Demographic and clinical factors correlating with high levels of psychological distress in HIV-positive women living in Ontario, Canada

Abstract

The concept of psychological distress includes a range of emotional states with symptoms of depression and anxiety and has yet to be reported in HIV-positive women living in Ontario, Canada, who are known to live with contributing factors. This study aimed to determine the prevalence, severity, and correlates of psychological distress among women accessing HIV care participating in the Ontario HIV Treatment Network Cohort Study using the Kessler Psychological Distress Scale (K10). The K10 is a 10-item, five-level response scale. K10 values range from 10 to 50 with values less than or equal to 19 categorized as not clinically significant, scores between 20 and 24 as moderate levels, 25-29 as high, and 30-50 as very high psychological distress. Correlates of psychological distress were assessed using the Pearson's chi-square test and univariate and multivariate logistic regression analysis. Moderate, high, and very high levels of psychological distress were experienced by 16.9, 10.4, and 15.1% of the 337 women in our cohort, respectively, with 57.6% reporting none. Psychological distress levels greater than 19, correlated with being unemployed (vs. employed/student/retired; AOR = 0.33, 95% CI: 0.13-0.83), living in a household without their child/children (AOR = 2.45, 95% CI: 1.33-4.52), CD4 counts < 200 cells/mm(3) (AOR = 2.07, 95% CI: 0.89-4.80), and to a lesser degree an education of some college or less (vs. completed college or higher; AOR=1.71, 95% CI: 0.99-2.95). Age and ethnicity, a priori variables of interest, did not correlate with psychological distress. Findings suggest that socioeconomic factors which shape the demography of women living with HIV in Ontario, low CD4 counts, and losing the opportunity to care for their child/children has a significant relationship with psychological distress. Approaches to manage psychological distress should address and make considerations for the lived experiences of women since they can act as potential barriers to improving psychological well-being.

Barriers to health-care and psychological distress among mothers living with HIV in Quebec (Canada)

“…This result confirms the increased vulnerability to psychological distress among MLHIV (Benoit et al, 2014;Brackis-Cott, Mellins, Dolezal, & Spiegel, 2007;Catz, Gore-Felton, & McClure, 2002). This high prevalence cuts across sociodemographic characteristics and cannot be explained by low socioeconomic position, immigration status, or time since HIV diagnostic.…”

“…While medical care is covered by insurance in Quebec, financial challenges can impair access to HIV medication because of the deductible of insurance companies which compels MLHIV to prioritize between their differing needs. These factors were associated with clinical psychological distress, supporting previous conclusions linking financial strain to psychological distress among PLHIV (Barsky & Albertini, 2006;Benoit et al, 2014;Cunningham et al, 1999;Moneyham et al, 2010;Reif et al, 2005).…”

“…WLHIV have to cope with both psychosocial and physical stressors that significantly impact the development of psychopathology (Benoit et al, 2014;Brackis-Cott, Mellins, & Block, 2003;Herek, Saha, & Burack, 2013;McIntosh & Rosselli, 2012). Among these stressors, access to health care, treatment, and satisfaction with medical providers are predominant.…”

Depression and Anxiety are Common in Acute HIV Infection and Associate with Plasma Immune Activation

“…However, another study has shown increased CD8+ T lymphocyte counts associating with symptoms of depression and anxiety [29]. By contrast, elevated symptoms of anxiety were associated with a higher CD4 count in one study [32], while others reported no associations between severity of self-reported affective symptoms or disorders and CD4 count [22, 33, 34]. The considerable individual, psychosocial, and disease-related heterogeneity of participants may add to the mixed findings in these studies.…”

Prevalence and correlates of psychological distress of middle-aged and older women living with HIV

“…However, there has been some consistency showing an association between better mental health and having a stable partner (Protopopescu et al, 2007), having higher education (Benoit et al, 2014;Murri et al, 2003) and having employment (Blalock, McDaniel, & Farber, 2002;Rueda et al, 2011).…”