Conclusions regarding HIV stigma in rural areas are hampered by lack of agreement about rural classification. This investigation examined perceptions of HIV stigma among males and females with HIV/AIDS in metropolitan, micropolitan, and rural areas. Two-hundred people with HIV/AIDS completed a measure of perceived HIV stigma. Their county or town of residence was used to classify community size. Results indicated that community size was related to one aspect of perceived stigma, disclosure concerns, differently for men and women. Rural women reported more disclosure concerns than did metropolitan and micropolitan women. They also reported more disclosure concerns than rural men. Men in micropolitan communities reported more disclosure concerns than men in rural areas and tended to report more disclosure concerns than men in metropolitan areas. Understanding the relationship of community size to HIV stigmatization requires acknowledging that many communities are neither urban nor rural, and it requires considering gender differences.
1 August 2020 in Psychological Trauma: Theory, Research, Practice, and Policy
The unprecedented COVID-19 pandemic has put a great strain on the physical and mental health of health care workers across the globe. This commentary provides an overview of mental health initiatives implemented at an academic medical center to support health care workers during this challenging time and highlights lessons learned. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
Rates of both traumatic event exposure and posttraumatic stress disorder (PTSD; 22%-54%) are disproportionately elevated among people living with HIV/AIDS (PLHA). Trauma and related psychopathology significantly affect quality of life and disease management in this patient population. The current study examined associations between internalized HIV stigma, mindfulness skills, and the severity of PTSD symptoms in trauma-exposed PLHA. Participants included 137 PLHA (14.6% female; M age = 48.94, SD = 8.89) who reported experiencing on average, five ( SD = 2.67) traumatic events; 34% met diagnostic criteria for PTSD. Results indicate that after controlling for sex, age, education, and number of traumatic events, internalized HIV stigma was positively related to overall PTSD symptom severity (β = .16, p < .05) and severity of re-experiencing (β = .19, p < .05) and hyper-arousal (β = .16, p = .05), but not avoidance, PTSD symptom clusters. Among the mindfulness facets measured, acting with awareness was uniquely negatively related to the overall severity of PTSD symptoms (β = − .25, p < .01) and the severity of re-experiencing (β = − .25, p < .05), avoidance (β = − .25, p < .05), and hyper-arousal (β = − .29, p < .01) PTSD symptom clusters. These effects were observed after accounting for covariates and shared variance with other mindfulness facets. Theoretically, the present findings suggest that internalized HIV stigma may serve as a vulnerability factor for the severity of certain PTSD symptoms, whereas acting with awareness may function as a protective or resiliency factor for the severity of PTSD symptoms. Implications for the treatment of trauma-exposed PLHA are discussed.
This investigation explored facets of anxiety sensitivity (AS—social, physical and mental concerns) in regard to somatization, anxiety and depression symptoms among people with HIV/AIDS. Significant relations were found for AS-physical concerns and somatization symptoms ( β = .52, p = .007) and AS-mental concerns and anxiety symptoms ( β = .29, p < .05), controlling for negative affectivity, gender and shared variance with other AS subscales. Together, AS subscales were significantly related to depression symptoms (Δ R2 = .11; p = .006), but no one subscale was independently related. Findings are discussed in terms of examining AS in better understanding the HIV/AIDS—anxiety relation.
This article describes the development of a manualized, eight-session multiple health behavior change program which addresses sleep, exercise, nutrition, substance use, and working with one’s healthcare team. Our goal was to design a structured, evidence-based program that could be facilitated by a single health professional and could act as an active, credible control for mind–body intervention studies. Psychoeducational content was adapted from the latest government and peer-reviewed guidelines. Preliminary work suggests the program is acceptable and feasible for use in patients of varying ages with heterogeneous mental and physical health problems. It is adaptable for both face-to-face and online delivery.