The moderation of Mindfulness-based stress reduction effects by trait mindfulness: results from a randomized controlled trial

Mindfulness-based stress reduction (MBSR) has shown effectiveness for a variety of mental health conditions. However, it is not known for whom the intervention is most effective. In a randomized controlled trial (N = 30), we explored whether individuals with higher levels of pretreatment trait mindfulness would benefit more from MBSR intervention. Results demonstrated that relative to a control condition (n = 15), MBSR treatment (n = 15) had significant effects on several outcomes, including increased trait mindfulness, subjective well-being, and empathy measured at 2 and 12 months after treatment. However, relative to controls, MBSR participants with higher levels of pretreatment mindfulness showed a larger increase in mindfulness, subjective well-being, empathy, and hope, and larger declines in perceived stress up to 1 year after treatment.     

Brief report: fathering a child living with HIV/AIDS: psychosocial adjustment and parenting stress

OBJECTIVE: To examine the psychosocial stressors experienced by fathers of children diagnosed with HIV/AIDS. METHODS: Thirty-one fathers whose children (ages 6 to 19) were participating in pediatric HIV clinical trials completed self-report measures of parenting stress, psychological distress, and need for psychosocial services. RESULTS: Over half of this sample experienced significantly elevated levels of both parenting stress and psychological distress compared to standardized norms. Ninety-seven percent of these men reported the need for services including gender-specific support groups, assistance with discipline, disease management, and assistance with planning for the future. CONCLUSIONS: Elevated levels of parenting stress and psychological distress in fathers of children living with HIV suggest the need for additional psychological intervention in this population.     

Community collaborative youth-focused HIV/AIDS prevention in South Africa and Trinidad: preliminary findings

BACKGROUND: South Africa and Trinidad and Tobago are disproportionately impacted by high rates of HIV/AIDS among adolescents. OBJECTIVE: The article describes the HIV crises in these countries; outlines a community participatory research framework to adapt and deliver family-based prevention; and presents preliminary data from intervention pilots in each setting. METHODS: Adapted interventions were piloted with N = 140 families in South Africa and N=16 families in Trinidad and Tobago to refine recruitment and retention efforts and to assess the adapted interventions' impact on family and risk-related constructs. RESULTS: Both settings reported promising results including high recruitment and retention and favourable pre to post changes in parent/youth frequency and comfort in talking about sensitive subjects, HIV transmission knowledge and attitudes about persons with HIV/AIDS. CONCLUSION: International HIV-prevention alliances are increasing. Such alliances are challenged by trust issues, power-differentials and ideological differences. Recommendations are provided on how some challenges can be overcome.     

HIV/AIDS knowledge and attitude towards people living with HIV/AIDS (PLWHA): a cross-sectional study of primary school teachers

BackgroundTeachers are in advantage position to propagate correct information with regard to HIV/AIDS thereby influencing attitude towards PLWHA. With correct information stigmatization leading to spread of the scourge might be prevented.Aims & ObjectivesThe study was conducted to determine knowledge and attitude of primary school teachers towards PLWHA.Methods & MaterialsThe cross-sectional survey was used to study a sample of 400 primary school teachers in Ebonyi State, Nigeria. The instrument used for data collection was researchers'' designed questionnaire. Out of 400 copies of questionnaire administered; 394 representing 98.5% return rate, were used for analysis of data.ResultsResults showed respondents had moderate (57.4%) knowledge concerning HIV/AIDS and positive attitude (3.09 ± 0.98) to PLWHA. Female teachers'' dispositions to PLWHA were better than the males based on their attitude scores and the difference was not significant in general knowledge of HIV/AIDS and attitude to PLWHA.ConclusionOur findings underscore the need for a universal health education programme, focusing on HIV/AIDS education, in education institutions that train teachers in Nigeria so as to possibly mitigate the discrepancy in knowledge regarding curability of AIDS and any undesirable attitude towards PLWHA that may arise among teachers.     

Attitude of antenatal attendees to people living with HIV/AIDS in Uyo, south-south Nigeria

Background

Stigmatization and discrimination of people living with HIV/AIDS has a negative impact on the global efforts to control the HIV/AIDS pandemic. Due to fear of stigmatization and discrimination, many people are reluctant to undergo voluntary counseling and testing, infected individuals are often unwilling to disclose their status and some of them still engage in high-risk behaviours leading to increased transmission of the virus.

Study design and setting

A study of the attitudes to people living with HIV/AIDS was carried out among antenatal clinic attendees at the University of Uyo Teaching Hospital with the aim of developing site-specific information and counseling interventions to reduce stigmatization and discrimination of people living with HIV/AIDS. Information was elicited from 265 randomly selected women who booked for antenatal care between September and December 2005 with the use of a self-administered questionnaire.

Results

263 questionnaires were duly completed and analyzed. The mean age of the respondents was 27 ± 5.1 years, majority of them (52.1%) were either unemployed or unskilled workers and 42.9% of them had tertiary education. Awareness and knowledge of HIV/ AIDS was high, (95.8%) and (86.7%) respectively. Majority of the respondents (55.6%) were also assessed as having a positive attitude to people living with HIV/AIDS (PLWHA). There was a statistically significant association between good knowledge of HIV/AIDS and a positive attitude to PLWHA (P=0.000) and a high educational status with a positive attitude to PLWHA (P=0.009).

Conclusion

combating stigma and discrimination is an important process in controlling the epidemic. Specific information and counseling interventions aimed at dispelling misconceptions about HIV/AIDS should be reinforced.     

Exercise training reduces oxidative stress in people living with HIV/AIDS: a pilot study

Background: Exercise training has been shown to be an effective strategy to balance oxidative stress status; however, this is underexplored in people living with HIV/AIDS (PLWHA).

Objective: To evaluate the effects of exercise training on oxidative stress in PLWHA receiving antiretroviral therapy.

Methods: Patients performed 24 sessions (3 times per week, 8 weeks) of either aerobic (AT), resistance (RT), or concurrent training (CT). Glutathione disulphide to glutathione ratio (GSSG/GSH) in circulating erythrocytes and thiobarbituric acid–reactive substances (TBARS) in plasma samples were assessed as oxidative stress markers. Eight PLWAH completed the training protocol (AT =3, RT =3, CT =2). The GSSG/GSH and TBARS values were logarithmically transformed to approximate a normal distribution. A paired t-test was used to determine the differences between baseline and post-training values.

Results: Data-pooled analysis showed a decrease in GSSG/GSH and TBARS after the training period: log GSSG/GSH= –1.26?±?0.57 versus –1.54?±?0.65, p?=?.01 and log TBARS =0.73?±?0.35 versus 0.43?±?0.21, p?=?.01. This was paralleled by a rise in peak oxygen uptake (VO_2peak?=?29.14?±?5.34 versus 32.48?±?5.75?ml kg^?1 min^?1, p?=?.04). All the subjects who performed resistance exercises showed an average gain of 37?±?8% in muscle strength with no difference between performing single or multiple sets in terms of muscle strength gain. The results reinforce the clinical importance of exercise as a rehabilitation intervention for PLWHA and emphasizes the safety of exercise at the physiological level with the potential to mediate health outcomes.     

Online support group use and psychological health for individuals living with HIV/AIDS

Objective

The Internet provides an opportunity for individuals with HIV/AIDS to obtain support and information in a timely and convenient manner. The present study examines the psychological effects of online support group use for individuals living with HIV/AIDS.

Methods

A total of 340 HIV positive online support group users completed an online survey.

Results

Results from structural equation modeling showed that individuals with higher levels of online support group participation had higher levels of empowering processes, which in turn, had higher levels of optimism toward life. Optimism was related to lower levels of loneliness and depression while loneliness was also related to higher levels of depression.

Conclusion

The findings suggest that participants with higher levels of online support group participation had better psychological health than those with lower levels of participation.

Practice implications

Findings suggest that the use of online support groups could be promoted to individuals with HIV/AIDS. Healthcare professionals should work to increase the motivation and confidence patients have in using online support groups. Health education should also be provided to patients with HIV/AIDS so to improve their skills and literacy in using online support groups.     

在HIV/AIDS小组心理治疗的实践

目的：在HIV／AIDS患者中开展小组心理治疗。探索经验和方法。方法：采用支持、认知为导向的集体心理治疗方法，对三位HIV／AIDS个体进行心理治疗。结果：三位患者在小组治疗后认同HIV身份之时，接纳自己，面对现实、减轻了孤独感。结论：在HIV／AIDS人员中实施集体心理治疗将有利于提高其生活质量。     

Association of IL-6, IL-10 and CXCL10 serum concentrations with visceral Kaposi's sarcoma in people living with HIV/AIDS

Human gammaherpesvirus 8 (HHV-8) is the etiologic agent of Kaposi’s sarcoma (KS), one of the most common cancers in people living with HIV/AIDS. It is believe that the course of both HIV and HHV-8 infection is associated with the imbalance of anti- and/or pro-inflammatory cytokines. Here, we evaluated the IL-6, TNF-α, IL-10, CCL2 and CXCL10 serum concentrations in HIV- and HIV/HHV-8 (without KS) individuals, and in patients with cutaneous or visceral AIDS-KS. Serum concentrations of IL-6, IL-10 and CXCL10 were significantly higher in the AIDS-KS group compared to HIV and HIV/HHV-8 individuals. Similarly, the concentrations of theses cytokines were higher in patients with visceral than in those with cutaneous AIDS-KS. The TNF-α concentration was significantly higher in the HIV group compared to HIV/HHV-8 (with and without KS) individuals, and CCL2 levels did not present significant difference among the groups. The HIV viral load was undetectable in all patients from the HIV and HIV/HHV-8 groups. On the other hand, in the AIDS-KS group, most patients had detectable HIV viral load. In this context, we believe that the cytokine levels in AIDS-KS may be result of a complex interaction between HIV, HHV-8 and immunity.     

Social support as a correlate of depression among people living with HIV and AIDS in Nigeria

BackgroundDepression is a highly prevalent mental disorder among PLHIV, whilst social support is important in disease prevention, health promotion, therapeutic measure especially for PLHIV.ObjectivesTo ascertain the different types and sources of social support and their association with depression among PLHIV in Nigeria.Materials and MethodsThe study was a correlation with 2515 PLHIV in three teaching hospitals in South-Eastern Nigeria. Data were collected between January to June, 2019 through interviews, using socio-demographic and Clinical Form and a Social Support Scale for PLHIV. SPSS-20 used for data analysis.ResultsIt was shown that average scores of instrumental and emotional social supports (IESS) were satisfactory and not influenced by sex (p = 0.894; p = 0.496), education (p = 0.805; p = 0.182), marital status (p = 0.076; p = 0.446) and length of antiretroviral therapy (p = 0.510; p = 0.136). People diagnosed for less than three years had more instrumental support (p = 0.05) than those diagnosed over three years. The regression score also revealed a high predictive power of IESS on depression of PLHIV.ConclusionPLHIV have satisfactory social support, especially from family not residing in the same household and emotional social support from friends. Analyses identified knowledge gaps in the community regarding the social support received by PLHIV and their depression symptoms.     

Internet-based health information consumer skills intervention for people living with HIV/AIDS

Medical information can improve health, and there is an enormous amount of health information available on the Internet. A randomized clinical trial tested the effectiveness of an intervention based on social- cognitive theory to improve information use among people living with HIV/AIDS. Men and women (N = 448) were placed in either (a) an 8-session intervention that focused on Internet information consumer skills or (b) a time-matched support group and were followed to 9 months postintervention. The Internet skills group demonstrated greater Internet use for health, information coping, and social support compared with the control group. The authors conclude that people with HIV infection may benefit from increased access to health information on the Internet and that vulnerability to misinformation and fraud can be reduced through behavioral interventions.     

艾滋病病毒感染者/艾滋病患者生存质量与社会支持调查

目的了解艾滋病病毒(HIV)感染者与艾滋病(AIDS)患者的生活质量、社会支持现状及其影响因素。方法选择山西省运城市夏县某村57例,以简明健康调查问卷(SF-36)及社会支持评定量表(SSRS)进行问卷调查,对相关数据进行统计分析。结果①HIV感染者/AIDS患者生存质量在生理职能、躯体疼痛以及情感职能方面的得分显著低于常模(t=-5.795,-3.359,-6.010;P<0.01),在精力方面的得分显著高于常模(t=2.639,P<0.05);②社会支持主要与健康状况、精力、社会功能和情感职能明显正相关(r=0.298,0.337,P<0.05;r=0.410,P<0.01;r=0.290,P<0.05)。结论 HIV感染者/AIDS患者获得的社会支持越多,其生活质量越好。     

Behavioral medicine and the management of HIV/AIDS

Psychosocial treatment studies provide a method for conducting causal investigations within a clinical environment. They can also inform about relations between psychosocial or biobehavioral processes on the one hand, and disease on the other. Our studies conducted on HIV-positive (HIV+) homosexual men indicate that a group-based cognitive behavioral stress management (CBSM) intervention can decrease distress, buffer the psychological and immunological sequelae of HIV+ serostatus notification, and improve surveillance of herpes viruses. Decreased dysphoria induced by CBSM appears to be a significant mediator of control over cellular immunity. Poor HIV+ African American women, as well as more affluent gay men, benefit from group-based CBSM, but important gender and sociocultural differences must be taken into account in developing protocols. Adherence to highly active antiretroviral therapy (HAART), coupled with good health behavior, can contain HIV/AIDS in most instances. In contrast, poor HAART adherence coupled with poor health behavior (e.g., unprotected sex) can lead to drug resistance and infection of partners with virulent mutated strains. Thus, now more than ever, behavioral medicine approaches to management and secondary prevention of HIV/AIDS are needed.     

Relationship-specific unsupportive social interactions and depressive symptoms among women living with HIV/AIDS: direct and moderating effects

Although unsupportive social interactions have demonstrated strong relations with psychological adjustment to illness, little research has been directed at the differential effects of unsupportive interactions from different relationship sources (i.e., family, friends, or a lover/spouse). The present study examines whether the source of unsupportive social interactions has differential main and interactive relations with depressive symptoms among an ethnically diverse sample of women living with HIV/AIDS (N = 146). After imposing demographic controls, unsupportive social interactions from family were found to have a main effect predicting more depressive symptoms. Furthermore, a significant interaction was identified between unsupportive interactions from a lover/spouse and from friends, such that high levels of unsupportive interactions from either or both sources predicted high levels of depressive symptoms. Only when neither source of unsupportive interactions was at a high level were nonclinical levels of depressive symptoms predicted.     

中国HIV/AIDS患者外周血单核细胞上TLR4表达和血浆TNF-α水平

目的 观察中国HIV/AIDS患者外周血单核细胞上Toll样受体4(TLR4)表达水平和血浆TNF-α浓度,初步探讨TLR4在HIV感染中的作用.方法 分别运用流式细胞术、ELISA法测定46例HIV/AIDS患者和30例健康对照者的外周血单核细胞上TLR4的表达及血浆TNF-α浓度,采用t检验和相关分析进行数据分析.结果 HIV/AIDS患者外周血单核细胞TLR4的表达率、血浆TNF-α浓度分别是52.19%±4.37%和(35.79±5.08)pg/ml,均显著高于健康对照组;单核细胞上TLR4的表达率与血浆TNF-α浓度、HIV-1病毒载量的相关系数分别是0.645和0.708,呈正相关.结论 中国HIV/AIDS患者外周血单核细胞TLR4表达上调,并且与患者体内HIV复制存在一定的相关性.     

HIV/AIDS人员心理卫生状况与心理社会影响因素

目的 :研究HIV/AIDS (艾滋病毒感染者 /艾滋病患者 )人群的心理卫生状态与心理社会因素的影响。方法 :采用病例对照研究方法。病例组与对照组两组对象均接受一般情况问卷、症状自评量表(Symptomchecklist 90 ,SCL -90 )、生活事件量表 (LifeEventScale ,LES)、生活质量综合评定问卷 (GenericQualityofLifeInventory -74,GQOLI -74)、自我接纳问卷 (Self -AcceptanceQuestionnaire ,SAQ )五个量表的测查。结果 :(1)病例组的SCL -90各个因子分高于对照组 (P <0 0 0 1) ;(2 )病例组总生活事件和负性生活事件得分高于对照组 (P =0 0 0 1) ;(3 )病例组自我接纳得分低于对照组 (P =0 0 0 1) ;(4 )病例组生活质量综合评定得分低于对照组 (P <0 0 0 1) ;(5 )多因素逐步回归分析 ,SCL -90总因子分相关因素主要为躯体症状严重程度 (负向评分 )、负性生活事件和自我接纳因子 ,躯体症状严重程度与SCL -90总因子分呈负相关 ,负性生活事件得分与SCL -90总因子分呈正相关 ,自我接纳得分与SCL -90总因子分呈负相关。结论 :HIV/AIDS组较对照组心理健康状态有明显差异 ,有较多的负性生活事件 ;自我接纳得分低于对照组 ;生活质量低于对照组。     

Prevalence of Pain in Patients with HIV/AIDS: A Cross-sectional Survey in a South Indian State

Objectives:

Primary - To measure the prevalence of pain in HIV/AIDS with patients.Secondary - To assess the type, site, severity, management of pain and impact of pain on quality of life in these patients.

Design:

Multicentre cross-sectional survey (This paper is a pilot study).

Settings:

ART centre at St. John''s Medical College Hospital, Bangalore and Snehadan, A supportive and care centre for HIV/ AIDS patients at Bangalore.

Materials and Methods:

Data sheet, Brief pain inventory and Short – Form McGill pain questionnaire.

Subjects:

This is an ongoing study and the pilot study includes 140 HIV/AIDS patients in different stages of the disease.

Results:

About 66.7% (28/42) in-patients and 24.5% (24/98) out-patients complained of pain. Of the 52 patients who reported pain, 32% (14/52) reported neuropathic pain and 68% (38/52) reported noci-ceptive pain. Headache was most common followed by pain in the soles of feet and low back. Only 26.9% (17/52) received any form of analgesic. Pain severity significantly affects the quality of life.

Conclusions:

Pain is a common and debilitating symptom of HIV/AIDS. It is however, under-estimated and under treated.     

A system for the analysis of BKV non-coding control regions: Application to clinical isolates from an HIV/AIDS patient

The human polyomavirus BK virus (BKV) is an important opportunistic pathogen whose disease prevalence continues to increase with the growing immunocompromised population. To date, the major determinant of replication in cell culture has not been formally proven. BKV exists as archetype virus and rearranged variants, which are classified based on the DNA sequence of their non-coding control regions (NCCRs). The archetype BKV NCCR is divided into five blocks of sequence and rearranged variants contain deletions and duplications of these blocks. In this study, a genetic system was developed and used to identify the major determinant of replication ability in primary renal proximal tubule epithelial cells, the natural host cell of BKV. This system was also used to analyze NCCR variants isolated from an immunocompromised patient which contain assorted rearrangement patterns and functional differences. This study solidifies the NCCR as the major genetic determinant of BKV replication ability in vitro.     

HIV/AIDS主要临床测查工具简评

HIV/AIDS给患者带来了心理、生理、社会、家庭等多方面的问题 ,心理学家和临床工作者根据临床经验修订和编制了多方面的临床测查工具 ,本文着重介绍了情绪、症状、心理卫生方面心理测量学指标较好的几个测查工具 ,以供国内学者研究之用