Factors Associated with Depressive Symptoms of HIV Positive Individuals Obtaining Anal Cancer Screening at Ponce De Leon Center, Atlanta, Georgia Pubblico

Abstract

 

Introductions: Depression is the most common comorbid illness associated with HIV. The prevalence of depression among HIV positive individuals is four times greater than among the general US population. Depression is associated with a decrease in working productivity, greater social isolation, a decline physical activity, risky sexual behavior and suboptimal adherence to Antiretroviral Treatment (ART).

Purpose:The purpose of this study was to determine the prevalence of depressive symptoms and examine which factors were associated with depressive symptoms among HIV positive individuals.

Methods:A total of one hundred patients were included in this project. Depressive symptoms were measured with the CES-D scale, perceived social support was captured with the MOS-SSS questionnaire and internalized AIDS-related stigma were quantified with internalized AIDS-related stigma scale (IA-RSS). Chi-square and t-test was used for groups comparison. Bivariate and multivariate analyses were employed to predict depressive symptoms.

Results:The prevalence of depressive symptoms was 38% in our study sample. Depressive symptoms were positively associated with internalized AIDS related stigma (R=0.335, P-value=0.0007), and current cigarette smoking status (R=0.245, P-value=0.015). Depressive symptoms and overall perceived social support were negatively associated with each other (R=0.379, P-value=0.0001). The subscale of perceived social support i.e.; emotional and informational support (R=0.391, p-value <0.0001), affectionate support (R=0.363, P-value=0.0002), Tangible support (R=0.271, P-value=0.0063), and positive social support (R=0.354, P-value=0.0003) was also negatively correlated with depressive symptoms. The odds of developing depressive symptoms increases 1.36 times for each self-reported internalized AIDS-related stigma (OR=, 95% CI (1.09, 1.71), p-value=0.007) and 3.1 time for current smokers (OR=3.1, 95% CI (1.17, 8.24), p-value=0.023). 

Recommendation:Screening of HIV positive patients for internalized AIDS-related stigma and tobacco consumption is recommended. Individuals with self-reported internalized AIDS-related stigma or smokers need further screening for depressive symptoms with short-form screening tools. Those showing depressive symptoms should be referred to mental health service providers. 

Key words: HIV positive, depressive symptoms, MOS-SSS, CESD, and IA-RSS

Table of Contents

 

Chapter I: INTRODUCTION     1

1.1 Introduction          1

1.2 Problem Statement          1

1.3 Purpose Statement          2

1.4 Significance          3

1.5 Definition of Terms and abbreviation      3

Chapter II: LITERATURE REVIEW        5

2.1. Introduction – What does the Global and Local HIV Data Tell Us?        5

2.2. Depression and in HIV positive individuals         6

2.3 Possible mechanism of depression in HIV positive Individuals    8

I. Biological factors     8

II.Psycho-social Model            8

2.4  The Relationship between depression and HIV  10

2.5 How depression affect HIV positive individuals?11

2.5.1 Depression and risky sexual behavior   11

2.5.2  Depression and Antiretroviral Treatment(ART)           12

2.5.3 Treatment of depression in HIV positive individuals    13

2.6 Depression Measurement instrument     14

2.7 Literature gap and why this study            15

Chapter III:METHODS16

2.1 Introduction          16

2.2 Population and Sample    16

2.3 Procedure  17

2.4 Research Design and Instrument17

2.4.1 Independent Variables  17

2.4.2 Dependent variable       18

2.5 Statistical Analysis19

2.6 Ethical consideration        19

2.7 Limitation19

Chapter IV: RESULT    20

Study participants       20

Table 2. Correlation between Depressive symptoms with different key variables in HIV positive individuals obtaining anal cancer screening at Ponce De Leon Center Atlanta, GA.   23

Depressive symptoms.           23

Bivariate Analysis       24

Multivariate Analysis  25

Table 3. The odds of developing Depressive symptoms for each risk factors for HIV positive individuals obtaining anal cancer screening at Ponce De Leon Center Atlanta, GA.  26

Figure 1. The relationship between depressive symptoms (CESD score) and Internalized AIDS-related stigma among HIV positive individuals obtaining anal cancer screening at Ponce De Leon Center Atlanta, GA.       27

Figure 2. Scatter plot describing the relationship between depressive symptoms (CESD score) and perceived social support (MOS-SSS) among HIV positive individuals obtaining anal cancer screening at Ponce De Leon Center Atlanta, GA.           28

Figure 3. Scatterplots with regression line between depressive symptoms (CESD score) and Affectionate social support among HIV positive individuals obtaining anal cancer screening at Ponce De Leon Center Atlanta, GA.29

Figure 4. Scatterplots with regression line between depressive symptoms and tangible social support among HIV positive individuals obtaining anal cancer screening at Ponce De Leon Center Atlanta, GA.           30

Figure 5. Scatterplots with regression line between depressive symptoms and Emotional and informational social support among HIV positive individuals obtaining anal cancer screening at Ponce De Leon Center Atlanta, GA.31

Figure 5. Scatterplots with regression line between depressive symptoms and positive social interaction social support among HIV positive individuals obtaining anal cancer screening at Ponce De Leon Center Atlanta, GA.32

Figure 6. Scatterplots with regression line between depressive symptoms (CESD score) and smoking status among HIV positive individuals obtaining anal cancer screening at Ponce De Leon Center Atlanta, GA.       33

Table 4. Multivariate analysis of key factors with depressive symptoms after including all statistically significant variables in the model.          33

Figure 6.  Predicted probability of presence of depressive symptoms (CESD score >16) by Internalized AIDS related stigma and smoking status among HIV positive individuals obtaining anal cancer screening at Ponce De Leon Center Atlanta, GA.    34

Chapter V: DISCUSSION          35

Conclusion       38

Limitation of the study           39

Recommendation       40

Reference       41

APPENDICES    45

CES-D  45

MOS-SSS (perceived social support) questionnaire   46

 

About this Master's Thesis

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• Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.

School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Parola chiave	HIV positive, depressive symptoms, MOS-SSS, CESD, and IA-RSS
Committee Chair / Thesis Advisor	Marconi,Vincent , Emory University
Partnering Agencies	Emory University schools, faculty or affiliated programs

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