Xiaonan Yu

Risk and protective factors in association with mental health problems among people living with HIV who were former plasma/blood donors in rural China.

Abstract A random sample of 271 people living with HIV (PLWH) who were former plasma/blood donors and a convenience sample of 67 HIV negative villagers were anonymously interviewed. Compared with the non-PLWH, PLWH reported higher prevalence of symptoms of depression (adjusted OR = 2.53, p=0.001), anxiety (adjusted OR = 1.85, p=0.04), and stress (adjusted OR = 1.77, p=0.06). Of the PLWH respondents, 81.7% received Highly Active Antiretroviral Therapy (HAART); 32.1% of whom reported some side effects. Respectively 13.7%, 37.4%, and 38.4% PLWH perceived discrimination from their family members, relatives/friends, and neighbors. Absence of HAART, poor physical function, perceived discrimination from relatives and friends, and low level of resilience were associated with depression (stepwise regression; β = − 0.28–0.17, R-square = 0.22), anxiety and stress (R-square = 0.32 and 0.16, respectively). The majority of respondents (70.1%) desired group intervention as a means for providing psychological support services. Relevant programs should both remove risk factors (e.g., absence of medical treatment, HIV-related discrimination) and promote protective factors (e.g., resilience). Support group is one of the potentially useful approaches to provide psychological support services.

Changes in condom use behaviours among clients of female sex workers in China

Background: Clients of female sex workers (CFSWs) are at risk for HIV transmission; relevant surveillance and interventions for this vulnerable group are scarce. The China-UK HIV/AIDS Prevention and Care Project launched an enhanced intervention programme involving peer education, seminars, testing services and social gatherings and so forth, and two behavioural surveillance studies (BSS) targeting CFSWs in Suining, Sichuan. Methods: Two cross-sectional BSS (a baseline survey and an evaluative survey) were conducted in September 2005 and May 2006, respectively. In total, 356 and 372 respondents who patronised some low-end sex services were interviewed by peer interviewers. Another triangulation condom audit exercise was conducted in June 2006. Results: Prevalence of respondents using at least one prevention service increased from 50.3% in 2005 to 68.5% in 2006 (AOR = 2.2). Respondents of the evaluative survey compared with their counterparts of the baseline survey had lower prevalence of inconsistent condom users in the last 6 months (44.1% vs 77.0%; AOR = 0.2) and higher prevalence of condom use in the last episode of commercial sex (78.0% vs 41.5%; AOR = 4.9). The triangulation audit showed that condoms were used by 73.8% of CFSWs. The multivariate analysis shows that year of study (OR = 0.3), self-reported sexually transmitted disease symptoms (OR = 2.9), use of face-to-face counselling services (OR = 0.5) and so forth were significantly associated with inconsistent condom use during commercial sex in the last 6 months. Conclusions: Condom use and service use behaviours changed in the study population over a time period when an enhanced intervention programme was implemented. Such effective programmes may be applied to other locations in China.

A pilot theory-based intervention to improve resilience, psychosocial well-being, and quality of life among people living with HIV in rural China.

This pilot study aimed at fostering resilience among people living with HIV and improving the HIV-negative participants’ acceptance of people living with HIV. A group of 75 people living with HIV who were former blood/plasma donors and 36 HIV-negative fellow villagers in rural China participated in the intervention. The 8 sessions lasted for 4 months and were facilitated by trained local family-planning officers. Efficacy of the intervention was assessed using a pre- and postprogram study design; measurements were made at baseline, at completion, and 3 months afterward completion. The authors found that the HIV-positive participants increased their levels of resilience, social support, and quality of life and that they reported fewer symptoms of depression, anxiety, and stress at the completion of the intervention; most of these changes were sustained at the 3-month follow-up. Such participants also reported subjective improvements on problem-solving skills, self-confidence, and a feeling of being cared for by others. In addition, the HIV-negative participants’ discriminatory attitudes toward people living with HIV were reduced after completing the intervention. The majority of the participants was satisfied with the intervention and would recommend it to others. The train-the-trainer approach was used effectively. Positive effects of the intervention have been revealed and future randomized controlled studies are warranted.

The role of social support on resilience, posttraumatic growth, hopelessness, and depression among children of HIV-infected parents in mainland China

Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) has a profound impact not only on the infected individuals, but also on their families. Children of the HIV-infected parents are particularly affected. The present study examined the relationship between social support, resilience, posttraumatic growth (PTG), hopelessness, and depression among 195 children of HIV-infected parents in mainland China. Results showed that 35.4% of the sample scored above the cutoff of the Childrens Depression Inventory. Results from structural equation modeling reported that social support had a significant positive relationship with resilience and PTG. Higher levels of resilience and PTG were associated with lower level of hopelessness which in turn, was associated with lower level of depression. The overall model achieved satisfactory fit. Interventions are needed to improve social support of the children affected by HIV so as to improve their mental health.

Suicidal ideation among HIV+ former blood and/or plasma donors in rural China.

Abstract Suicidal ideation is life-threatening and is prevalent among people living with HIV (PLWH). A dearth of such studies was conducted in China. This study investigated the prevalence of suicidal ideation and associated factors among PLWH who were former blood and/or plasma donors (FBPD) in a rural county in central China. Prospective respondents were randomly selected from a local registry; 176 PLWH who were FBPD joined the study. With informed consent, these PLWH and their spouse were interviewed separately and anonymously. Respectively, 34 and 8% of the sampled (index) PLWH self-reported having suicidal ideation and making a suicidal attempt in the last year. The multivariate analyses results showed that the index PLWHs Physical Function subscale score of the Medical Outcomes Study HIV Health Survey scale (Odds ratio (OR)=6.67, 95% CI=1.69–26.27, ≤25 percentiles against >75 percentiles), the Depression subscale score of the Depression, Anxiety, and Stress Scales (DASS; OR=9.26, 95% CI=1.32–64.77), and the spouses Depression subscale score of the DASS (OR=7.64, 95% CI=1.37–42.77) were independently associated with the index PLWHs suicidal ideation. HIV-related variables (e.g., duration of diagnosis, treatment and side effects) and perceived discrimination of the index PLWH, and HIV status of the PLWHs spouse, were not significant factors. Depression is a risk factor for suicides. Moreover, depression may be contagious and the depression status of the spouse also matters. Treatments for depression and prevention intervention for suicides targeting PLWH in rural China are not readily available. Such services are greatly warranted and need to be provided to both the PLWH and his/her spouse.

Psychometric Properties of the Chinese Version of the Revised Posttraumatic Growth Inventory for Children (PTGI-C-R):

We investigated the psychometric properties of the modified 8-item Chinese version of the Revised Posttraumatic Growth Inventory for Children (PTGI-C-R) among 3256 adolescents in Chengdu, China, after the Sichuan Earthquake in 2008. The PTGI-C-R showed good reliability (Cronbach’s α = .86; composite reliability = 0.87). A single factor was extracted by exploratory factor analysis and confirmed by confirmatory factor analysis in 2 randomly split half subsamples. Multigroup analyses showed that the single-factor structure was stable across gender groups and age groups (age <15 years and ≥15 years). The PTGI-C-R was negatively correlated with depression (r = −0.21) and positively correlated with resilience, social support, and perceived importance of health, family, and friendship (r ranged from 0.34 to 0.40). Our findings support the idea that the PTGI-C-R is a reliable and valid measure of posttraumatic growth among Chinese adolescents having experienced a natural disaster. Validation of the scale in the context of other traumatic events is warranted.