Social Relations,Coping, and Psychological Distress Among Persons With HIV/AIDS1

The interrelationships among social support, coping style, and psychological distress were examined using longitudinal data from a sample of 212 persons with HIV/AIDS. Structural equation modeling analyses showed significant indirect effects on psychological distress for avoidant coping, feeling loved and understood, satisfaction with support, rejection by family members, discrimination because of HIV status, and number of AIDS symptoms. The inclusion of negative social interactions in the model is an important extension of the stress‐support literature. Feeling loved and understood mediated the relationship between social support and coping style choice. Results highlight the multidimensional nature of the processes that shape psychological outcomes in HIV disease. and suggest several potential points of intervention, including social‐support efforts that increase the sense that one matters to others, and interventions to assist patients to move from avoidant to active coping strategies.     

Patterns of Coping Among Persons with HIV Infection: Configurations, Correlates, and Change

This study examines coping in response to HIV infection, using longitudinal data from a nationally representative sample (n = 2,864) of HIV-infected persons. We investigated configurations of coping responses, the correlates of configuration membership, the stability of coping configurations, and the relationship of coping to emotional well-being. Four coping configurations emerged from cluster analyses: relatively frequent use of blame-withdrawal coping, frequent use of distancing, frequent active-approach coping, and infrequent use of all three coping strategies (passive copers). Passive copers had few symptoms, high levels of physical functioning, and high emotional well-being; blame-withdrawal copers had the opposite pattern. Of those completing a second interview 1 year after baseline, 46% had the same coping configuration. Increases in the number of HIV-related symptoms raised the probability of blame-withdrawal coping at follow-up, whereas decreases raised the probability of passive coping. Infrequent use of coping responses at baseline was related to greater emotional well-being 1 year later. This result, in conjunction with the high levels of emotional well-being in the passive cluster, suggests that high levels of distress can induce blame-withdrawal coping whereas coping efforts are minimal when social support and emotional well-being are high. Results highlight issues in ascertaining the causal direction between coping and psychological outcomes, as well as in specifying the nature of stressful situations with which people are coping.     

The Perceived Benefits of Religious and Spiritual Coping Among Older Adults Living with HIV/AIDS

Although religious and spiritual beliefs and practices have been frequently associated with greater psychological well-being among illness populations, little is known about the specific benefits individuals perceive they receive from these beliefs and practices. This issue was examined in interviews with 63 older HIV-infected adults. Participants reported a variety of benefits from their religious and spiritual beliefs and practices, including: (1) evokes comforting emotions and feelings; (2) offers strength, empowerment, and control; (3) eases the emotional burden of the illness; (4) offers social support and a sense of belonging; (5) offers spiritual support through a personal relationship with God; (6) facilitates meaning and acceptance of the illness; (7) helps preserve health; (8) relieves the fear and uncertainty of death; (9) facilitates self-acceptance and reduces self-blame. These perceived benefits suggest potential mechanisms by which religion/spirituality may affect psychological adjustment.     

Disengagement and Engagement Coping with HIV/AIDS Stigma and Psychological Well-Being of People with HIV/AIDS

The stigma associated with HIV/AIDS poses a psychological challenge to people living with HIV/AIDS. We hypothesized that that the consequences of stigma-related stressors on psychological well-being would depend on how people cope with the stress of HIV/AIDS stigma. Two hundred participants with HIV/AIDS completed a self-report measure of enacted stigma and felt stigma, a measure of how they coped with HIV/AIDS stigma, and measures of depression and anxiety, and self-esteem. In general, increases in felt stigma (concerns with public attitudes, negative self-image, and disclosure concerns) coupled with how participants reported coping with stigma (by disengaging from or engaging with the stigma stressor) predicted self-reported depression, anxiety, and self-esteem. Increases in felt stigma were associated with increases in anxiety and depression among participants who reported relatively high levels of disengagement coping compared to participants who reported relatively low levels of disengagement coping. Increases in felt stigma were associated with decreased self-esteem, but this association was attenuated among participants who reported relatively high levels of engagement control coping. The data also suggested a trend that increases in enacted stigma predicted increases in anxiety, but not depression, among participants who reported using more disengagement coping. Mental health professionals working with people who are HIV positive should consider how their clients cope with HIV/AIDS stigma and consider tailoring current therapies to address the relationship between stigma, coping, and psychological well-being.     

Culture at the Heart of Coping with HIV/AIDS

This study explored the manner in which a South African informal community coped with living with HIV/AIDS by relying on existing assets and local resources. A case study research design applying participatory reflection and action principles was used. Focus group/workshop sessions were conducted with ten selected female educators from the community. In addition, individual interviews with stakeholders and other members of the community (n=31, males=6, females=25) were also carried out. Supplemental data collection methods included observation, visual techniques, field notes and a reflective journal. The study found that community members coped with HIV/AIDS by relying on culture and family, faith in God, religiosity and prayer. Inner strength, hope, optimism and expectancy appeared to be key resources for informal settlement residents.     

Meaning-Making Coping Among Cancer Patients in Sweden and South Korea: A Comparative Perspective

Journal of Religion and Health - The present study compared meaning-making coping among cancer patients in Sweden and South Korea, with a focus on the sociocultural context. Semi-structured...     

Posttraumatic Growth Among HIV/AIDS Patients1

Correlates (n= 835 at Time 1) and predictors (n= 434 at Time 2) of posttraumatic growth (PTG; perceiving positive life changes stemming from diagnosis) over 1.6 years were examined among a diverse sample of HIV/AIDS patients. PTG was common–59% of participants reported to have experienced at least moderate positive changes since diagnosis. At Time 1, PTG had significant negative associations with age, alcohol use, depression, and pessimism; and positive associations with African American ethnicity (vs. White), female gender, eating a healthy diet, and optimism. At Time 2, religiosity was positively associated with PTG. The process of experiencing PTG over time was associated with lower levels of depression over time. Although the underlying process of PTG remains unclear, these results suggest that PTG is worthy of intervention focus.     

The Relationship Between Attitudes Toward Persons Who Are Gay and Persons With AIDS,and HIV and AIDS Knowledge

A total of 86 counseling students were assessed on their attitudes toward persons who are gay, attitudes toward persons with AIDS (Acquired Immune Deficiency Syndrome), and level of HIV (human immunodeficiency virus) and AIDS knowledge. Demographic data consisted of sex, age, and HIV- and AIDS-related training. Results indicated that the attitudinal and knowledge variables were correlated so that positive attitudes toward both groups corresponded with high levels of knowledge. There were no significant differences among these variables on the demographic factors. Implications of these results are discussed, with special emphasis placed on counselor education.     

Coping, Conflictual Social Interactions, Social Support, and Mood Among HIV-Infected Persons

This study considers the interrelationships among coping, conflictual social interactions, and social support, as well as their combined associations with positive and negative mood. Research has shown that each of these variables affects adjustment to stressful circumstances. Few studies, however, examine this full set of variables simultaneously. One hundred forty HIV-infected persons completed a questionnaire containing measures of coping, social support, conflictual social interactions, and positive and negative mood. Factor analyses showed that perceived social support and conflictual social interactions formed separate factors and were not strongly related. Compared to perceived social support, social conflict was more strongly related to coping behaviors, especially to social isolation, anger, and wishful thinking. Conflictual social interactions were more strongly related to negative mood than was perceived social support. Coping by withdrawing socially was significantly related to less positive and greater negative mood. The findings point to the importance of simultaneously considering coping, supportive relationships, and conflictual relationships in studies of adjustment to chronic illness. In particular, a dynamic may occur in which conflictual social interactions and social isolation aggravate each other and result in escalating psychological distress.     

A Psychoeducational Group Intervention for Family Members of Persons with HIV/AIDS

We describe a psychoeducational group intervention for family members of persons living with AIDS. The 33 family members were compared with 13 waiting-list controls in order to evaluate the effectiveness of the intervention. We focus on the practice aspects of the intervention, its development and implementation, and our belief that it is an apparently effective approach for helping family members work through the social and emotional aspects of the devastating impact of HIV/AIDS.     

Reasons and Justifications for Considering Pregnancy Among Women Living with HIV/AIDS

Despite the risks associated with pregnancy, available data suggest that HIV-infected women are no less likely to become pregnant than uninfected women. To understand HIV-infected women's reasons for wanting to have a child, focused interviews were conducted with a predominantly minority sample of 51 HIV-infected women in New York City. They were noted to actively weigh both the potential risks and benefits of their pregnancy decisions. Women reported three major reasons for wanting a child: (1) her husband/boyfriend really wants children, (2) having missed out on raising her other children, and (3) believing that a child would make her feel complete, fulfilled, and happy. Women also reported several justifications which they believed offset the risks of pregnancy, including: (1) other HIV-infected women were having healthy babies, (2) feeling optimistic about having a healthy baby due to the prophylactic effects of AZT (zidovudine), (3) having faith that God will protect the child, (4) being young and "healthy" will prevent transmission, and (5) feeling that she is better able to raise a child now. These findings suggest that to make fully informed pregnancy decisions, women should be encouraged to explore their reasons for wanting pregnancy, as well as discuss the potential risks.     

Social Support,Conflict, and Integration Among Women Living With HIV/AIDS1

The relationship between depressive symptoms and perceptions of available social support, social conflict, and subjective social integration were examined as part of a psychosocial study of Puerto Rican, African American, and non‐Hispanic White women living with HIV/AIDS (N= 146) in New York City. Lower levels of subjective social integration and higher levels of social conflict were associated with more depressive symptoms. Perceived availability of social support was not significantly associated with depression in comparison with these other forms of support. No evidence was found for a stress‐buffering or a stress‐amplification effect. Significant ethnic differences in levels of social integration and social conflict also were noted. Results suggest that intervention efforts should go beyond addressing support to further address the conflict and lack, of integration experienced.     

Predicting Burnout Among HIV/AIDS and Oncology Health Care Workers

Abstract

This study examined the relationship between repressive coping, controllability, self-esteem and comparative optimism for health-related events. Repressors (low trait anxiety-high defensiveness) compared with both (a) specific control groups on anxiety and defensiveness (e.g., low-anxious, high-anxious and defensive high anxious) and (b) total nonrepressors were significantly more comparatively optimistic for health-related events. Repressors remained significantly more comparatively optimistic than total nonrepressors when self-esteem was partialled out.

For individual events, repressors differed in comparative optimism for events which were rated as high controllability. It is concluded that repressors are exhibiting comparative optimism over and above nonrepressor groups for events which are rated as controllable. These results suggest that comparative optimism findings may be exaggerated by not controlling for the disproportionate influence of repressors in skewing sample means. Suggestions for future studies are discussed.     

大学生对艾滋病的乐观偏差

研究采用问卷法,以北京6所高校的278名被试为样本,考察了大学生对艾滋病的乐观偏差。结果表明,被试对艾滋病的感染和治愈存在着双重乐观偏差;艾滋病知识掌握程度既与感染艾滋病的乐观偏差无显著相关,也与治愈艾滋病的乐观偏差无显著相关。     

Using the Spiritual Perspective in Counseling Persons with HIV/AIDS: An Integrative Approach

The authors explore counseling persons infected with HIV and AIDS, within the specific themes of rejection, powerlessness, and death. These themes have been chosen because they are common concerns of people with HIV and AIDS. Selected quotations from 14 interviews with persons diagnosed with HIV/AIDS are used to clarify these concerns. Specific counseling recommendations are provided to make counseling an effective, compassionate endeavor with this population. Counselors are encouraged to struggle with these themes to enhance the counseling they provide to people with HIV and AIDS.     

Differences in Individual and Dyadic Coping Among Low and High Depressed, Partially Remitted, and Nondepressed Persons

Investigations of the individual and interpersonal coping resources of depressed persons are underrepresented in the field of research on depression. Whereas some studies have been conducted on depressed couples evaluating individual coping or social support from others, only a few studies have addressed the topic of dyadic coping, or the way both partners cope together. In the present effort, male and female participants with a current or past diagnosis of depression, all of whom were married or cohabiting in a close relationship, reported on their individual and dyadic coping and were compared on these variables with a matched group of control participants. Results corroborate previous findings on deficits in individual coping, and to a lesser degree in dyadic coping.     

The Close Relationship Context and HIV/AIDS Risk Reduction Among Mexican Americans

The purpose of this study was to determine, within a community sample of 115 Mexican Americans, the association of relationship variables to participants' HIV risk perception, use of condoms, and HIV-related communication with a relationship partner. Hierarchical multiple regression analyses with the total sample and within each gender separately revealed that intimacy and commitment were related to HIV risk perception, condom use, and HIV-related communication even after effects of age, gender, acculturation, marital status, and length of relationship were controlled. The pattern of significant correlates differs, however, in the total, women-only, and men-only samples. Results suggest that intimacy and commitment are important elements of the close relationship context that should be considered in HIV risk reduction efforts among Mexican Americans.     

Sex,Drugs, Violence,and HIV Status Among Male-to-Female Transgender Persons in Houston,Texas

SUMMARY

To inform the Community Planning Group (Houston, Texas) in setting HIV-prevention priorities, risk behavior surveys were completed by 67 male-to-female (MtF) transgender persons. By self-identification, 58% were preoperative and 48% were self-described heterosexual women. We found this small sample of male-to-female transgender individuals to have high rates of HIV infection, and high prevalence of risky behaviors, intimate partner violence, and suicidal ideation. Twenty-seven percent were infected with HIV. Barriers were seldom used during oral sex and used less than half the time for anal sex with either primary or casual partners. Nearly one-third of the sample reported use of methamphetamines, amyl nitrite or LSD and 40% reported crack or cocaine use. Intimate partner violence and forced sex were reported by 50% and 25%, respectively. Suicidal ideation was reported by 16% in the last 30 days; lifetime suicidal ideation was 60%.