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.     

Improving Young Male Couples’ Sexual and Relationship Health in the 2GETHER Program: Intervention Techniques,Environments of Care,and Societal Considerations

Young male couples are at high risk for acquiring human immunodeficiency virus (HIV). However, few HIV prevention programs meet the needs of young male couples that express an interest in how to maintain healthy relationships. As such, we developed 2GETHER, a couple-based program that integrates HIV risk reduction and sexual health information into a relationship education program specific to young male couples. 2GETHER was guided by cognitive-behavioral theories of HIV risk reduction and relationship functioning and was informed by a social–ecological perspective to address factors within and outside the couple that can impact sexual and relationship health. As a micro-level intervention, 2GETHER intervenes directly with couples via psychoeducation and cognitive-behavioral strategies to change couples’ communication patterns, sexual health behaviors, and relationship satisfaction. Successful implementation of 2GETHER requires mezzo-level interventions that create an affirming environment of care for sexual minority individuals and facilitators who are culturally competent in working with young male couples. Although macro-level interventions to change societal acceptance of and policies germane to sexual minority couples are beyond the scope of 2GETHER, we discuss how clinicians can advocate for systemic changes to improve sexual minority couples’ health, and how 2GETHER addresses the impact of such macro-level factors on the couple’s relationship. Our experience developing and testing 2GETHER indicates that HIV prevention programs for young male couples should reflect the unique contexts shaping sexual minority individuals’ relationships and lives, and that programs should intervene within and across multiple levels when possible to improve health for sexual minority men.     

Understanding HIV Prevention With College‐Going Black Women: An NIMH‐Funded Pilot Study

Black women are disproportionately affected by HIV. Limited research has examined race and gender as psychological variables of influence. In this National Institute of Mental Health pilot study, the authors used semistructured interviews to explore the heterogeneity of identity within race and gender and possible interactions with sexual risk perceptions and behavior in a sample of Black women attending college in an urban city. The article presents emergent themes, recommendations, and questions for future research. El VIH afecta a las mujeres negras de forma desproporcionada. Un número limitado de investigaciones ha examinado la raza y el sexo como variables psicológicas de influencia. En este estudio piloto del Instituto Nacional de Salud Mental, los autores usaron entrevistas semiestructuradas para explorar la heterogeneidad de la identidad dentro de la raza y el sexo, así como posibles interacciones con las percepciones de riesgo y comportamiento sexual en una muestra de mujeres negras cursando estudios universitarios en una ciudad urbana. El artículo presenta temas emergentes, recomendaciones y preguntas para futuras investigaciones.     

Preventing HIV infection among injecting drug users: Intuitive and counter-intuitive findings

The disease now called AIDS was first reported among injecting drug users in 1981. This article reviews the last 15 years of research on preventing HIV infection and AIDS among injecting drug users. Many of the findings were surprising in the context of previous understandings of the illicit injection of psychoactive drugs—both with respect to the much-larger-than-expected size of the epidemic and the much-greater-than-expected potential for behavior change among drug injectors (IDU). The research is reviewed within a framework of eight issues: the importance of the problem in the United States, the global diffusion of injecting drug use, the global diffusion of HIV among IDUs, potential rapid spread of HIV among IDUs, risk reduction among IDUs, community-level prevention, syringe exchange programs, and developing a public-health perspective on psychoactive drug use.     

华生关怀理论在慢性病患者护理中的应用探索

随着我国经济的发展,人群中疾病谱和死因谱发生了重大变化。以心脑血管疾病、恶性肿瘤为代表的慢性病已成为严重威胁人们健康的公共卫生问题。慢性病的主要特点是病程长,迁延不愈,反复发作,它对人的共同影响有：身体功能、心理、社会生活等的影响。护理理论家华生提出关怀护理理论,关怀必须是护理人员结合科学与人文知识在与患者的互动关系中按照关怀的10个要素来完成,目标是帮助患者达到身体、心理及心灵更高程度的协调。本文介绍了关怀理论的主要内容、慢性病的特点,并通过实际病例应用阐述了关怀理论在慢性病患者临床护理中的应用。     

处理疼痛的理念

处理疼痛的理念各有不同。有人认为手术后疼痛很正常,挺着吧。人老了,腰腿痛就该扛着。而有的人会积极给予止痛治疗,以患者舒适为目标。2007年7月我国卫生部签发了关于《医疗机构诊疗科目名录》中增加“疼痛科”的文件,说明我国进入了一个止痛治疗的新时代。得到疼痛治疗是患者的基本权利,也是医师的崇高职责。有疼有痛忍着不治的时代即将过去,及早、及时为患者止痛是人道主义的体现。     

再谈在中国应提倡使用避孕套预防艾滋病

人们性观念的转变和性行为准则的放松导致了性传播疾病(STDs)逐年增多.据统计,中国已进入艾滋病(AIDS)的广泛流行期.再次提出应当提倡使用避孕套,充分发挥避孕套的双重保护作用以限制AIDS在国内的蔓延;通过大量的资料,再次阐述了推广使用避孕套的必要性和重要性,并就在国内推广过程中可能会出现的相关问题作了进一步说明.     

酒精性肝损伤的防治思考

艾滋病是当前许多国家面临的最主要的公共卫生和社会问题。社会支持在艾滋病的预防与控制方面发挥着重要作用,运用社会支持网络理论,阐述了社会支持的概念与作用,分析了艾滋病患者的社会支持需要及艾滋病患者社会支持现状,并提出了完善社会支持系统的几点建议。     

医科大学生在农村进行艾滋病防治干预模式的探索

艾滋病在中国正处于快速蔓延期,目前艾滋病的宣教和干预,集中在年底艾滋病日前后,集中在大城市,基层农村做得很少。而国家每年培养的数以万计的医科类大学生却没有充分发挥作用。有鉴于此,特组织策划2007防艾乡村大讲堂活动以探索医科大学生在农村进行艾滋病防治干预的新模式。     

患者隐私权的研究现状与保护进展

患者隐私权是患者的一项重要人格权。世界范围内病人权利运动的广泛开展及公民个人隐私保护意识的逐渐增强,使患者隐私权越来越受到关注。目前学者们对患者的隐私和隐私权看法各异,现行法律也没有统一明确的界定。但国内外对患者隐私权的研究与保护都有不同程度的关注与进展,并在法律上予以体现。