Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Bischof, L.
Longitudinal assessment of psychosocial outcomes for patients enrolled in multidisciplinary HIV care with rapid and cost-covered treatment
Humanmedizin; [ Diplomarbeit ] Medizinische Universität Graz; 2024. pp. 47
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Siebenhofer-Kroitzsch Andrea
- Altmetrics:
- Abstract:
- Context: Psychosocial challenges (e.g., poor mental health) hinder engagement at each step of the HIV Care Cascade for people living with HIV (PLWH). Multidisciplinary HIV care models with dedicated resources for mental health support, alongside free and rapid antiretroviral therapy (ART) initiation may attenuate psychosocial issues. To date, little research has explored changes in mental health and associated factors of PLWH while engaged in such a care model. Objective: To assess psychological distress, perceived HIV related stigma, and perceived social support while enrolled in multidisciplinary care with cost-covered and rapid ART initiation. Study Design: 96-week mixed-method prospective cohort study in a quaternary hospital-based HIV clinic. Care was provided by a multidisciplinary team composed of onsite physicians, nurses, social workers, clinical pharmacists and a psychiatrist. ART was provided free of charge on site and as soon as possible (ideally within 7 days) after linkage to care. Population Studied: Newly diagnosed PLWH recruited since January 2020. As of June 2022, 39 PLWH were enrolled, most are male (n=32, 82%), migrants (n=30, 77%), unemployed (n=23, 59%), and have at least a college-level education (n=25, 64%). Instruments: Three patient reported outcome measures (PROMs) were administered at weeks 4, 24, 48, and 96: (1) Kessler Psychological Distress Scale 6-item version (score range 6-30; scores between 19-30 indicate probable to serious mental illness); (2) Internalized AIDS-Related Stigma Scale (score range 0-7; higher scores indicate greater perceived stigma); and (3) Medical Outcomes Study Social Support Survey (score range 0-100; higher scores indicate greater perceived social support). Descriptive statistics and linear mixed model analyses were reported. Results: At the four time-points, average scores ranged from: 22.0-25.6 (SD range: 4.0-6.8) for psychological distress; 3.9-5.2 (SD range: 2.1-2.3) for internalized stigma; and 48.8-59.7 (SD range: 28.7-36.0) for perceived social support. For all PROMs, no significant differences were found over time and by sociodemographics at enrollment. Conclusion Preliminary results showed that, irrespective of sociodemographics and time enrolled, PLWH continue to face challenges with mental health, stigma and social support, despite engagement in multidisciplinary care with free and rapid ART initiation. Further research is required to understand unmet psychosocial needs of PLWH and how multidisciplinary care pathways unfold in real-world contexts.