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AIDS and Behavior
Erschienen in: AIDS and Behavior 6/2009

01.12.2009 | Original Paper

One Year After ART Initiation: Psychosocial Factors Associated with Stigma Among HIV-Positive Mozambicans

Erschienen in: AIDS and Behavior | Ausgabe 6/2009

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Abstract

The pathways through which stigma is associated with psychological distress remains understudied in Africa. This study evaluates stigma among 277 Mozambicans who were on an antiretroviral therapy (ART) regimens for a full year. Using bivariate and multiple regression analyses, we examine psychosocial factors (disclosure decisions, perceived social support, and depression) associated with stigma, at ART initiation and 1 year later. We found 1 year after initiating ART, participants reported no change in stigma, a decrease in perceived social support, and an increase in depressive symptomology. Disclosing HIV status to friends (versus family or partner) was associated with lower levels of stigma. These findings suggest that HIV care in comparable settings should include counselling, support groups, and peer support, that includes stigma and disclosure concerns prior to and during the first year following diagnosis. Most importantly, assessment and treatment of depression should be incorporated into ongoing HIV care.
Literatur
1.
Holzemer WL, Uys LR. Managing AIDS stigma. Sahara J. 2004;1(3):165–74.PubMed
2.
MISAU. Demographic impact of HIV/AIDS in Mozambique: update from the 2007 epidemiological surveillance round Maputo. Mozambique: Mozambique Ministry of Health; 2008.
3.
4.
Micek MA, Baptista A, Ferro J, Melo A, Gimbel-Sherr K, Gimbel-Sherr S, et al., editors. Evaluating the flow of adults in public HIV care systems in Mozambique: identifying obstacles to care. Oral presentation at: The 17th International AIDS Conference; August 3–8; Mexico City; 2008.
5.
Yang L, Kleinman A, Link B, Phelan J, Lee S, Good B. Culture and stigma: adding moral experience to stigma theory. Soc Sci Med. 2007;64(7):1524–35.CrossRefPubMed
6.
Parker R, Aggleton P. HIV and AIDS-related stigma and discrimination: a conceptual framework and implications for action. Soc Sci Med. 2003;57(1):13–24.CrossRefPubMed
7.
Corrigan P, Watson A. HIV and AIDS-related stigma and discrimination: a conceptual framework and implications for action. Soc Sci Med. 2003;57(1):13–24.CrossRef
8.
Nyblade LC. Measuring HIV stigma: existing knowledge and gaps. Psychol Health Med. 2006;11(3):335–45.CrossRefPubMed
9.
Pulerwitz J, Michaelis AP, Lippman SA, Chinaglia M, Diaz J. HIV-related stigma, service utilization, and status disclosure among truck drivers crossing the Southern borders in Brazil. AIDS Care. 2008;20(2):198–204.CrossRef
10.
Hutchinson PL, Mahlalela X. Utilization of voluntary counseling and testing services in the Eastern Cape, South Africa. AIDS Care. 2006;18(5):446–55.CrossRefPubMed
11.
Rao D, Kekwaletswe TC, Hosek S, Martinez J, Rodriguez F. Stigma and social barriers to medication adherence with urban youth living with HIV. AIDS Care. 2007;19(1):28–33.CrossRefPubMed
12.
Rintamaki LS, Davis TC, Skripkauskas S, Bennett CL, Wolf MS. Social stigma concerns and HIV medication adherence. AIDS Patient Care STDs. 2006;20(5):359–68.CrossRefPubMed
13.
Ware NC, Wyatt MA, Tugenberg T, Ware NC, Wyatt MA, Tugenberg T. Social relationships, stigma and adherence to antiretroviral therapy for HIV/AIDS. AIDS Care. 2006;18(8):904–10. [Research Support, N.I.H., Extramural].CrossRefPubMed
14.
Sikkema K, Kalichman S, Hoffmann R, Koob J, Kelly J, Heckman T. Coping strategies and emotional well-being among HIV-infected men and women experiencing AIDS-related bereavement. AIDS Care. 2000;12(5):613–24.CrossRefPubMed
15.
Sirey JA, Bruce ML, Alexopoulos GS, Perlick DA, Raue P, Friedman SJ, et al. Perceived stigma as a predictor of treatment discontinuation in young and older outpatients with depression. AIDS Care. 2001;158(3):479–81.
16.
DiIorio C, McCarty F, Depadilla L, Resnicow K, Holstad MM, Yeager K. Adherence to antiretroviral medication regimens: a test of a psychosocial model. AIDS Behav. 2007;3:3.
17.
Purcell DW, Latka MH, Metsch LR, Latkin CA, Gomez CA, Mizuno Y, et al. Results from a randomized controlled trial of a peer-mentoring intervention to reduce HIV transmission and increase access to care and adherence to HIV medications among HIV-seropositive injection drug users. J Acquir Immune Defic Syndr. 2007;46(Suppl 2):S35–47.PubMed
18.
Holzemer WL, Uys L, Makoae L, Stewart A, Phetlhu R, Dlamini PS, et al. A conceptual model of HIV/AIDS stigma from five African countries. J Adv Nurs. 2007;58(6):541–51.CrossRefPubMed
19.
NIH. Panel on clinical practices for treatment of HIV. Guidelines for the use of antiretroviral agents in HIV-infected adults and adolescents. Atlanta: Centers for Diseases Control and Prevention; 2002.
20.
Remien RH, Bastos FI, Jnr VT, Raxach JC, Pinto RM, Parker RG, et al. Adherence to antiretroviral therapy in a context of universal access, in Rio de Janeiro, Brazil. AIDS Care. 2007;19(6):740–8.CrossRefPubMed
21.
Godin G, Côté J, Naccache H, Lambert LD, Trottier S. Prediction of adherence to antiretroviral therapy: a one-year longitudinal study. AIDS Care. 2005;17(4):493–504.PubMed
22.
Adedayo A, Modupeola A, Timothy A, editors. Scaling up antiretroviral therapy use for HIV-positive adults in southwestern Nigeria. 12th Conference on Retroviruses and Opportunistic Infections; 2005 February 22–25; Boston; 2005.
23.
Nachega JB, Stein DM, Lehman DA, Hlatshwayo D, Mothopeng R, Chaisson RE, et al. Adherence to antiretroviral therapy in HIV-infected adults in Soweto, South Africa. AIDS Res Hum Retrovir. 2004;20(10):1053–6.CrossRefPubMed
24.
Health and Development Networks. Stigma, HIV/AIDS, and disclosure: summary of stigma-AIDS eForum discussion. Chiang Mai: Health and Development Networks; 2006.
25.
Lee SJ, Detels R, Rotheram-Borus MJ, Duan N, Lord L. Depression and social support among HIV-affected adolescents. AIDS Patient Care STDS. 2007;21(6):409–17.CrossRefPubMed
26.
McDowell TL, Serovich JM. The effect of perceived and actual social support on the mental health of HIV-positive persons. AIDS Care. 2007;19(10):1223–9.CrossRefPubMed
27.
Golub SA, Tomassilli JC, Parsons JT. Partner serostatus and disclosure stigma: implications for physical and mental health outcomes among HIV-positive adults. AIDS Behav. 2008;9:9.
28.
Paxton S. The paradox of public HIV disclosure. AIDS Care. 2002;14(4):559–69.PubMed
29.
Antelman G, Fawzi MS, Kaaya S, Mbwambo J, Msamanga G, Hunter D, et al. Predictors of HIV-1 serostatus disclosure: a prospective study among HIV-infected pregnant women in Dar es-Salaam, Tanzania. AIDS. 2001;15(14):1865–74.CrossRefPubMed
30.
Medley A, Garcia-Moreno C, McGill S, Maman S. Rates, barriers and outcomes of HIV serostatus disclosure among women in developing countries: implications for prevention of mother-to-child transmission programmes. Bull World Health Organ. 2004;82(4):299–307.PubMed
31.
Pearson CR, Micek MA, Simoni JM, Hoff PD, Matediana E, Martin DP, et al. Randomized control trial of peer-delivered, modified directly observed therapy for HAART in Mozambique. J Acquir Immune Defic Syndr. 2007;46(2):238–44.CrossRefPubMed
32.
Pearson CR, Micek M, Simoni JM, Matediana E, Martin DP, Gloyd S. Modified directly observed therapy to facilitate highly active antiretroviral therapy adherence in Beira, Mozambique. Development and implementation. J Acquir Immune Defic Syndr. 2006;43(Suppl 1):S134–41.PubMed
33.
Pearson CR, Simoni JM, Gloyd SS. Evaluation of a Portuguese-version of psychsocial measures in a study of adherence to HAART in Mozambique. Society for Behavioral Medicine 27th Annual Meeting and Scientific Sessions; March 22–25; San Francisco; 2006.
34.
Berger BE, Ferrans CE, Lashley FR. Measuring stigma in people with HIV: psychometric assessment of the HIV stigma scale. Res Nurs Health. 2001;24(6):518–29.CrossRefPubMed
35.
Berger BE, Ferrans CE, Lashley FR. Measuring stigma in people with HIV: psychometric assessment of the HIV stigma scale. Res Nurs Health. 2001;24(6):518–29.CrossRefPubMed
36.
Golin CE, Liu H, Hays RD, Miller LG, Beck CK, Ickovics J, et al. A prospective study of predictors of adherence to combination antiretroviral medication. J Gen Intern Med. 2002;17(10):756–65.CrossRefPubMed
37.
Radloff LS. The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas. 1977;1:385–401.CrossRef
38.
Andresen EM, Malmgren JA, Carter WB, Patrick DL. Screening for depression in well older adults: evaluation of a short form of the CES-D (Center for Epidemiologic Studies Depression Scale). Am J Prev Med. 1994;10:77–84.PubMed
39.
Kulik JA, Mahler HIM. Emotional support as a moderator of adjustment and compliance after coronary artery bypass surgery: a longitudinal study. J Behav Med. 1993;12:56–63.
40.
Murphy DA, Greenwell L, Hoffman D. Factors associated with antiretroviral adherence among HIV-infected women with children. Women Health. 1993;36(1):97–111.
41.
Baum CB. An introduction to modern econometrics using Stata College Station. Texas: STATA Press; 2006.
42.
Emlet CA. A comparison of HIV stigma and disclosure patterns between older and younger adults living with HIV/AIDS. AIDS Patient Care STDs. 2006;20(350):358.
43.
Smith R, Rossetto K, Peterson BL. A meta-analysis of disclosure of one’s HIV-positive status, stigma and social support. AIDS Care. 2008;17:1–10.
44.
Dlamini P, Kohi T, Uys L, Phetlhu R, Chirwa M, Naidoo J, et al. Verbal and physical abuse and neglect as manifestations of HIV/AIDS stigma in five African countries. Public Health Nurs. 2007;24(5):389–99.CrossRefPubMed
45.
Kalichman SC, Klein SJ, Kalichman MO, O’Connell DA, Freedman JA, Eaton L, et al. HIV/AIDS case managers and client HIV status disclosure: perceived client needs, practices, and services. Health Soc Work. 2007;32(4):259–67.PubMed
46.
Tarwireyi F. Stigma and discrimination: coping behaviours of people living with HIV and AIDS in an urban community of Mabvuku and Tafara, Harare, Zimbabwe. Cent Afr J Med. 2005;51(7–8):71–6.PubMed
47.
Fulk LJ, Kane BE, Phillips KD, Bopp CM, Hand GA. Depression in HIV-infected patients: allopathic, complementary, and alternative treatments. J Psychosom Res. 2004;57(4):339–51.PubMed
48.
Yun LW, Maravi M, Kobayashi JS, Barton PL, Davidson AJ. Antidepressant treatment improves adherence to antiretroviral therapy among depressed HIV-infected patients. J Acquir Immune Defic Syndr. 2005;38(4):432–8.CrossRefPubMed
49.
Laperriere A, Ironson GH, Antoni MH, Pomm H, Jones D, Ishii M, et al. Decreased depression up to one year following CBSM+ intervention in depressed women with AIDS: the smart/EST women’s project. J Health Psychol. 2005;10(2):223–31.CrossRefPubMed
50.
Rousaud A, Blanch J, Hautzinger M, De Lazzari E, Peri JM, Puig O, et al. Improvement of psychosocial adjustment to HIV-1 infection through a cognitive-behavioral oriented group psychotherapy program: a pilot study. AIDS Patient Care STDS. 2007;21(3):212–22.CrossRefPubMed
51.
Balfour L, Kowal J, Silverman A, Tasca GA, Angel JB, Macpherson PA, et al. A randomized controlled psycho-education intervention trial: improving psychological readiness for successful HIV medication adherence and reducing depression before initiating HAART. AIDS Care. 2006;18(7):830–8.CrossRefPubMed
52.
Olatunji BO, Mimiaga MJ, O’Cleirigh C, Safren SA. Review of treatment studies of depression in HIV. Top HIV Med. 2006;14(3):112–24.PubMed
53.
Simoni JM, Pantalone DW, Plummer MD, Huang B. A randomized controlled trial of a peer support intervention targeting antiretroviral medication adherence and depressive symptomatology in HIV-positive men and women. Health Psychol. 2007;26(4):488–95.CrossRefPubMed
54.
Simbayi LC, Kalichman S, Strebel A, Cloete A, Henda N, Mqeketo A. Internalized stigma, discrimination, and depression among men and women living with HIV/AIDS in Cape Town, South Africa. Soc Sci Med. 2007;64(9):1823–31. [Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov’t].CrossRefPubMed
55.
Prachakul W, Grant J, Keltner N. Relationships among functional social support, HIV-related stigma, social problem solving, and depressive symptoms in people living with HIV: a pilot study. J Assoc Nurses AIDS Care. 2007;18(6):67–76.CrossRefPubMed
Metadaten
Titel
One Year After ART Initiation: Psychosocial Factors Associated with Stigma Among HIV-Positive Mozambicans
Publikationsdatum
01.12.2009
Erschienen in
AIDS and Behavior / Ausgabe 6/2009
Print ISSN: 1090-7165
Elektronische ISSN: 1573-3254
DOI
https://doi.org/10.1007/s10461-009-9596-0

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