Perceived Discrimination and Symptoms of Cognitive Dysfuntion Among Middle-Age and Older Persons Living With HIV in China: A Multicenter Cross-Sectional Study of the Mediating Role of Mental Health Symptoms and Social Isolation

Abstract

Perceived discrimination is associated with symptoms of cognitive dysfunction (SOCD) among middle-age and older persons living with HIV (PLWH). We aimed to explore how the association between perceived discrimination and SOCD was mediated by mental health symptoms and social isolation. The sample included 321 PLWH, ages 45 years and older, for a multicenter cross-sectional study. Structural equation modeling showed an acceptable model fit and a significant total indirect effect between perceived discrimination and SOCD. All three indirect effect pathways were significant, suggesting that perceived discrimination could influence SOCD through mental health symptoms, through social isolation, or through mental health symptoms and then social isolation. Our study demonstrates that perceived discrimination is a concern for the management of cognitive function among middle-age and older PLWH. Both mental health symptoms and social isolation are critical elements in the design and evaluation of interventions for promoting cognitive health.

Anxiety, depression, and sleep disturbances among people on long-term efavirenz-based treatment for HIV: a cross-sectional study in Beijing, China

“…The three leading causes of burden of disease in 2030 are projected to include HIV/AIDS, unipolar depressive disorders, and ischaemic heart disease [ 1 ], and mental disorders have been leading causes of disability worldwide [ 2 ]. Due to the particularities of AIDS, people living with HIV (PLHIV) face more challenges than HIV-uninfected individuals, including a loss of social support, mental health issues, discrimination and cognitive impairment [ 3 ]. More attention should be brought to the neuropsychiatric disturbances in PLHIV.…”

Age and Mental Health Symptoms Among Chinese Persons With HIV: The Mediating and Moderating Role of Perceived Discrimination

“…Multiple linear regression models were applied to examine the association between age and mental health symptoms (dependent variable) and the moderating effect of perceived discrimination. Although our previous study had defined age 45 years as the cutoff between younger and older age (Han et al, 2021b), we did not encode age from a continuous variable to categorical variables. Age and perceived discrimination were transformed to Z scores before conducting regression models to avoid structural multicollinearity (age, perceived discrimination, and age × perceived discrimination).…”

“…Of the 1,304 participants, 90 were excluded due to missing data. More details of the HSMS are available in other publications (Han, Hu, Pei, et al, 2021; Han, Hu, Wang, et al, 2021a, 2021b). In this study, we only used data from participants aged 18 years and older, which limited our sample to 1,210 PWH.…”