Depression Among Hispanic and Black Older Women Living With HIV

Monday, 29 July 2019: 9:50 AM

Rosina Cianelli, PhD, MPH, RN, IBCLC, FAAN
Schol of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA
Natalia Villegas, PhD, MSN, RN, IBCLC
School of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA
Giovanna De Oliveira, PhD, MSN, ARNP, ANP-C, PMHNP-BC
University of Miami, School of Nursing, Miami, FL, USA
Nilda (Nena) Peragallo Montano, DrPH, RN, FAAN
Schol of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

Purpose: The growing number of older minority women (50+) diagnosed with HIV has implications for healthcare, social services, research, and policy. The Centers for Disease Control and Prevention projects that older adults (aged 50+) will account for 71% of the HIV-infected population by 2020. Minority older women are disproportionately affected by HIV, accounting for 60% of new diagnoses in the US (18% Hispanic older women and 42% Black older women) of women living with HIV. HBOWLH are greatly impacted by health disparities and are traditionally underrepresented in clinical trials and receiving health-related services. The purpose of this study was to explore depression among HBOWLH.

Methods: A qualitative descriptive design was selected for this study. Purposive sampling was used to recruit participants in an ambulatory care center in South Florida. The sample size was determined using the concept of saturation and was achieved with 28 with HBOWLH. Face to face in-depth interviews were conducted in English or Spanish according with the preference of the participants. The in-depth interviews were conducted using a semi-structured interview guide with pre-scripted questions and follow-up probing questions to ensure consistency among participants The interviews lasted 45 to 60 min, they were audio recorded. and transcribed verbatim in English and Spanish. Conventional content analysis was used to identify and define the major themes that emerged from the interviews.

Results: The mean age of participants was 57.36 years (SD = 6.36, range 50 -77), with a mean number of years of education of 11.39 years (SD = 2.10). The majority of the participants reported being single or in a relationship (n= 20) and living alone (n =17). In terms of religion, the majority of participants were Baptist (n= 13) followed by Episcopalian (n=6). Most also reported having a public health insurance (n =27) and not working currently (n= 24). Participants were diagnosed with HIV a mean of 20.95 years ago (SD= 7.07). The analysis of the interview data led to five main themes: (a) Dealing with HIV and now the shadow of depression, (b) Somatic symptoms related to depression and anxiety, (c) HIV as a death sentence: impending doom, (d) Using spirituality to overcome depression, (e) Effects of adherence to HIV treatment on depression.

Conclusion: After analyzing the common themes from our sample, it is evident that HBOWLH may benefit from community-based psychosocial support and HIV risk reduction interventions. Health care providers need to increase their awareness when working with this population when it comes to screening for depression and anxiety related symptoms. Proper referral should be promptly done in order to engage them in treatment early on. Psychotherapy should be focused on fostering resilience and improving coping skills. Social support can be a coping help to cope with HIV and non-HIV related stressors. Such support is crucial as a protective factor against depression, especially among HBOWLH who are suffering with a debilitating chronic illness.

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