Depression, social support, and stigma as predictors of quality of life over time: results from an Asha-based HIV/AIDS intervention in India.
Quality of life (QOL) is associated with better outcomes in HIV/AIDS populations. We explored predictors of improved QOL over time in 600 Women Living with HIV/AIDS (WLH/A) in India [mean age = 34.31, SD = 6.97], enrolled in a nurse-led-Asha (Accredited Social Health Activist) intervention. Trained local interviewers ascertained self-report data at baseline and six-month follow-up (post-intervention). Latent Class Analysis (LCA) identified constellations of responses on psychosocial indicators (depression, social support, internalized stigma and stigma fears); their relationship with QOL over time was examined. We identified three classes: Class 1) Highest Social Resources/Lowest Depression; Class 2) Some Social Resources/Highest Depression; and Class 3) Lowest Social Resources/Higher Depression. At baseline, Class 3 reported the lowest QOL (M = 0.25, SD = 0.26); Class 1 reported the highest (M = 0.37, SD = 0.33). Class 2's QOL did not differ from Class 3's QOL, likely due to the potent effects of high depression. At six-month follow-up, all groups reported improved QOL; class membership no longer predicted variability (contrast between Class 2 and 1 = -0.05, 95% CI = -0.14, 0.04; contrast between Class 3 and 1 = 0.01, 95% CI = -0.03, 0.05; contrast between Class 3 and 2 = 0.07, 95% CI = -0.02, 0.16). Psychosocial indicators are important predictors of QOL; an Asha-supported approach may have broad applicability to improve QOL in WLH/A in India.
['Garfin|Dana Rose|DR|', 'Shin|Sanghyuk S|SS|', 'Ekstrand|Maria L|ML|', 'Yadav|Kartik|K|', 'Carpenter|Catherine L|CL|', 'Sinha|Sanjeev|S|', 'Nyamathi|Adeline M|AM|']
D000328:Adult D023241:Antiretroviral Therapy, Highly Active D003863:Depression D005260:Female D015658:HIV Infections D006801:Humans D007194:India D008297:Male D008875:Middle Aged D011788:Quality of Life D057566:Self Report D057545:Social Stigma D012944:Social Support
depression social support stigma quality of life HIV AIDS Latent Class Analysis