HIV-related shame and health-related quality of life among older, HIV-positive adults
- 671 Downloads
This study investigated how HIV-related shame is associated with health-related quality of life (HRQoL) in older people living with HIV (PLHIV). Structural equation modeling tested whether HIV-related shame was associated with three dimensions of HRQoL (physical, emotional, and social well-being) and whether there were significant indirect associations of HIV-related shame with the three HRQoL dimensions via depression and loneliness in a sample of 299 PLHIV ≥50 years old. Results showed that depression and loneliness were key mechanisms, with depression at least partially accounting for the association between HIV-related shame and both emotional and physical well-being, respectively, and loneliness accounting for the association between HIV-related shame and social well-being. HIV-related shame appears to be an important correlate of HRQoL in older PLHIV and may provide a promising leveraging point by which to improve HRQoL in older PLHIV.
KeywordsHIV/AIDS Aging Quality of life Shame Depression Loneliness
This study was funded by the National Institute of Mental Health (Grant Numbers R01MH067566, K01MH103080, and T32MH19105).
Compliance with ethical standards
Conflict of interest
Wilson Vincent, Xindi Fang, Sarah K. Calabrese, Timothy G. Heckman, Kathleen J. Sikkema, and Nathan B. Hansen declares that they have no conflict of interest.
Human and animal rights and Informed consent
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors. Informed consent was obtained from all individual participants included in the study.
- CDC. (2015). HIV among people aged 50 and over. Retrieved September 29, 2014, from http://www.cdc.gov/hiv/risk/age/olderamericans/
- Dilley, J. W., Schwarcz, S., Murphy, J., Joseph, C., Vittinghoff, E., & Scheer, S. (2011). Efficacy of personalized cognitive counseling in men of color who have sex with men: Secondary data analysis from a controlled intervention trial. AIDS and Behavior, 15, 970–975. doi: 10.1007/s10461-010-9771-3 CrossRefPubMedGoogle Scholar
- Dilley, J. W., Woods, W. J., Loeb, L., Nelson, K., Sheon, H., Mullan, J., et al. (2007). Brief cognitive counseling with HIV testing to reduce sexual risk among men who have sex with men: Results from a randomized controlled trial using paraprofessional counselors. Journal of Acquired Immune Deficiency Syndromes, 44, 569–577.CrossRefPubMedGoogle Scholar
- Eaton, L. A., Huedo-Medina, T. B., Kalichman, S. C., Pellowski, J. A., Sagherian, M. J., Warren, M., et al. (2012). Meta-analysis of single-session behavioral interventions to prevent sexually transmitted infections: Implications for bundling prevention packages. American Journal of Public Health, 102, e34–e44. doi: 10.2105/AJPH.2012.300968 CrossRefPubMedPubMedCentralGoogle Scholar
- Fuller, W. A. (2009). Measurement error models (Vol. 305). New York, NY: Wiley.Google Scholar
- Goffman, E. (1963). Stigma: Notes on the management of spoiled identity. Englewood Cliffs, NJ: Prentice-Hall.Google Scholar
- Kemeny, M. E., Gruenewald, T. L., & Dickerson, S. S. (2004). Shame as the emotional response to threat to the social self: Implications for behavior, physiology, and health. Psychological Inquiry, 15, 153–160.Google Scholar
- Kline, R. B. (2015). Principles and practice of structural equation modeling. New York, NY: The Guilford Press.Google Scholar
- Matos, M., & Pinto-Gouveia, J. (2014). Shamed by a parent or by others: The role of attachment in shame memories relation to depression. International Journal of Psychology and Psychological Therapy, 14, 217–244.Google Scholar
- Muthén, L. K., & Muthén, B. O. (2010). Mplus user’s guide (6th ed.). Los Angeles, CA: Muthén & Muthén.Google Scholar
- Peplau, L. A. (1987). Loneliness—Theory, research, and applications—Foreword. Journal of Social Behavior and Personality, 2, R5-R5.Google Scholar
- Rodriguez-Penney, A. T., Iudicello, J. E., Riggs, P. K., Doyle, K., Ellis, R. J., Letendre, S. L., et al. (2013). Co-morbidities in persons infected with HIV: Increased burden with older age and negative effects on health-related quality of life. AIDS Patient Care STDs, 27, 5–16. doi: 10.1089/apc.2012.0329 CrossRefPubMedPubMedCentralGoogle Scholar
- Sikkema, K. J., Hansen, N. B., Meade, C. S., Kochman, A., & Fox, A. M. (2009). Psychosocial predictors of sexual HIV transmission risk behavior among HIV-positive adults with a sexual abuse history in childhood. Archives of Sex Behavior, 38, 121–134. doi: 10.1007/s10508-007-9238-4 CrossRefGoogle Scholar
- Tangney, J. P., & Dearing, R. L. (2003). Shame and guilt. New York, NY: Guilford Press.Google Scholar
- Wen, M., Hawkley, L. C., & Cacioppo, J. T. (2006). Objective and perceived neighborhood environment, individual SES and psychosocial factors, and self-rated health: An analysis of older adults in Cook County, Illinois. Social Science and Medicine, 63, 2575–2590. doi: 10.1016/j.socscimed.2006.06.025 CrossRefPubMedGoogle Scholar
- Yesavage, J. A., Brink, T. L., & Rose, T. L. (2000). Geriatric depression scale (GDS). In A. P. Association (Ed.), Handbook of psychiatric measures (pp. 544–546). Washington, DC: American Psychiatric Association.Google Scholar