Paper
Monday, November 14, 2005
Correlates of Body Habitus Changes in Persons With HIV/AIDS
Kenn M. Kirksey, RN, PhD, APRN, BC1, Margaret E. Mueller, RN, MSN, CNS2, Inge B. Corless, RN, PhD, FAAN3, Patrice Kenneally Nicholas, RN, DNSc, MPH, ANP3, William Holzemer, RN, PhD, FAAN4, Jeanne Kemppainen, RN, PhD, CNS5, Kathleen Nokes, RN, PhD, FAAN6, Mary Jane Hamilton, RNC, PhD7, Lucille Sanzero Eller, RN, PhD8, Nancy R. Reynolds, RN, PhD9, Pamela Dole, RN, EdD, MPH, NP10, Eli Haugen Bunch, RN, DNSc11, Yun-Fang Tsai, PhD, RN12, Marta Rivero-Mendez, DNS, RN13, Elizabeth F. Sefcik, PhD, RN, APRN, BC7, Carmen Portillo, PhD, RN, FAAN4, Christopher L. Coleman, PhD, MPH, APRN, BC, ACRN14, Dean Wantland, RN, MS, MSN4, Gladys E. Canaval, PhD, MSc, RN15, and Claudia P. Valencia, MSc, RN15. (1) Department of Nursing Research, Harris County Hospital District, Houston, TX, USA, (2) Department of Nursing, California State University, Fresno; Veteran's Administration Healthcare System, Fresno, CA, USA, (3) Massachusetts General Hospital Institute of Health Professions, Boston, MA, USA, (4) Community Health Systems, University of California, San Francisco, San Francisco, CA, USA, (5) School of Nursing, The University of North Carolina at Wilmington, Wilmington, NC, USA, (6) Hunter-Bellevue School of Nursing, Hunter College, New York, NY, USA, (7) College of Nursing & Health Sciences, Texas A&M University-Corpus Christi, Corpus Christi, TX, USA, (8) College of Nursing, Rutgers, the State University of New Jersey, Newark, NJ, USA, (9) College of Nursing, Ohio State University, Columbus, OH, USA, (10) HIV Center, St Vincents Hospital & Health Center, New York, NY, USA, (11) Institute of Nursing Science, University of Oslo, Blindern, Norway, (12) Department of Nursing, Chang Gung University, Tao-Yuan 333, Taiwan, (13) Medical Sciences Campus, School of Nursing, University of Puerto Rico, San Juan, PR, PR, (14) School of Nursing, University of Pennsylvania, Philadelphia, PA, USA, (15) Universidad del Valle, Santiago de Cali, Colombia
| Learning Objective #1: Identify the influence of classic sociodemographic attributes (e.g., age, ethnicity, gender) upon lipodystrophic symptomatology in persons with HIV/AIDS |
| Learning Objective #2: Determine the relationship between the use of highly active antiretroviral therapies and self-reported body fat changes in individuals living with HIV/AIDS |
Background/Purpose: Life expectancies in HIV-infected persons have improved with the advent of highly active antiretroviral therapies (HAART). While defined as a chronic illness, there has been an exacerbation in medication-related symptoms. The purpose of this study was to identify the relationships among body fat changes (one of the most pervasive symptoms) and select predictor variables.
Theoretical Framework: The Diefenbach and Leventhal Self-Regulation Model of Illness Representation was the guiding framework for establishing relationships among person, illness representation, self-care and outcomes appraisal.
Design/Methods: A descriptive, correlational design was used to collect data from 1,217 subjects in the United States, Colombia, Norway, Puerto Rico, and Taiwan. This research was conducted under the auspices of the UCSF International HIV/AIDS Nursing Research Network. Participants were asked to complete a Sociodemographic Data Form, AACTG Body Change and Distress Scale, and the Revised Sign and Symptom Check List for Persons with HIV Disease.
Findings/Conclusions: The sample (n=1,217) consisted of approximately 68% (n=821) males, and 57.9% (n=777) African-American/Blacks or Hispanic/Latinos. More than 2/3 (n=923, 75.8%) reported “barely adequate” or “totally inadequate” income, and 65% (n=785) did not work for pay. Nearly 41% (n=493) had AIDS, and 54.3% (n=655) reported co-morbidities. Approximately 70% of the sample experienced lipodystrophy. Positive relationships were noted between age and lipoatrophy (face, r=0.124, p=0.000, n=842; buttocks, r=0.086, p=0.013, n=845; and arms/legs, r=0.161, p=0.000, n=845). There was a negative correlation between gender and neck fat (r=-0.130, p=0.000, n=845) and a positive relationship between ethnicity and arm/leg lipoatrophy (r=0.164, p=0.000, n=856). There were positive correlations between individuals previously taking HAART and fat losses (buttocks, r= 0.098, p=0.004, n=857; arms/legs, r=0.090, p=0.009, n=856), and presently taking HAART and fat gain (belt/waist, r=0.093, p=0.006, n=875).
Implication: These findings have the potential to enhance the knowledge base related to lipodystrophy and nursing management strategies in persons with HIV/AIDS.