As a chronic illness,
HIV/AIDS requires life-long treatment adherence and retention-and thus
sufficient attention to the psychosocial dimensions of chronic disease care in
order to produce favourable antiretroviral treatment (ART) outcomes in a
sustainable manner. Given the high prevalence of depression in chronic HIV
patients, there is a clear need for further research into the determinants of
depression in this population. In order to comprehensively study the predictors
of depressive symptoms in HIV patients on ART, the socio-ecological theory
postulates to not only incorporate the dominant individual-level and the more
recent community-level approaches, but also incorporate the intermediate, but
crucial family-level approach.
The present study aims to extend the current
literature by simultaneously investigating the impact of a wide range
individual-level, family-level and community-level determinants of depression
in a sample of 435 patients enrolled in the Free State Province of South Africa
public-sector ART program. Structural equation modeling is used to explore the
relationships between both latent and manifest variables at two time points.
Besides a number of individual-level correlates-namely education, internalized
and external stigma, and avoidant and seeking social support coping styles-of
depressive symptoms in HIV patients on ART, the study also revealed the
important role of family functioning in predicting depression. While family
attachment emerged as the only factor to continuously and negatively impact
depression at both time points, the second dimension of family functioning,
changeability, was the only factor to produce a negative cross-lagged effect on
depression.
The immediate and long-term impact of family functioning on
depression draws attention to the role of family dynamics in the mental health
of people living with HIV/AIDS. In addition to individual-level and
community-based factors, future research activities should also incorporate the
role of the family context in research into the mental health of HIV patients,
as our results demonstrate that the familial context in which a person with HIV
on ART resides is inextricably interconnected with his/her health outcomes.
Purchase full article at: http://goo.gl/pGBNF6
By: Wouters E1,2, Masquillier C3, le Roux Booysen F4,5.
- 1Department of Sociology and Centre for Longitudinal and Life Course Studies, University of Antwerp, Sint-Jacobstraat 2, 2000, Antwerp, Belgium. edwin.wouters@ua.ac.be.
- 2Centre for Health Systems Research and Development, University of the Free State, Bloemfontein, Republic of South Africa. edwin.wouters@ua.ac.be.
- 3Department of Sociology and Centre for Longitudinal and Life Course Studies, University of Antwerp, Sint-Jacobstraat 2, 2000, Antwerp, Belgium.
- 4Centre for Health Systems Research and Development, University of the Free State, Bloemfontein, Republic of South Africa.
- 5Department of Economics, University of the Free State, Bloemfontein, Republic of South Africa.
- AIDS Behav. 2016 Jan 18.
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