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The quality of life of HIV-infected women is associated with psychiatric morbidity
- Authors:
- TOSTES M.A., CHALUB M., BOTEGA N.J.
- Journal article citation:
- AIDS Care, 16(2), February 2004, pp.177-186.
- Publisher:
- Taylor and Francis
Evaluates the effect of clinical, demographic and psychiatric factors on the health-related quality of life of 76 women with HIV infection seen in two HIV reference centres in Brazil. The generic questionnaire for evaluation of Health-Related Quality of Life (SF-36), the Hospital Anxiety and Depression Scale (HAD) and the Clinical Interview Schedule (CIS-R) were used. The statistical tests included the covariance analysis. The sub-group of the non-AIDS symptoms (clinical stage B) showed the worst quality of life. The variables which better explained the scoring variation on both the mental and physical components of the SF-36 were related to mental health. The more mental symptoms present, the worse the health-related quality of life. Concludes that care strategies should be rethought in the area of mental health which are directed toward HIV+ patients, by virtue of the levels of mental health symptoms found and the request for care which the research revealed.
HIV risk among female sex workers in Miami: the impact of violent victimization and untreated mental illness
- Authors:
- SURRATT Hilary, et al
- Journal article citation:
- AIDS Care, 24(5-6), May 2012, pp.553-561.
- Publisher:
- Taylor and Francis
The lifestyle of street-based female sex workers, enmeshed as they often are in chronic patterns of substance use, sexual risk, homelessness, and violent victimisation exposes them to risk of HIV. The authors examined the contributions of victimisation history and abuse-related factors to mental health and sexual risk behaviours, while also considering the impact of environmental risk factors. Using targeted sampling strategies, 562 Miami-based female sex workers were recruited onto an intervention trial testing the relative effectiveness of two alternative case management strategies in establishing linkages with health services and reducing risk for HIV. Lifetime prevalence of abuse was extremely high at 88%. Nearly half reported abuse before the age of 18, while 34% reported violent encounters with “dates” or clients in the past 90 days. Serious mental illness (SMI) was quite common, with 74% reporting symptoms of depression, anxiety, or traumatic stress. For those with histories of abuse, SMI appeared to mediate the association between abuse-related trauma and unprotected sex behaviours. It is concluded that mental health treatment appears to be an important component of effective HIV prevention among this vulnerable group, and should therefore form part of a compendium of services offered to female sex workers.
Psychological distress patterns of women and mothers presenting for HIV-related mental health care
- Authors:
- REECE Michael, BASTA Tania B., KOERS Erin
- Journal article citation:
- Journal of HIV/AIDS and Social Services, 3(2), 2004, pp.93-109.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Over a seven year period, data were collected from 228 women living with HIV upon their self-enrollment into mental health care at an HIV-related mental health clinic in the USA. Analyses were conducted to explore the symptoms of mental health distress being presented by women upon their enrollment into care and, in particular, associations between these symptoms and characteristics of motherhood. Findings suggest that women living with HIV present for care with significant levels of psychological distress symptoms and that factors related to parenthood are associated with diverse clinical presentations. As an increasingly prevalent component of the HIV social services system, women living with HIV are in need of access to services that are responsive to their unique mental health issues and that are based upon an understanding of the extent to which familial variables influence psychological distress. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
Women and HIV invisible no longer: a national study of women's experiences of HIV
- Author:
- SOPHIA FORUM
- Publisher:
- Terrence Higgins Trust
- Publication year:
- 2018
- Pagination:
- 90
- Place of publication:
- London
This report explores the needs and experiences of women living with and affected by HIV. It is based on a project to make women visible in the HIV response in the UK and was co-produced with women living with and affected by HIV which included a literature review, online surveys of women living with HIV and women concerned about HIV, and a mapping of services available. The report’s findings highlight significant unmet need, in both prevention services and support services that meet women’s needs across intersecting issues such as violence, mental health and immigration. The report calls for greater gender equity in research, funding, data, services and support. Specifically, it calls for researchers to develop a better understanding of the link between violence, gender and HIV in the UK and create better opportunities for women living with HIV to participate in local service design. (Edited publisher abstract)
The impact of intimate partner violence, substance use, and HIV on depressive symptoms among abused low-income urban women
- Authors:
- ILLANGASEKARE Samantha L., et al
- Journal article citation:
- Journal of Interpersonal Violence, 28(14), 2013, pp.2831-2848.
- Publisher:
- Sage
Intimate partner violence (IPV), substance use, and HIV are often co-occuring health problems affecting low-income urban women, and have been described as connected epidemics making up a “syndemic.” Research suggests that each issue separately is associated with depressive symptoms, but no studies have examined the combined effect of IPV, substance use and HIV on women’s depression. Interviews were conducted with 96 women recruited from community health clinics serving low-income women in an urban U.S. city. All women were over 17, not pregnant, English-speaking, without private insurance and had experienced physical IPV in the past year. Women were primarily African American (82%) and 82% were receiving income assistance. Twenty seven percent were HIV-positive, and 27% had used heroin or cocaine in the past 6 months. Based on the Centers for Epidemiological Studies Depression Scale (CES-D ), 73% were depressed. Women who experienced severe IPV in the past 6 months were compared to women who experienced no IPV or psychological IPV only in the past 6 months; those who experienced severe IPV were 5.3 times more likely to be depressed, controlling for HIV status, drug use, age, and relationship status. Women who experienced severe IPV, were HIV-positive, and used drugs (7.3% of sample) were 7.98 times as likely to be depressed as women without these characteristics. These findings confirm that severe IPV is significantly associated with depression among urban abused women. Furthermore, this research suggests that the syndemic effect of IPV, substance use, and HIV could be even more detrimental to women’s mental health. Health practitioners and researchers should be aware of the combined impact of the IPV, substance use, and HIV syndemic and consider how they can address the mental health needs of urban women. (Publisher abstract)
Preliminary outcomes of a model program for increasing treatment access for African American women who use crack cocaine and are at risk for contracting HIV
- Authors:
- OKPAKU Samuel, et al
- Journal article citation:
- Journal of Evidence-Based Social Work, 7(1-2), January 2010, pp.41-57.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
In the United States, the threat of HIV/AIDS to African American women's health has become the focus of much concern. Despite African Americans only representing 12.3% of the US population, they represent 64% of all female HIV cases. This paper describes a federally funded community-based programme that provides services to African American women at risk for HIV/AIDS in Nashville, Tennessee. The Treatment Access Project provides a culturally relevant set of interventions specific to crack cocaine users aimed at reducing substance use and HIV/AIDS risk behaviours. The components of the programme include: pre-treatment services; case management; and substance abuse treatment. An evaluation of the programme based on analysis of data for 153 individuals who completed both the intake interview and the 6-month interview is described. The results demonstrated improvements in substance use behaviours, HIV/AIDS risk behaviours, mental health status, and various measures of self-sufficiency. The article concludes that this model is important for the continued development of culturally relevant interventions aimed at reducing the disproportionate rates of HIV/AIDS within the African American community by ensuring treatment access to all populations.
Church ladies, good girls, and locas: stigma and the intersection of gender, ethnicity, mental illness, and sexuality in relation to HIV risk
- Authors:
- COLLINS Pamela Y., VON UNGER Hella, ARMBRISTER Adria
- Journal article citation:
- Social Science and Medicine, 67(3), August 2008, pp.389-397.
- Publisher:
- Elsevier
Inner city women with severe mental illness may carry multiple stigmatised statuses. In some contexts these include having a mental illness, being a member of an ethnic minority group, being an immigrant, being poor and being a woman who does not live up to gendered expectations. These potentially stigmatising identities influence both the way women's sexuality is viewed and their risk for HIV infection. This qualitative study applies the concept of intersectionality to facilitate understanding of how these multiple identities intersect to influence women's sexuality and HIV risk. The authors report the first-hand accounts of 24 Latina women living with severe mental illness in New York City. In examining the interlocking domains of these women's sexual lives, they found that the women seek identities that define them in opposition to the stigmatising label of “loca” (Spanish for crazy) and bestow respect and dignity. These identities have unfolded through the additional themes of “good girls” and “church ladies”. Therefore, in spite of their association with the “loca”, the women also identify with faith and religion (“church ladies”) and uphold more traditional gender norms (“good girls”) that are often undermined by the realities of life with a severe mental illness and the stigma attached to it. However, the participants fall short of their gender ideals and engage in sexual relationships that they experience as disempowering and unsatisfying. The effects of their multiple identities as poor Latina women living with severe mental illness in an urban ethnic minority community are not always additive, but the interlocking effects can facilitate increased HIV risks. Interventions should acknowledge women's multiple layers of vulnerability, both individual and structural, and stress women's empowerment in and beyond the sexual realm.
Mental disorders and drug abuse in persons living with HIV/AIDS
- Authors:
- KLINKENBERG W. D., SACKS S.
- Journal article citation:
- AIDS Care, 16(Supplement 1), January 2004, pp.S22-S42.
- Publisher:
- Taylor and Francis
This article reviews the literature on the prevalence of mental and substance use disorders among persons living with HIV/AIDS. Drug use, both injection and non-injection, substantially increases the risk for HIV infection. While injection drug users have the highest prevalence rates for HIV, substantially elevated rates of HIV infection are also present among crack cocaine users and individuals with substance use disorders generally. Persons with HIV/AIDS and a mental and/or substance use disorder have highly variable patterns of accessing services. Persons with HIV/AIDS who have a serious mental illness are more highly involved with services than other groups. Most individuals with co-occurring disorders report some involvement with outpatient primary medical care, although ancillary services such as mental health and substance abuse treatment, transportation assistance, and case management improve involvement in medical care. Women with HIV/AIDS and co-occurring mental and substance use disorders experience unique vulnerabilities, particularly those related to exposure to traumatic events. Given the complexity of needs with which triply or multiply diagnosed individuals present, effective treatment programmes are likely to be those that provide some degree of integrated care.
Trauma, coping, and depression among women with HIV/AIDS in New York City
- Authors:
- SIMONI J.M., NG M.T.
- Journal article citation:
- AIDS Care, 12(5), October 2000, pp.567-580.
- Publisher:
- Taylor and Francis
Among 230 HIV-positive women in New York city, the researchers examined the association of retrospective self-reports of sexual and physical abuse, current coping strategies and depressive symptomatology. Results revealed a high prevalence of abuse in childhood and adulthood. Childhood abuse positively correlated with the frequency of current adaptive and avoidant coping strategies. Implications for improving the psychological functioning of women living with HIV/AIDS are discussed.
Sexual coercion among women living with a severe and persistent mental illness: review of the literature and recommendations for mental health providers
- Authors:
- WEINHARDT Lance S., BICKHAM Nicole L., CAREY Michael P.
- Journal article citation:
- Aggression and Violent Behavior, 4(3), 1999, pp.307-317.
- Publisher:
- Elsevier
Women with severe and persistent mental illness are at enhanced risk for sexual coercion and several resulting sexual health complications. This article examines the prevalence and types of sexual coercion encountered by women with severe and persistent mental illness and provides recommendations for interventions to reduce the prevalence of sexual coercion. Argues that mental health professionals working with this population need to provide increased attention to the problem of sexual coercion and can take measures to intervene safely and effectively.