Appearance Concerns and Psychological Distress Among HIV-Infected Individuals with Injection Drug Use Histories: Prospective Analyses

Abstract

Morphologic alterations in body composition are common among HIV-infected individuals, and these changes are associated with increased appearance concerns. Previous cross-sectional data indicate that appearance concerns among HIV-infected individuals are related to increased levels of psychological distress. However, to date, no known prospective data have been published on these relationships. The purpose of the current study was to address the temporal prediction of appearance concerns on depression and anxiety severity. Data were culled from a prospective, randomized controlled trial of cognitive behavioral therapy for depression and medication adherence in individuals with a history of injection drug use (IDU). Participants were 89 HIV-infected individuals who were randomized to either a cognitive behavioral therapy or treatment as usual condition. Linear mixed-level modeling revealed elevated levels of appearance concerns were prospectively related to increased depression and anxiety, as rated by both clinician-administered and self-report measures. Appearance concerns among depressed, IDU, HIV-infected individuals are associated with changes in psychological distress. Psychosocial interventions should consider the role of appearance as it relates to psychological functioning.

Barriers and Facilitators to Engagement in Lifestyle Interventions Among Individuals With HIV

“…PLWH may try to gain weight to avoid the social stigma associated with HIV. Appearance concerns are common in PLWH as the illness and/or treatment may affect body changes such as increased fat in the belly, neck, shoulders, breasts, and face (Blashill, Gordon, & Safren, 2012). One participant reported, “I’m not too big but I had like a little pouch.…”

Body Representations of People With Hiv/Aids: Between Visibility and Secrecy

“…13 Para M., os valores e padrões de corpo começaram a mudar ao longo da vida. Obesa na adolescência, ser chamada de O uso dos ARVs e a infecção modificaram seu corpo, que se tornou uma vitrine da doença, o que ela tenta esconder pelo medo do preconceito.…”

“…Obesa na adolescência, ser chamada de O uso dos ARVs e a infecção modificaram seu corpo, que se tornou uma vitrine da doença, o que ela tenta esconder pelo medo do preconceito. Estudo realizado por Blashill 13 revela que a PVHA tem sua qualidade de vida ameaçada pela lipodistrofia, sendo que as que são diagnosticadas têm duas vezes mais receio de serem reconhecidas como soropositivas para HIV devido à sua aparência física.…”

“…Mudanças corporais percebidas na vivência da infecção pelo HIV e suas implicações na vida das pessoas foram relacionadas ao medo do preconceito 13 e mudança nas interações vividas pelo sujeito.…”

Optimizing adherence to highly active antiretroviral therapy among marginalized, HIV-positive women with comorbid depression: the role of the nurse practitioner

“…Unfortunately, the authors analyzed stigma and depression as a single variable, so it is difficult to determine the impact depression alone had on body image, or if stigma affected depression and vice versa. Blashill, Gordon and Safren (2012), studied a mixed gender sample of 89 PL WHA with opioid-dependence, and found that concerns about physical appearance were associated with increased depression and anxiety. Unfortunately, neither of these studies stratified the results by gender, however, they were included in this project because of the consistency in the relationship between body image and depression.…”