1. Depression, social support, and stigma as predictors of quality of life over time: results from an Asha-based HIV/AIDS intervention in India.
- Author
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Garfin, Dana Rose, Shin, Sanghyuk S, Ekstrand, Maria L, Yadav, Kartik, Carpenter, Catherine L, Sinha, Sanjeev, and Nyamathi, Adeline M
- Subjects
Humans ,HIV Infections ,Antiretroviral Therapy ,Highly Active ,Depression ,Quality of Life ,Social Support ,Adult ,Middle Aged ,India ,Female ,Male ,Social Stigma ,Self Report ,AIDS ,HIV ,Latent Class Analysis ,depression ,quality of life ,social support ,stigma ,Clinical Research ,HIV/AIDS ,Mental Health ,Infectious Diseases ,Behavioral and Social Science ,Good Health and Well Being ,Public Health and Health Services ,Psychology ,Public Health - Abstract
Quality of life (QOL) is associated with better outcomes in HIV/AIDS populations. We explored predictors of improved QOL over time in 600 Women Living with HIV/AIDS (WLH/A) in India [mean age = 34.31, SD = 6.97], enrolled in a nurse-led-Asha (Accredited Social Health Activist) intervention. Trained local interviewers ascertained self-report data at baseline and six-month follow-up (post-intervention). Latent Class Analysis (LCA) identified constellations of responses on psychosocial indicators (depression, social support, internalized stigma and stigma fears); their relationship with QOL over time was examined. We identified three classes: Class 1) Highest Social Resources/Lowest Depression; Class 2) Some Social Resources/Highest Depression; and Class 3) Lowest Social Resources/Higher Depression. At baseline, Class 3 reported the lowest QOL (M = 0.25, SD = 0.26); Class 1 reported the highest (M = 0.37, SD = 0.33). Class 2's QOL did not differ from Class 3's QOL, likely due to the potent effects of high depression. At six-month follow-up, all groups reported improved QOL; class membership no longer predicted variability (contrast between Class 2 and 1 = -0.05, 95% CI = -0.14, 0.04; contrast between Class 3 and 1 = 0.01, 95% CI = -0.03, 0.05; contrast between Class 3 and 2 = 0.07, 95% CI = -0.02, 0.16). Psychosocial indicators are important predictors of QOL; an Asha-supported approach may have broad applicability to improve QOL in WLH/A in India.
- Published
- 2019