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

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.

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.

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.

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.

ABSTRACTDespite advancements in HIV prevention and treatment, disparities persist across the U.S. that are geographically and demographically unique. This study analyzed HIV burden and prevention efforts in three urban counties, Suffolk County, MA (Boston), Orange County, FL (Orlando), and Philadelphia County, PA (Philadelphia), using AIDSVu data. We assessed HIV prevalence, new diagnoses, Pre-Exposure Prophylaxis (PrEP) use, PrEP-to-Need Ratio (PnR), and key social and structural determinants of health (SSDoH) to contextualize local trends within national patterns. Findings revealed significant disparities. For the three counties, Philadelphia exhibited the highest overall HIV prevalence and lowest PrEP uptake, while Orange County reported the highest rate of new diagnoses. Demographic groups, socioeconomic factors, including poverty, insurance coverage and housing instability, further shaped HIV outcomes across these regions. These results highlight the need for evidence-driven interventions, expanded PrEP access, and policy reforms to HIV prevention and care in high-burden communities.

South Africa has the world's highest HIV burden. Assisted partner notification (APN) has been shown to improve HIV testing uptake and case finding, yet little is known about its implementation in contexts where gender inequalities, stigma and complex relationship dynamics shape disclosure. This qualitative study explored implementation experiences of APN services among healthcare providers and patients in Cape Town. Between March 2021 and February 2022, we conducted semi-structured interviews, WhatsApp diary studies and fieldwork observations with 34 participants, including 10 healthcare providers, 12 female patients and 12 key informants. Data were analyzed using thematic analysis. Findings revealed significant disconnect between formal APN protocols and clinical practice. Despite official guidelines emphasizing voluntary participation, informal practices termed "getting involved" emerged where providers engaged in unstructured assistance with partner notification. Key challenges included compromised voluntary participation, coercive tactics, communication barriers and concerns about social harm and privacy breaches. In response, providers and patients developed alternative strategies, notably "collusion-testing" and reliance on informal "assistants" from personal support networks. APN processes and safeguards should be more clearly outlined in HIV testing policies, with greater provider training to reduce coercive practices and better integrate community support systems.

Despite the availability of resources such as Ryan White-funded clinics, which provide free/low-cost HIV care services, significant disparities in viral suppression rates exist. This study investigates whether neighborhood characteristics and socioeconomic factors are associated with viral suppression rates among people with HIV (PWH) in Southern California neighborhoods with Ryan White clinics. Forty Southern California zip codes with a combined estimated population of 1.4 million were analyzed. Beta regression models were used to assess neighborhood characteristics and socioeconomic factors associated with the proportion of PWH who are virally suppressed per zip code. Neighborhoods with a higher public transit score, safety score, and Healthy Places Index score had greater proportions of PWH who were virally suppressed. Longer average commute times, higher poverty rates, lack of health insurance, and higher average hours of work per week were negatively associated with viral suppression. Additionally, no association was found between the proportion of PWH who are virally suppressed and neighborhood walkability score, educational attainment, and employment. Findings highlight the need for tailored interventions that address specific community needs. The presence of HIV treatment services may not ensure access or uptake, underscoring the importance of addressing socioeconomic and local structural contexts.