Aids Care-Psychological and Socio-Medical Aspects of Aids/hiv最新文献

High rates of AIDS-related mortality and HIV incidence persist due to delayed antiretroviral therapy (ART) uptake and retention. We qualitatively assessed the feasibility and acceptability of "From Now On" (FNO) - a short video-based psychosocial support intervention to increase ART uptake and improve psychosocial well-being among men newly diagnosed with HIV in South Africa. In-depth interviews were conducted with men who were shown FNO during post-test HIV counselling (n = 12) and with counsellors (n = 9) who used FNO. Participants reported that FNO alleviated the immediate shock following their diagnosis; reduced fear (of death, ART side-effects, stigma and rejection) and instilled hope. Counsellors observed men calming down and positive impacts of FNO on counselling: increased attention, engagement and credibility. FNO appeared to reframe the mental model of living with HIV: "life goes on"; that one can not only live a long, healthy life on ART, but also thrive. The video encouraged disclosure and appeared to reduce internalised stigma. These qualitative findings indicate high intervention acceptability and feasibility and the potential of FNO to increase ART uptake through multiple pathways. Findings generate a hypothesis that warrants further investigation: "From Now On" could improve post-test HIV counselling and systematically provide psychosocial support through a low cost and scalable intervention.

Background: Individuals living with HIV/AIDS (PLHA) often face challenges such as depression, anxiety, fear, anger, worry, and social isolation. This study aimed to assess the coping strategies employed by PLHA and their influence on quality of life in selected tertiary hospitals in Ekiti State, Nigeria.Methods: A descriptive cross-sectional research design was employed, targeting HIV/AIDS patients attending two tertiary hospitals in Ekiti State. A total of 146 respondents were recruited using a convenience sampling technique. During clinic visits, two pretested adapted questionnaires were administered: the Brief COPE to measure coping strategies and the World Health Organization Quality of Life (WHOQOL-HIV BREF) to evaluate the quality of life of HIV/AIDS patients. Data was analyzed using descriptive and inferential statistics, including chi-square tests.Results: The mean age of respondents was 19.6 ± 0.87 years. Approximately 32% reported acquiring HIV/AIDS through blood transfusion, 23.3% through unprotected sex, while 18.5% were unsure of the mode of transmission. The majority of respondents exhibited a poor overall quality of life. The most common coping strategies identified were religion (85.6%), social withdrawal (71.9%), and responsibility and acceptance (65.1%). Additionally, a statistically significant relationship was found between spending time alone, attending counseling sessions, and the use of coping strategies such as responsibility and acceptance, and the quality of life of respondents (p < 0.05).Conclusions: The findings indicate that PLHA employ various coping strategies that significantly influence their quality of life. It is recommended that nurses and other healthcare professionals provide education on effective coping strategies to enhance the quality of life for individuals living with HIV/AIDS.

Introduction: There is a high prevalence of poor mental health among people with HIV, intersecting with structural inequalities, stigma and co-morbidities. A new person-centred approach to care that utilises health coaching to prioritise health and well-being and connects people to existing sources of support or voluntary sector organisations (social prescribing) could benefit people with HIV.

Methods: Theory of Change (ToC) methodology was used to develop a health coaching and social prescribing intervention for people with HIV. Two successive ToC workshops were held in September 2023 with a multi-disciplinary group of 39 stakeholders from across the HIV sector.

Results: The two workshops resulted in a TOC map which specified the components and intended outcomes of the intervention, identified the target population of people with HIV for the intervention, identified training requirements for healthcare staff and developed process indicators for monitoring and evaluation of the intervention.

Conclusion: The ToC method enabled stakeholders with broad-ranging experience, skills and perspectives concerning the mental health and well-being among people with HIV, to co-develop an appropriate which is being evaluated in the "Psychosocial intervention for people Living with HIV: Evidence from a Randomised Evaluation (SPHERE)" trial across eight HIV clinics in England in 2025.

Introduction: High rates of burnout have been observed among HIV care personnel, which has been connected to reductions in professional quality of life and patient care quality. However, limited literature explores how personnel mental wellbeing might influence professional quality of life, including burnout.

Methods: We assess the relationship between trauma and adversity, psychological resilience, and Professional Quality of Life (PQoL), including burnout, compassion fatigue, and compassion satisfaction, with 114 personnel in a community-based HIV Service Organization (HSO) in urban Tennessee between October 2017 and November 2019. Firth's Logistic regression models were used to estimate the association between childhood adversity, adult trauma effects, and professional quality of life with resilience as a moderator, adjusting for gender, race, age, professional role, and adversity scores.

Results: Higher resilience and trauma scores and older age were associated with lower odds of burnout and compassion fatigue, with some differences by gender. While the odds of compassion satisfaction increased as resilience increased, there was insufficient evidence to conclude an interaction effect between trauma and resilience for each of the PQoL outcomes. Discussion: Future research should explore resilience as a multi-dimensional construct to assess if factors such as organizational trauma resilience influence professional quality of life among HSO personnel.

Health-related quality of life (HRQoL) is an important indicator for people living with HIV/AIDS (PLHA). However, data on HRQoL among men who have sex with men (MSM) in Indonesia remains limited. This study aimed to measure HRQoL among MSM individuals based on their status. This cross-sectional study involved 152 MSM participants. We measured HRQoL using the EQ-5D-5L instrument and compared utility scores among HIV-negative, HIV-positive, and AIDS groups. Results showed a significant and substantial decline in HRQoL with the progression of HIV status, with the AIDS group having the lowest utility score (0.416) compared to the HIV-positive (0.908) and HIV-negative (0.981) groups. However, there was no significant difference between the HIV-negative and HIV-positive groups. In the multivariate analysis, socio-demographic factors were not significant in predicting HRQoL, while all EQ-5D-5L domains were significant predictors. In conclusion, while current interventions are effective in maintaining physical function, the primary burden on HRQoL shifts to pain and psychological issues. This finding underscores the need for a holistic public health approach that integrates mental health services and social support into HIV care.

With HIV evolving into a chronic disease, attention is shifting to quality of life (QoL) of people living with HIV (PLWH). We analyzed monitoring data on QoL of PLWH followed up at the Antwerp HIV clinic between 2016-2023, using the WHO-QOL-HIV BREF. Using logistic regression, we analyzed associations of QoL after adjusting for covariates. Changes in QoL across repeated measurements were calculated for a standardized period (mean change score per year). We used data from 1068 PLWH at baseline and 470 at follow-up. Overall, 76.0% had a good QoL, but people with a non-European background scored significantly lower. After controlling for covariates, acceptance of HIV status, place of birth, sexual orientation, relationship status, and subjective health were associated with QoL. Longitudinal analyses revealed no significant improvement in QoL over time. In this study, PLWH scored below a potential target of 90% with good QoL. Specific interventions are needed to improve the QoL of PLWH and should focus on mental health, sexual well-being, and sleep quality. Acceptance of HIV status was the strongest determinant of QoL and may indicate promising intervention avenues. PLWH with a migrant background may benefit from a tailored approach, particularly in the environmental domain.

Poor sleep quality and perceived stress are common among people living with HIV (PLWH), but the underlying mechanisms linking the two remain unclear. This study examined whether resilience mediates the relationship between sleep quality and perceived stress, and whether this mediation is moderated by age. We analyzed baseline data from 800 PLWH enrolled in a longitudinal cohort study in Guangxi, China. Validated scales assessed sleep quality, resilience, and perceived stress. Path analysis tested a moderated mediation model, controlling for covariates. Poor sleep quality was significantly associated with higher perceived stress (β = 1.367, P < 0.001). Resilience partially mediated this relationship, with an indirect effect coefficient accounting for 32.3% of the total effect. Furthermore, age moderated the indirect effect of sleep quality on stress through resilience. The mediation effect was stronger in participants aged 50 and above (0.359, 95% CI: 0.159-0.613) than in those under 50 (0.255, 95% CI: 0.109-0.450). These findings suggest that resilience plays a key role in buffering the negative impact of poor sleep on perceived stress, particularly among older adults. Interventions aimed at improving sleep and enhancing resilience may help reduce stress among PLWH, especially in aging populations.

HIV-related stigma affects the well-being and quality of life of people with HIV (PHIV). To evaluate the impact of HIV-related stigma on the quality of life among PHIV in Dar es Salaam, we conducted a qualitative study between December 2021 and June 2022. We enrolled participants in the Dar es Salaam Urban Cohort Study who were from the Ilala Municipality of Dar es Salaam. Using a semi-structured discussion guide, three focus group discussions (FGDs) were conducted with the 33 participants. FGDs were audio-recorded, transcribed verbatim and analyzed thematically. The impact of stigma on quality of life was grouped into three themes: (1) health impact manifested as failure to attend clinic as scheduled, poor adherence to medication and appetite and weight loss; (2) psychosocial impact manifested as fear, stress, depression, family instability, limited social interaction and a difficult learning environment and (3) economic impact manifested as denied employment opportunities, loss of job, denied financial support and a lack of economic support. PHIV experience stigma, which affects their economic status, health and well-being. Therefore, strengthening programmes, such as community education, awareness campaigns, peer support groups among PHIV and the establishment of microeconomic groups for PHIV may reduce stigma and improve quality of life.

HIV is a highly stigmatized condition, and negative beliefs about HIV and people with HIV are frequently internalized. This paper describes how we designed, implemented, and evaluated RESET, an intervention aiming to reduce internalized HIV stigma among people with HIV in the Netherlands. This face-to-face, three-session workshop series was designed, implemented, and evaluated with Intervention Mapping, a systematic approach to behavior change that uses theory and evidence, as well as participatory processes, in the planning of interventions. Intervention Mapping comprises six steps: (1) conducting a needs assessment and drafting a Logic Model of the Problem; (2) specifying intervention outcomes and objectives, and drafting a Logic Model of Change; (3) designing the intervention by selecting theory and evidence-based methods for behavior change and then developing their practical applications; (4) producing and pre-testing the intervention; (5) planning for implementation; and (6) planning process and effect evaluations. For each step, we describe the tasks involved and how we approached each task as we designed, implemented, and evaluated RESET. By transparently reporting how RESET was developed, we illuminate success and challenges and demonstrate how Intervention Mapping can be leveraged to develop effective interventions for reducing stigma, including internalized HIV stigma.

Health-related quality of life (HRQoL) is a key outcome in managing people with HIV. This study examined how sociodemographic factors relate to HRQoL. People with HIV from a Dutch treatment center completed a questionnaire assessing eight HRQoL domains: general health, anxiety and depression, social support, stigma, sexuality problems, self-esteem, sleeping difficulties and side effects. Sociodemographic factors included gender, age, education, employment, religion, marital status, sexual orientation, sex of sexual partners, and year of HIV diagnosis. Multivariable regression assessed associations, and an intersectional multilevel analysis (MAIHDA) evaluated intersectionality. Among 271 participants (mean age 47.6 years), most identified as male (84.5%) and homosexual (62.7%). Median time since HIV diagnosis was 10 years. Older age was associated with higher self-esteem, and lower education with more sleeping difficulties. Unemployment, heterosexual orientation, and sexual inactivity were associated with poorer HRQoL. Specifically, unemployment was linked to worse outcomes across most domains, while sexual inactivity was associated with greater stigma, less social support, and more sexuality problems. MAIHDA analysis revealed that intersecting sociodemographic factors explained up to 24.6% of HRQoL variance, particularly in mental, physical, and general health. Routine HRQoL assessment in HIV care enables the identification of vulnerable individuals and guides personalized interventions.