scholarly journals Psychological distress during the initial COVID-19 pandemic in an Italian cohort of people living with HIV: an online survey

2021 ◽  
Author(s):  
Valentina Delle Donne ◽  
Nicoletta Ciccarelli ◽  
Valentina Massaroni ◽  
Francesca Lombardi ◽  
Silvia Lamonica ◽  
...  

Abstract Our aim was to explore the psychological impact of the initial 2019 Coronavirus (COVID-19) pandemic in a cohort of people living with HIV (PLWH), a population at increased risk of psychological distress. PLWH, treated at our unit, responded an online survey. Data on demographics, clinical and physical symptoms, contact history, as well as knowledge, concerns, precautionary measures and additional information required with respect to COVID-19 during the first phase of the pandemic in Italy were collected. Additionally, the Impact of Event Scale-Revised (IES-R) (identifying COVID-19 pandemic as specific traumatic life event) and the Depression, Anxiety and Stress Scale (DASS-21) were also administered. Out of 98 participants, 44 (45%) revealed from mild to severe psychological impact distress from COVID-19 according to IES-R. According to DASS-21, a lower percentage of significant levels of depression (14%), anxiety (11%) or stress (6%) were reported. Higher education, unemployment, number of perceived physical COVID-19 symptoms, concerns contracting COVID-19 and the situation regarding the pandemic in Italy, and the need of additional information to prevent COVID-19 infection were positively associated to psychological distress. Moreover, female gender, older age, recent HIV diagnosis and unawareness of own viremia were associated to a higher psychological distress. Almost half of our cohort experienced significant levels of distress related to the COVID-19 pandemic. Women, elderly patients and those with recent HIV diagnosis resulted to be the more psychological fragile subgroup. Our findings could help to identify patients in need of psychological interventions to improve wellbeing of PLWH.

2020 ◽  
Author(s):  
Valentina Delle Donne ◽  
Nicoletta Ciccarelli ◽  
Valentina Massaroni ◽  
Francesca Lombardi ◽  
Silvia Lamonica ◽  
...  

Abstract Purpose: Our aim was to explore the psychological impact of the 2019 Coronavirus Disease (COVID-19) on People Living with HIV (PLWH), a population at increased risk of psychological distress.Methods: PLWH participated to an online survey exploring demographic and clinical data, physical symptoms, contact history, knowledge and concerns, precautionary measures and additional information about COVID-19 during the first phase of the pandemic in Italy. The Impact of Event Scale-Revised (IES-R) (identifying COVID-19 pandemic as specific traumatic life event) and the Depression, Anxiety and Stress Scale (DASS-21) were also comprised. Results: Out of 98 participants, 45% revealed from mild to severe psychological impact from COVID-19 according to IES-R. A lower percentage, instead, complained significant levels of depression (14%), anxiety (11%) or stress (6%) according to DASS-21. Aging, education, being unemployed, number of possible COVID-19 physical symptoms, concerns about risk of contracting COVID-19 and pandemic situation in Italy, and needing additional information to prevent COVID-19 infection were positively associated to a higher risk of negative psychological impact. Moreover, female gender, fewer years from HIV diagnosis and not being aware of own viremia were associated to a higher risk of negative psychological outcomes.Conclusion: Almost half of our PLWH sample experienced significant levels of distress related to COVID-19 pandemic. Women and those with recent HIV diagnosis seem the more psychological fragile subgroup. Our findings could help to identify patients most in need of psychological interventions to improve wellbeing of PLWH.


Author(s):  
Joseph Nelson Siewe Fodjo ◽  
Edlaine Faria de Moura Villela ◽  
Stijn Van Hees ◽  
Pieter Vanholder ◽  
Patrick Reyntiens ◽  
...  

COVID-19 affects persons living with HIV (PLWH) both directly (via morbidity/mortality) and indirectly (via disruption of HIV care). From July–November 2020, an online survey was conducted to investigate the psychosocial well-being of PLWH and changes in HIV care during the second semester of the COVID-19 outbreak. Data were collected on the socio-demographic characteristics of PLWH, their psychosocial well-being, impact of COVID-19 preventive measures on their daily routines and HIV follow-up. Of the 247 responses analyzed (mean age: 44.5 ± 13.2 years; 73.7% male), 67 (27.1%) and 69 (27.9%) respondents screened positive for anxiety (GAD-2 score ≥ 3) and depression (PHQ-2 score ≥ 3), respectively. HIV care had returned to pre-COVID-19 state for 48.6% PLWH, and 108 (43.7%) had no HIV follow-up during the past month. Over three quarters (76.1%) of respondents expressed willingness to receive the COVID-19 vaccine. Compared to previous findings in April 2020, substance use increased from 58.6% to 67.2% (p < 0.001). Our findings suggest that the well-being and medical follow-up of PLWH are still affected after almost a year into the COVID-19 outbreak. Remote HIV follow-up (telemedicine) with psychosocial support should be envisaged in the medium to long-term. Given that most PLWH accept COVID-19 vaccination, they may be prioritized for this intervention.


2020 ◽  
Vol 14 (11.1) ◽  
pp. 128S-132S
Author(s):  
Alfiya Denebayeva ◽  
Arpine Abrahamyan ◽  
Aelita Sargsyan ◽  
Karine Kentenyants ◽  
Ainur Zhandybayeva ◽  
...  

Introduction: Antiretroviral therapy (ART) is an effective preventive strategy against tuberculosis (TB) in people living with HIV (PLWH). In Kazakhstan, according to the revised HIV treatment guideline (2017), ART should be initiated immediately after HIV diagnosis established, regardless of CD4+ count. Aim: To evaluate the impact of early initiation of ART on TB infection in PLWH registered in the Center of Prevention and Control of AIDS, Almaty, Kazakhstan, between 2008 and 2018. Methodology: A retrospective cohort study was conducted using the data of 4,053 patients from electronic HIV case management system (2008-2018) (EHCMS). Results: The study revealed low rates (12.6%) of rapid ART (≤ 1 month after HIV diagnosis). Patients in the rapid ART initiation group were less likely to develop TB compared with those who started treatment >1 month after the HIV detection (odds ratio 1.6; 95% confidence interval [1.1, 2.2]; p = 0.00799). Interestingly, the risk for developing TB among patients receiving ART ≥ 1 month after HIV diagnosis was significantly higher compared with those not taking any treatment. The latter was explained by several confounding not addressed during the analysis, since ART was prescribed to patients with primarily deeper immunodeficiency, while the patients not receiving ART were less immunocompromised. Conclusion: Despite the recently changed HIV treatment guideline in Kazakhstan, ART is still initiated based on the disease severity. In 2018, the initiation of ART during the first month after HIV diagnosis increased by 50%. However, it is necessary to reduce the time to initiation of ART for all patients.


2020 ◽  
Author(s):  
Taisuke Togari ◽  
Yoji Inoue ◽  
Gaku Oshima ◽  
Sakurako Abe ◽  
Rikuya Hosokawa ◽  
...  

Abstract Background: For Japanese people living with HIV, this study aimed at the following: verifying the three-factor model of stress-related growth scales; confirming the impact of stress-related growth on mental health and physical symptoms; and determining differences in the effects of stress-related growth on health by time since HIV diagnosis. Methods: A cross-sectional anonymous self-administered online survey which was prepared on the basis of the participatory research method was conducted from July 2013 to February 2014 and from December 2016 to July 2017 for all Japanese web users living with HIV. We analyzed the data of 1,422 participants who responded regarding the number of years since diagnosis and where transmission was sexual. The mean age (standard deviation) was 38.6 (8.3) years. Results: Stress-related growth comprises three factors: self-perception, interpersonal relationships, and philosophy of life. In the group over 4 years since diagnosis, logistic and Poisson regression analysis simultaneously including all the scales showed a positive effect; in the group with less than 4 years since diagnosis, such an association was found only for self-perception. In the group with over 4 years since diagnosis, positive growth in interpersonal relationships and self-perception led to reduced somatic symptoms; however, philosophy of life was linked to increased physical symptoms. When the group with less than 4 years since diagnosis was included, no correlation was evident with philosophy of life; positive growth in self-perception led to reduced physical symptoms; positive changes in interpersonal relationships produced increased physical symptoms. Conclusions: Toward assisting people living with HIV/AIDS, we found that personal and group relationships played an important role in creating positive changes regarding respondents’ perceptions of life and other people.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Maurizio Bonati ◽  
Rita Campi ◽  
Michele Zanetti ◽  
Massimo Cartabia ◽  
Francesca Scarpellini ◽  
...  

Abstract Background Quarantine as a preventive action to reduce people’s exposure to a contagious disease has substantial psychological impact. We aimed to collect information on psychologically distressing experiences of Italians living in quarantine during the COVID-19 pandemic. Methods From 6 to 20 April 2020 participants filled out an online questionnaire. Demographic and physical symptoms data from the prior 14 days of quarantine were collected. Psychological impact of quarantine was assessed by the COVID-19 Peritraumatic Distress Index (CPDI). Results In all, 20,158 participants completed the online survey. Of these, 11,910 (59.1%) were from Lombardy, the region with 37.7% of positive cases identified during the survey period. 30.1% of responders were male. About half (55.9%) of responders were 18–50 years old, 54.3% had a tertiary level of education, 69.5% were workers, 84.1% were living in houses with ≥3 rooms, and 13.7% were living alone. 9.7% had had contact with COVID-19 positive people. Of all responders, 9978 (48.6%) reported a psychological impact, 8897 (43.4%) of whom reported mild or moderate and 1081 (5.2%) severe psychological impact. The multivariate analysis, after adjustments, showed that an increasing CPDI score was associated with gender (female), first-second educational level, being unemployed, living in a ≤2 room house, having had new health problems during the previous 14 days, and not having been out of the house in the previous week. Concerning the type of psychological distress, 2003 responders (9.9%) reported moderate to severe depressive symptoms, 1131 (5.5%) moderate to severe anxiety symptoms, and 802 (3.9%) moderate to severe physical symptoms. A positive correlation was found between responder rate (per 10.000 residents) and positive COVID-19 cases (per 10.000 residents) by region (rs = + 0.83, p = < 0.0001), and between responder rate and region latitude (rs = + 0.91, p = < 0.0001), with a greater response rate in the north. Considering Lombardy Region responders, a negative correlation between CPDI score and distance from place of residence to the red zone (Nembro-Alzano) was found. Higher prevalence of psychological distress was found up to 25 km away from the red zone and, in particular, severe distress up to 15 km. Conclusions Policy makers and mental health professionals should be aware of quarantine’s adverse mental health consequences. Factors influencing the success of quarantine and infection control practices for both disease containment and community recovery should be identified and additional support to vulnerable persons at increased risk of adverse psychological and social consequences of quarantine should be guaranteed.


2020 ◽  
Author(s):  
Taisuke Togari ◽  
Yoji Inoue ◽  
Gaku Oshima ◽  
Sakurako Abe ◽  
Rikuya Hosokawa ◽  
...  

Abstract Background: For Japanese people living with HIV, this study aimed at the following: verifying the three-factor model of stress-related growth scales; confirming the impact of stress-related growth on mental health and physical symptoms; and determining differences in the effects of stress-related growth on health by time since HIV diagnosis. Methods: A cross-sectional anonymous self-administered online survey which was prepared on the basis of the participatory research method was conducted from July 2013 to February 2014 and from December 2016 to July 2017 for all Japanese web users living with HIV. We analyzed the data of 1,422 participants who responded regarding the number of years since diagnosis and where transmission was sexual. The mean age (standard deviation) was 38.6 (8.3) years. Results: Stress-related growth comprises three factors: self-perception, interpersonal relationships, and philosophy of life. In the group over 4 years since diagnosis, logistic and Poisson regression analysis simultaneously including all the scales showed a positive effect; in the group with less than 4 years since diagnosis, such an association was found only for self-perception. In the group with over 4 years since diagnosis, positive growth in interpersonal relationships and self-perception led to reduced somatic symptoms; however, philosophy of life was linked to increased physical symptoms. When the group with less than 4 years since diagnosis was included, no correlation was evident with philosophy of life; positive growth in self-perception led to reduced physical symptoms; positive changes in interpersonal relationships produced increased physical symptoms. Conclusions: Toward assisting people living with HIV/AIDS, we found that personal and group relationships played an important role in creating positive changes regarding respondents’ perceptions of life and other people.


2020 ◽  
Author(s):  
Khanh Ngoc Cong Duong ◽  
Tien Nguyen Le Bao ◽  
Phuong Thi Lan Nguyen ◽  
Thanh Vo Van ◽  
Toi Phung Lam ◽  
...  

BACKGROUND The first nationwide lockdown due to the COVID-19 pandemic was implemented in Vietnam from April 1 to 15, 2020. Nevertheless, there has been limited information on the impact of COVID-19 on the psychological health of the public. OBJECTIVE This study aimed to estimate the prevalence of psychological issues and identify the factors associated with the psychological impact of COVID-19 during the first nationwide lockdown among the general population in Vietnam. METHODS We employed a cross-sectional study design with convenience sampling. A self-administered, online survey was used to collect data and assess psychological distress, depression, anxiety, and stress of participants from April 10 to 15, 2020. The Impact of Event Scale-Revised (IES-R) and the Depression, Anxiety, and Stress Scale-21 (DASS-21) were utilized to assess psychological distress, depression, anxiety, and stress of participants during social distancing due to COVID-19. Associations across factors were explored using regression analysis. RESULTS A total of 1385 respondents completed the survey. Of this, 35.9% (n=497) experienced psychological distress, as well as depression (n=325, 23.5%), anxiety (n=195, 14.1%), and stress (n=309, 22.3%). Respondents who evaluated their physical health as average had a higher IES-R score (beta coefficient [B]=9.16, 95% CI 6.43 to 11.89), as well as higher depression (B=5.85, 95% CI 4.49 to 7.21), anxiety (B=3.64, 95% CI 2.64 to 4.63), and stress (B=5.19, 95% CI 3.83 to 6.56) scores for DASS-21 than those who rated their health as good or very good. Those who self-reported their health as bad or very bad experienced more severe depression (B=9.57, 95% CI 4.54 to 14.59), anxiety (B=7.24, 95% CI 3.55 to 10.9), and stress (B=10.60, 95% CI 5.56 to 15.65). Unemployment was more likely to be associated with depression (B=3.34, 95% CI 1.68 to 5.01) and stress (B=2.34, 95% CI 0.84 to 3.85). Regarding worries about COVID-19, more than half (n=755, 54.5%) expressed concern for their children aged &lt;18 years, which increased their IES-R score (B=7.81, 95% CI 4.98 to 10.64) and DASS-21 stress score (B=1.75, 95% CI 0.27 to 3.24). The majority of respondents (n=1335, 96.4%) were confident about their doctor’s expertise in terms of COVID-19 diagnosis and treatment, which was positively associated with less distress caused by the outbreak (B=–7.84, 95% CI –14.58 to –1.11). CONCLUSIONS The findings highlight the effect of COVID-19 on mental health during the nationwide lockdown among the general population in Vietnam. The study provides useful evidence for policy decision makers to develop and implement interventions to mitigate these impacts. CLINICALTRIAL


Author(s):  
Charles Patrick Namisi ◽  
John C. Munene ◽  
Rhoda K. Wanyenze ◽  
Anne R. Katahoire ◽  
Rosalinda M. Parkes-Ratanshi ◽  
...  

Abstract Aims This study aimed to determine the prevalence of, factors associated with, and to build a theoretical framework for understanding Internalsed HIV-related Stigma Mastery (IHSM). Methods A cross-sectional study nested within a 2014 Stigma Reduction Cohort in Uganda was used. The PLHIV Stigma Index version 2008, was used to collect data from a random sample of 666 people living with HIV (PLHIV) stratified by gender and age. SPSS24 with Amos27 softwares were used to build a sequential-mediation model. Results The majority of participants were women (65%), aged ≥ 40 years (57%). Overall, IHSM was 45.5% among PLHIV, that increased with age. Specifically, higher IHSM correlated with men and older women “masculine identities” self-disclosure of HIV-diagnosis to family, sharing experiences with peers. However, lower IHSM correlated with feminine gender, the experience of social exclusion stress, fear of future rejection, and fear of social intimacy. Thus, IHSM social exclusion with its negative effects and age-related cognition are integrated into a multidimensional IHSM theoretical framework with a good model-to-data fit. Conclusion Internalised HIV-related Stigma Mastery is common among men and older women. Specificially, “masculine identities” self-disclose their own HIV-positive diagnosis to their family, share experiences with peers to create good relationships for actualising or empowerment in stigma mastery. However, social exclusion exacerbates series of negative effects that finally undermine stigma mastery by young feminine identities. Thus, stigma mastery is best explained by an integrated empowerment framework, that has implications for future practice, policy, and stigma-related research that we discuss.


BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e047650
Author(s):  
Wiraporn Pothisiri ◽  
Paolo Miguel Manalang Vicerra

ObjectiveThe COVID-19 situation in Thailand was controlled with various social measures. Much of the information covered in the media and in studies focused on the public health and economic aspects of the pandemic. This study aimed to explore the psychological well-being of older people, which is important especially in an ageing society categorised as low income or middle income due to the limits of economic and healthcare resources.SettingThe impact of COVID-19 on older persons in Thailand, an online survey, taken across nine provinces within the five regions of the country.ParticipantsInformation was collected from 1230 adults aged at least 60 years old.If an older person was illiterate, unable to access the internet or had a disability preventing them from responding to the survey, an intermediary residing in the community conducted the survey interview.Primary and secondary outcome measuresThe analysis focused on the worries of older adults and the factors associated with psychological distress experienced during the pandemic using logistic regression analysis.ResultsThe majority of people aged at least 60 years old experienced psychological distress during COVID-19. Employment loss (OR 1.08, 95% CI 0.78 to 1.38), inadequate income (OR 1.77, 95% CI 1.28 to 2.44) and debt incursion (OR 2.74, 95% CI 1.57 to 4.80) were detrimental to psychological well-being. The negative changes in the perception of their health status (OR 1.92, 95% CI 1.23 to 2.99) and decreased life satisfaction (OR 1.49, 95% CI 0.45 to 1.87) also weighed on older Thais. The protective factors for psychological well-being were residing in rural areas (OR 0.46, 95% CI 0.35 to 0.61) and being married (OR 0.75, 95% CI 0.55 to 1.01).ConclusionObserving the concerns of the older population is important for introducing policies that can alleviate their precarious financial and health statuses.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kristie C. Waterfield ◽  
Gulzar H. Shah ◽  
Gina D. Etheredge ◽  
Osaremhen Ikhile

Abstract Background With the indiscriminate spread of COVID-19 globally, many populations are experiencing negative consequences such as job loss, food insecurity, and inability to manage existing medical conditions and maintain preventive measures such as social distancing and personal preventative equipment. Some of the most disadvantaged in the COVID-19 era are people living with HIV/AIDS and other autoimmune diseases. Discussion As the number of new HIV infections decrease globally, many subpopulations remain at high risk of infection due to lack of or limited access to prevention services, as well as clinical care and treatment. For persons living with HIV or at higher risk of contracting HIV, including persons who inject drugs or men that have sex with men, the risk of COVID-19 infection increases if they have certain comorbidities, are older than 60 years of age, and are homeless, orphaned, or vulnerable children. The risk of COVID-19 is also more significant for those that live in Low- and Middle-Income Countries, rural, and/or poverty-stricken areas. An additional concern for those living the HIV is the double stigma that may arise if they also test positive for COVID-19. As public health and health care workers try to tackle the needs of the populations that they serve, they are beginning to realize the need for a change in the infrastructure that will include more efficient partnerships between public health, health care, and HIV programs. Conclusion Persons living with HIV that also have other underlying comorbidities are a great disadvantage from the negative consequences of COVID-19. For those that may test positive for both HIV and COVID-19, the increased psychosocial burdens stemming from stress and isolation, as well as, experiencing additional barriers that inhibit access to care, may cause them to become more disenfranchised. Thus, it becomes very important during the current pandemic for these challenges and barriers to be addressed so that these persons living with HIV can maintain continuity of care, as well as, their social and mental support systems.


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