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Serostatus Disclosure as a Predictor of Metal Health and Physical Health Among HIV-Seropositive Adults
Title
Serostatus Disclosure as a Predictor of Metal Health and Physical Health Among HIV-Seropositive Adults
Creator
Niel, Kristin
Date
2011-05-09, 2011-05
Description
As estimated 1,200,000 people in the United States were living with HIV in 2009 (UNAIDS, 2010). African Americans have an incidence rate seven...
Show moreAs estimated 1,200,000 people in the United States were living with HIV in 2009 (UNAIDS, 2010). African Americans have an incidence rate seven times that of Caucasians. Research has shown that HIV-positive people have high levels of psychological distress (Cook et al., 2006); depression is the most frequently diagnosed disorder (Treisman, Angelino, & Hutton, 2001). Distress negatively impacts physical health (Comer, Henker, Kemeny, & Wyatt, 2000; Cruess et al., 2005) and medication adherence (Cook, et al., 2006; Mellins et al., 2002) in HIV-positive patients. Although disclosure of HIV-seropositivity can lead to increased social support (Armistead, Morse, Forehand, Morse, & Clark, 1999), it may also lead to social rejection, prejudice and increased distress (Cederfjall, Langius-Eklof, Lidman, & Wredling, 2001; Kalichman, DiMarco, Austin, Luke, & DiFonzo, 2003). This study examined 110 HIV-positive patients at an urban medical clinic. Patients completed self-report measures as part of a larger study investigating posttraumatic growth in HIV/AIDS. It was hypothesized that (a) more participants would disclose to friends and partners than to family; (b) participants who disclosed to more people would endorse fewer symptoms of distress; and (c) participants who disclosed to fewer people would be less likely to adhere to medical regimens and routinely attend medical appointments, and have poorer health outcomes. Distress was measured by Psychiatric Symptom Index (PSI), Beck Depression Inventory (BDI), and the Impact of Event Scale (IES). Viral load and CD4 cell counts were found in medical charts, and the AIDS Clinical Trails Group Adherence Follow-up Questionnaire measured adherence. Analyses reveal that 67.3% of participants disclosed to family, 55.5% to at least one partner, and 45.5% to friends. A negative association existed between full disclosure and IES Avoidance scale (r = -.20, p< .05). There were positive associations between disclosure to family and the PSI Depression Scale (r = .22, p < .05), Cognitive Disturbance Scale (r = .21, p < .05), and PSI Total Score (r = .22, p < .05), implying that disclosure to more groups of people may be associated with increases in psychological distress ratings. Implications of these findings are discussed.
M.S. in Psychology, May 2011
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POSTTRAUMATIC GROWTH AMONG HIV-SEROPOSITIVE ADOLESCENTS AND YOUNG ADULTS
Title
POSTTRAUMATIC GROWTH AMONG HIV-SEROPOSITIVE ADOLESCENTS AND YOUNG ADULTS
Creator
Niel, Kristin A.
Date
2016, 2016-12
Description
An estimated 1,218,400 individuals in the United States were living with HIV/AIDS in 2014 (CDC, November 2015). In addition, 9,731 youth...
Show moreAn estimated 1,218,400 individuals in the United States were living with HIV/AIDS in 2014 (CDC, November 2015). In addition, 9,731 youth between the ages of 13 and 24 were newly diagnosed with HIV, with 81% of those diagnoses between ages 20 and 24. African-Americans accounted for 44% of new infections, with young gay and bisexual men accounting for 72% of new infections in all persons between 13 and 24. Research has suggested that a diagnosis of HIV/AIDS can be experienced as a trauma (Kelly et al., 1998; Nightingale, Sher, Mattson, Thilges, & Hansen, 2011). Posttraumatic growth (PTG) is characterized by significant, positive transformations that may occur in response to trauma and has been linked to improved mental and physical health among people living with cancer and adults living with HIV (Barskova & Oesterreich, 2009); however, these relations have not been sufficiently explored among youth living with HIV/AIDS. This study examined 71 HIV-seropositive youth at an urban medical clinic. It was hypothesized that (1) some youth would experience their HIV diagnosis as traumatic; (2) some youth would experience PTG; (3) higher levels of PTG would be associated with better health-related quality of life; (4) PTG would be positively associated with medical regimen adherence, and this relation would be mediated by serostatus disclosure; (5) PTG would be positively associated with physiological health, and this relation would be mediated by serostatus disclosure; and (6) the relation between serostatus disclosure and PTG would be moderated by social support satisfaction. Analyses revealed that 73.2% of participants experienced their diagnosis as traumatic, and 71.8% reported some level of PTG. A positive relation existed between PTG and the Social Relationships Domain of quality of life (β= .32, p < .01). Serostatus disclosure did not act as a mediator for the relations between PTG and adherence or health; however, there was a negative relation between disclosure and appointment attendance (β = -.46, p < .05). Finally, social support satisfaction moderated the relation between disclosure and PTG, such that the relation was stronger in those with average or high support satisfaction than those with lower satisfaction. Clinical and future research implications of these findings are discussed.
Ph.D. in Psychology, December 2016
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