Perceived discrimination, self-exclusion and well-being among people with HIV as a function of lipodystrophy symptoms / Discriminación percibida, autoexclusión y bienestar entre las personas con VIH en función de los síntomas de la lipodistrofia

This study examined the effects of perceived discrimination on the well-being of people with HIV and the mediating role of self-exclusion as a function of the participants' symptoms of lipodystrophy. An ex post facto study with a sample of 706 people with HIV was conducted. Selfperception of lipoatrophy and lipohypertrophy, perceived discrimination, self-exclusion and psychological well-being were measured. Results of hierarchical cluster analysis showed participants could be categorized into three groups: no lipodystrophy, mixed syndrome with predominant lipoaccumulation and lipoatrophy. Results of structural equation modeling revealed that the negative effects of perceived discrimination on well-being were mediated to a large extent by self-exclusion. Invariance analysis revealed that the mediating role of self-exclusion was not the same in the three clusters. Complete mediation of self-exclusion in the groups without lipodystrophy and with predominant lipoaccumulation was confirmed. Regarding lipoatrophy, the negative effects of perceived discrimination were greater and only partly mediated by self-exclusion. In conclusion, having lipodystrophy exposed people to more discrimination; lipoatrophy was the most stigmatizing condition (AU)

Este estudio examinó los efectos de la discriminación percibida sobre el bienestar de las personas con VIH y el papel mediador de la autoexclusión en función de los síntomas de lipodistrofia de los participantes. Se realizó un estudio ex post facto con una muestra de 706 personas con VIH. Se midió la autopercepción de lipoatrofia y lipohipertrofia, discriminación percibida, autoexclusión y bienestar psicológico. Los resultados del análisis de agrupamiento jerárquico mostraron que los participantes podían clasificarse en tres grupos: sin lipodistrofia, síndrome mixto con lipoacumulación predominante y lipoatrofia. Los resultados del modelado de ecuaciones estructurales revelaron que los efectos negativos de la discriminación percibida sobre el bienestar estaban mediados en gran medida por la autoexclusión. El análisis de invarianza reveló que el papel mediador de la autoexclusión no era el mismo en los tres grupos. Se confirmó la mediación completa de la autoexclusión en los grupos sin lipodistrofia y con lipoacumulación predominante. Con respecto a la lipoatrofia, los efectos negativos de la discriminación percibida fueron mayores y solo parcialmente mediados por la autoexclusión. En conclusión, tener lipodistrofia expone a las personas a más discriminación; la lipoatrofia fue la condición más estigmatizante (AU)

Subtle and blatant perceived discrimination and well-being in lesbians and gay men in Spain: The role of social support.

BACKGROUND: The situation of lesbians and gay men (LGs) in Spain has improved significantly in recent decades. However, Spanish society still exhibits prejudice and discrimination. The current study pursues three main goals: 1) to analyse the extent to which LGs perceive blatant and subtle discrimination, 2) to explore the relationship between perceived discrimination and LGs’ psychological and subjective well-being, and 3) to analyse the possible mediational role of social support in reducing the negative influence of perceived discrimination on well-being. METHOD: The sample comprised 237 lesbians and 232 gay men. RESULTS: The results show higher perceived subtle than blatant discrimination, and that subtle discrimination affects LGs’ well-being more negatively than blatant discrimination. Results show that social support helps to alleviate the negative effects of discrimination on well-being. CONCLUSIONS: These results are important and may contribute to the design of interventions to improve the well-being of lesbians and gay men.

Assessment of an intervention to reduce the impact of stigma on people with HIV, enabling them to cope with it / Evaluación de una intervención dirigida a reducir el impacto del estigma en las personas con VIH capacitándolas para afrontarlo

The goal of this study was to assess an intervention program to reduce the impact of stigma on people with HIV and to enable them to cope with it. A quasi-experimental design, with non-equivalent control group and pre- and posttest was used. Participants were 221 people with HIV, of whom 164 received the intervention and 56 made up the nonequivalent control groups. The dependent variables were perception of stigma-enacted and internalized-, self-esteem, perception of selfefficacy, strategies used to cope with stigma-primary control, secondary control, and avoidance-and quality of life. Analysis of variance (MANOVAS and ANOVAS) was conducted to determine pretest differences and differential scores in both groups, and analysis of covariance (MANCOVAS and ANCOVAS) was performed to assess the efficacy of the program. The results showed reduction of perceived stigma and avoidance strategies and an increase in perceived self-efficacy to cope with stigma, disposition to use approach strategies, self-esteem, and quality of life. These results indicate that it is possible to train people with HIV to cope with stigma

Este estudio tuvo como objetivo evaluar un programa de intervención dirigido a disminuir el impacto del estigma en las personas con VIH y a capacitarlas para afrontarlo. Se utilizó un diseño cuasiexperimental, con grupo control no equivalente, y prueba previa y posterior. Participaron 221 personas con VIH, 164 recibieron la intervención y 56 formaron parte de los grupos de control no equivalente. Las variables dependientes fueron la percepción de estigma -declarado e internalizado-, la autoestima, la percepción de autoeficacia, las estrategias de afrontamiento del estigma -control primario, secundario y de evitación- y, la calidad de vida. Se realizaron análisis de las varianzas (MANOVAS y ANOVAS) para comprobar las diferencias en el pre-test y en las puntuaciones diferenciales en ambos grupos, y análisis de la covarianza (MANCOVAS y ANCOVAS) para evaluar la eficacia del programa. Los resultados mostraron una reducción del estigma percibido y de las estrategias de evitación y, un incremento en la autoeficacia percibida para afrontar el estigma, en la disposición al uso de estrategias de aproximación y en la autoestima y la calidad de vida. Estos resultados indican que es posible capacitar a las personas con VIH para afrontar el estigma

Quejas cognitivas en personas con infección por el virus de la inmunodeficiencia humana en España: prevalencia y variables relacionadas / Cognitive complaints in people with human immunodeficiency virus in Spain: prevalence and related variables

Fundamento y objetivo: La existencia de quejas cognitivas en personas con VIH ha sido poco estudiada en España. El objetivo de este estudio fue conocer la prevalencia de quejas cognitivas en personas con VIH, así como sus posibles relaciones con variables demográficas, clínicas y psicológicas, en la época de los tratamientos antirretrovirales combinados. Pacientes y método: Estudio multicéntrico observacional desarrollado en 4 hospitales y 10 ONGs en el que participaron 791 personas con VIH en España. Para la recogida de datos se utilizó un cuestionario autorreferido que evaluó variables demográficas y clínicas, e incluyó también la evaluación de quejas cognitivas, el estado emocional y la calidad de vida. El análisis de datos incluyó pruebas estadísticas descriptivas e inferenciales. Resultados: Casi la mitad de la muestra (49,8%) manifestó quejas cognitivas, un 72,1% hallando relación con interferencia en la vida diaria. La memoria y la concentración fueron las áreas más percibidas como alteradas. La presencia de queja cognitiva se relacionó significativamente con un mayor tiempo de infección, un menor número de CD4, carga viral indetectable y peor calidad de vida. Un análisis discriminante mostró que la depresión, la ansiedad, una mayor edad, estar sin pareja y un bajo nivel de estudios fueron las variables que permitieron clasificar mejor a las personas con VIH y queja cognitiva. Conclusiones: Las quejas cognitivas son frecuentes en personas con VIH en la época de los tratamientos antirretrovirales combinados. Este hecho está relacionado con una peor salud psicológica y calidad de vida, así como con un peor estado inmunológico y virológico (AU)

Background and objective Cognitive complaints have been scarcely studied in people with HIV in Spain. The aim of this research was to know the prevalence of cognitive complaints in HIV-infected people, as well as its potential relationships with demographic, clinical and psychological variables, in the era of combination antiretroviral therapies. Patients and method Observational multicenter study developed in 4 hospitals and 10 NGOs, in which 791 people with HIV in Spain participated. A self-reported questionnaire was used to evaluate demographic and clinical variables, and an assessment of cognitive complaints, emotional status and quality of life variables was also included. Descriptive and inferential tests were used for statistical analyses. Results Almost half of the sample (49.8%) referred cognitive complaints, in 72.1% of them an association with interference on daily living activities was found. Memory and attention were the areas most prevalently perceived as affected. The existence of cognitive complaints correlated with a longer HIV infection, lower CD4+ cell count, undetectable viral load and worse quality of life. A discriminant analysis determined that depression, anxiety, older age, living with no partner and low education level allowed to classify optimally HIV-infected people with cognitive complaints. Conclusions Self-reported cognitive complaints are frequent in people infected with HIV in the current era of combination antiretroviral therapies. This fact is related to emotional disturbances and poor quality of life, but also to impaired immunological and virological status (AU)

[Cognitive complaints in people with human immunodeficiency virus in Spain: prevalence and related variables]. / Quejas cognitivas en personas con infección por el virus de la inmunodeficiencia humana en España: prevalencia y variables relacionadas.

BACKGROUND AND OBJECTIVE: Cognitive complaints have been scarcely studied in people with HIV in Spain. The aim of this research was to know the prevalence of cognitive complaints in HIV-infected people, as well as its potential relationships with demographic, clinical and psychological variables, in the era of combination antiretroviral therapies. PATIENTS AND METHOD: Observational multicenter study developed in 4 hospitals and 10 NGOs, in which 791 people with HIV in Spain participated. A self-reported questionnaire was used to evaluate demographic and clinical variables, and an assessment of cognitive complaints, emotional status and quality of life variables was also included. Descriptive and inferential tests were used for statistical analyses. RESULTS: Almost half of the sample (49.8%) referred cognitive complaints, in 72.1% of them an association with interference on daily living activities was found. Memory and attention were the areas most prevalently perceived as affected. The existence of cognitive complaints correlated with a longer HIV infection, lower CD4+ cell count, undetectable viral load and worse quality of life. A discriminant analysis determined that depression, anxiety, older age, living with no partner and low education level allowed to classify optimally HIV-infected people with cognitive complaints. CONCLUSIONS: Self-reported cognitive complaints are frequent in people infected with HIV in the current era of combination antiretroviral therapies. This fact is related to emotional disturbances and poor quality of life, but also to impaired immunological and virological status.