Guoping Ji

A multilevel intervention for HIV-affected families in China: Together for Empowerment Activities (TEA).

This article analyzes the efficacy of the Together for Empowerment Activities (TEA) intervention in decreasing depressive symptoms and improving social support for persons living with HIV (PLH) and their family members. A total of 79 families, consisting of 88 PLH and 79 family members, were recruited from Anhui province, China, and randomized to the TEA intervention (n = 38) or a control condition (n = 41). The intervention was delivered at three levels: 1) TEA Gathering (small group for PLH and family members); 2) TEA Time (home-based family activities with children that accompany each TEA Gathering); and 3) TEA Garden (community events that build social integration). Face-to-face interviews were administered at baseline, 3, and 6 months. Mixed-effects regression models and kernel density estimation were used for data analysis. PLH and their family members in the intervention reported significant improvements in depressive symptoms, social support, and family functioning at the 3-month and 6-month follow-up assessments compared to those in the control condition. Heterogeneous intervention effects on social support and family functioning were indicated at the 6-month follow-up. The intervention could have various effect patterns for different subgroups within the intervention condition. This study provides preliminary data to support the feasibility and efficacy of a multilevel intervention.

Facing HIV as a family: predicting depressive symptoms with correlated responses.

This study makes an effort to go beyond traditional analytical models to explore the complex and interactive nature of family processes. A total of 79 families affected by HIV in China participated in the study (79 persons living with HIV [PLH] and 79 seronegative family members), with in-person interviews conducted in 2009. A higher level of depressive symptoms was reported by PLH participants than their family members. Negative associations between depressive symptoms and social support and family relations were observed for both PLH and their family members. Results from actor-partner interdependence models indicate that the depressive symptoms of PLH and their family members were positively correlated when either the family relations measure or the social support measure was included in the model. Results highlight the link between family experience and individual well-being, with implications for designing and implementing interventions for families impacted by HIV.

HIV disclosure in rural China: predictors and relationship to access to care.

This study examined the main reasons and predictors of HIV disclosure and its relationship to access to care among people living with HIV (PLH) in a rural area of China. A sample of 88 PLH from three counties was interviewed in 2009. In our sample, the rates of disclosure were higher within and outside family. Trust (31%), needing help (28%), and close relationships (26%) were the three main reasons of selecting the person to disclose by a PLH. Using a multivariate analysis, level of HIV disclosure to partners and members within the community was only significantly associated with use of antiretroviral treatment (ART) (β = 2.76; 95% Confidence Interval (CI): 0.77, 4.74). After adjusting for demographics, time since HIV diagnosis and ART, we found HIV disclosure (β = 0.07; 95% CI: 0.01, 0.13) was a significant predictor for access to care. In order to improve PLHs’ access to health services and care, future intervention programs should consider both the potential benefits and risks associated with HIV disclosure (intentional and unintentional), and assist PLHs to prepare for HIV disclosure and reduce potential negative impacts that come with it.

Child behaviour and parenting in HIV/AIDS-affected families in China

Human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) among families in China poses many challenges for caregivers and their children. A total of 154 caregivers of HIV/AIDS-affected children were interviewed to examine child behaviour in HIV/AIDS-affected families. Parenting skills were found to be correlated with child delinquency, and this correlation was influenced by the number of children in the family and the childs age. Illiterate caregivers were more likely to have delinquent children, and parenting skills had less of an association with child delinquency among illiterate caregivers. Study findings underscore the necessity of emphasizing good parenting skills in interventions with caregivers of HIV/AIDS-affected children in China in order to improve child behaviour and overall family well-being.

Perceived burden in adherence of antiretroviral treatment in rural China.

Abstract To determine the level of antiretroviral treatment adherence and explore the correlated factors of perceived burden of taking antiretroviral medications among people living with HIV (PLH) in a rural area of China. Data were collected from 66 PLH who were currently receiving antiretroviral treatment. Face-to-face interviews were conducted during August to October, 2009. Approximately 18.2% of participants failed to adhere to antiretroviral treatment in the previous 30 days. A majority of PLH reported that taking antiretroviral medications posed a burden to them. Those who perceived a higher level of burden were more likely to be women, to have lower annual income, and to report a high level of depressive symptoms, poor physical health, and strained family interactions. Findings suggest that future programs in promoting adherence to antiretroviral treatment should address issues related to psychosocial well-being and PLHs interactions with their family members.

Emotional social support and access to care among older people living with HIV in rural China.

Globally, the number of older people living with HIV (PLH) is growing. Additionally, older PLH are facing particular challenges related to accessing health care. The objective of this study is to investigate the older PLHs access to care and its relationship to emotional and tangible social support.

Parents living with HIV and children's stress and delinquent behaviors in China

Objective: The current study aims to explore the association of parents living with HIV (PLHs) and their childrens self-esteem, everyday stress, and delinquent behaviors. Design: The study samples included 79 families with 79 PLHs and 79 children. Methods: Multiple regression analysis was used on baseline data collected in 2009 from a pilot study in Anhui Province, China. Results: The results indicated that children from a family with both parents infected with HIV or children from families having multiple children were more likely to report a higher level of everyday stress. Male PLHs have significant influence on their childrens everyday stress compared with female PLHs. Children reporting a lower level of parental care and lower self-esteem were significantly more likely to report a higher level of delinquent behaviors. In addition, we have found a strong positive correlation between families with multiple children and their childrens delinquent behaviors. Conclusions: The findings indicate that the severity of psychological and behavioral problems of children living in different HIV-affected families may be dependent not only on factors related to the children but also on factors related to their parents and families. Therefore, parental and family level factors should be considered when providing care and support to children living in HIV-affected families.

Antiretroviral Therapy Initiation Following Policy Changes: Observations From China.

China’s HIV/AIDS treatment policies have been evolving over the preceding decade. This study describes patterns of antiretroviral therapy (ART) initiation for a sample of people living with HIV/AIDS (PLHIV) in rural Anhui, China, where most PLHIV were infected via paid plasma donation during the 1990s. A total of 481 PLHIV who were receiving ART were included in our analyses. Times between HIV diagnosis and the initiation of ART were examined relative to the time points when major ART-related policies changed in China. More than half (53%) of PLHIV who had been diagnosed by 2003 received ART within 6 months, whereas 93% of PLHIV who had been diagnosed in 2010 or later received ART within 6 months. The study results provide additional support that the “Four Frees and One Care” policy in 2003 and the relaxation of ART eligibility in 2010 have facilitated the initiation of treatment for PLHIV in China.Background Drug abuse is one of the important variables influencing protective sexual behavior. The objective of this study was to explore how risky sexual behaviors develop in drug abusing women using human ecological theory. Methods In this study, we used a descriptive exploratory approach. The participants were 32 drug abusing women from two of the selected drop-in centers (DICs) in south Tehran, Iran, where we could have access to a vast number of female drug users. Data was collected using semi-structured face-to-face interviews. Qualitative content analysis was used to analyze the data using Graneheim and Lundman procedure. Findings Risky sexual behavior in drug use disorders in women was found in four themes with thirteen emerged; sexual untaught at micro-system with two subthemes “unsafe home” and “drop out of school”, Perception of differences at meso-system with three subthemes “lack of link between family and school”, “doing manly behavior” and “low awareness of health puberty than peers”, inappropriate marriages at exo-system with three subthemes “stigma”, “fear of losing love relationship” and “self-devotion”, marginalization at macro-system with four subthemes “barrier access to rights”, “selling sex as a tool of security”, “lack of belief as a sex worker” and “mistrust and doubt partner” using implication of human ecological theory. Conclusion Findings suggest that strategies supporting the discovery of risky sexual behaviors in drug use disorders in women are important in order to provide counseling and education to form their decisions toward safety sex.

Exploring Coping and Social Support with Gender and Education Among People Living with HIV in China.

Social support promotes positive coping strategies among people living with HIV (PLH); however, little is known about the various aspects of social support and their distinct effects on coping. The present study investigates the specific links between coping and perceived social support with respect to gender and education among PLH. A total of 522 PLH in Anhui, China, participated in an assessment that collected data on demographics, perceived tangible and emotional support, and cognitive and behavioral coping. The assessment was conducted using the computer-assisted personal interviewing method. The data were analyzed using linear mixed models. Emotional support was significantly associated with both cognitive and behavioral coping. Tangible support was significantly associated with behavioral coping but not with emotional coping. Women reported significantly lower levels of emotional support, cognitive coping, and behavioral coping than men did. Significant associations between tangible support and coping were found only among illiterate males. Women living with HIV are in greater need of social support and coping strategies. Future interventions should be gender specific, with targeted support for women with lower education levels to enhance their coping strategies.ResumenEl apoyo social promueve estrategias positivas de afrontamiento entre las personas viviendo con el VIH (PVV). Sin embargo, poco es sabido sobre los aspectos variados del apoyo social y sus efectos distintos del afrontamiento. Este estudio investiga las enlaces específicas entre el afrontamiento y el apoyo social percibido con el respeto al genero y la educación entre PVV. Un total de 522 PVV de Anhui, China participaron en la evaluación la cual colectaba data demográfico, data del apoyo emocional y perceptivo, y data del afrontamiento cognitivo y conductual. La evaluación fue analizado usando modelos mixtos y lineales. El apoyo emocional era asociado significativamente con el afrontamiento conductual pero no con el afrontamiento cognitivo. El apoyo tangible era asociado significativamente con el afrontamiento conductual per no con el afrontamiento emocional. Las mujeres reportaron niveles del apoyo emocional, del afrontamiento cognitivo, y del afrontamiento conductual significadamente bajos que los hombres. Encontraron las asociaciones significados entre el apoyo tangible y el apoyo cognitivo entre los hombres analfabetos. Las mujeres viviendo con VIH necesitan mas apoyo social con estrategias del afrontamiento. Las intervenciones futuros deben ser diseñados según el genero, con el apoyo dirigido para las mujeres con bajos niveles de educación para que mejoren sus estrategias del afrontamiento.

Children's body mass index and nutrition intake in HIV/AIDS.

Abstract HIV/AIDS in China poses many challenges for caregivers and their children. A total of 154 caregivers of HIV/AIDS-affected families were interviewed to examine the childrens nutrition intake and body mass index (BMI) in the context of HIV/AIDS in the family. The results showed that 25% of children in HIV/AIDS-affected families were underweight or at risk of being underweight according to US criteria. More than half the children reported that their consumption of protein such as meat, eggs or milk ranged from not at all to two times during the past month. About 40% of the children sometimes or often went hungry due to insufficient food. The study findings underscore the need to improve the nutrition and general health of children of people living with HIV/AIDS.