Stigma, Hopelessness, Depression and Associated Factors in People Living with HIV

Year 2022, Volume: 19 Issue: 3, 621 - 630, 27.12.2022

Ayşegül Kılıçlı Şahide Akbulut Tuba Damar Çakırca

https://doi.org/10.35440/hutfd.1191096

Abstract

Background: It was aimed to determine stigma, hopelessness, depression and associated factors in people living with HIV (PLWH).
Materials and Methods: This descriptive cross-sectional study included 57 PLWH who admitted to Şanlıurfa Training and Research Hospital hospital between March 01-April 30, 2022. Berger HIV Stigma Scale, Beck Hope-lessness Scale and Beck Depression Inventory were filled during face-to-face interviews with patients.
Results: It was determined Berger HIV-Stigma Scale mean score was high level (104.5±16.7), Beck Hopelessness Scale mean score was medium level (7.6±6.1) and Beck Depression Inventory mean score was medium level (16.3±13.7). Hopelessness rate was determined as 63.2% and depression rate as 40.4%. It was found a moder-ate correlation between stigma and hopelessness (r=0.44), a high level of correlation between stigma and depression (r=0.52), and a very high positive correlation between hopelessness and depression (r=0.80). Besides, a hopeless individual living with HIV was found to be odds 76 times more likely to be exposed to de-pression than a hopeful individual. In the regression analysis, it was determined that being single and growing up in a non-conservative family decreased HIV-stigma. On the other hand, it was observed that having to hide being infected with HIV increased HIV-stigma. It was determined that having to hide contagion with HIV de-creased hopelessness (odds=0.13) but depression increased hopelessness (odds=1.21). It was determined that hopelessness increased depression (odds=1.87).
Conclusions: Stigma, hopelessness and depression are seen at high rates among PLWH and hopelessness in-creases depression significantly.

Keywords

HIV, Stigma, Hopelessness, Depression

Supporting Institution

YOKTUR

Project Number

YOKTUR

Thanks

The authors would like to give thanks to participants to study and Şanlıurfa Training and Research Hospital.

HIV İle Yaşayan Bireylerde Damgalanma, Umutsuzluk Depresyon ve İlişkili Faktörler

Abstract

Amaç: HIV ile yaşayan bireylerde (PLWH) damgalanma, umutsuzluk, depresyon ve ilişkili faktörlerin belirlenmesi amaçlandı.
Materyal ve Metod: Bu tanımlayıcı-kesitsel tipteki araştırmaya 01 Mart – 30 Nisan 2022 tarihleri arasında XXX hastanesine başvuran 57 PLWH hastası dahil edilmiştir. Berger HIV Stigma Ölçeği, Beck Umutsuzluk Ölçeği ve Beck Depresyon Envanteri hastalarla yüz yüze görüşülerek dolduruldu. Araştırmanın birincil sonuçları HIV ile damgalanma, umutsuzluk ve depresyondur.
Bulgular: Berger HIV-Damgalanma Ölçeği puan ortalamasının yüksek seviyede (104.5±16.7), Beck Umutsuzluk Ölçeği puan ortalamasının orta seviyede (7.6±6.1) ve Beck Depresyon Envanteri puan ortalamasının orta seviyede (16.3±13.7) olduğu belirlenmiştir. Umutsuzluk oranı %63.2, depresyon oranı ise %40.4 olarak belirlendi. Damgalanma ile umutsuzluk arasında orta düzeyde (r:0.44), damgalanma ile depresyon arasında yüksek düzeyde (r:0.52) ve umutsuzluk ile depresyon arasında çok yüksek düzeyde pozitif bir ilişki (r:0.80) vardı. Ayrıca, HIV ile yaşayan umutsuz bir bireyin, umutlu bir bireye göre depresyona maruz kalma olasılığının 76 kat daha fazla olduğu bulundu. Bekar olmanın ve muhafazakar olmayan bir ailede büyümenin HIV-damgalanmayı azalttığı belirlendi. HIV bulaşmasını gizlemek zorunda kalmanın HIV-damgalanmayı artırdığı belirlendi. HIV bulaşmasını gizlemek zorunda kalmanın umutsuzluğu azalttığı (odss=0.13), depresyonun ise umutsuzluğu artırdığı (odss=1.21) belirlendi. Umutsuzluğun depresyonu artırdığı belirlendi (odss=1.87).
Sonuç: Bu çalışma HIV ile yaşayan bireylerin HIV ile damgalanma, umutsuzluk ve depresyondan önemli ölçüde etkilendiğini ve bu hastalarda umutsuzluğun depresyonu artırdığı vurgulamaktadır.

Keywords

HIV, Damgalanma, Umutsuzluk, Depresyon

Project Number

YOKTUR

References

• 1. UNAIDS DATA 2021. Global Summary of the AIDS Epidemic, 2020. (2021). https://www.unaids.org/sites/default/files/media_asset/JC3032_AIDS_Data_book_2021_En.pdf
• 2. Republic of Turkey Ministry of Health General Directorate of Public Health (2021, November 15). HIV-AIDS Statistics. https://hsgm.saglik.gov.tr/tr/bulasici-hastaliklar/hiv-aids/hiv-aids-liste/hiv-aids-istatislik.html Date of Access: 11.06.2022
• 3. Corrigan PW, Rao D. On the self-stigma of mental illness: Stages, disclosure, and strategies for change. Canadian journal of psychiatry 2012;57:464–469. https://doi.org/10.1177/070674371205700804
• 4. Reif S, Wilson E, McAllaster C, Pence B. The Relationship of HIV-related stigma and health care outcomes in the US Deep South. AIDS and Behavior 2019;23(Suppl3):242–250. https://doi.org/10.1007/s10461-019-02595-5
• 5. Rintamaki L, Kosenko K, Hogan T, Scott AM, Dobmeier C, Tingue E, et al. The role of stigma management in HIV treatment adherence. International journal of environmental research and public health 2019;16(24):5003. https://doi.org/10.3390/ijerph16245003
• 6. Thapa S, Hannes K, Buve A, Bhattarai S, Mathei C. Theorizing the complexity of HIV disclosure in vulnerable populations: A grounded theory study. BMC Public Health 2018;18(162):1-13. https://doi.org/10.1186/s12889-018-5073-x
• 7. Felker-Kantor EA, Wallace ME, Madkour AS, Duncan DT, Andrinopoulos K, Theal K. HIV stigma, mental health, and alcohol use disorders among people living with HIV/AIDS in New Orleans. Journal of urban health 2019;96(6):878–888. https://doi.org/10.1007/s11524-019-00390-0
• 8. Jallow A, Ljunggren G, Wändell P, Wahlström L, Carlsson AC. HIV-infection and psychiatric illnesses - A double edged sword that threatens the vision of a contained epidemic: The Greater Stockholm HIV Cohort Study. The Journal of infection 2017;74(1):22–28. https://doi.org/10.1016/j.jinf.2016.09.009
• 9. Yousuf A, Mohd Arifin SR, Musa R, Isa ML. Depression and HIV Disease Progression: A Mini-Review. Clinical Practice and Epidemiology in Mental Health 2019;15:153–159. https://doi.org/10.2174/1745017901915010153
• 10. Tesfaw G, Ayano G, Awoke T, Assefa D, Birhanu Z, Miheretie G, et al. Prevalence and correlates of depression and anxiety among patients with HIV on-follow up at Alert Hospital, Addis Ababa, Ethiopia. BMC Psychiatry 2016;16(368):1-7. https://doi.org/10.1186/s12888-016-1037-9
• 11. Duko B, Geja E, Zewude M, Mekonen S. Prevalence and associated factors of depression among patients with HIV/AIDS İn Hawassa, Ethiopia, cross-sectional Study. Annals of General Psychiatry 2018;17(45):1-6. https://doi.org/10.1186/s12991-018-0215-1
• 12. Ciesla JA, Roberts JE. Meta-analysis of the relationship between HIV infection and risk for depressive disorders. The American Journal of Psychiatry 2001;158(5):725-730. https://doi.org/10.1176/appi.ajp.158.5.725
• 13. Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods 2007;39:175-191. https://doi.org/10.3758/bf03193146
• 14. Cohen J. Statistical power analysis. Current Directions in Psychological Science 1992;1(3):98-101. https://doi.org/10.1111/1467-8721.ep10768783 15. Berger BE, Ferrans CE, Lashley FR. Measuring stigma in people with HIV: Psychometric assessment of the HIV stigma scale. Research in Nursing & Health 2001;24(6):518-529. https://doi.org/10.1002/nur.10011 16. Yıldız Mİ, Başar K, Karadağ Çaman Ö, İnkaya AÇ. The reliability and validity of the Turkish form of Berger HIV Stigma Scale. Archives of Neuropsychiatry 2021;58:292−299. https://doi.org/10.29399/npa.27299
• 17. Beck AT, Lester D, Trexler L. The measurement of pessimism: The Beck Hopelessness Scale. Journal Of Consulting and Clinical Psychology 1974;42(6):861-865. https://doi.org/10.1037/h0037562
• 18. Seber G, Dilbaz N, Kaptanoğlu C, Tekin D. Hopelessness Scale: validity and reliability. Crisis Journal 1993;1(3):139-142. https://toad.halileksi.net/sites/default/files/pdf/umutsuzluk-olcegi-toad.pdf
• 19. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Archives of General Psychiatry 1961;4:561–571. https://doi.org/10.1001/archpsyc.1961.01710120031004
• 20. Hisli N. Validity and reliability of the Beck Depression Inventory for university students. Psychology Journal 1989;7(22):3-13. https://toad.halileksi.net/sites/default/files/pdf/beck-depresyon-envanteri-toad.pdf
• 21. Takada S, Weiser SD, Kumbakumba E, Muzoora C, Martin JN, Hunt PW, et al. The dynamic relationship between social support and HIV-related stigma in rural Uganda. Annals of Behavioral Medicine 2014;48(1):26–37. https://doi.org/10.1007/s12160-013-9576-5
• 22. SeyedAlinaghi SA, Paydary K, Kazerooni PA, Hosseini M, Sedaghat A, Emamzadeh-Fard S, et al. Evaluation of stigma index among people living with HIV/AIDS (PLWHA) in six cities in Iran. Thrita 2013;2(4):69-75. https://doi.org/10.5812/thrita.11801
• 23. Mohite VR, Mohite RV, George J. Correlates of perceived stigma and depression among the women with HIV/AIDS infection. Bangladesh Journal of Medical Science 2015;14(2):151-158. https://doi.org/10.3329/bjms.v14i2.21864
• 24. Zang YX, Golin CE, Bu J, Emrick CB, Nan Z, Ming-Qiang L. Coping strategies for HIV-related stigma in Liuzhou, China. AIDS and Behavior 2014;18(Suppl 2(0 2):S212–220. https://doi.org/10.1007/s10461-013-0662-2
• 25. Varni SE, Miller CT, McCuin T, SolomonS. Disengagement and engagement coping with HIV/AIDS stigma and psychological well-being of people with HIV/AIDS. Journal of Social and Clinical Psychology 2012;31(2):123–150. https://doi.org/10.1521/jscp.2012.31.2.123
• 26. Demirel OF, Mayda PY, Yıldız N, Sağlam H, Koçak BT, Habip Z, et al. Self-stigma, depression, and anxiety levels of people living with HIV in Turkey. The European Journal of Psychiatry 2018;32(4):182-186. https://doi.org/10.1016/j.ejpsy.2018.03.002
• 27. Govende RD, Schlebusch L. Hopelessness, depression and suicidal ideation in HIV-positive persons. South African Journal of Psychiatry 2012;18(1):16-21. https://www.researchgate.net/publication/279673418_Hopelessness_depression_and_suicidal_ideation_in_HIV-positive_persons
• 28. Schönnesson LN, Ross MW, Garcia‑Huidobro D, Eriksson LE, Andersson G, Williams ML, et al. Hopelessness and HIV infection: An exploratory study with a gender-specifc perspective. BMC Psychology 2022;10(46):1-12. https://doi.org/10.1186/s40359-022-00755-2
• 29. Cavazos-Rehg P, Xu C, Borodovsky J, Kasson E, Byansi W, Nabunya P, et al. The impact of discomfort with HIV status and hopelessness on depressive symptoms among adolescents living with HIV in Uganda. AIDS Care 2021;33(7):867-872. https://doi.org/10.1080/09540121.2020.1778625
• 30. DeJean D, Giacomini M, Vanstone M, Brundisini F. Patient experiences of depression and anxiety with chronic disease: A systematic review and qualitative meta-synthesis. Ontario Health Technology Assessment Series 2013;13(16):1-33. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3817854/pdf/ohtas-13-33a.pdf
• 31. Mekonen T, Belete H, Fekadu W. Depressive symptoms among people with HIV/AIDS in Northwest Ethiopia: Comparative study. BMJ Open 2021;11(7)e048931:1-7. https://doi.org/10.1136/bmjopen-2021-048931
• 32. Seid S, Abdu O, Mitiku M, Tamirat KS. Prevalence of depression and associated factors among HIV/AIDS patients attending antiretroviral therapy clinic at Dessie referral hospital, South Wollo, Ethiopia. International Journal of Mental Health Systems 2020;14(55):2-8. https://doi.org/10.1186/s13033-020-00389-0
• 33. Rueda S, Gibson K, Rourke SB, Gogolishvili D, Globerman J, Chambers L, et al. Mastery moderates the negative effect of stigma on depressive symptoms in people living with HIV. AIDS and Behavior 2012;16:690–699. https://doi.org/10.1007/s10461-010-9878-6
• 34. Edelman EJ, Cole CA, Richardson W, Boshnack N, Jenkins H, Rosenthal MS. Stigma, substance use and sexual risk behaviors among HIV-infected men who have sex with men: A qualitative study. Preventive Medicine Reports 2016;3:296-302. https://doi.org/10.1016/j.pmedr.2016.03.012
• 35. Shrestha R, Copenhaver M, Bazazi AR, Huedo-Medina TB, Krishnan A, Altice FL. A moderated mediation model of HIV-Related stigma, depression, and social support on health-related quality of life among ıncarcerated Malaysian men with HIV and opioid dependence. AIDS and Behavior 2017;21:1059–1069. https://doi.org/10.1007/s10461-017-1693-x
• 36. Tsai AC, Bangsberg DR, Emenyonu N, Senkungu JK, Martin JN, Weiser SD. The social context of food insecurity among persons living with HIV/AIDS in rural Uganda. Social Science & Medicine 2011;73(12):1717-1724. https://doi.org/10.1016/j.socscimed.2011.09.026
• 37. Weiser SD, Tuller DM, Frongillo EA, Senkugu J, Mukibi N, Bangsberg DR. Food insecurity as a barrier to sustained antiretroviral therapy adherence in Uganda. PLoS One 2010;5(4):e10340. https://doi.org/10.1371/journal.pone.0010340
• 38. Johnson JG, Alloy LB, Panzarella C, Metalsky GI, Rabkin JG, Williams JB, et al. Hopelessness as a mediator of the association between social support and depressive symptoms: Findings of a study of men with HIV. Journal of Consulting and Clinical Psychology 2001;69(6):1056–1060. https://doi.org/10.1037//0022-006x.69.6.1056
• 39. Turkish Statistical Institute (TURSTAT) - TÜİK 2021. (2022). Birth statistics. Retrieved from https://data.tuik.gov.tr/Bulten/Index?p=Dogum-Istatistikleri-2021-45547 Publication Date: 12 May 2022.