A sample of 100 African-American women living with HIV in Chicago and Birmingham in the period 2013-2015 was recruited for participation in a stigma-reduction intervention. The primary goal of the study was to investigate the relationship between HIV-related stigma and viral suppression. A secondary goal was to determine if depression and nonadherence might play an intermediary role between stigma and viral suppression.
An important issue is how depression and substance use interact with the control of the HIV treatment continuum. A group of 14,380 persons with HIV were studied to determine how depressive symptoms along with alcohol and other substance use affect the continuum of care in these patients. Standard statistical procedures were used in the analysis. In those with no or mild depressive symptoms, heavy alcohol had no association with viral suppression; but, among those with moderate or severe symptoms heavy alcohol use did have a negative effect on viral load.
It is not known how sleep disturbance might contribute to risk of depression in adults with HIV. The investigators addressed this question by using data from the Multicenter AIDS Cohort Study (MACS), which is a longitudinal study following men who have sex with men (MSM), some with HIV and others without HIV. Information on self reported sleep problems for greater than two weeks and increased depression symptoms using the CES-D screening tool provided baseline and data every 6 months over 12 years of follow-up.
Depression is found frequently with HIV/AIDS, but the reasons for this association are unclear. An important question is the possible effect of immunological factors on depression. In 201 persons with HIV/AIDS being seen in clinics in Uganda a study was mounted to address this issue. Information on depression was collected, and the diagnosis of major depressive disorder (MDD) was based on DSM-IV criteria. The frequency of MDD was 30.8% in this population.
For the 6th consecutive year there has been an almost 35% increase in the number of journal articles that address HIV and Aging issues. Many in the current Annotated Bibliography for 2018 reflect the observation that the older adult with HIV is at markedly increased risk for multimorbidity. Increasingly HIV treating physicians are spending most of their time managing non-HIV conditions.
Many research reports identify cognitive impairment in adults with HIV. Tracing this impairment to HIV infection itself has been elusive. This paper investigates whether physical activity and associated cardiovascular risk may underlie these reported increased rates of cognitive impairment. The study used 988 participants (20% women) with well-controlled HIV infection at entry into the AIDS Clinical Trials Group (ACTG) Protocol A5322 (HAILO). The cardiometabolic risk profiles between women and men with HIV were assessed.
Using a sample of 122 PLWH (People Living With HIV) and 95 HIV negatives, ages 35-65, the study created a composite score that assessed trauma, economic hardship (food insecurity and low socioeconomic status), and a stress composite variable (TES). Study participants also completed a comprehensive neuropsychological battery and an assessment of activities of daily living (ADLs). The PLWH group had more traumatic events, more food insecurity, lower socioeconomic status, and higher perceived stress when compared to the uninfected group (p<0.0001).
During the period of 2004 to 2015 54,102 new HIV diagnoses in older adults (50 years and older) were tabulated from 31 European countries. A larger younger group (15-59 years) was collected for comparison. Also, information on age, sex, transmission route and CD4 count was obtained. During the 12-year study period for the entire group the average rate of new HIV diagnoses increased 2.6 per 100,000 in the population. The diagnoses increased significantly among older men, 2.2%, women, 1.3%, men who have sex with men, 5.8%, and injection drug users, 7.4%.
Cytokines are important players in the homeostasis of the immune system in those infected with HIV. A study of 50 newly-infected HIV patients and 50 controls was completed with a 12-month follow-up. Before the start of therapy pro-inflammatory cytokines: Tumor necrosis factor-alpha (TNF-a), Interleukin-6 (IL-6), and anti-inflammatory cytokines: Interleukins 4 and 10 (IL-4 and IL-10) as well as Transforming growth factor beta (TGF-b) were elevated.
Because older persons living with HIV are experiencing both age-associated and HIV-related problems, new care models to address this combined burden are necessary. Investigators in San Francisco sought out more first-hand information on needs from patients older than 50 years and their providers at an HIV clinic. They used surveys with 77 patients and 26 providers as well as separate focus groups with 31 older patients and 20 staff members. Transcripts were used to identify frequent themes.
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