HIV-related Mental Health Research Articles

HIV-related mental health care: Factors influencing dropout among low-income, HIV-positive individuals

A prospective design was used to collect data from 132 HIV-positive individuals presenting for mental health care at an inner-city HIV-related mental health clinic located in a large metropolitan area of the Southeastern USA. Data were analyzed to assess associations between study variables and whether participants returned for care following an initial mental health assessment. Hierarchical logistic regression analyses were conducted to determine the extent to which the addition of measures of health beliefs and HIV-related stigma would enhance the predictive capacity of a dropout model that included demographics and health status measures. As health beliefs and HIV-related stigma were added to the model, the predictive capacity increased significantly (R2 = 0.29 to R2 = 0.63, p < 0.05). Those who did not return for care had higher levels of perceived barriers to mental health care, higher levels of HIV-related stigma, were more likely to be of non-white ethnicity and had lower T-cell counts. These findings indicate that mental health providers may need to ensure care systems are responsive to the social and cultural characteristics of clients, and the HIVepidemic itself, in order to effectively engage clients into care.

Determinants of quality of life in black African women with HIV living in London

A major sub-population of people with HIV in the UK comes from Sub-Saharan Africa, a high proportion being refugees. Some evidence from previous literature points to different determinants and lower levels of quality of life for women with HIV as compared to men. This study examined quality of life and its determinants in a sample of black African women with HIV living in London. Participants were 56 women who completed questionnaires on demographics, HIV impact, coping style (problem-focused and wishful thinking) and social support. The majority were single parents, had arrived in the UK within the last ten years and were unemployed. Compared to two samples of women with HIV (London and Montreal), reported HIV-related mental health impact was significantly higher and physical (but not mental) health-related quality of life were significantly lower. Both physical and mental health-related quality of life were significantly lower than UK norms for other people (men and women) with chronic illnesses. In hierarchical multiple regression, better mental health-related quality of life was predicted by practical coping style and higher social support. This sub-group of the HIV population appears to be in particularly great need for social support and services.

Can community mental health centers meet the challenge of HIV? a response to Knox, Davis, and Friedrich

As the catastrophe that is the HIV epidemic increases its grip, a systematic appraisal of the need for mental health services for individuals and families affected by HIV and AIDS is needed. The article in this issue of the Community Mental Health Journal by Knox, Davis and Freidrich presents a well-conceived model for the organization and targeting of HIV-related mental health services. This model recognizes that the psychological impact of the epidemic is felt far more widely than among those who are infected, from the ~well but worried" to caregivers and significant others, as well as those whose behavior places them at risk for infection. The authors propose a central role for Community Mental Health Centers (CMHCs) in the development and provision of this comprehensive range of mental health services. For mental health professionals, HIV has led to new professional roles, which have continued to evolve as the number of affected individuals has increased and the characteristics of the infected population have changed. In addition, many mental health professionals have needed to confront and successfully address personal biases and preju

HIV-related mental health nursing issues

UMAN immunodeficiency virus (HIV) has already challenged many oncology nurses to cope with new and pressing issues. Research to date indicates that progression from seropositivity to clinical acquired immunodeficiency syndrome (AIDS) will probably occur in most patients. This means that nurses in nearly all care settings will be affected by the epidemic. The prevalence of neuropsychiatric disorders in AIDS makes it imperative that oncology nurses be sensitive to HIVrelated mental health nursing issues. Adults with HIV are typically young, so they and their social networks are not well prepared to grapple with terminal illness. AIDS is heavily imbued with stigmas of contagion, sexual transmissibility, and intravenous drug use. Discrimination may be based on race, gender, ethnicity, and/or sexual orientation. Regardless of personal history, HIV positivity suggests to many the negative cultural stereotypes of homosexuality and/or drug addiction For some who contracted HIV via covert sexual activity or intravenous drug use, the disclosure of HIV seropositivity represents an unwanted disclosure of these previously covert activities. Such disclosures may provoke crises of personal identity, social discord, unemployment, and isolation. It is important to discuss HIV status directly with patients in order to understand the social context of their illness. Who else knows? How have those individuals responded? These are key questions in accurately evaluating the individual’s sup