A Structural Equation Model of HIV-related Symptoms, Depressive Symptoms, and Medication Adherence

Yoo‐Jeong, Moka; Waldrop‐Valverde, Drenna; McCoy, Katryna; Ownby, Raymond L.

doi:10.16966/2380-5536.123

Cited by 5 publications

(3 citation statements)

References 35 publications

(46 reference statements)

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“…While social support, especially support utilization, was negatively associated with depressive symptoms. The results from some studies had indicated a high level of depressive symptoms were related to a poor level of medication compliance and could reduce the quality of life and treatment outcome, [ 13 , 19 , 20 ] while social support was confirmed to alleviate the level of depression. [ 10 , 21 ] Support utilization reflects the degree of utilizing various types of available support, such as modes of pouring out to other people, seeking help, and participating in social activities in their daily lives.…”

Section: Discussionmentioning

confidence: 99%

The relationship of social support, mental health, and health-related quality of life in human immunodeficiency virus-positive men who have sex with men

et al. 2018

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The objective of this study was to reveal the relationships of mental health, social support, health-related quality of life (HRQOL) as well as their dimensions in HIV-positive men who have sex with men (MSM).HIV-positive MSM were interviewed by a cross-sectional study design using the world Health Organization quality of life bref scale, social support rating scale, and self-rated anxiety and depression scales. Canonical correlation analysis and structural equation model (SEM) were utilized to analyze to the collected data.Three first pair of canonical variables that was statistically significant (P < .0001) and verified could account for the largest cumulative proportion were computed from canonical correlation analysis. The results showed, among the dimensions, depression and anxiety were negatively correlated with support utilization and physical health, while subjective support and support utilization were positively correlation with social relationship health. Structural equation model results showed that support utilization (0.632, T = 10.44), depression (0.816, T = 20.37), and environmental dimension (0.833, T = 38.47) had the largest standardized factor loading in social support, mental health, and HRQOL. The structural coefficient between social support and mental health was −0.433 (T = −5.88), between mental health and HRQOL was −0.592 (T = −10.33), between social support and HRQOL was 0.290 (T = 4.10), indicated social support not only exerted a direct influence, but also mediated mental health to have an indirect effect on HRQOL for HIV-positive MSM.Environmental dimension is the foremost factor of HRQOL for HIV-positive MSM. Alleviating anxiety symptoms maybe improve physical health, while promoting the support utilization is an effective measure of alleviating depression and improving social relationship health for this special group.

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Section: Discussionmentioning

confidence: 99%

The relationship of social support, mental health, and health-related quality of life in human immunodeficiency virus-positive men who have sex with men

et al. 2018

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“…In the study by Rahmati the HIV patients had experienced waiting for death, suicide attempts and feeling of hopelessness due to HIV stigma [27]. Given the fact that there is an inverse relationship between the high levels of psychological problems, especially depression, and the follow-up of the treatment process by HIV patients [36], it might be said that depression and psychosocial problems will adversely affect the attainment of the goals set for coping with HIV.…”

Section: Patient Experiences After Receiving Servicesmentioning

confidence: 99%

HIV Positive Patients' Experience of Receiving Health Care Services: A Phenomenology Study in Iran

Asadi¹,

Imani-Nasab²,

Garavand³

et al. 2018

TOAIDJ

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Introduction:Most of the studies on HIV/AIDS health care status are usually conducted in big cities while small towns and rural areas are faced with specific challenges. This study aimed to identify the barriers and problems encountered by HIV-positive patients when receiving health services in the small cities and rural areas of Iran.Methodology:This is a qualitative study that was conducted using an interpretive phenomenology method in 2016. This study was conducted through a semi-structured interview for which a purposeful sampling method was used. In the present study, data saturation was observed after 15 interviews, but more than 17 interviews were conducted to ensure the reliability of the interview. Data were analyzed by Colaizzi's method using MAXQDA10 software.Findings:Barriers and problems encountered by patients when receiving health care services consisted of 10 categories, 32 main themes and 67 sub-themes. The categories were as follows: fear of revealing the disease, fear of confronting providers, seeking support, not visiting health care providers, inappropriate behavior of health care staff, concealing the disease, hardship endurance, financial concerns, psychological stress and pressure, and disclosure of patient information.Conclusion:Recognizing the problems of HIV-positive patients in using health care services and resolving them can help to reassure the patients about the health system. Introduction of supporting policies and regulations, appropriate public education, training health sector personnel, and provision of medical equipment and facilities would positively affect the process of solving the problems of HIV-Patients (treating HIV patients).

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“…Higher frequency of depression has been repeatedly documented in HIV+ compared to HIV-negative (HIV-) subjects: a 2001 meta-analysis found the frequency of MDD to be nearly two times higher in HIV+ subjects (27), with more recent work confirming that figure (1, 28, 29). Beyond the psychological toll of depression in HIV+ subjects, the ramifications extend to its impact on survival, mainly through its effect on treatment adherence (30) and secondary control of the infection: untreated depression was associated with significantly decreased odds of achieving >90% adherence to HAART and significantly lower odds of controlling HIV RNA levels to <500 copies/ml (31). In another study, somatic symptoms of depression were associated with shortened survival in HIV+ patients (32).…”

Section: Discussionmentioning

confidence: 99%

Potential Mechanism for HIV-Associated Depression: Upregulation of Serotonin Transporters in SIV-Infected Macaques Detected by 11C-DASB PET

et al. 2019

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Purpose: Increased incidence of depression in HIV+ patients is associated with lower adherence to treatment and increased morbidity/mortality. One possible underlying pathophysiology is serotonergic dysfunction. In this study, we used an animal model of HIV, the SIV-infected macaque, to longitudinally image serotonin transporter (SERT) expression before and after inoculation, using 11C-DASB (SERT ligand) PET imaging. Methods: We infected seven rhesus macaques with a neurovirulent SIV strain and imaged them at baseline and multiple time points after inoculation (group A). Pyrosequencing methylation analysis of the SERT promoter region was performed. We also measured SERT mRNA/protein in brain single-cell suspensions from another group (group B) of SIV-infected animals (n = 13). Results: Despite some animals showing early fluctuations, 86% of our group A animals eventually showed a net increase in midbrain/thalamus binding potential (BP ND ) over the course of their disease (mean increased binding between last time point and baseline = 30.2% and 32.2%, respectively). Repeated-measures mixed-model analysis showed infection duration to be predictive of midbrain BP ND (p = 0.039). Thalamic BP ND was statistically significantly associated with multiple CSF cytokines (P < 0.05). There was higher SERT protein levels in the second group (group B) of SIV-infected animals with SIV encephalitis (SIVE) compared to those without SIVE (p = 0.014). There were no longitudinal changes in SERT gene promoter region percentage methylation between baselines and last time points in group A animals. Conclusion: Upregulated SERT leading to lower synaptic levels of serotonin is a possible mechanism of depression in HIV+ patients, and extrapolating our conclusions from SIV to HIV should be sought using translational human studies.

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A Structural Equation Model of HIV-related Symptoms, Depressive Symptoms, and Medication Adherence

Cited by 5 publications

References 35 publications

The relationship of social support, mental health, and health-related quality of life in human immunodeficiency virus-positive men who have sex with men

The relationship of social support, mental health, and health-related quality of life in human immunodeficiency virus-positive men who have sex with men

HIV Positive Patients' Experience of Receiving Health Care Services: A Phenomenology Study in Iran

Potential Mechanism for HIV-Associated Depression: Upregulation of Serotonin Transporters in SIV-Infected Macaques Detected by 11C-DASB PET

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