Psychosocial and Spiritual Factors and Depression Among African-Americans Living with HIV/AIDS

Wednesday, July 13, 2011: 2:05 PM

Safiya George Dalmida, PhD, MSN, APRN
Family and Community Nursing, Emory University, Atlanta, GA
Harold Koenig, MD
Psychiatry, Duke University, Durham, NC

Learning Objective 1: Identify psychosocial factors that have been shown to be significantly associated with mental health outcomes (depression) among people living with HIV/AIDS, particularly HIV-positive African Americans.

Learning Objective 2: Describe spiritual and religious correlates of depression among HIV-positive outpatients and discuss potential clinical implications.

Purpose: African Americans (AA) with HIV/AIDS experience significant stress and depression. Spirituality/religion are important factors among AA and people with HIV/AIDS. The aim of this study was to identify the psychosocial factors associated with depression among HIV+ AA.

Methods: A cross-sectional study was conducted with 262 HIV+ AA outpatients in the southeastern US. SPSS, correlations and hierarchical regression statistics were used.

Results: : About half (54.2%) completed high school or had a G.E.D. and 30.3% attended college, technical or graduate school. Majority (89.7%) were unemployed or on disability. Many (61.3%) had undetectable HIV viral loads (<50-400 copies/ml). Mean sample age was 45±7.7 years, mean depression score was 19.3±12.6, mean HIV medication adherence score was 24.2±5.9 on a scale from 0-30 with higher scores representing better adherence, and mean CD4 count was 465.8±387.1 cells/µL. Mean negative religious coping (RCOPE) was 4.86±5.34) and positive RCOPE was16.6±5.06, with higher scores representing more coping on a scale from 0-21. RESULTS: Depression was significantly inverse associated with positive RCOPE (r= –.24; p=.000), social support satisfaction (r= –.35; p=.000), mental HRQOL (r= –.69; p=.000), physical HRQOL (r= –.45; p=.000) and HIV medication adherence (r= –.29), and significantly positively associated with negative RCOPE (r=.50; p=.000). Negative and positive RCOPE, social support satisfaction, and gender were significant predictors of depressive symptoms, controlling for socio-demographics.

Conclusion: HIV+ AA experience significant stress and depressive symptoms and those who use religion to cope in a positive manner report less depressive symptoms and those who use religion to cope in a negative or less positive manner report more depressive symptoms. In this sample, religious coping, gender (being female), and social support were significant predictors of depression. FUTURE DIRECTIONS: More research is necessary to examine these relationships over time and to examine other mediator/moderator relationships between spirituality/religiosity and mental health in HIV+ AA.