medigraphic.com
Instituto Nacional de Salud Pública

2015, Number S2

<< Back Next >>

salud publica mex 2015; 57 (S2)

Psychosocial factors associated with late HAART initiation in Mexican patients with HIV

Nogueda-Orozco MJ, Caro-Vega Y, Crabtree-Ramírez B, Vázquez-Pineda F, Sierra-Madero JG

Language: Spanish
References: 29
Page: 135-141
PDF size: 363.16 Kb.


ABSTRACT

Objective. To explore the association between psychosocial factors and late highly active antiretroviral therapy (HAART) initiation in a sample of Mexican patients with HIV. Materials and methods. We conducted a crosssectional study at the HIV Clinic of the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), and applied structured questionnaires to 150 patients who initiated HAART between January 2010 and August 2011. Late HAART initiation (LHI) was considered when patients started HAART with CD4 counts of ‹200+ cells/mm³. Results. By multivariate analysis, the strongest psychosocial risk factor for LHI observed was self-stigma towards HIV/ AIDS. In addition, being tested by medical prescription, not by own initiative, as well as having one or more previous medical contacts, were associated with greater risk for LH. Conclusions. Our findings suggest the need to develop psychosocial interventions to decrease negative self-image and stigmatizing attitudes and behaviors in risk groups for HIV in Mexico.


REFERENCES

  1. Larson BA, Brennan A, McNamara L, Long L, Rosen S, SanneI, et al. Lost opportunities to complete CD4 Lymphocyte testing among patients who tested positive for HIV in South Africa. Bull World Health Organ 2010;88:675-680.

  2. Emery S, Neuhaus JA, Phillips AN, Babiker A, Cohen CJ, Gatell J, et al. Strategies for Management of Antiretroviral Therapy Study Group (SMART). Major clinical outcomes in antiretroviral therapy (ART)-naive participants and those not receiving ART at baseline in the SMART study. J Infect D 2008;197:1133-1144.

  3. Mussini C, Manzardo C, Johnson M, Monforte A, Uberti-Foppa C, Antinori A, et al. Patients presenting with AIDS in the HAART era: a collaborative cohort analysis. J Acquir Immune Defic Syndr 2008;22(18):2461-2469. doi:10.1097/QAD.0b013e328314b5f1

  4. Sabin CA, Smith, CJ, Youle M, Lampe FC, Bell DR, Puradiredja D, et al. Deaths in the era of HAART: contribution of late presentation, treatment exposure, resistance and abnormal laboratory markers. AIDS 2006;20(1):67-71.

  5. Krentz HB, Gill MJ. The direct medical costs of late presentation (<350/ mm) of HIV infection over a 15-year period. AIDS Res Treat 2002;757135. doi:10.1155/2012/757135

  6. Fisher M. Late diagnosis of HIV infection: major consequences and missed opportunities. Curr Opin Infect Dis 2008;21:1-3.

  7. Crabtree-Ramírez B, Caro-Vega Y, Shepherd BE, Wehbe F, Cesar C, Cortés C, et al. Cross-sectional analysis of late initiation in Latin America and the Caribbean: late testers and late presenters. PLoS One 2011;6(5):e20272.

  8. Shorter MM, Ostermann J, Crump JA, Tribble AC, Itemba DK, Mgonja A, et al. Characteristics of HIV voluntary counseling and testing clients before and during care and treatment scale-up in Moshi, Tanzania. J Acquir Immune Defic Syndr 2009;52:648-654.

  9. Anderson M, Elam G, Gerver S, Solarin I, Fenton K, Easterbrook P. ‘‘It took a piece of me’’: initial responses to a positive HIV diagnosis by Caribbean people in the UK. AIDS Care 2010;22:1493-1498.

  10. Beer L, Fagan JL, Valverde E, Bertolli J. Health-related beliefs and decisions about accessing HIV medical care among HIV infected persons who are not receiving care. AIDS Patient Care STDs 2009;23:785-792.

  11. Chida Y, Vedhara K. Adverse psychosocial factors predict poorer prognosis in HIV disease: a meta-analytic review of prospective investigations. Brain Behav Immun 2009;23:434-445.

  12. Genberg BL, Hlavka Z, Konda KA, Maman S, Chariyalertsak S, Chingono A, et al. A comparison of HIV/AIDS-related stigma in four countries: negative attitudes and perceived acts of discrimination towards people living with HIV/AIDS. Soc Sci Med 2009;68:2279-2287.

  13. Mukolo A, Villegas R, Aliyu M, Wallston KA. Predictors of late presentation for HIV diagnosis: a literature review and suggested way forward. AIDS Behav 2013;13(1):5–30. doi: 10.1007/s10461-011-0097-6

  14. Nunnally JC, Bernstein IH. Psychometric Theory. Third edition. New York: McGrawHill, 1994.

  15. Nogueda-Orozco MJ, Pérez-Terán B, Barrientos-Casarrubias V, Robles- García R, Sierra-Madero J. Escala de Ansiedad y Depresión Hospitalaria (HADS): Validación en pacientes mexicanos con infección por VIH. Psicología Iberoamericana 2013;21(2):29-37.

  16. Mahajan AP, Sayles JN, Patel VA, Remien RH, Sawires SR, Ortiz DJ, et al. Stigma in the HIV/AIDS epidemic: a review of the literature and recommendations for the way forward. AIDS 2008;22(suppl 2):S67-S79.

  17. Kinsler JJ, Wong MD, Sayles JN, Davis C, Cunningham WE. The effect of perceived stigma from a healthcare provider on access to care among a low-income HIV positive population. AIDS Patient Care STDS 2007;21(8):584-592.

  18. Infante C, Zarco A, Cuadra SM, Morrison K, Caballero M, Bronfman M, Magis C. HIV/AIDS-related stigma and discrimination: the case of health care providers in Mexico. Salud Publica Mex 2006;48(2):141-150.

  19. Vanable P, Carey M, Blair D, Littlewood R. Impact of HIV related stigma on health behaviors and psychological adjustment among HIV-positive men and women. AIDS Behav 2006;10(5):473-482.

  20. Chesney M, Smith A. Critical delays in HIV testing and care. The potential role of stigma. Am Behav Scient 1999;42(7):1162-1174.

  21. Fortenberry JD, McFarlane M, Bleakley A, Bull S, Fishbein M, Grimely DM, et al. Relationships of stigma and shame to gonorrhea and HIV screening. Am J Public Health 2002;92(3):378-381.

  22. Lieber E, Li L, Wu Z, Rotheram-Borus MJ, Guan J, NIMH Collaborative HIV Prevention Trial Group. HIV/STD stigmatization fears as a health seeking barrier in China. AIDS Behav 2006;10(5):463-471.

  23. Carrizosa CM, Blumberg EJ, Hovell MF, Martinez-Donate AP, Garcia- Gonzaalez G, Lozada R, et al. Determinants and prevalence of late HIV testing in Tijuana, Mexico. AIDS Patient Care STDS 2010; 24(5):333-340.

  24. Vogel D, Wade N, Haake S. Measuring self-stigma associated with seeking psychosocial help. J Couns Psych 2006;53(3):325-337.

  25. Ickovicks, JR, Hamburger ME, Vlahov D, Schownbaum EE, Schuman P, Boland RJ, et al. Mortality, CD4 cell count decline, and depressive symptoms among HIVseropositive women. JAMA 2001; 285(11):1466-1474.

  26. Smith LR, Fisher JD, Cunningham CO, Amico KR. Understanding the Behavioral Determinants of Retention in HIV Care: A Qualitative Evaluation of a Situated Information, Motivation, Behavioral Skills Model of Care Initiation and Maintenance. AIDS Patient Care STDS 2012;26(6):344-55. doi: 10.1089/apc.2011.0388.

  27. Mayben, JK, Kramer JR, Kallen MA, Franzini L, Lairson DR, Giordano TP. Predictors of delayed HIV diagnosis in a recently diagnosed cohort. AIDS Patient Care STDS 2007;21:195-204.

  28. Wohl AR, Tejero J, Frye DM. Factors associated with late HIV testing for Latinos diagnosed with AIDS in Los Angeles. AIDS Care 2009;21:1203-1210.

  29. Moyer V. Screening for HIV: U.S. Preventive Services Task Force Recommendation Statement. Ann Inter Med 2013; April. doi:10.7326/0003- 4819-159-1-201307020-00645.




2020     |     www.medigraphic.com