Top

Gepubliceerd in:

21-04-2024

Depression mediates the relationship between exposure to stigma and medication adherence among people living with HIV in low-resource setting: a structural equation modeling approach

Auteurs: Sahabi Kabir Sulaiman, Muhammad Sale Musa, Fatimah Isma’il Tsiga-Ahmed, Saidu Idris Ahmad, Salisu Abubakar Haruna, Abdullahi Abdurrahman Zubair, Bello Tijjani Makama, Aminu Hussein, Abdulwahab Kabir Sulaiman, Farouq Muhammad Dayyab, Abdulaziz Tijjani Bako

Gepubliceerd in: Journal of Behavioral Medicine | Uitgave 4/2024

Abstract

This study hypothesizes that depression mediates the association between exposure to stigma and medication non-adherence in people living with HIV (PLHIV). We recruited 372 PLHIV from the Stigma, health-related Quality of life, antiretroviral Adherence, and Depression among people living with HIV (SQuAD-HIV) project, a multicenter cross-sectional study conducted between October 2021 and February 2022 among PLHIV attending six ART clinics in two geopolitical regions of northern Nigeria. A structural equation modeling (SEM) framework, utilizing the full information maximum likelihood estimator, was used to elucidate the pathways linking stigma, depression, and ART medication adherence, adjusting for sociodemographic characteristics. The total number of eligible participants analyzed (353) included 32.7% male PLHIV with a mean age (SD) of 39.42 (10.14). Being female was positively associated with adherence (β, 95% CI 0.335, 0.163–0.523, p-value < 0.001) but negatively associated with stigma (β, 95% CI − 0.334, − 0.561 to − 0.142, p-value = 0.001), while urban residence was negatively associated with stigma (β, 95% CI − 0.564, − 0.804 to − 0.340, p-value < 0.001). Our analysis also indicated that a higher level of experienced stigma was associated with decreased medication adherence. This association was partially mediated by depression (indirect effect = (0.256) (− 0.541) = − 0.139; p-value < 0.01). The proportion of the association between stigma and medication adherence explained through mediation by depression was 35.6%. These findings underscore the need for targeted interventions aimed at lowering exposure to stigma among PLHIV to improve medication adherence.

vorige artikel Impact of mindfulness versus supportive sex education on stress in women with sexual interest/arousal disorder

volgende artikel COVID-19 and changes in young adults’ weight concerns

Alleen toegankelijk voor geautoriseerde gebruikers

Altice, F., Evuarherhe, O., Shina, S., Carter, G., & Beaubrun, A. C. (2019). Adherence to HIV treatment regimens: Systematic literature review and meta-analysis. Patient Preference and Adherence, 13, 475–490.PubMedPubMedCentral

Arbuckle, J. L. (1996). Full information estimation in the presence of incomplete data. In: Advanced structural equation modeling. Psychology Press.

Arifin, W. N., & Yusoff, M. S. B. (2016). Confirmatory factor analysis of the Universiti Sains Malaysia emotional quotient inventory among medical students in Malaysia. SAGE Open, 6, 2158244016650240.

Association (WMA) WM. (2009). Declaration of Helsinki. Ethical principles for medical research involving human subjects. Jahrb Für Wiss Ethik, 14, 233–238.

Banerjee, A. V., Duflo, E., Glennerster, R., & Kothari, D. (2010). Improving immunisation coverage in rural India: Clustered randomised controlled evaluation of immunisation campaigns with and without incentives. BMJ, 340, c2220.PubMedPubMedCentral

Bollen, K. A. (1989). Structural equations with latent variables. Wiley.

Cheung, G. W. & Wang, C. (2017). Current approaches for assessing convergent and discriminant validity with SEM: Issues and solutions. In Academy of management proceedings. https://doi.org/10.5465/AMBPP.2017.12706abstract

Chuah, F. L. H., Haldane, V. E., Cervero-Liceras, F., Ong, S. E., Sigfrid, L. A., Murphy, G., Watt, N., Balabanova, D., Hogarth, S., Maimaris, W., & Otero, L. (2017). Interventions and approaches to integrating HIV and mental health services: A systematic review. Health Policy and Planning, 32, 27–47.

dos Santos, M. M., Kruger, P., Mellors, S. E., Wolvaardt, G., & van der Ryst, E. (2014). An exploratory survey measuring stigma and discrimination experienced by people living with HIV/AIDS in South Africa: The people living with HIV stigma index. BMC Public Health, 14, 80.PubMedPubMedCentral

Enders, C. K. (2001). The impact of non-normality on full information maximum-likelihood estimation for structural equation models with missing data. Psychological Methods, 6, 352–370.PubMed

Fornell, C., & Larcker, D. F. (1981). Evaluating structural equation models with unobservable variables and measurement error. Journal of Marketing Research, 18, 39–50.

Furlanetto, L. M., Mendlowicz, M. V., & Romildo, B. J. (2005). The validity of the Beck Depression Inventory-Short Form as a screening and diagnostic instrument for moderate and severe depression in medical inpatients. Journal of Affective Disorders, 86, 87–91.PubMed

Goffman, E. (2009). Stigma: Notes on the management of spoiled identity. Simon and Schuster.

Gonzalez, J. S., Batchelder, A. W., Psaros, C., & Safren, S. A. (2011). Depression and HIV/AIDS treatment nonadherence: A review and meta-analysis. Journal of Acquired Immune Deficiency Syndromes, 58, 181–187. https://doi.org/10.1097/QAI.0b013e31822d490aCrossRefPubMed

HIV/AIDS Fact Sheet_WHO. (2021). Available from: https://www.who.int/news-room/fact-sheets/detail/hiv-aids

Hair, J. F., Black, W. C., Babin, B. J., Anderson, R. E., & Tatham, R. L. (2006). Multivariate data analysis Vol. 6.

Haldane, V., Jung, A. S., Foo, C. D., Shrestha, P., Urdaneta, E., Turk, E., Gaviria, J. I., Boadas, J., Buse, K., Miranda, J. J., & Strathdee, S. A. (2022). Integrating HIV and substance misuse services: A person-centred approach grounded in human rights. The Lancet Psychiatry, 9, 676–688.PubMed

Hu, L., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary Journal., 6, 1–55.

Iacob, S. A., Iacob, D. G., & Jugulete, G. (2017). Improving the adherence to antiretroviral therapy, a difficult but essential task for a successful HIV treatment—clinical points of view and practical considerations. Frontiers in Pharmacology, 8, 299234.

Jackson, D. L., Gillaspy, J. A., Jr., & Purc-Stephenson, R. (2009). Reporting practices in confirmatory factor analysis: An overview and some recommendations. Psychological Methods, 14, 6–23.PubMed

Joreskog, K. & Sorbom, D. (1993). Structural equation modelling: Guidelines for determining model fit. NY University Press of America

KabirSulaiman, S., Sale Musa, M., Isma’ilTsiga Ahmed, F., Muhammad Dayyab, F., KabirSulaiman, A., Dabo, B., Ahmad, S. I., Haruna, S. A., Zubair, A. A., Hussein, A., & Usman, S. (2023). COVID-19 vaccine hesitancy among people living with HIV in a low-resource setting: A multi-center study of prevalence, correlates and reasons. Vaccine, 41, 2476–84.

Katz, I. T., Ryu, A. E., Onuegbu, A. G., Psaros, C., Weiser, S. D., Bangsberg, D. R., & Tsai, A. C. (2013). Impact of HIV-related stigma on treatment adherence: systematic review and meta-synthesis. Journal of the International AIDS Society, 16, 18640.PubMedPubMedCentral

Lam, L. W. (2012). Impact of competitiveness on salespeople’s commitment and performance. Journal of Business Research., 65, 1328–1334.

Langebeek, N., Gisolf, E. H., Reiss, P., Vervoort, S. C., Hafsteinsdóttir, T. B., Richter, C., Sprangers, M. A., & Nieuwkerk, P. T. (2014). Predictors and correlates of adherence to combination antiretroviral therapy (ART) for chronic HIV infection: A meta-analysis. BMC Medicine, 12, 142.PubMedPubMedCentral

LM, C. (2001). A comparison of inclusive and restrictive strategies in modern missing data procedures. Psychological Methods, 6, 330–351.

Lowther, K., Selman, L., Harding, R., & Higginson, I. J. (2014). Experience of persistent psychological symptoms and perceived stigma among people with HIV on antiretroviral therapy (ART): A systematic review. International Journal of Nursing Studies, 51, 1171–1189.PubMed

MacCallum, R. C., Roznowski, M., & Necowitz, L. B. (1992). Model modifications in covariance structure analysis: The problem of capitalization on chance. Psychological Bulletin, 111, 490–504.PubMed

MacKinnon, D. P., Fairchild, A. J., & Fritz, M. S. (2007). Mediation Analysis. Annual Review of Psychology, 58, 593–614.PubMedPubMedCentral

MacLean, J. R., & Wetherall, K. (2021). The association between HIV-stigma and depressive symptoms among people living with HIV/AIDS: A systematic review of studies conducted in South Africa. Journal of Affective Disorders, 287, 125–137.PubMed

Mahajan, A. P., Sayles, J. N., Patel, V. A., Remien, R. H., Ortiz, D., Szekeres, G., & Coates, T. J. (2008). Stigma in the HIV/AIDS epidemic: A review of the literature and recommendations for the way forward. AIDS, 22, S67-79.PubMed

Medley, A., Kennedy, C., O’Reilly, K., & Sweat, M. (2009). Effectiveness of peer education interventions for HIV prevention in developing countries: A systematic review and meta-analysis. AIDS Education and Prevention., 21, 181–206.PubMedPubMedCentral

Mitzel, L. D., Vanable, P. A., Brown, J. L., Bostwick, R. A., Sweeney, S. M., & Carey, M. P. (2015). Depressive symptoms mediate the effect of HIV-related stigmatization on medication adherence among HIV-infected men who have sex with men. AIDS Behavior, 19, 1454–1459.PubMed

Monjok, E., Smesny, A., & Essien, E. J. (2009). HIV/AIDS—Related stigma and discrimination in Nigeria: Review of research studies and future directions for prevention strategies: Original research article. African Journal of Reproductive Health, 13, 21–35.PubMedPubMedCentral

Nachega, J. B., Uthman, O. A., Peltzer, K., Richardson, L. A., Mills, E. J., Amekudzi, K., & Ouedraogo, A. (2015). Association between antiretroviral therapy adherence and employment status: Systematic review and meta-analysis. Bulletin of the World Health Organization, 93, 29–41.PubMed

Nanni, M. G., Caruso, R., Mitchell, A. J., Meggiolaro, E., & Grassi, L. (2014). Depression in HIV infected patients: A review. Current Psychiatry Reports, 17, 530.

Onyebuchi-Iwudibia, O., & Brown, A. (2014). HIV and depression in Eastern Nigeria: The role of HIV-related stigma. AIDS Care, 26, 653–657.PubMed

Operario, D., Sun, S., Bermudez, A. N., Masa, R., Shangani, S., van der Elst, E., & Sanders, E. (2022). Integrating HIV and mental health interventions to address a global syndemic among men who have sex with men. The Lancet HIV, 9, e574–e584.PubMedPubMedCentral

Rao, D., Elshafei, A., Nguyen, M., Hatzenbuehler, M. L., Frey, S., & Go, V. F. (2019). A systematic review of multi-level stigma interventions: State of the science and future directions. BMC Medicine, 17, 41.PubMedPubMedCentral

Rao, D., Feldman, B. J., Fredericksen, R. J., Crane, P. K., Simoni, J. M., Kitahata, M. M., & Crane, H. M. A. (2012). Structural equation model of HIV-related stigma, depressive symptoms, and medication adherence. AIDS Behavior, 16, 711–716.PubMed

Rao, D., Kekwaletswe, T. C., Hosek, S., Martinez, J., & Rodriguez, F. (2007). Stigma and social barriers to medication adherence with urban youth living with HIV. AIDS Care, 19, 28–33.PubMed

Rosseel, Y. (2012). lavaan: An R package for structural equation modeling. Journal of Statistical Software, 48, 1–36.

Rueda, S., Mitra, S., Chen, S., Gogolishvili, D., Globerman, J., Chambers, L., Wilson, M., Logie, C. H., Shi, Q., Morassaei, S., & Rourke, S. B. (2016). Examining the associations between HIV-related stigma and health outcomes in people living with HIV/AIDS: A series of meta-analyses. British Medical Journal Open, 6, e011453.

Sayles, J. N., Hays, R. D., Sarkisian, C. A., Mahajan, A. P., Spritzer, K. L., & Cunningham, W. E. (2008). Development and psychometric assessment of a multidimensional measure of internalized HIV stigma in a sample of HIV-positive adults. AIDS Behavior, 12, 748–758.PubMed

Segars, A. H. (1997). Assessing the unidimensionality of measurement: A paradigm and illustration within the context of information systems research. Omega, 25, 107–121.

Shubber, Z., Mills, E. J., Nachega, J. B., Vreeman, R., Freitas, M., Bock, P., Nsanzimana, S., Penazzato, M., Appolo, T., Doherty, M., & Ford, N. (2016). Patient-reported barriers to adherence to antiretroviral therapy: A systematic review and meta-analysis. PLOS Medicine, 13, e1002183.PubMedPubMedCentral

Spaan, P., van Luenen, S., Garnefski, N., & Kraaij, V. (2020). Psychosocial interventions enhance HIV medication adherence: A systematic review and meta-analysis. Journal of Health Psychology, 25, 1326–1340.PubMed

Sweeney, S. M., & Vanable, P. A. (2016). The association of HIV-related stigma to HIV medication adherence: A systematic review and synthesis of the literature. AIDS and Behavior, 20, 29–50.PubMed

Tapp, C., Milloy, M. J., Kerr, T., Zhang, R., Guillemi, S., Hogg, R. S., Montaner, J., & Wood, E. (2011). Female gender predicts lower access and adherence to antiretroviral therapy in a setting of free healthcare. BMC Infectious Diseases, 11, 86.PubMedPubMedCentral

Turan, B., Hatcher, A. M., Weiser, S. D., Johnson, M. O., Rice, W. S., & Turan, J. M. (2017). Framing mechanisms linking HIV-related stigma, adherence to treatment, and health outcomes. American Journal of Public Health, 107, 863–869.PubMedPubMedCentral

Turan, B., Rice, W. S., Crockett, K. B., Johnson, M., Neilands, T. B., Ross, S. N., Kempf, M. C., Konkle-Parker, D., Wingood, G., Tien, P. C., & Cohen, M. (2019). Longitudinal association between internalized HIV stigma and antiretroviral therapy adherence for women living with HIV: The mediating role of depression. AIDS, 33, 571–576.PubMed

Turan, B., Smith, W., Cohen, M. H., Wilson, T. E., Adimora, A. A., Merenstein, D., Adedimeji, A., Wentz, E. L., Foster, A. G., Metsch, L., & Tien, P. C. (2016). Mechanisms for the negative effects of internalized HIV-related stigma on antiretroviral therapy adherence in women: The mediating roles of social isolation and depression. Journal of Acquired Immune Deficiency Syndromes, 72, 198–205.PubMed

Uthman, O. A., Magidson, J. F., Safren, S. A., & Nachega, J. B. (2014). Depression and adherence to antiretroviral therapy in low-, middle- and high-income countries: A systematic review and meta-analysis. Current HIV/AIDS Reports, 11, 291–307.PubMedPubMedCentral

Whittaker, T. A. (2012). Using the modification index and standardized expected parameter change for model modification. The Journal of Experimental Education, 80, 26–44.

Wilson, I. B., Lee, Y., Michaud, J., Fowler, F. J., & Rogers, W. H. (2016). Validation of a new three-item self-report measure for medication adherence. AIDS Behavior, 20, 2700–2708.PubMed

Woldegeorgis, B. Z., Zekarias, Z., Adem, B. G., Obsa, M. S., & Kerbo, A. A. (2023). Prevalence and determinants of opportunistic infections among HIV-infected adults receiving antiretroviral therapy in Ethiopia: A systematic review and meta-analysis. Frontiers in Medicine, 10, 1087086.PubMedPubMedCentral

Yuh, J. N., Ellwanger, K., Potts, L., & Ssenyonga, J. (2014). Stigma among HIV/AIDS patients in Africa: A critical review. Procedia-Social and Behavioral Sciences, 140, 581–585.

Zeng, C., Li, L., Hong, Y. A., Zhang, H., Babbitt, A. W., Liu, C., Li, L., Qiao, J., Guo, Y., & Cai, W. (2018). A structural equation model of perceived and internalized stigma, depression, and suicidal status among people living with HIV/AIDS. BMC Public Health, 18, 138.PubMedPubMedCentral

Zhang, Y., Chai, C., Xiong, J., Zhang, L., Zheng, J., Ning, Z., & Wang, Y. (2023). The impact of anxiety, depression, and social support on the relationship between HIV-related stigma and mental health-related quality of life among Chinese patients: A cross-sectional, moderate-mediation study. BMC Psychiatry, 23, 818.PubMedPubMedCentral

Titel: Depression mediates the relationship between exposure to stigma and medication adherence among people living with HIV in low-resource setting: a structural equation modeling approach
Auteurs: Sahabi Kabir Sulaiman
Muhammad Sale Musa
Fatimah Isma’il Tsiga-Ahmed
Saidu Idris Ahmad
Salisu Abubakar Haruna
Abdullahi Abdurrahman Zubair
Bello Tijjani Makama
Aminu Hussein
Abdulwahab Kabir Sulaiman
Farouq Muhammad Dayyab
Abdulaziz Tijjani Bako
Publicatiedatum: 21-04-2024
Uitgeverij: Springer US
Gepubliceerd in: Journal of Behavioral Medicine / Uitgave 4/2024
Print ISSN: 0160-7715
Elektronisch ISSN: 1573-3521
DOI: https://doi.org/10.1007/s10865-024-00488-0

Andere artikelen Uitgave 4/2024

Diet and physical activity behaviors: how are they related to illness perceptions, coping, and health-related quality of life in young people with hereditary cancer syndromes?

Open Access

Increased frequency of light physical activity during midlife and old age buffers against cognitive declines

Open Access

Posttraumatic stress and probable post traumatic stress disorder as it relates to smoking behavior and beliefs among trauma exposed hispanic persons who smoke

Bohn Stafleu van Loghum

Welkom bij Scalda & Bohn Stafleu van Loghum

Registreer

Login

Depression mediates the relationship between exposure to stigma and medication adherence among people living with HIV in low-resource setting: a structural equation modeling approach

Abstract

Andere artikelen Uitgave 4/2024

Diet and physical activity behaviors: how are they related to illness perceptions, coping, and health-related quality of life in young people with hereditary cancer syndromes?

Increased frequency of light physical activity during midlife and old age buffers against cognitive declines

Posttraumatic stress and probable post traumatic stress disorder as it relates to smoking behavior and beliefs among trauma exposed hispanic persons who smoke

The effects of acute exercise on stress reactivity assessed via a multidimensional approach: a systematic review

COVID-19 and changes in young adults’ weight concerns

Prospective trajectories of depression predict mortality in cancer patients

Bohn Stafleu van Loghum

Welkom bij Scalda & Bohn Stafleu van Loghum

Registreer

Login

Deel dit onderdeel of sectie (kopieer de link)

Abstract

Log in om toegang te krijgen

Diet and physical activity behaviors: how are they related to illness perceptions, coping, and health-related quality of life in young people with hereditary cancer syndromes?

Increased frequency of light physical activity during midlife and old age buffers against cognitive declines

Posttraumatic stress and probable post traumatic stress disorder as it relates to smoking behavior and beliefs among trauma exposed hispanic persons who smoke

The effects of acute exercise on stress reactivity assessed via a multidimensional approach: a systematic review

COVID-19 and changes in young adults’ weight concerns

Prospective trajectories of depression predict mortality in cancer patients