Distress, Sleep Difficulty, and Fatigue in Women Co-Infected With HIV and HPV

Abstract

Women with HIV infection report elevated and persisting psychosocial distress, sleep difficulty, and fatigue. The objective of this study was to examine psychosocial distress, sleep difficulty, and fatigue in a group of lower socioeconomic status women co-infected with HIV and HPV (N = 60). After controlling for relevant health behavioral and medical variables, multiple regression analyses indicated that greater psychosocial distress was associated with greater fatigue (p < .01), as well as greater sleep difficulty (p < .01). Sleep difficulty partially mediated the relationship between distress and fatigue (Sobel test, z = 2.39, p = .02). Stress management and sleep-based cognitive behavioral intervention approaches may be useful for treating fatigue in these women, possibly through reductions in psychosocial distress and improvements in sleep quality.

Oxytocin, Social Support, and Sleep Quality in Low-Income Minority Women Living With HIV

“…None of these factors were significantly associated with OT, the global PSQI score, or any component scores, thus we did not control for these factors in our analysis. However, prior research links perceived stress, depression, anxiety, and disease status to both OT and sleep quality (Cruess et al, 2003; Fekete et al, 2011; Marion et al, 2009; Nokes & Kendrew, 2001; Phillips et al, 2005; Scantamburlo et al, 2007; Wibbeler, Reichelt, Husstedt, & Evers, 2012). Therefore in order to hold stress and mood levels constant our study controlled for perceived stress, anxiety, and depression.…”

“…Higher distress in women living with HIV was associated with more sleep difficulties and higher fatigue (Marion et al, 2009). Other research links higher distress to greater sleep disturbances in men and women living with HIV, which in turn may be associated with poorer immune function (Cruess et al, 2003).…”

Self-reported sleep disturbance is associated with lower CD4 count and 24-h urinary dopamine levels in ethnic minority women living with HIV

“…Furthermore, healthy African-American women demonstrated poorer sleep quality compared to white women as measured by self-reported sleep quality and NREM electroencephalographic (EEG) power (Hall et al, 2009). Most studies examining sleep in WLWH focus on the associations between sleep and psychosocial outcomes such as fatigue and quality of life (Lee et al, 2001; Phillips et al, 2005; Marion et al, 2009). However, sleep may represent a potentially understudied salient correlate of neuroendocrine and immune processes in WLWH.…”

Facilitators of and barriers to HIV self-management: Perspectives of HIV-positive women in China

“…Women living with HIV/AIDS struggle especially to manage the many daily tasks and HIV-related symptoms (Jones et al, 2010; Marion et al, 2009; Shannon & Lee, 2008). The social context in which this self-management happens is important, and the various social roles that women perform can facilitate or hinder them from completing their self-management tasks (Webel & Higgins, 2011).…”

“…For HIV-positive women, managing the disease is a major concern—particularly in cultures where women have little power to regulate their sexual availability to men and are thus at increased risk for exposure to HIV (Dickens, 2008). The concerns for Chinese women living with HIV include stigma, serostatus disclosure, medication access, medication adherence, and continuation of family obligations (Jones et al, 2010; Marion et al, 2009; Voss, Portillo, Holzemer, & Dodd, 2007). There is very limited research focusing on interventions for HIV-positive women in Chinese culture, particularly in the context of self-management.…”