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Tuberculosis Incidence and Mortality Rates Among People Living with HIV Receiving Antiretroviral Therapy at the Buea Regional Hospital: A Seven Year Retrospective Study
Henry Dilonga Meriki,
Kah Emmanuel Nji,
Kukwah Anthony Tufon,
Yaoh Adolf Tah,
Pascal Nji Atanga,
Anna Longdoh Njunda,
Irene Ane Anyangwe
Issue:
Volume 5, Issue 2, December 2019
Pages:
82-90
Received:
20 May 2019
Accepted:
25 June 2019
Published:
31 July 2019
Abstract: Introduction: The use of antiretroviral therapy (ART) has dramatically decreased HIV-associated morbidity and mortality in high-and low-income countries with a corresponding reduction in tuberculosis (TB) incidence. Nevertheless, the risk of TB remains substantially higher in people living with HIV (PLHIV) compared to non-HIV infected individuals. In Cameroon, free ART was introduced in 2007 and our understanding of the possible role of ART in reducing HIV-associated TB remains limited. We assessed TB incidence, mortality and risk factors for TB and mortality among PLHIV treated at Buea Regional Hospital between 2008 and 2014. Materials and Methods: In a retrospective study we reviewed the records of 1,477 HIV patients on ART. The data was entered and analysed using SPSS version 21. Bivariate and Multivariate logistic regression analysis were used to determine the risk factors associated with TB and mortality occurrences at 5% significance level. Results: Of the 1477 patients’ records that was reviewed, females (70.7%) constituted a greater proportion. Majority of the participants (60.5%) were between the ages 21-40 years (mean: 37.5 ± 11.5. SD). A total of 209 patients developed TB giving an overall TB incidence density rate 4.25/100PYR (95% CI: 2.47-6.46). There was an increasing trend in the incidence of TB over the years from 1.69 (95% CI: 0.72-1.98) in 2008 to 19.63 (95% CI: 7.36-21.20) in 2014. The overall mortality rate was 12.4% (183/1477) of which 38.8% (71/183) of them were on TB treatment or previously treated for TB. In a multivariate analysis, low CD4 cells level at ART initiation (AOR: 1.3, 95% CI: 1.11-.2.10), WHO HIV clinical stage 3 and 4 (AOR: 1.52, 95% CI: 1.01-2.22) were significantly associated with increase odds of TB occurrence. Conclusion: Even in the era of HAART, TB still remains a significant cause of mortality among PLHIV and therefore efforts should be scaled-up for early diagnosis and prompt treatment of TB.
Abstract: Introduction: The use of antiretroviral therapy (ART) has dramatically decreased HIV-associated morbidity and mortality in high-and low-income countries with a corresponding reduction in tuberculosis (TB) incidence. Nevertheless, the risk of TB remains substantially higher in people living with HIV (PLHIV) compared to non-HIV infected individuals. ...
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Awareness and Behaviours Relating to Prevention of Sexually Transmitted Infections (STIs) Among Students of Higher Institutions in South West Nigeria
Adeniyi Augustine Adebayo,
Bello Folasade Olanike,
Adeyemo Olabisi Timothy,
Bakare Adewumi,
Ayankunle Mojisola Olumide,
Agboola Segun Matthew
Issue:
Volume 5, Issue 2, December 2019
Pages:
91-96
Received:
4 July 2019
Accepted:
30 July 2019
Published:
19 August 2019
Abstract: Background: Sexually transmitted infections (STIs) constitute a major health concern worldwide, this is particularly so in the developing and low resource countries and important factor in the prevention and treatment is the awareness and attitudes of the people toward these diseases. Methodology: The study was conducted among the students in higher institutions in Ekiti state using a self-administered questionnaires following a two-stage stratified clustered sampling. Results: A total number of 150 questionnaires were distributed, with a response rate of 90% (135) and an average age of 22.94 years. The males were statistically older than the females (P<0.03). Gonorrhoea, syphilis and HIV enjoyed better awareness compared to other STIs with (95.4%), (79.2%) and (77.7%) respectively with Chlamydia being the least known STI with only 16.2% of the respondents being aware. The male students had a higher incidence of multiple sexual partners than their female counterparts, with the difference being statistically significant both in the last 12 months (37.8% vs. 8.7%, P<0.001) and total numbers of sexual partners ever 54.1% vs. 21.7%, P<0.0001). Majority of respondents (50%) had their sexual debut between 15-20 years but a sizable number had first intercourse below 15 years of age (20%). Eighty-two percent (82%) and 50% of the respondents acknowledge the use of condom for prevention of STI transmission and contraception respectively. Conclusion: The knowledge of the students on STIs is above average except for Chlamydia infection. The practice of the students concerning sexual intercourse and prevention of STIs including HIV is disturbing, especially sexual intercourse and low level of condom use.
Abstract: Background: Sexually transmitted infections (STIs) constitute a major health concern worldwide, this is particularly so in the developing and low resource countries and important factor in the prevention and treatment is the awareness and attitudes of the people toward these diseases. Methodology: The study was conducted among the students in highe...
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The Efficacy of Anti-Retroviral Therapy on HIV Patients with and Without Tuberculosis: A Comparative Study in a State Hospital Bida Niger State Nigeria
Ebenezer Obi Daniel,
Aminat Abiola Ojewale,
Paul Olaiya Abiodun,
Gabriel Omoniyi Ayeni,
Olayinka Victor Ojo,
Oladapo Michael Olagbegi
Issue:
Volume 5, Issue 2, December 2019
Pages:
97-104
Received:
22 July 2019
Accepted:
13 August 2019
Published:
26 August 2019
Abstract: There is a general broad knowledge surrounding the possible complications and opportunistic infections that patients with HIV can be exposed to, one of which is Tuberculosis, a popular co-morbid disease in HIV patients. Several studies have unraveled the efficacy of ARVs on the CD4 counts in HIV patients, but there exists knowledge gap in establishing the efficacy of ARV therapy among HIV patients with Tuberculosis (TB). The main objective of this study was to compare the efficacy of antiretroviral therapy on HIV positive patients with and without tuberculosis. A quasi-experimental design was employed in this study. Eighty (80) patients were recruited in total from the ARV-TB clinic of general hospital Bida. Forty (40) HIV patients without TB, and HIV patients with TB were recruited consecutively into group A and B respectively. Each group participants’ baseline CD4 counts were estimated and recorded, after which both groups were subjected to a six weeks ARV therapy. Data were collected weekly (for six weeks) by conducting laboratory test of CD4 counts for both groups’ patients. The data were analyzed using SPSS version 25.0 software. Descriptive statistics of mean, standard deviation and percentages were used to summarize the data, while inferential statistics of t-test, ANOVA, ANCOVA and Bonferoni pairwise comparison were used to test the significant differences as appropriate. Alpha level was set at 0.05. The study revealed that the CD4 count of HIV patients without TB (group A) at baseline was found to be statistically significantly higher than those with TB (group B), and also revealed a statistical significant difference in the CD 4 count across the seven-time-point period of the study (baseline and the six weeks of ARV therapy) in the two groups (P<0.05). The study also revealed that there was no statistically significant difference in the CD4 count of groups A and B comparatively after six weeks of ARV therapy. Recommendations among others include; extension of the study tentacle to increased number of health facilities and longer study period, conducting studies on the impact of the dual therapy (ARV and anti-TB) on the co-infected patients, and the need for all stakeholders involved in the treatment of HIV patients to continuously update their knowledge base on the management of the HIV patients with and without TB, for a more productive and goal-oriented treatment outcome, void of sentiments and discrimination.
Abstract: There is a general broad knowledge surrounding the possible complications and opportunistic infections that patients with HIV can be exposed to, one of which is Tuberculosis, a popular co-morbid disease in HIV patients. Several studies have unraveled the efficacy of ARVs on the CD4 counts in HIV patients, but there exists knowledge gap in establish...
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Knowledge of HIV/AIDS and the Use of Contraceptives (Condom) as Prevention Among Students of Federal College of Education, Kontagora, Niger State
Aliyu Mohammed,
Oyerinde Olufemi Oyesegun
Issue:
Volume 5, Issue 2, December 2019
Pages:
105-109
Received:
22 July 2019
Accepted:
2 September 2019
Published:
16 September 2019
Abstract: The study investigates the knowledge of HIV/AIDS and the use of contraceptive among the students of Federal college of Education, Kontagora. The subject of study were randomly selected. Sample of 300 students were used for the study. The instruments use for the study was questionnaire validated and tested for reliability. Data collected were analyzed using Pearson Product Moment Correlation Coefficient and t-test as appropriate. The finding revealed that there was significant relationship between the student’s knowledge and other sexual transmitted diseases. There was significant different between the student knowledge of HIV/AIDS and the use of condom as preventive devices. There was significant difference between student knowledge and other sexually transmitted diseases. There was significant difference between the student knowledge of mode of transmission of HIV/AIDS and other STDS among students of Federal college of Education, Kontagora. The student’s knowledge of contraceptive had no significant relation to the knowledge of contraceptive device. Based on these findings the following recommendations were made. AID Education should be incorporated in the school curriculum; also adequate information on knowledge of HIV/AIDS should be made available to the students of Federal college of Education, Kontagora through technology and health education.
Abstract: The study investigates the knowledge of HIV/AIDS and the use of contraceptive among the students of Federal college of Education, Kontagora. The subject of study were randomly selected. Sample of 300 students were used for the study. The instruments use for the study was questionnaire validated and tested for reliability. Data collected were analyz...
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Knowledge of HIV Transmission and Risky Sexual Behavioural Practices Among Selected Adolescents and Young Adults in Lagos, Nigeria
Taiwo Modupe Balogun,
Olawale Dally,
Omobolanle Awofala
Issue:
Volume 5, Issue 2, December 2019
Pages:
110-114
Received:
28 August 2019
Accepted:
28 September 2019
Published:
11 October 2019
Abstract: The adolescents and young adults constitute a high risk group for HIV infection due to their common involvement with risky sexual behavioural practices. This study was carried out to assess the basic knowledge of HIV and also identify the risky sexual behavioural practices for infection among studied adolescents and young adults. A self-administered structured questionnaire containing 15 items on demographics, knowledge of HIV/AIDS and risky sexual behavioural practices that may predispose to new infections was completed by respondents and used for data collection. Participation in this survey was voluntary and anonymous among selected adolescents and young adults. One hundred and forty four (144) out of 160 questionnaires that were shared among the adolescents and the youth were completed and returned giving a response rate of 90%. The study population was aged 10-24 years and majority of the respondents 90 (62.5%) were in the age group 21-24 years while their mean age was 18±3.9 years. There was good awareness about HIV and its routes of transmission among respondents (96%). The mean age of sexual debut was 15±5.2 years. Condom use among the sexually active respondents was low 33 (22.9%). Thirteen (9.0%) of the respondents were involved with casual unprotected sex while 59% of respondents had taken HIV tests. The knowledge of HIV transmission was good while risky sexual behavioural practices for new infections such as early sexual debut, low condom use and low uptake of counseling and testing services with resultant lack of knowledge of personal HIV status, keeping multiple sex partners, were prevalent among studied adolescents and young adults in Lagos, Nigeria.
Abstract: The adolescents and young adults constitute a high risk group for HIV infection due to their common involvement with risky sexual behavioural practices. This study was carried out to assess the basic knowledge of HIV and also identify the risky sexual behavioural practices for infection among studied adolescents and young adults. A self-administere...
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Determinants of Adherence Levels to Oral Pre-exposure Prophylaxis among Seronegative Partners in HIV Discordant Heterosexual Relationships
Samuel Mwangi Mwaura,
Rysper Eve Rajula,
Angeline Chepchirchir Kirui
Issue:
Volume 5, Issue 2, December 2019
Pages:
115-123
Received:
27 September 2019
Accepted:
15 October 2019
Published:
24 October 2019
Abstract: Adherence to pre-exposure prophylaxis (PrEP) medication is key for its efficacy in prevention of Human Immunodeficiency Virus (HIV) infection acquisition by uninfected partner in HIV discordant couples during high risk periods of HIV exposure. This study aimed at establishing determinants of adherence levels to oral PrEP drugs among seronegative partners in HIV discordant heterosexual relationships attending and registered at Mbagathi Hospital Comprehensive Care Center (CCC). The study adopted a cross-sectional design that applied two data collection methods: semi structured questionnaires guided interview and a checklist that assessed respondents’ medical records. Both qualitative and quantitative data was collected. Convenience sampling method was used to get a sample size of 51 participants in serodiscordant heterosexual relationships taking oral PrEP. Data was analyzed using Statistical Package for the Social Sciences (SPSS) IBM statistics version 24 software. Both descriptive and inferential analysis were done. Level of significance was set at P value of ≤ 0.05. A higher proportion of the respondents were females (52.9%) and male (47.1%). Most were self-employed (56.9%) with primary level of education (39.2%) and between 30-39 years age group (38%). Adherence levels assessed included; adherence to intake of oral PrEP pills (89.4%), adherence to time of taking PrEP (96%) and adherence to scheduled clinic appointments (80%). Male respondents were 1.01 times more likely to adhere to intake of PrEP pills than females. Determinants that positively influenced adherence to PrEP intake included: increase in age and higher education (p=0.01); longer period of being in HIV discordant relationship (p=0.04); use of condom after PrEP break (p=0.04); partners’ adherence support and having a plan of remembering to take PrEP e.g. an alarm (p=0.04); and increase in frequency of doing a HIV test (p=0.04). Determinants that negatively influenced adherence to PrEP intake included: presence of side effects (p=0.003); engaging in extra marital sex (p=0.04) and alcohol use (p=0.05). The positive determinants of good adherence should be upheld and negative determinants should be addressed. In management of these clients there is need to look out for determinants that promote adherence that include maturity in age, level of education, length of being in discordant status and partners support. Programs should be initiated to create awareness on the effect of bad social habits like alcoholism and extra marital affairs. Laboratory services access should be strengthened in monitoring patients’ adherence and side effects to treatment.
Abstract: Adherence to pre-exposure prophylaxis (PrEP) medication is key for its efficacy in prevention of Human Immunodeficiency Virus (HIV) infection acquisition by uninfected partner in HIV discordant couples during high risk periods of HIV exposure. This study aimed at establishing determinants of adherence levels to oral PrEP drugs among seronegative pa...
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Socio-cultural Factors Influencing Adherence to Antiretroviral Therapy Among People Living with HIV/AIDS in a Tertiary Hospital in Southwestern Nigeria
Okunola Oluseye Ademola,
Muoghalu Caroline,
Irinoye Adedayo Ishola
Issue:
Volume 5, Issue 2, December 2019
Pages:
124-133
Received:
22 August 2019
Accepted:
24 September 2019
Published:
8 November 2019
Abstract: The study investigated the socio-cultural factors influencing adherence to antiretroviral drugs among people living with HIV in a University Teaching Hospital in South-western Nigeria. It investigated the influence of various socio-cultural factors on adherence of PLWHA to treatment regimen People Living with HIV/AIDS (PLWHA) of antiretroviral therapy (ART) in Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife and assessed the prevalence of adherence to ART among PLWHA in the study area. These were with the view to ascertaining the influence of socio-cultural factors in the PLWHA’s adherence to antiretroviral therapy in the study location. The study design was a cross-sectional where both qualitative and quantitative research methods were adopted. The quantitative data were collected using structured questionnaire. The participants were HIV diagnosed patients attending clinic at the Obafemi Awolowo University Teaching Hospitals Complex in Ile-Ife where ages were between 18 and 60 years. Also two focus group discussion sessions were held with 10 males and 10 females living with HIV and currently on ART. Furthermore, in-depth interviews were conducted on three purposively selected healthcare givers (an experienced nurse, a doctor and a pharmacist) in the clinic. The quantitative data were analyzed using descriptive statistics such as tables and percentages and inferential statistics such as Chi Square and cross-tabulations. The qualitative data were analyzed in themes based on the objectives. The findings from the study indicated level of adherence to ART was 89.0% among the respondents. There was a statistically significant relationship (χ2 = 22.14; p < 0.01) between social and family supports and the degree of adherence to ART among PLWHA. There was a statistically significant relationship between level of adherence and respondents’ age (χ2 = 66.05, p < 0.05). The older the respondents’ age, the higher the level of adherence to ART. Also the relationship between educational level and adherence to ART was explored and found to be statistically significant (χ2 = 26.04, p < 0.05). Adherence is inversely proportional to educational attainment. Nutrition, polygyny, difficulty in financing transportation fare to the clinic, unemployment, drug hawkers, religion, excuse duty from work and waking up very early were highlighted as socio-cultural barriers to adherence to ART. Fear of death, strong family support, religious belief, not seeking alternative treatment, absence of rituals and perceived improved health status were identified as very strong facilitators to adherence. The study concluded that socio-cultural factors exert very strong influences on PLWHA’s adherence to antiretroviral therapy.
Abstract: The study investigated the socio-cultural factors influencing adherence to antiretroviral drugs among people living with HIV in a University Teaching Hospital in South-western Nigeria. It investigated the influence of various socio-cultural factors on adherence of PLWHA to treatment regimen People Living with HIV/AIDS (PLWHA) of antiretroviral ther...
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Influence of Stigma on Pre-Exposure Prophylaxis (PrEP) Care Continuum Among Men and Transwomen Who Have Sex with Men (MTWSM) in the United States
Jude Ssenyonjo,
Roman Shrestha,
Michael Copenhaver
Issue:
Volume 5, Issue 2, December 2019
Pages:
134-140
Received:
15 October 2019
Accepted:
9 November 2019
Published:
17 November 2019
Abstract: Despite evidence from recent trials of the efficacy of pre-exposure prophylaxis (PrEP) in reducing the risk of contracting HIV, PrEP uptake has been slow due to a range of social, structural, and behavioral factors. In this systematic review, we examined the influence of stigma on the PrEP care continuum among men and transwomen who have sex with men (MTWSM). We conducted a literature search in the PubMed electronic database (2012–2018) that focused on the PrEP care continuum among high-risk MTWSM. We explored studies that specifically looked at the influence of stigma on the PrEP cascade among these socially disadvantaged populations. Our search yielded 161 articles, of which nine were ultimately included in our systematic review. The results showed a significant association between stigma and unwillingness to seek or use PrEP suggesting that stigma may negatively affect willingness and uptake of PrEP among these high-risk groups.
Abstract: Despite evidence from recent trials of the efficacy of pre-exposure prophylaxis (PrEP) in reducing the risk of contracting HIV, PrEP uptake has been slow due to a range of social, structural, and behavioral factors. In this systematic review, we examined the influence of stigma on the PrEP care continuum among men and transwomen who have sex with m...
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Assessment of Risky Sexual Behaviors Among University Students in Kigali, Rwanda
Gashema Pierre,
Ariane Umutoni,
Zephanie Nzeyimana,
Tafadzwa Dzinamarira
Issue:
Volume 5, Issue 2, December 2019
Pages:
141-146
Received:
17 October 2019
Accepted:
25 November 2019
Published:
4 December 2019
Abstract: Risky sexual behaviors (RSB) remain a public health concern among university students who are considered as key population for a nation’s economic development. The aim of this study was to determine the proportion of sexually active students, RSB and their associated factors among students from two selected universities in Kigali. We employed a cross sectional study with data collection using a pre-tested questionnaire. IBM SPSS version 21 was employed for data analysis. Chi-square test was used to assess association between RSB and explanatory factors assuming a 95% confidence interval, 5% margin of error and statistical significance at P value less than 0.05. A total 269 university students with almost equal representation of both males and females, 49.8% and 50.2%, respectively were enrolled. Of these 269, 68.4% were sexually active during the period of data collection. RSB reported among university students include having multiple sexual partners with an average number of life sexual partners of 3.5, having at least one other sexual partner out of marriage (21%), paying for sex (16%), receiving payment for sex (10%), having unprotected sex with only 15% of them using always using condoms with risk sexual partners and only 6% using condoms while drunk or after using drugs. RSB were more common among younger aged (between 20 and 26 years old) with peak at 23 years old, unmarried (12.6%), widowed (50%), cohabitating (41.2%), prenuptial sex (22%) groups. Findings also revealed that working students, with self-employment or professional employment, are likely to engage in sexual activity after taking drugs or alcohol. All in all, RSB are still a major problem among university students. This calls for a review of current interventions addressing sexual health among this population. There is also a need for further studies with larger sample sizes.
Abstract: Risky sexual behaviors (RSB) remain a public health concern among university students who are considered as key population for a nation’s economic development. The aim of this study was to determine the proportion of sexually active students, RSB and their associated factors among students from two selected universities in Kigali. We employed a cro...
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HIV/AIDS in Kisii County: Current Status and Challenges
Gladys Nyamoita Mokua,
Geoffrey Mokua Maroko,
Augustus Onchari Nyakundi,
Meshack Ondora Onyambu
Issue:
Volume 5, Issue 2, December 2019
Pages:
147-155
Received:
22 November 2019
Accepted:
9 December 2019
Published:
20 December 2019
Abstract: In 2012, adult HIV/AIDS prevalence in Kisii County was disproportionately high at 8.6%, against the national average of 5.6%. Thus, the researchers set out to investigate the current status and intervention measures in place in combating the condition. Mixed method approach combining both qualitative and quantitative data collection techniques was used. It entailed a desk review of HIV/AIDS materials for the period 2010-2018. Published data on HIV/AIDS in Kisii County from a diverse set of stakeholders was used. Quantitative data was also extracted from online databases, County reports and proposals. Qualitative data was generated from key informant interviews and focus group discussions. Comparative analysis of the qualitative information obtained from the respondents and the documented information was done and conclusions were drawn. Quantitative data was expressed as percentages and the data was presented in form of graphs and tables. Findings indicated that although HIV and AIDS remain a challenge in Kisii County, commendable strides have been made in its management and possible containment. The Kenya HIV estimates report for 2018 indicates that Kisii County has a prevalence rate of 4.4% against the national prevalence of 4.8%. The study also revealed that over 80% of HIV response is funded from external sources with more focus on biomedical interventions with less priority on the non-biomedical interventions. Based on the findings, the study recommends coordination among implementing partners for accurate data documentation and resource distribution. Deliberate efforts also need to be made to increase resources for prevention especially behavioral and structural interventions.
Abstract: In 2012, adult HIV/AIDS prevalence in Kisii County was disproportionately high at 8.6%, against the national average of 5.6%. Thus, the researchers set out to investigate the current status and intervention measures in place in combating the condition. Mixed method approach combining both qualitative and quantitative data collection techniques was ...
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Differences in Coping Self-efficacy, Social Relations and Depression Among HIV-infected Ethnic Danes and Non-ethnic Danes in Denmark: A Cross-sectional Study
Ane Soendergaard,
Tinne Laursen,
Margaret Chesney,
Morten Sodemann,
Lotte Rodkjaer
Issue:
Volume 5, Issue 2, December 2019
Pages:
156-163
Received:
23 November 2019
Accepted:
16 December 2019
Published:
24 December 2019
Abstract: Health-related quality of life is lower in people living with HIV compared to the general population, particularly because of higher levels of depression. Little is known about the differences between HIV-infected ethnic Danes and HIV-infected non-ethnic Danes at risk of depression. This study aimed to explore coping styles and social relations among HIV-infected ethnic Danes and non-ethnic Danes in two outpatient clinics. HIV-infected individuals from two out-patients clinics were included in a questionnaire-based study. The Beck Depression Inventory II (BDI-II) was used to assess the prevalence and severity of depressive symptoms. Coping was measured using the Coping Self-Efficacy scale (CSE) and social relations factors were marital status, loneliness, disclosure of HIV status and satisfaction with support from family and friends. Among 442 HIV-infected individuals, 21% were in risk of depression assessed by The Beck Depression Inventory II (BDI-II ≥ 20) and higher among non-ethnic Danes. The difference in mean Coping self-efficacy (CSE) between those at risk of depression and those not at risk was -78.95 95%CI (-89.10; -68.81). Non-ethnic Danes had higher scores on two CSE subscales, compared with ethnic Danish HIV-infected individuals. No ethnic difference was found in the subscale social support. Reduced logistic regression model showed that loneliness, satisfaction with support from family and friends and marital status was associated with risk of depression. Improvement of CSE and social relations seems to be important to resilience to depression among HIV-infected individuals. Lack of social support might be a barrier for HIV-infected achieving resilience to depression, despite ethnicity.
Abstract: Health-related quality of life is lower in people living with HIV compared to the general population, particularly because of higher levels of depression. Little is known about the differences between HIV-infected ethnic Danes and HIV-infected non-ethnic Danes at risk of depression. This study aimed to explore coping styles and social relations amo...
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