count, race, sex, income level, and current level of bodily pain. The present results suggest that pain-related anxiety may play a role in the experience of anxiety and depressive symptoms among PLHA.