The Mental Health of People Living with HIV in China, 1998–2014: A Systematic Review

Niu, Lu; Luo, Dan; Liu, Ying; Silenzio, Vincent; Xiao, Shuiyuan

doi:10.1371/journal.pone.0153489

Cited by 105 publications

(107 citation statements)

References 33 publications

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“…The proportion of depressive symptoms in the current study was lower than the median prevalence of depressive symptoms among the general PLWH in China (60.6%) from a systematic review [38]. However, the median prevalence of depressive symptoms among PLWH in the systematic review was based on studies mostly conducted in rural China with smaller sample sizes (< 200) while the current study was conducted in Guangzhou, the third biggest city in China, with a larger sample size (411) [38, 39]. PLWH in rural China often have more mental health problems than those in big cities [38].…”

Section: Discussionmentioning

confidence: 56%

“…However, the median prevalence of depressive symptoms among PLWH in the systematic review was based on studies mostly conducted in rural China with smaller sample sizes (< 200) while the current study was conducted in Guangzhou, the third biggest city in China, with a larger sample size (411) [38, 39]. PLWH in rural China often have more mental health problems than those in big cities [38]. Even though PLWH in the current study had a smaller proportion of depressive symptom than the general PLWH in China, they were more likely to suffer from depression than populations with other chronic diseases such as diabetes (e.g., 38.4% > 31.0%) [40].…”

Section: Discussionmentioning

confidence: 99%

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A structural equation model of perceived and internalized stigma, depression, and suicidal status among people living with HIV/AIDS

Zeng

Hong

et al. 2018

BMC Public Health

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BackgroundPrevious studies have shown positive association between HIV-related stigma and depression, suicidal ideation, and suicidal attempt among people living with HIV/AIDS (PLWH). But few studies have examined the mechanisms among HIV-related stigma, depression, and suicidal status (suicidal ideation and/or suicidal attempt) in PLWH. The current study examined the relationships among perceived and internalized stigma (PIS), depression, and suicidal status among PLWH in Guangzhou, China using structural equation modeling.MethodsCross-sectional study by convenience sampling was conducted and 411 PLWH were recruited from the Number Eight People’s Hospital from March to June, 2013 in Guangzhou, China. Participants were interviewed on their PIS, depressive symptoms, suicidal status, and socio-demographic characteristics. PLWH who had had suicidal ideation and suicidal attempts since HIV diagnosis were considered to be suicidal. Structural equation model was performed to examine the direct and indirect associations of PIS and suicidal status. Indicators to evaluate goodness of fit of the structural equation model included Chi-square Statistic, Comparative Fit Index (CFI), Root Mean Square Error of Approximation (RMSEA), Standardized Root Mean Square Residual (SRMR), and Weighted Root Mean Square Residual (WRMR).ResultsMore than one-third (38.4%) of the PLWH had depressive symptoms and 32.4% reported suicidal ideation and/or attempt since HIV diagnosis. The global model showed good model fit (Chi-square value = 34.42, CFI = 0.98, RMSEA = 0.03, WRMR = 0.73). Structural equation model revealed that direct pathway of PIS on suicidal status was significant (standardized pathway coefficient = 0.21), and indirect pathway of PIS on suicidal status via depression was also significant (standardized pathway coefficient = 0.24). There was a partial mediating effect of depression in the association between PIS and suicidal status.ConclusionsOur findings suggest that PIS is associated with increased depression and the likelihood of suicidal status. Depression is in turn positively associated with suicidal status and plays a mediating role between PIS and suicidal status. Therefore, to reduce suicidal ideation and attempt in PLWH, targeted interventions to reduce PIS and improve mental health status of PLWH are warranted.

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Section: Discussionmentioning

confidence: 56%

Section: Discussionmentioning

confidence: 99%

A structural equation model of perceived and internalized stigma, depression, and suicidal status among people living with HIV/AIDS

Zeng

Hong

et al. 2018

BMC Public Health

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“…Univariate analyses were first used to assess the unadjusted odds ratios for each variable. Although there were divergence results about socio‐demographic differences of depression and anxiety in previous studies, most reported a significant association with gender, age, residence, marital status and socioeconomic status (which is usually measured by education, employment and income) in people living with HIV and those who are not . Thus, we adjusted the crude odds ratios for each clinical and psychosocial factor to account for these variables and the residual pseudo‐likelihood technique was used for parameter estimation.…”

Section: Methodsmentioning

confidence: 99%

“…Mental health morbidity affecting people living with HIV is becoming an increasing concern worldwide with depression and anxiety most prevalent . At the end of September 2018 there were 849,602 people living with HIV in China of whom 41.5% were AIDS patients .…”

Section: Introductionmentioning

confidence: 99%

Longitudinal trajectories of emotional problems and unmet mental health needs among people newly diagnosed with HIV in China

et al. 2019

Self Cite

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Introduction Concern over mental health morbidity affecting people living with HIV is increasing worldwide. The objective of this study was to describe the longitudinal trajectories of depression and anxiety, and mental health service utilization among people newly diagnosed with HIV. Methods This was an observational cohort study that enrolled people newly diagnosed with HIV consecutively and followed them for one year in Changsha, China. Socio‐demographic, clinical and psychological data were collected at the baseline and at one‐year follow‐up. Participants were recruited between March 1, 2013 and September 30, 2014. The final follow‐up was in September 30, 2015. Results Among 557 people newly diagnosed with HIV enrolled at the baseline, 410 (73.6%) completed the one‐year follow‐up survey (median (interquartile range) age at follow‐up: 29 (25, 39) years; 376 men (91.7%)), and were included in the analysis. 39.3% and 30.2% of the 410 participants were screened with significant symptoms of depression and anxiety at baseline respectively. An overall drop in the prevalence of each condition was found at follow‐up, however, 10.5% and 6.1% of participants were found to have persistent depression and anxiety. The results of mixed‐effect models showed that bisexuality, homosexual transmission, other clinical symptoms (for example, not on antiretroviral therapy (ART)), non‐disclosure, higher levels of HIV/AIDS‐related stress, and lack of social support were associated with significant symptoms of depression and anxiety. One year after diagnosis, 8.3% had visited healthcare providers for emotional or psychological problems. Conclusions Despite the obvious need people newly diagnosed with HIV in China rarely seek professional help. Integrating depression and anxiety screening and referral into HIV care settings is warranted.

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“…Given the acute HIV stigma in China, among healthcare providers as well as the general population (Yang, Leu, Simoni, Chen, Shiu, & Zhao, 2015), Chinese PLWHA are at risk for diminished physical and mental health outcomes and poorer overall quality of life (Niu, Luo, Liu, Silenzio, & Xiao, 2016; Yang, Xie, Simoni, Shiu, Chen, Zhao, et al, 2016). Persons of lower socio-economic status, rural origin, and ethnic or sexual minority status, face additional and intersecting challenges to optimal health (Tao, Kipp, Liu, Zhang, Ruan, Yin et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

Unable to be a Human Being in Front of Other People: A Qualitative Study of Self-Isolation Among People Living with HIV/AIDS in China

Xie

Yang

Simoni

et al. 2017

J Clin Psychol Med Settings

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In China, acute stigma accompanying an HIV diagnosis can lead to self-isolation. In a cultural setting where family relationships are highly valued and contribute critically to well-being, such self-isolation can thwart HIV self-management and engagement in medical care, and so heighten risk for health disparities. To understand this phenomenon, we conducted individual in-depth interviews with 34 persons living with HIV/AIDS (PLWHA) in Shanghai and Beijing. Inductive content analysis revealed a range of forms of self-isolation motivation, beliefs, and behaviors influenced by: 1) internalized stigma and desire to avoid discrimination; 2) HIV-related factors such as HIV-knowledge and disease progression: and 3) familial factors such as a sense of responsibility and family members’ reactions. Based on a proposed framework centering on dialectical family influences (whereby PLWHA are pushed away from, yet pulled toward the family fold), implications for provision of multidisciplinary care in medical settings are considered, including culturally appropriate strategies to decrease health disparities.

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The Mental Health of People Living with HIV in China, 1998–2014: A Systematic Review

Cited by 105 publications

References 33 publications

A structural equation model of perceived and internalized stigma, depression, and suicidal status among people living with HIV/AIDS

A structural equation model of perceived and internalized stigma, depression, and suicidal status among people living with HIV/AIDS

Longitudinal trajectories of emotional problems and unmet mental health needs among people newly diagnosed with HIV in China

Unable to be a Human Being in Front of Other People: A Qualitative Study of Self-Isolation Among People Living with HIV/AIDS in China

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