Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 15 de 15
Filtrar
1.
AIDS Care ; 30(3): 318-324, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-28814104

RESUMO

Built and social environments, including one's perception of their environment, are important determinants of health. The intersection of gender and HIV status may complicate the role of neighborhood cohesion in safety, personal well-being, and health outcomes for populations impacted by social and structural inequities. Among women in particular, social cohesion within the neighborhood they reside in may have a greater influence on health outcomes compared to their male counterparts. We sought to examine perception of neighborhood cohesion (validated scale with a range 0-100, with higher scores indicating higher perceived neighborhood cohesion) among women living with HIV, impacted by social-structural inequities, receiving combination antiretroviral therapy, and enrolled in the Longitudinal Investigations into Supportive Ancillary health services (LISA) study in British Columbia, Canada. Cross-sectional data on neighborhood cohesion and socio-demographic data were collected in an interviewer-administered survey. Of the 1,000 LISA participants interviewed, 908 (including 249 women and 659 men) had complete data for the variables of interest. At the bivariate level, women had worse perceived neighborhood cohesion scores compared to men (median: 56 [95% CI: 44-66] vs. 60 [95% CI: 47-71]). Multivariable model results indicated that for women living with HIV in our sample, greater neighborhood cohesion scores were positively associated with stable housing (ß coefficient = 7.85; 95% CI: 3.61, 12.10, p < 0.001), and negatively associated with greater perceived HIV stigma (ß coefficient = -1.19; 95% CI: -2.24 to-0.15; p = 0.025). The results illustrate the gendered nature of experiencing built and social environments, and highlight the need for women-centred interventions to address the social determinants of HIV burden associated with negative perceptions of neighborhood cohesion.


Assuntos
Infecções por HIV/psicologia , Relações Interpessoais , Características de Residência/estatística & dados numéricos , Capital Social , Determinantes Sociais da Saúde , Meio Social , Participação Social , Estigma Social , Adulto , Antirretrovirais/uso terapêutico , Colúmbia Britânica/epidemiologia , Estudos Transversais , Feminino , Infecções por HIV/diagnóstico , Infecções por HIV/tratamento farmacológico , Serviços de Saúde , Habitação , Humanos , Masculino , Pessoa de Meia-Idade , Percepção , Fatores de Risco , Adulto Jovem
2.
J Int AIDS Soc ; 18: 20024, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26443752

RESUMO

INTRODUCTION: Combination antiretroviral therapy (ART) significantly decreases morbidity, mortality and HIV transmission. We aimed to characterize the timing of ART initiation based on CD4 cell count from 2000 to 2012 and identify factors associated with late initiation of treatment. METHODS: Participants from the Canadian Observational Cohort (CANOC), a multi-site cohort of HIV-positive adults initiating ART naively after 1 January 2000, in three Canadian provinces (British Columbia, Ontario and Québec) were included. Late initiation was defined as a CD4 count <200 cells/mm(3) or an AIDS-defining illness before ART initiation (baseline). Temporal trends were assessed using the Cochran-Armitage test, and independent correlates of late initiation were identified using logistic regression. RESULTS: In total, 8942 participants (18% female) of median age 40 years (Q1-Q3 33-47) were included. The median baseline CD4 count increased from 190 cells/mm(3) (Q1-Q3 80-320) in 2000 to 360 cells/mm(3) (Q1-Q3 220-490) in 2012 (p<0.001). Overall, 4274 participants (48%) initiated ART with a CD4 count <200 cells/mm(3) or AIDS-defining illness. Late initiation was more common among women, non-MSM, older individuals, participants from Ontario and BC (vs. Québec), persons with injection drug use (IDU) history and individuals starting ART in earlier calendar years. In sub-analysis exploring recent (2008 to 2012) predictors using an updated CD4 criterion (<350 cells/mm(3)), IDU and residence in BC (vs. Québec) were no longer significant correlates of late initiation. CONCLUSIONS: This analysis documents increasing baseline CD4 counts over time among Canadians initiating ART. However, CD4 counts at ART initiation remain below contemporary treatment guidelines, highlighting the need for strategies to improve earlier engagement in HIV care.


Assuntos
Fármacos Anti-HIV/uso terapêutico , Infecções por HIV/tratamento farmacológico , Saúde Pública , Adulto , Contagem de Linfócito CD4 , Canadá , Feminino , Infecções por HIV/imunologia , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Tempo
3.
AIDS Care ; 26(1): 53-64, 2014 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-23656484

RESUMO

The social-structural challenges experienced by people living with HIV (PHA) have been shown to contribute to increased use of the emergency department (ED). This study identified factors associated with frequent and nonurgent ED use within a cohort of people accessing antiretroviral therapy (ART) in a Canadian setting. Interviewer-administered surveys collected socio-demographic information; clinical variables were obtained through linkages with the provincial drug treatment registry; and ED admission data were abstracted from the Department of Emergency Medicine database. Multivariate logistic regression was used to compute odds of frequent and nonurgent ED use. Unstable housing was independently associated with ED use (adjusted odds ratio [AOR] =1.94, 95% confidence interval [CI] 1.24-3.04]), having three or more ED visits within 6 months of the interview date [AOR: 2.03 (95% CI: 1.07-3.83)] and being triaged as nonurgent (AOR = 2.71, 95% CI: 1.19-6.17). Frequent and nonurgent use of the ED in this setting is associated with conditions requiring interventions at the social-structural level. Supportive housing may contribute to decreased health-care costs and improved health outcomes amongst marginalized PHA.


Assuntos
Serviço Hospitalar de Emergência/estatística & dados numéricos , Mau Uso de Serviços de Saúde/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Habitação/estatística & dados numéricos , Adulto , Antirretrovirais/uso terapêutico , Canadá , Intervalos de Confiança , Estudos Transversais , Feminino , Infecções por HIV/tratamento farmacológico , Infecções por HIV/psicologia , Pesquisas sobre Atenção à Saúde , Humanos , Entrevistas como Assunto , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Razão de Chances , Fatores Socioeconômicos
4.
AIDS Care ; 26(5): 587-94, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24111944

RESUMO

This study examined the prevalence and correlates associated with lifetime and recent violence among a sample of harder-to-reach human immunodeficiency virus (HIV)-positive women living in British Columbia (BC), Canada. Interviewer-led surveys with 1000 participants gathered quantitative data on social, economic, and structural characteristics such as housing status, relationship status, family structure, history of drug use, and sexual behavior. Logistic regression analysis modeled associations between independent variables and experiences of violence at baseline. Cox regression analyses with time-dependent covariates determined correlates of lifetime and recent violence among HIV-positive women. Of the 249 women in the study, an overwhelming proportion of women (81%) reported experiences of violence in their lifetime. Among those, 22% reported recent experiences of violence, and 56% of the women reported more than five violent episodes in their lifetime. Lifetime violence was independently associated with HIV-related stigma (adjusted odds ratio [AOR] = 2.18, 95% confidence interval [CI] = 1.14-5.70), previous tobacco use (AOR = 2.79, 95% CI = 1.10-7.07), ever having a drinking problem (AOR = 2.82, 95% CI = 1.28-6.23), and ever having received care for a mental health condition (AOR = 2.42, 95% CI = 1.06-5.52). Recent violence was associated with the current illicit drug use (AOR = 2.60, 95% CI = 1.14-5.90), and currently residing in unstable housing (AOR = 2.75, 95% CI = 1.31-5.78). This study underscores the need to consider potential experiences of historical and current violence as part of comprehensive care for women living with HIV.


Assuntos
Infecções por HIV/epidemiologia , Habitação/estatística & dados numéricos , Comportamento Sexual/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Violência/estatística & dados numéricos , Saúde da Mulher , Adulto , Colúmbia Britânica/epidemiologia , Feminino , Humanos , Saúde Mental , Pessoa de Meia-Idade , Avaliação das Necessidades , Prevalência , Fatores de Risco , População Rural , Comportamento Sexual/psicologia , Classe Social , Inquéritos e Questionários , Violência/prevenção & controle , Violência/psicologia
5.
J Int Assoc Provid AIDS Care ; 13(1): 56-62, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24309754

RESUMO

Initiating highly active antiretroviral therapy (HAART) with low CD4 counts or AIDS-defining illnesses (ADIs) increases risk of treatment failure and death. We examined factors associated with late initiation among 18- to 29-year-olds within the Canadian Observational Cohort (CANOC) collaboration, a multi-site study of HIV-positive persons who initiated HAART after 2000. Late initiation was defined as beginning HAART with a CD4 count <200 cells/mm(3) and/or having a baseline ADI. Multivariable logistic regression was used to identify independent correlates of late initiation. In total, 1026 individuals (422 from British Columbia, 400 from Ontario, and 204 from Quebec) met our age criteria. At HAART initiation, median age was 27 years (interquartile range, 24, 28 years). A total of 412 individuals (40%) identified as late initiators. Late initiation was associated with female gender, age >25 years at initiation, initiating treatment in earlier years, and having higher baseline viral load. The high number of young adults in our cohort starting HAART late indicates important target populations for specialized services, increased testing, and linkages to care.


Assuntos
Infecções por HIV/tratamento farmacológico , Adolescente , Adulto , Antirretrovirais , Terapia Antirretroviral de Alta Atividade , Canadá/epidemiologia , Estudos de Coortes , Feminino , Infecções por HIV/epidemiologia , Humanos , Masculino , Análise Multivariada
6.
J Int AIDS Soc ; 16: 17433, 2013 Jan 11.
Artigo em Inglês | MEDLINE | ID: mdl-23336725

RESUMO

INTRODUCTION: The increasing proportion of women living with HIV has evoked calls for tailored services that respond to women's specific needs. The objective of this investigation was to explore the concept of women-specific HIV/AIDS services to identify and define what key elements underlie this approach to care. METHODS: A comprehensive review was conducted using online databases (CSA Social Service Abstracts, OvidSP, Proquest, Psycinfo, PubMed, CINAHL), augmented with a search for grey literature. In total, 84 articles were retrieved and 30 were included for a full review. Of these 30, 15 were specific to HIV/AIDS, 11 for mental health and addictions and four stemmed from other disciplines. RESULTS AND DISCUSSION: The review demonstrated the absence of a consensual definition of women-specific HIV/AIDS services in the literature. We distilled this concept into its defining features and 12 additional dimensions (1) creating an atmosphere of safety, respect and acceptance; (2) facilitating communication and interaction among peers; (3) involving women in the planning, delivery and evaluation of services; (4) providing self-determination opportunities; (5) providing tailored programming for women; (6) facilitating meaningful access to care through the provision of social and supportive services; (7) facilitating access to women-specific and culturally sensitive information; (8) considering family as the unit of intervention; (9) providing multidisciplinary integration and coordination of a comprehensive array of services; (10) meeting women "where they are"; (11) providing gender-, culture- and HIV-sensitive training to health and social care providers; and (12) conducting gendered HIV/AIDS research. CONCLUSIONS: This review highlights that the concept of women-specific HIV/AIDS services is a complex and multidimensional one that has been shaped by diverse theoretical perspectives. Further research is needed to better understand this emerging concept and ultimately assess the effectiveness of women-specific services on HIV-positive women's health outcomes.


Assuntos
Síndrome da Imunodeficiência Adquirida/diagnóstico , Síndrome da Imunodeficiência Adquirida/terapia , Serviços de Saúde da Mulher , Feminino , Humanos
7.
AIDS Care ; 25(8): 937-47, 2013 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-23320437

RESUMO

As mortality rates decrease in British Columbia, Canada, supportive services (e.g. housing, food, counseling, addiction treatment) are increasingly conceptualized as critical components of care for people living with HIV/AIDS. Our study investigates social and clinical correlates of supportive service use across differing levels of engagement. Among 915 participants from the Longitudinal Investigations into Supportive and Ancillary health services (LISA) cohort, 742 (81%) reported using supportive services. Participants were nearly twice as likely to engage daily in supportive services if they self-identified as straight (95% confidence interval [CI], adjusted odds ratio [AOR]: 1.69), had not completed high school (95% CI, AOR: 1.97), had an annual income of < $15,000 (95% CI, AOR: 1.81), were unstably housed (95% CI, AOR: 1.89), were currently using illicit drugs (95% CI, AOR: 1.60), or reported poor social capital in terms of perceived neighborhood problems (95% CI, AOR: 1.15) or standard of living (95% CI, AOR: 1.70). Of interest, after adjusting for sociodemographic and socioeconomic variables, no clinical markers remained an independent predictor of use of supportive services. High service use by those demonstrating social and clinical vulnerabilities reaffirms the need for continued expansion of supportive services to facilitate a more equitable distribution of health among persons living with HIV.


Assuntos
Antirretrovirais/uso terapêutico , Infecções por HIV/tratamento farmacológico , Serviços de Saúde/estatística & dados numéricos , Adesão à Medicação/estatística & dados numéricos , Classe Social , Adulto , Colúmbia Britânica , Estudos de Coortes , Feminino , Infecções por HIV/psicologia , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Razão de Chances , Apoio Social , Fatores Socioeconômicos
8.
AIDS Care ; 25(1): 95-102, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-22672228

RESUMO

This study identifies factors associated with self-perceived HIV-related stigma (stigma) among a cohort of individuals accessing antiretroviral therapy in British Columbia, Canada. Data were drawn from the Longitudinal Investigations into Supportive and Ancillary Health Services study, which collects social, clinical, and quality of life (QoL) information through an interviewer-administered survey. Clinical variables (i.e., CD4 count) were obtained through linkages with the British Columbia HIV/AIDS Drug Treatment Program. Multivariable linear regression was performed to determine the independent predictors of stigma. Our results indicate that among participants with high school education or greater the outcome stigma was associated with a 3.05 stigma unit decrease (95% CI: -5.16, -0.93). Having higher relative standard of living and perceiving greater neighborhood cohesion were also associated with a decrease in stigma (-5.30 95% CI: -8.16, -2.44; -0.80 95% CI: -1.39, -0.21, respectively). Lower levels of stigma were found to be associated with better QoL measures, including perceiving better overall function (-0.90 95% CI: -1.47, -0.34), having fewer health worries (-2.11 95% CI: -2.65, -1.57), having fewer financial worries (-0.67 95% CI: -1.12, -0.23), and having less HIV disclosure concerns (-4.12 95% CI: -4.63, -3.62). The results of this study show that participants with higher education level, better QoL measures, and higher self-reported standards of living are less likely to perceive HIV-related stigma.


Assuntos
Fármacos Anti-HIV/uso terapêutico , Infecções por HIV/tratamento farmacológico , Infecções por HIV/psicologia , Autoeficácia , Estigma Social , Adolescente , Adulto , Colúmbia Britânica , Contagem de Linfócito CD4 , Feminino , Acessibilidade aos Serviços de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Percepção , Vigilância da População , Qualidade de Vida , Estereotipagem , Inquéritos e Questionários , Adulto Jovem
9.
Int J Epidemiol ; 42(4): 947-55, 2013 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-22461127

RESUMO

The Longitudinal Investigations into Supportive and Ancillary health services (LISA) study is a cohort of people living with HIV/AIDS who have ever accessed anti-retroviral therapy (ART) in British Columbia, Canada. The LISA study was developed to better understand the outcomes of people living with HIV with respect to supportive services use, socio-demographic factors and quality of life. Between July 2007 and January 2010, 1000 participants completed an interviewer-administered questionnaire that included questions concerning medical history, substance use, social and medical support services, food and housing security and other social determinants of health characteristics. Of the 1000 participants, 917 were successfully linked to longitudinal clinical data through the provincial Drug Treatment Program. Within the LISA cohort, 27% of the participants are female, the median age is 39 years and 32% identify as Aboriginal. Knowledge translation activities for LISA include the creation of plain language summaries, internet resources and arts-based engagement activities such as Photovoice.


Assuntos
Fármacos Anti-HIV/uso terapêutico , Infecções por HIV/tratamento farmacológico , Serviços de Saúde/estatística & dados numéricos , Adulto , Imagem Corporal , Colúmbia Britânica/epidemiologia , Farmacorresistência Viral , Feminino , Abastecimento de Alimentos/estatística & dados numéricos , Infecções por HIV/epidemiologia , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Habitação/estatística & dados numéricos , Humanos , Internet , Estudos Longitudinais , Masculino , Adesão à Medicação , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Apoio Social , Fatores Socioeconômicos , Estereotipagem , Pesquisa Translacional Biomédica/estatística & dados numéricos , Revelação da Verdade , Violência/estatística & dados numéricos
10.
PLoS One ; 8(12): e83649, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24391803

RESUMO

BACKGROUND: Cohort data examining differences by gender in clinical responses to combination antiretroviral therapy (ART) remain inconsistent and have yet to be explored in a multi-province Canadian setting. This study investigates gender differences by injection drug use (IDU) history in virologic responses to ART and mortality. METHODS: Data from the Canadian Observational Cohort (CANOC) collaboration, a multisite cohort study of HIV-positive individuals initiating ART after January 1, 2000, were included. This analysis was restricted to participants with a follow-up HIV-RNA plasma viral load measure and known IDU history. Weibull hazard regression evaluated time to virologic suppression (2 consecutive measures <50 copies/mL), rebound (>1000 copies/mL after suppression), and all-cause mortality. Sensitivity analyses explored the impact of presumed ART use in pregnancy on virologic outcomes. RESULTS: At baseline, women (1120 of 5442 participants) were younger (median 36 vs. 41 years) and more frequently reported IDU history (43.5% vs. 28.8%) (both p<0.001). Irrespective of IDU history, in adjusted multivariable analyses women were significantly less likely to virologically suppress after ART initiation and were at increased risk of viral load rebound. In adjusted time to death analysis, no differences by gender were noted. After adjusting for presumed ART use in pregnancy, observed gender differences in time to virologic suppression for non-IDU, and time to virologic rebound for IDU, became insignificant. CONCLUSIONS: HIV-positive women in CANOC are at heightened risk for poor clinical outcomes. Further understanding of the intersections between gender and other factors augmenting risk is needed to maximize the benefits of ART.


Assuntos
Fármacos Anti-HIV/uso terapêutico , Infecções por HIV/tratamento farmacológico , Adulto , Canadá , Estudos de Coortes , Feminino , Infecções por HIV/complicações , Infecções por HIV/virologia , Humanos , Masculino , Pessoa de Meia-Idade , Gravidez , Complicações Infecciosas na Gravidez/tratamento farmacológico , Complicações Infecciosas na Gravidez/virologia , Fatores de Risco , Caracteres Sexuais , Abuso de Substâncias por Via Intravenosa/complicações , Fatores de Tempo , Resultado do Tratamento , Carga Viral
11.
Artigo em Inglês | MEDLINE | ID: mdl-22318879

RESUMO

BACKGROUND: Among those accessing treatment, highly active antiretroviral therapy (HAART) has transformed HIV into a chronic and manageable condition. However, high levels of adherence are required to derive a sustained, long-term clinical benefit. The aim of this study was to examine the predictors of adherence based on prescription refill among persons on HAART in British Columbia, Canada. METHODS: This study utilizes data collected between July 2007 and January 2010, as part of the Longitudinal Investigations into Supportive and Ancillary health services (LISA) cohort, which is a study of HIV-positive persons who have accessed antiretroviral therapy (ART) in British Columbia. Participants were considered optimally adherent if they were dispensed ≥95% of their prescribed antiretrovirals. RESULTS: Of a total of 566 participants, only 316 (55.8%) were optimally adherent to HAART. Independent predictors of optimal adherence were increasing age (adjusted odds ratio [AOR] = 1.84, 95% confidence interval [CI]: 1.44-2.33), male gender (AOR = 1.68, 95% CI: 1.07-2.64), and being enrolled in a comprehensive adherence assistance program (AOR = 4.26, 95% CI: 2.12-8.54). Having an annual income <$15 000 (AOR = 0.47, 95% CI: 0.31-0.72) and both former and current injection drug use (AOR = 0.46, 95% CI: 0.29-0.73 and AOR = 0.35, 95% CI: 0.20-0.58, respectively) were independently associated with suboptimal (<95%) adherence. CONCLUSIONS: We found that women and people who inject drugs are at increased risk of being suboptimally adherent to HAART. Optimal adherence remains a significant public health and clinical goal in the context of rapidly expanding access to HAART.


Assuntos
Terapia Antirretroviral de Alta Atividade , Soropositividade para HIV/tratamento farmacológico , Adesão à Medicação , Abuso de Substâncias por Via Intravenosa/complicações , Adulto , Fatores Etários , Fármacos Anti-HIV/uso terapêutico , Colúmbia Britânica , Feminino , Soropositividade para HIV/complicações , Humanos , Renda , Estudos Longitudinais , Masculino , Adesão à Medicação/estatística & dados numéricos , Pessoa de Meia-Idade , Fatores Sexuais
12.
AIDS Behav ; 15(8): 1612-22, 2011 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-21850442

RESUMO

Housing is a known determinant of health behaviors, which includes adherence to Antiretroviral Therapy (ART). Within the Longitudinal Investigations into Supportive and Ancillary Health Services (LISA) study, unstable housing is inversely associated with adherence. Several comprehensive adherence support services have emerged to improve adherence for unstably housed or otherwise vulnerable populations. The Maximally Assisted Therapy (MAT) program in Vancouver, British Columbia uses a multidisciplinary approach to support HIV-positive clients with a history of addictions or mental illness, many of whom also experience episodic homelessness. This study investigated the association between antiretroviral adherence and use of support services, including the MAT program, amongst people living with HIV and AIDS who are unstably housed in the LISA sample. Of the 212 unstably housed participants, those who attended the MAT program were 4.76 times more likely to be ≥95% adherent (95% CI 1.72-13.13; P = 0.003) than those who did not. The findings suggest that in the absence of sustainable housing solutions, programs such as MAT play an important role in supporting treatment adherence in this population.


Assuntos
Serviços de Saúde Comunitária/estatística & dados numéricos , Infecções por HIV/tratamento farmacológico , Habitação , Pessoas Mal Alojadas , Adesão à Medicação/psicologia , Adulto , Colúmbia Britânica , Estudos Transversais , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/psicologia , Acessibilidade aos Serviços de Saúde , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Assunção de Riscos , Apoio Social , Fatores Socioeconômicos
13.
AIDS Care ; 23(11): 1456-66, 2011 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-21767109

RESUMO

With significant reductions in AIDS-related morbidity and mortality, HIV is increasingly viewed as a chronic condition. However, people on antiretroviral therapy (ART) are experiencing new challenges such as metabolic and morphological body changes, which may affect self-perceived body image. The concept of body image is complex and encompasses an individual's perception of their existential self, physical self and social interpretation of their body by others. The Longitudinal Investigations into Supportive and Ancillary Health Services (LISA) cohort is a prospective study of HIV-positive persons on ART. An interviewer-administered survey collects socio-demographic and health information including body image, stigma, depression, food insecurity, and quality of life (QoL). In bivariate analyses, Chi-squared or Wilcoxon rank sum tests were used to compare individuals reporting positive body image with those reporting negative body image. Multivariate logistic regression was used to examine associations between negative body image and covariates. Of 451 LISA participants, 47% reported negative body image. The adjusted multivariate analysis showed participants who reported high stigma in the presence of depressive symptoms were more likely to have negative body image compared to people reporting low stigma and no depressive symptoms (adjusted odds ratio [AOR]: 2.41, confidence interval [CI]: 1.24-4.68). The estimated probability of a person having positive body image without stigma or depression was 68%. When stigma alone was included, the probability dropped to 59%, and when depression was included alone the probability dropped to 34%. Depressive symptoms and high stigma combined resulted in a probability of reporting positive body image of 27%. Further efforts are needed to address body image among people living with HIV. In order to lessen the impacts of depression on body image, such issues must be addressed in health care settings. Community interventions are also needed to address stigma and negative body image to improve the lives of people living with HIV.


Assuntos
Imagem Corporal , Transtorno Depressivo/psicologia , Infecções por HIV/psicologia , Autoimagem , Estigma Social , Adulto , Antirretrovirais/uso terapêutico , Colúmbia Britânica , Quimioterapia Combinada , Feminino , Infecções por HIV/tratamento farmacológico , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Qualidade de Vida
14.
AIDS Care ; 23(2): 245-51, 2011 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-21259138

RESUMO

Understanding the neighbourhood perceptions of individuals living with HIV in urban and non-urban areas may help identify potential barriers to uptake and effectiveness of therapy. We evaluate how neighbourhood perceptions are influenced by socio-economic factors, such as food security and stable housing and other explanatory variables, among individuals receiving highly active antiretroviral therapy (HAART) in British Columbia. Neighbourhood perceptions, quality of life and socio-demographic information were collected in an interviewer-administered survey with study participants. Perception of neighbourhood problems, perception of neighbourhood cohesion and perception of relative standard of living were evaluated using previously defined scales. Bivariate and multivariate analyses were carried out to determine associations with neighbourhood perceptions, food security and stable housing. Our analyses were based on 457 participants, of whom 133 (29%) were food secure and 297 (65%) had stable housing. Mean scores for perceptions of neighbourhood problems and cohesion were 35 (IQR 15-58) and 57 (IQR 46-69), respectively. Being food secure and having stable housing was associated with a 9% and 11% decrease in perception of neighbourhood problems, respectively, and a 6% increase in the perception of neighbourhood cohesion in both cases. Food security and stable housing are related to neighbourhood perceptions among individuals on HAART. The results point to potential targets for intervention, involving improvements to living conditions such as housing and food security, which may promote treatment success for HAART, especially in marginalized communities.


Assuntos
Abastecimento de Alimentos , Infecções por HIV , Habitação , Qualidade de Vida , Características de Residência , Síndrome da Imunodeficiência Adquirida/tratamento farmacológico , Síndrome da Imunodeficiência Adquirida/epidemiologia , Síndrome da Imunodeficiência Adquirida/psicologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Terapia Antirretroviral de Alta Atividade , Colúmbia Britânica/epidemiologia , Feminino , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Infecções por HIV/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Meio Social , Fatores Socioeconômicos , Adulto Jovem
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...