Enacting support within church communities for people living with HIV or AIDS

Social support is important in managing HIV and AIDS. Some people living with HIV or AIDS (PLWHA) have sought support from churches, despite their reputation for stigmatising PLWHA. Semi-structured interviews were conducted with 21 PLWHA and 21 church leaders to identify ways that churches can effectively enact support for PLWHA through improved communication about HIV, AIDS, and related issues. Church leaders also were asked about the institutional barriers to enacting support for PLWHA. Implementing these strategies consistently and holistically will require intentional efforts to address the barriers within church organisations to create environments that are welcoming to and supportive of PLWHA.     

Predictors of anxiety and depression among newly diagnosed people living with HIV: A longitudinal study

This longitudinal study examined whether past resilience and internalized stigma predicted anxiety and depression among newly diagnosed Spanish-speaking people living with HIV (PLWH). We also analyzed whether coping strategies mediated this relationship. Data were collected at two time points from 119 PLWH. Approximately a third of participants had scores indicative of anxiety symptoms, the same result was found for depressive symptoms. Structural equations modeling revealed that 61% of the variance of anxiety and 48% of the variance of depression 8 months after diagnosis was explained by the proposed model, which yielded a good fit to data. Anxiety and depressive symptoms were significantly and negatively predicted by positive thinking, thinking avoidance, and past resilience, and positively predicted by self-blame. Additionally, anxiety was positively predicted by internalized stigma. Past resilience negatively predicted internalized stigma, self-blame, and thinking avoidance and it positively predicted positive thinking. Internalized stigma positively predicted self-blame. Moreover, internalized stigma had a significant indirect effect on anxiety symptoms through self-blame, and past resilience had significant indirect effects on anxiety symptoms and depressive symptoms through internalized stigma and coping. The results point to the need for clinicians and policy makers to conduct systematic assessments and implement interventions to reduce internalized stigma and train people living with HIV to identify and use certain coping behaviors.     

Religious coping,stigma, and psychological functioning among HIV-positive African American women

The present study examined the role of religious coping in psychological distress and adjustment both cross-sectionally and longitudinally among 141 HIV-positive African American women. Cross-sectional analyses showed that negative religious coping was associated with poorer mental health and functioning, and greater perceptions of stigma and discrimination. Longitudinal analyses revealed that greater negative religious coping at baseline significantly predicted greater changes in mental health in a negative direction 12 months later. Positive religious coping was not associated with any measures of psychological well-being, nor did it predict any mental health outcomes at 12 months. However, participants who experienced high levels of HIV-related stigma and reported high levels of positive religious coping were less depressed than those who reported lower levels of positive religious coping. These results suggest that for this population, negative religious coping was a more salient determinant of psychological distress than positive religious coping was of psychological health.     

Exploring Perceived Social Support from Peer Facilitators in an HIV Treatment Adherence Intervention for African American Patients: A Content Analysis of Participant Perspectives

HIV treatment adherence interventions increasingly rely on peer facilitators to promote treatment adherence and improve patient retention, yet little is known about how participants perceive the role performed by peer facilitators. The present study examined participant perceptions in terms of the social support from peer facilitators in a hospital‐based intervention in Chicago. Content analysis was conducted with reference to four types of social support (instrumental, informational, emotional and affiliational) on exit interviews with 11 participants enrolled in the intervention that targeted African‐American patients living with HIV/AIDS. We examined how the type of social support perceived by participants was related to their self‐reported behaviours in three domains: adherence, sexual safety and general coping. Our analysis revealed that most participants perceived informational and emotional support from their peer facilitators, followed by instrumental support. Affiliational support was the least frequently perceived type of social support. We found that perceived informational support from peer facilitators with regard to adherence had greater impact and credibility amongst participants than the same type of support from medical providers. Informational support was cited most frequently with regard to influencing adherence and sexual safety behaviours, whereas perceived emotional support was cited primarily with helping participants cope with HIV. Copyright © 2015 John Wiley & Sons, Ltd.     

Personality functioning in people living with HIV

This investigation adopted a multiple case study approach to determine the personality functioning in people living with HIV/ AIDS (PLWHA). Participants comprised a convenience sample of four PLWHA (male?=?3, female?=?1). The majority of the participants were white (n?=?3) and one was black African. Only one participant was married at the time of participation. Data on aspects such as their suicidal ideation, affect, problem solving styles, ego functioning, self-perception, and interpersonal functioning were collected using the Rorschach inkblot test and clinical interview. The data were actuarially analysed and organised under themes, namely; dominant personality style, capacity for control and stress, situational related stress, affect, interpersonal relations and self-perception. Findings revealed that participants had high levels of potential mood disorders and interpersonal difficulties for which targeted psychological services may be needed.     

Effects of cognitive-behavioural therapy on anxiety,depression and condom use in people with HIV in Mexico City: a pilot study

Anxiety and depression in people living with HIV (PLWH) are negatively associated with healthy sexual behaviours. We pilot-tested a Cognitive-Behavioural Therapy (CBT)-based intervention to reduce anxiety and depression, aimed to increase serostatus disclosure to sexual partners, quality of sexual life (QoSL) and condom use. The study had a single-case experimental design (AB) with follow-up measures. Eleven PLWH with moderate/severe anxiety/depression received six-module CBT intervention delivered in ten one-hour individual weekly sessions. Anxiety, depression, consistent/correct condom use and QoSL were measured. Depression and anxiety decreased after the intervention (depression baseline [BL] Mdn = 21, final [F] Mdn = 3, z = -2.934, p = .003; anxiety BL Mdn = 30, F Mdn = 4, z = -2.941, p = .003). QoSL improved (BL Mdn = 28, F Mdn = 13, z = -2.625, p = .009), along with participants’ ability to use condoms (57.14 vs.100, z = -2.937, p = .003). Effect size was large, changes were maintained at follow-up measurements. The CBT intervention had positive effects in reducing anxiety and depression, which could facilitate the acquisition of healthy sexual behaviours. Further studies are important to clarify the benefits of targeting emotional variables to improve wellbeing and prevention behaviours in PLWH.     

Illness disclosure and mental health among women with HIV/AIDS

The current study examines two contrasting models of the relationship between illness disclosure and mental health among an ethnically‐diverse group of women with HIV/AIDS. In the first, and commonly accepted model, illness disclosure predicts enhanced mental health status. In the second or alternate model, based on the stigmatization that accompanies HIV/AIDS infection, illness disclosure predicts poorer mental health. We also explore an alternate interpretation for this second model, namely that the mental health status of participants is predictive of their levels of disclosure. A total of 176 women from three major ethnic groups were interviewed and assessed during the baseline visit for a comprehensive longitudinal study. Results showed that these women constituted a highly‐disclosed population; over one‐third of them had disclosed their HIV status to their entire social networks. Contrary to expectation, disclosure was unrelated to mental health among the African‐American (n = 72) and European‐American (n = 47) women. Among the Latina women (n = 57), however, greater disclosure was related to higher levels of depression, psychological distress, and reported pain. Regression analyses controlling for age, education, and illness severity showed that disclosure makes a small but independent contribution to the prediction of mental health status. Thus, among the Latinas, the data were consistent with both the stigma model and the hypothesis that greater distress predicts wider disclosure. General patterns of disclosure are described and possible explanations for the inconsistent relationships found between disclosure and mental health among the three ethnic groups are considered. Copyright © 2000 John Wiley & Sons, Ltd.     

Mental health and religion from an attachment viewpoint: overview with implications for future research

I argue in this article that attachment theoretical considerations provide insights into why certain moderators underlie the links observed between religion and mental health. Three sets of moderators are discussed. First, contextual factors associated with heightened attachment activation (e.g., stress, unavailability of one's secular attachment figures, low social welfare) increase the strength of the links observed between religion and mental health. Second, aspects of mental health that are most notably affected by having a safe haven to turn to and a secure base to depart from are particularly reliably linked to religion. Other attachment-related aspects of mental health that religion may promote concerns attenuation of grief and reparation of internal working models following loss of and/or experiences of having been insensitively cared for by other attachment figures. Finally, aspects of religion that are most consistently linked to mental health are partially those that express attachment-components, including belief in a personal, loving God with whom one experiences a close and secure relationship.     

The Role of the Black Church in HIV Prevention: Exploring Barriers and Best Practices

Black people have the highest rate of HIV/AIDS infection in the USA, and they are less likely to access quality physical and mental healthcare. To address these disparities as outlined in the National HIV/AIDS Strategy, there is a need for culturally congruent, innovative approaches to HIV/AIDS prevention. The first multi‐denominational national study of Black faith leaders was conducted utilizing focus groups that were held in 11 US cities. The 265 participants were faith leaders who reported involvement in such prevention practices as sponsoring HIV/AIDS workshops, integrating HIV/AIDS messaging in the worship service, hosting HIV/AIDS screenings, distributing written materials about HIV/AIDS through the bulletin or flyers, pastoral counselling, advocating for policies that provide quality healthcare to the community and disseminating HIV/AIDS prevention messages through new media such as the Church website. These findings, including attention to barriers to engagement, provide insight into innovative practices that can be integrated into faith‐based HIV/AIDS prevention programming. Copyright © 2016 John Wiley & Sons, Ltd.     

CD4 Count and Physical Symptoms Among Urban African American Mothers with HIV: An Examination of the Role of Optimism and Depressive Symptoms

The current study examined the link between immune functioning (CD4 count) and physical symptoms, as well as the moderating role of optimism and depressive symptoms, in a sample of 99 low income, inner city African American women with HIV. Although there was no main effect of CD4 count on physical symptoms, depressive symptoms moderated the association between CD4 count and physical symptoms. More compromised immune functioning (lower CD4 count) was associated with more physical symptoms under conditions of higher levels of depressive symptoms, but not lower levels of depressive symptoms. This finding was observed using both a self-report measure and a clinician-rating of women’s depressive symptoms. There were no main or interactive effects for optimism. Clinical implications and future research directions are presented.     

Portraits of Well-Being: Photography as a Mental Health Support for Women With HIV

Many women living with HIV/AIDS (WL-HIV/AIDS) experience significant mental distress. Although creative arts strategies are well positioned to help support women by inspiring creativity and meaning-making, few arts programs have been implemented and evaluated with this population. The authors conducted a photography project with 30 WL-HIV/AIDS from three United States cities. Participants took pictures to capture their lives with HIV/AIDS and described their photos and stories in group and individual sessions. Using thematic analysis, the authors identified that the project supported women’s mental health in four ways by facilitating empowerment and helping women to express themselves, address their mental health with new tools like photography, and process past traumas. Photography projects may help WL-HIV/AIDS understand and manage their mental health.     

Culturally Sensitive AIDS Educational Videos for African American Audiences: Effects of Source, Message, Receiver, and Context

The importance of using culturally sensitive educational materials in HIV-related interventions with racial and ethnic minority groups is widely recognized. However, little empirical research has been conducted to assess the relative effectiveness of different techniques for creating culturally sensitive AIDS educational videos. Two field experiments with three samples of African American adults (N = 174, 173, and 143) were conducted to assess how source characteristics (race of communicator), message characteristics (multicultural message vs. culturally specific message), and audience characteristics (racial distrust and AIDS-related distrust) influence proximate (perceptions of the message's credibility and attractiveness) and distal (AIDS-related attitudes, beliefs, and behavioral intentions) output variables for AIDS educational videos. In Study 1, an AIDS video with a culturally specific message was rated as more credible, more attractive, and of higher quality than was a video with a multicultural message. The multicultural message was rated less favorably when delivered by a White announcer than when the announcer was Black. In Study 2, the same pattern was replicated with a second community sample and a campus-based sample. Study 2 also indicated that a multicultural message might be more effective if delivered in a culturally specific context, namely, after audience members watch a culturally specific video. Minimal changes were observed in distal outcome variables. It is argued that influencing proximate output variables is necessary, though not sufficient, for effecting long-term change in AIDS-related attitudes, beliefs, and behaviors.     

有偿献血艾滋病患者的情绪状况及影响因素分析

考察有偿献血艾滋病患者的情绪状况 ,探讨他们面临的艾滋病压力和家庭状况、周围环境、身体状况等对情绪的影响。采用Beck抑郁量表、焦虑自评量表、艾滋病压力量表作为测查工具 ,测查了 1 85名有偿献血艾滋病患者 ,并收集了他们的人口学资料和生理学指标信息。结果发现 :( 1 )有偿献血艾滋病患者存在着严重的情绪障碍 ,他们的焦虑程度不但显著高于正常人 ,而且显著高于神经衰弱者和焦虑症者 ,且 92 %的患者有中、重度抑郁障碍 ;( 2 )身体症状和情绪 /生存压力能够显著预测焦虑的程度 ,社会压力和情绪 /生存压力能够显著预测抑郁的程度。因此 ,有偿献血艾滋病患者抑郁、焦虑情绪障碍严重 ,症状和艾滋病压力是情绪障碍的有效预测因素。     

Gendered adversity and mental health of adolescents orphaned by AIDS in a rural South African community: An exploratory study

This study explored gender differences in adversity and mental health among South African adolescents orphaned by AIDS. Adolescents (N = 121; females = 45.5%; mean age 14.14 years, SD = 2.09) self-reported their childhood adversities and probable mental ill health on the Child Trauma and General Health Questionnaire. Results revealed that female participants orphaned by AIDS were significantly more likely to report childhood adversity at total score level as compared to male participants. However, both male and female participants reported comparable scores on subscales of childhood adversity (emotional abuse, physical abuse, sexual abuse, and physical neglect). Moreover, female participants displayed higher composite mental ill health and all its subscales except for social dysfunction. Our findings suggest that gender-sensitive programmes and policies to address the effect of childhood adversity and mental ill health among adolescents orphaned by AIDS, are urgently needed.     

Factors Influencing Condom Use Among African American Women: Implications for Risk Reduction Interventions

Examined factors associated with condom use in a community-based sample of 423 sexually active African American women. Measures were selected to reflect the components in prevailing models of health behavior. Condom users were higher on AIDS health priority, prevention attitudes, stage of change, behavioral intentions, reported more frequent and comfortable sexual communication with partners, perceived greater partner and peer approval for condom use, and reported that peers also used condoms. Women in exclusive relationships evidenced earlier stage of change, lower intentions to use condoms, fewer peers who engaged in preventive behaviors, perceived themselves to have lower risk, and had lower rates of condom use, higher education, and family income. Women in fluid relationships were at particularly high risk, with lower rates of condom use relative to women not in a relationship and greater sexual risk for HIV. Implications for HIV-risk reduction interventions with African American women are discussed.     

Underlying correlation structures of parental stress, general health and anxiety

A partial least square regression (PLSR) was performed on the Swedish Parenthood Stress Questionnaire (SPSQ) sum score and subscales on incompetence, role restriction, social isolation, spouse relationship and health problems, using 42 items from the General Health Questionnaire (GHQ) and 20 items from the State Anxiety Inventory (STAI-X1). The dataset contained 227 fathers and 301 mothers of children aged 1.0-6.6 years from a population-based study on parental psychological distress in the general Norwegian population, and all items correlated positively with SPSQ. Subscales on spouse relationship, incompetence, social isolation and role restriction related to items on state anxiety and depression. The SPSQ subscale on health problems related to GHQ items on somatic symptoms and social dysfunction. The STAI-X1 item "not feeling rested" had a particularly important effect on parental stress. Underlying correlation structures between parental stress and items from STAI-X1 and GHQ were explored, but only the SPSQ sum score could be acceptably predicted. PLSR as a statistical methodology was found useful for health and psychometric data.     

Partner Influences and Gender-Related Factors Associated with Noncondom Use Among Young Adult African American Women

We examined the partner influences and gender-related correlates of noncondom use among African American women. The prevalence of noncondom use was 45.3%. Women whose sexual partners were noncondom users were four times more likely to believe that asking their partner to use a condom implied he was unfaithful, three times as likely to have a partner who resisted using condoms, three times more likely to receive AFDC, twice as likely to be sexually nonassertive, three times more likely to believe that it was not difficult to find an eligible African American man, and three times as likely to have had one sexual partner. HIV prevention tailored towards African American women should address these partner influences and gender-related factors.     

The Role of Anxiety Sensitivity and Mindful Attention in Anxiety and Worry About Bodily Sensations Among Adults Living With HIV/AIDS

The current study examined cognitive factors that may be relevant to understanding anxiety and worry about bodily sensations among an HIV/AIDS population. Specifically, this investigation tested the main and interactive effects of anxiety sensitivity and mindful attention on anxious arousal, bodily vigilance, interoceptive fear, and HIV symptom distress among 164 adults with HIV/AIDS. Results indicated that anxiety sensitivity was positively related to anxious arousal, bodily vigilance, and interoceptive fear, but not HIV symptom distress. Mindful attention was negatively related to anxious arousal, interoceptive fear, and HIV symptom distress, but not bodily vigilance. These main effects for anxiety sensitivity and mindful attention were evident after controlling for disease stage, years with HIV, and demographic variables. There were no interactive effects between anxiety sensitivity and mindful attention. Results are discussed in terms of the clinical implications for identifying and treating anxiety and worry about bodily sensations among adults with HIV/AIDS. Limitations of this study include the use of cross-sectional data and self-report assessments.     

(Teen)Age is More than a Number: Generational Identity within the Context of HIV and AIDS

This study explored some of the complexities through which young adults construct and represent their sexual identities within the context of HIV/AIDS. The sample comprised a total of 136 (female = 77; male = 59) Indian and African learners, who were between the ages 15–19 years, in a co-educational school in the province of KwaZulu-Natal. The main methods of data collection employed were questionnaires and semi-structured interviews. The findings revealed that most young people understand their teenage years as transitional, hormonal and necessarily experimental, and particularly with regard to sexual experimentation. The dominance of heterosexual morality and the transitional status of the adolescents appeared to erode young adults' power to act as responsible agents.     

Stigmatizing attitudes of the community towards people living with HIV/AIDS

This research involved an exploratory study in which a questionnaire was used to investigate the personal stigma and perceived community stigma regarding HIV/AIDS in a South African community. Student fieldworkers interviewed a convenient sample of 901 respondents from different races, gender and age groups, and found that respondents tended towards stigmatizing persons with HIV/AIDS. Yet, this degree of stigmatization was significantly less severe than the degree of stigmatization that respondents attributed to the community at large. Altogether 17% of the respondents had high stigmatizing attitudes, while 42% perceived the stigmatization by others in the community to be high. Race group, personal knowledge of someone with HIV, area of residence, gender and age group impacted on the respondents' personal tendency to stigmatize those with HIV/AIDS. The article discusses the difference between the level of personal stigma attached by the respondents and that perceived by them to be attached by the community. Attention is also paid to the possible implications of stigmatizing behaviour patterns and interventions on a community level. Copyright © 2006 John Wiley & Sons, Ltd.