Women from Africa living with HIV in London: a descriptive study

There are no studies that have examined the particular needs and experiences of African women living with HIV in the UK at a time when they represent an increasingly large proportion of the UK HIV epidemic. This study explores the illness biographies and daily lives of HIV-positive African women receiving treatment in London. Sixty-two women from 11 African countries attending HIV specialist clinics in five London hospitals participated in self-completion questionnaires and in depth semi-structured interviews. Using a narrative approach, women were asked to talk about their HIV status in the broader context of their life history. Important differences exist within this group based mainly on nationality, income, education level and legal status in the UK. However, marked similarities also emerged which were related in part to their situation as migrants and were compounded by their illness. Stigma, both actual and perceived, had a profound impact on women's lives, making control of information about their situation a matter of acute concern. This had an effect on how women accessed health services and voluntary sector agencies. The resilience of women in dealing with difficulties in their lives was strengthened by religious belief. Such similarities and differences need to be properly understood by health and social care professionals if they are to offer the most appropriate care for this growing population of patients.     

HIV感染者/AIDS患者自杀原因分析及危机干预

目的通过对艾滋病病毒(HIV)感染者伎滋病(AIDS)患者自杀原因的分析，探讨危机的干预措施，以预防HIV感染者／AIDS患者的自杀。方法收集1991～2003年间北京地坛医院收治的848例HIV感染者／AIDS患者病历，统计自杀成功或未遂的全部已知病例，采用医学和心理学的干预手段。结果2002年6月实施干预前后各统计424例患者，干预以前自杀人数为21例，实施干预以后的自杀人数为2例。结论对HIV感染者／AIDS患者进行积极的危机干预，能有效地预防自杀事件的发生。     

Evaluation of an HIV prevention intervention for women living with HIV

ABSTRACT

It is estimated that 23% of the adults and adolescents living with HIV in the United States are female. The Division of HIV/AIDS Prevention at the Centers for Disease Control and Prevention (CDC) funds evidence-based interventions (EBIs) to reduce HIV risk behaviors, including HIV prevention programs for people living with HIV and their partners. While EBIs have been shown to be effective in controlled research environments, there are limited data on intervention implementation in real-world settings. Women Involved in Life Learning from Other Women (WILLOW) is a four-session small-group intervention that targets heterosexual women aged 18–50 who are living with HIV. This evaluation assessed changes in participants’ HIV knowledge, attitudes, beliefs and risk behaviors. A repeated measures design was used to collect participant risk behaviors at baseline, and again at three and six months post-intervention. Changes in attitudes, beliefs, and risk behaviors were assessed using generalized estimating equations. After participation in WILLOW, participants reported increased HIV knowledge, attitudes and beliefs, being more supportive of condom use, and reduced prevalence of HIV risk behaviors. Findings suggest that the WILLOW intervention can be successfully delivered by community-based organizations to reduce HIV risk behaviors among members of this high-risk population.     

Resiliency in young children whose mothers are living with HIV/AIDS

Resiliency was investigated among well children 6-11 years of age (N = 111) whose mothers are living with AIDS or are HIV symptomatic to determine if mother's HIV status was a risk factor that could effect child resiliency, as well as investigate other factors associated with resiliency. Assessments were conducted with mother and child dyads over four time points (baseline, 6-, 12-, and 18-month follow-ups). Maternal illness was a risk factor for resiliency: as maternal viral load increased, resiliency was found to decrease. Longitudinally, resilient children had lower levels of depressive symptoms (by both mother and child report). Resilient children also reported higher levels of satisfaction with coping self-efficacy. A majority of the children were classified as non-resilient; implications for improving resiliency among children of HIV-positive mothers are discussed.     

Four-year behavioral outcomes of an intervention for parents living with HIV and their adolescent children

OBJECTIVE: The adjustment of parents living with HIV (PLH) and their adolescent children was examined over 4 years in response to an intervention. Outcomes at 2 years had been previously published. METHODS: A randomized controlled trial was conducted, with a representative sample from New York City. RESULTS: In the intervention condition, fewer adolescents became teenage parents, and conduct problems tended to be lower over 4 years than in the standard care condition. Fewer parents were drug dependent and tended to relapse into substance use or use passive coping styles compared with the standard care condition over 4 years. The time-trend analysis showed that the significant reductions in problem behaviors and emotional distress previously observed over 15-24 months in the intervention condition, then eroded over time and were non-significant at 48 months. CONCLUSIONS: Ongoing support and skills are needed to maintain intervention effects over longer periods.     

老年HIV感染者运动促进与障碍因素的质性研究

目的 描述老年HIV感染者运动的促进与障碍因素,为制订相应的运动促进项目提供依据.方法 本研究为描述性质性研究,采用便利抽样和目的 抽样法选取2020年7月至2021年1月上海市艾滋病定点诊疗机构艾滋病门诊的老年HIV感染者12名进行半结构式访谈.采用传统内容分析和归纳式内容分析法分析资料.结果 12名访谈对象中男性8...     

Psychosocial issues of women with HIV/AIDS

This article discusses some of the issues specifically associated with women and HIV. The myth is that women do not get AIDS and that lesbians do not get AIDS either. It also explores the unique sociocultural context in which HIV-infected women exist. The hope is to put faces on the numbers that are increasing each day as women get infected, and to offer advice to therapists on how to deal with these issues.     

Coping styles among families of children with HIV infection

The primary aim of this study was to examine coping strategies among families of HIV-infected children and how they relate to medical, central nervous system (CNS) and family environment factors. Caregivers of HIV-positive children (N=52) completed a family coping measure (F-COPES) and provided information regarding family environment. Data regarding medical and CNS status were obtained from patient records. Results indicated that families' passive coping and spiritual support were among the coping techniques used most often, and social support was used least often. Medical variables were unrelated to any coping styles. Families of children with CNS impairment endorsed more passive coping techniques than families of children with no apparent deficits. A trend was found for non-biological caregivers to seek out more community resources and support than biological caregivers. Findings suggest the need to target families least likely to utilize resources, and to teach them to effectively seek out and benefit from social and community supports.     

Community support to families living with HIV in London: An agency overview

In 1996 a structured questionnaire, relating to services provided, was completed by 12 agencies providing support to families with HIV in London. A wide range of information, practical and therapeutic services were available from these agencies but these usually had a primary focus on supporting the adults in these families. Only one agency had been set up specifically to offer a direct service for children within their own home or community. Services for children within most agencies consisted of organized child care or social activities. often provided to enable parents to access other services at the centre. Concern was frequently expressed that the normal and emotional needs, especially of older children, were not being met. Many children attending events at these agencies were unaware of the diagnosis or the reasons for attending these centres. Implications are discussed on how future development of services in the voluntary and statutory sector will need to address the specific and changing needs of infected and affected children.     

Psychosocial needs, mental health, and HIV transmission risk behavior among people living with HIV/AIDS in St Petersburg, Russia

OBJECTIVES: The number of new HIV infections in Russia has doubled annually since 1996. A total of 232 424 HIV infections have been officially recorded but the actual number probably exceeds one million. Very little is known about the social, psychological, behavioral, and health care service access of persons living with HIV in Russia. DESIGN: A cross-sectional sample of 470 persons with HIV/AIDS recruited in 2002 using a representative sampling plan in major St. Petersburg HIV care and service agencies. METHODS: Participants completed anonymous self-administered questionnaires that elicited detailed information about social and psychological characteristics, HIV serostatus disclosure and discrimination experiences, and risk practices since learning of their HIV positive status. RESULTS: Most participants were young (mean age, 25.3 years), knew of their HIV positive status for about 2 years, and had histories of injecting drug use as well as sexual risk behavior. A large proportion reported encountering discrimination including being forced to sign documents acknowledging their HIV status (47.9%), refusal of general health care (29.6%), being fired from their jobs (9.9%), and being forced from their family homes (9.0%). Over one-third had probable clinical depression. Most remained sexually active since learning of their HIV positive serostatus, approximately half engaged in unprotected sex with HIV negative partners, and condoms were not used one-third of the time with discordant partners. A majority of injecting drug users in the sample still shared needles. CONCLUSIONS: HIV-infected persons in Russia experience a wide range of social, psychological, and care access problems. Improved services are urgently needed for persons living with HIV/AIDS in Russia.     

HIV/AIDS患者并发贫血的临床研究

目的　了解艾滋病病毒 /艾滋病 (HIV/AIDS)患者贫血并发情况 ,探讨贫血程度对判定HIV/AIDS患者病情进展的意义。方法　对未经治疗的HIV/AIDS患者检测免疫功能指标 (CD+ 4 T细胞 )和全血细胞计数。遵循美国疾病控制与预防中心 (CDC) 1993年诊断标准 ,对 94例HIV/AIDS患者按病情阶段分为A、B、C组。对血红蛋白浓度 (HGB)和病情阶段及CD+ 4 T细胞之间的关系进行统计学分析。结果　 94例HIV/AIDS患者中有 37例并发贫血 ,在A、B、C组贫血的发生率分别为 5 6 %、2 4 1%、6 1 7% ,贫血发生率在 3组间差异有非常显著的统计学意义 (χ2 =2 1 2 6 3,P <0 0 0 1)。 37例贫血患者的HGB在 3组间差异有显著的统计学意义 (F =4 978,P =0 0 13)。对 94例AIDS患者的CD+ 4 T细胞与HGB进行曲线拟合分析 ,发现二者之间存在曲线相关 (P <0 0 0 1) ,曲线回归方程为HGB =2 3 2 4 6×ln(CD+ 4 )。结论　AIDS患者贫血的发生率较高 ,贫血的发生率及严重程度随着病情的进展而发展。HGB随着免疫功能的衰减而下降。贫血的程度对AIDS患者的病情评判有重要意义     

A randomized trial of a proactive cellular telephone intervention for smokers living with HIV/AIDS

OBJECTIVE: To assess the efficacy of an innovative smoking cessation intervention targeted to a multiethnic, economically disadvantaged HIV-positive population. DESIGN: A two-group randomized clinical trial compared a smoking cessation intervention delivered by cellular telephone with usual care approach. METHODS: Current smokers from a large, inner city HIV/AIDS care center were recruited and randomized to receive either usual care or a cellular telephone intervention. The usual care group received brief physician advice to quit smoking, targeted self-help written materials and nicotine replacement therapy. The cellular telephone intervention received eight counseling sessions delivered via cellular telephone in addition to the usual care components. Smoking-related outcomes were assessed at a 3-month follow-up. RESULTS: The trial had 95 participants and 77 (81.0%) completed the 3-month follow-up assessment. Analyses indicated biochemically verified point prevalence smoking abstinence rates of 10.3% for the usual care group and 36.8% for the cellular telephone group; participants who received the cellular telephone intervention were 3.6 times (95% confidence interval, 1.3-9.9) more likely to quit smoking compared with participants who received usual care (P = 0.0059). CONCLUSIONS: These results suggest that individuals living with HIV/AIDS are receptive to, and can be helped by, smoking cessation treatment. In addition, smoking cessation treatment tailored to the special needs of individuals living with HIV/AIDS, such as counseling delivered by cellular telephone, can significantly increase smoking abstinence rates over that achieved by usual care.     

A pilot coping improvement intervention for late middle-aged and older adults living with HIV/AIDS in the USA

As AIDS becomes more prevalent among late middle-aged and older adults, mental health support services that facilitate the coping and adjustment efforts of this group are increasingly needed. The current article: (1) outlines a coping improvement group intervention for HIV-infected older adults; and (2) examines the efficacy of the intervention utilizing a small sample (N = 16) of older adults living with HIV/AIDS in Milwaukee, Wisconsin and New York City. The intervention focused on enabling HIV-infected older adults to accurately appraise sources of stress, develop adaptive coping responses and access social support resources to facilitate coping efforts. An evaluation of this pilot intervention, conducted using a pretest-posttest, no control group design, revealed that the intervention increased participants' perceptions of social support, produced higher perceptions of social wellbeing and enabled participants to engage in more planful problem solving, confrontive coping and future optimism. Intervention participants also experienced less stressor burden associated with AIDS-related loss and health concerns. While the current intervention showed potential to facilitate the adjustment efforts of HIV-infected older adults, randomized clinical trials of this intervention with larger samples are needed before its appropriateness for this population can be determined.     

Psychosocial Adjustment of Women to Living with HIV/AIDS

Psychosocial adjustment to living with HIV/AIDS was examined in a purposive sample of 146 New York City, African-American, Puerto Rican, and White non-Hispanic women using the Psychosocial Adjustment to Illness Scale, self-report version (PAIS-SR). Puerto Rican participants reported significantly more problems than African-Americans on the Summary Scale and the Domestic Environment and Psychological Distress domain subscales and significantly more problems than either Whites or African-Americans on the Social Environment domain subscale. Problematic sexual relationships were found to be significantly associated with race/ethnicity, although scores did not differ significantly between any two groups. On average, women in all three racial/ethnic groups reported high levels of psychosocial adjustment problems to their illness relative to normative data for cancer patients. These findings suggest that, while all HIV-infected women may be at risk for problematic psychosocial adjustment to living with HIV/AIDS, Puerto Rican women may be especially vulnerable.     

Psychosocial needs expressed by the natural caregivers of HIV infected children

The presence in a family of a young child with AIDS, with the exception of a small number of transfusion-infected children, implies almost necessarily the presence of an infected adult, usually the mother. The problem in such a situation is not that of a child with a fatal illness but that of an entire family. Our study included a sample of thirty natural caregivers. These were mostly mothers but others responsible for the care of a seropositive child, such as fathers, aunts and grandmothers, were also included. The aim of the project was to describe their perceptions of their own psycho-social needs. Our results reveal that these caregivers are economically disadvantaged. They need help in coping with stress and their life situation. Their need to confide in others is frequently not met. However, the need to learn how to protect themselves and other members of the family against both HIV and other infections and to know the course and the treatments associated with this disease are seen by them, both as being very important and as being well met, particularly by the health professionals who care for them.     

179例HIV／AIDS病人肝脏损害的临床研究

目的探讨艾滋病病毒（HIV）感染者／艾滋病（AIDS）病人的肝脏功能损害情况及其影响因素。方法回顾分析179例HIV／AIDS病人临床资料,根据肝脏功能损害程度,分为肝功能正常组、肝功能轻度损害组、中度损害组、重度损害组,比较各组间相关情况。结果肝功能损害组使用肝毒性药物、合并HBV和／或HCV感染的比例均高于肝功能正常组,两者比较差异有显著的统计学意义（P值分别为0．039、0．030、0．003）。中重度肝功能损害组使用肝毒性药物的比例高于轻度损害组,两者比较差异有显著的统计学意义（P=0．037）。结论HIv／AIDS病人肝脏损害发生率高,而男性、使用肝损害药物、合并HBV和／或HCV是HIV／AIDS病人发生肝脏损害的危险因素。     

Relationship between expressed HIV/AIDS-related stigma and HIV-beliefs/knowledge and behaviour in families of HIV infected children in Kenya

OBJECTIVES: To quantify expressed stigma in clients of the Kangemi program for HIV+ children, and to characterize the association between stigma and other population characteristics. METHODS: By means of a household survey we created a stigma index and indices for other social and knowledge domains that influence HIV-related healthcare. We used chi2, anova, and correlation to identify associations between domains. RESULTS: The mean (+/-SD) expressed stigma on a six points scale (6 = least stigma) was 3.65 +/- 1.64. Composite scores on knowledge about AIDS were skewed toward more knowledge; and analysis of individual knowledge items indicates that most respondents reject erroneous traditional beliefs and myths about the causes and transmission routes of AIDS. Respondents who were younger, had never married, and had less education expressed greater stigma. Differences in stigma were associated with poor knowledge about AIDS and negative attitudes toward testing, but not with gender or tribal affiliation. Condom use at last intercourse, unrelated to stigma, was only 40% (n = 218). CONCLUSIONS: While this population has good knowledge about AIDS and appraises risks realistically, it fails to reduce these risks. Associations between stigma and other domains can inform interventions that improve HIV care and mitigate spread of HIV.     

Effects of behavioral intervention on substance use among people living with HIV: the Healthy Living Project randomized controlled study

AIM: Reductions in substance use were examined in response to an intensive intervention with people living with human immunodeficiency virus (HIV) (PLH). DESIGN, SETTING AND PARTICIPANTS: A randomized controlled trial was conducted with 936 PLH who had recently engaged in unprotected sexual risk acts recruited from four US cities: Milwaukee, San Francisco, New York and Los Angeles. Substance use was assessed as the number of days of use of 19 substances recently (over the last 90 days), evaluated at 5-month intervals over 25 months. INTERVENTION: A 15-session case management intervention was delivered to PLH in the intervention condition; the control condition received usual care. MEASUREMENTS: An intention-to-treat analysis was conducted examining reductions on multiple indices of recent substance use calculated as the number of days of use. FINDINGS: Reductions in recent substance use were significantly greater for intervention PLH compared to control PLH: alcohol and/or marijuana use, any substance use, hard drug use and a weighted index adjusting for seriousness of the drug. While the intervention-related reductions in substance use were larger among women than men, men also reduced their use. Compared to controls, gay and heterosexual men in the intervention reduced significantly their use of alcohol and marijuana, any substance, stimulants and the drug severity-weighted frequency of use index. Gay men also reduced their hard drug use significantly in the intervention compared to the control condition. CONCLUSIONS: A case management intervention model, delivered individually, is likely to result in significant and sustained reductions in substance use among PLH.     

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.