mental health AIDS

Summer 2008 Newsletter / Volume 9, Issue 4

Resources

Books & Articles

Acevedo, V. (2008). Cultural competence in a group intervention designed for Latino patients living with HIV/AIDS. Health & Social Work, 33(2), 111-120.

"This article describes a group intervention designed for Latino patients living with HIV/AIDS in New York City. The intervention effectively integrates culturally competent practice with traditional social work practice[, setting the stage] ... for participants to explore issues commonly faced by patients living with HIV/AIDS in a cultural context. Case examples are used to describe themes that emerged during the intervention, which illustrate cultural influences on issues such as adherence, social isolation, stigma, disclosure, safer sex practices, and patient-provider communication. Cultural factors inherent ... [in] Latino culture that are known to influence a patient's health experience and the development of effective interventions are also presented" (p. 111).

Everall, I.P., & Grant, I. (Eds.). (2008). HIV and the brain: The neuropsychiatry of HIV. International Review of Psychiatry, 20(1), 1-101.

"The advent of effective antiretroviral therapy substantially altered the natural history of HIV infection[,] with major reductions in mortality allowing infected individuals to live considerably longer. ... [In turn] a new set of challenges ha[s emerged] ... for both researchers and clinicians engaged in the understanding and treatment of HIV and its central nervous system related disorders. These contemporary challenges are reflected in the composition and contents of the papers included in this review [that address] ... three different areas: HIV biology and neuropathology; clinical issues of HIV neurocognitive impairment; and ... co-morbid severe mental illness[es] and their treatment in the setting of HIV infection" (p. 1).

Galletly, C.L., Pinkerton, S.D., & Petroll, A.E. (2008). CDC recommendations for opt-out testing and reactions to unanticipated HIV diagnoses [Commentary]. AIDS Patient Care & STDs, 22(3), 189-193.

"The U.S. Centers for Disease Control and Prevention (CDC) now recommend ... testing all health care patients for HIV – regardless of their reported risk behaviors – using an 'opt-out' approach in which patients are informed that an HIV test will be conducted unless they explicitly decline to be tested. These new testing procedures will facilitate the identification of persons living with HIV who are unaware of their infection. However, some of these newly diagnosed persons may not previously have considered the possibility that they might have HIV and may be ill-equipped to cope with an HIV diagnosis. The present commentary reviews the potential reactions of persons who receive unanticipated HIV-positive diagnoses and suggests that additional research is needed to better understand these reactions and associated harms" (p. 189).

Harris, G.E., & Larsen, D. (2008). Understanding hope in the face of an HIV diagnosis and high-risk behaviors. Journal of Health Psychology, 13(3), 401-415.

"Receiving an HIV diagnosis can be emotionally devastating, leading the newly diagnosed to believe that all hope for a good future is lost. Participants in the present study were overwhelmed by the initial diagnosis. Often believing that hope was unobtainable, they engaged in high-risk behaviors. In time, participants began to re-experience hope and alter their high-risk lifestyles. Hope was found in five main experiences, including: (1) receiving support; (2) engaging in meaningful life experiences; (3) perceiving options; (4) receiving treatment; and (5) maintaining life quality. Healthcare professionals should consider these five categories as potential sources for fostering hope when working with people who are engaged in high-risk behavior and newly diagnosed with HIV" (p. 412).

Ickovics, J.R. (2008). "Bundling" HIV prevention: Integrating services to promote synergistic gain. Preventive Medicine, 46(3), 222-225.

"Bundling is defined as the aggregation of services to increase effectiveness (i.e., creating synergy of effort). The purpose of this commentary is to review the utilization and potential benefits of bundling in its application to HIV prevention. ... Bundling of HIV prevention provides an opportunity to reach high-risk persons who are asymptomatic and/or may not otherwise seek care by eliminating barriers to prevention" (p. 222).

Ingram, B.L., Flannery, D., Elkavich, A., & Rotheram-Borus, M.J. (2008). Common processes in evidence-based adolescent HIV prevention programs. AIDS & Behavior, 12(3), 374-383.

"Dissemination of evidence-based HIV prevention programs for adolescents will be increased if community interventionists are able to distinguish core, essential program elements from optional, discretionary ones. We selected five successful adolescent HIV prevention programs, used a qualitative coding method to identify common processes described in the procedural manuals, and then compared the programs. Nineteen common processes were categorized as structural features, group management strategies, competence building, and addressing developmental challenges of adolescence. All programs shared the same structural features (goal-setting and session agendas), used an active engagement style of group management, and built cognitive competence. Programs varied in attention to developmental challenges, emphasis on behavioral and emotional competence, and group management methods. This qualitative analysis demonstrated that successful HIV programs contain processes not articulated in their developers' theoretical models. By moving from the concrete specifics of branded interventions to identification of core, common processes, we are consistent with the progress of 'common factors' research in psychotherapy" (p. 374).

Kang, E., Mellins, C.A., Yiu Kee Ng, W., Robinson, L.-G., & Abrams, E.J. (2008). Standing between two worlds in Harlem: A developmental psychopathology perspective of perinatally acquired human immunodeficiency virus and adolescence. Journal of Applied Developmental Psychology, 29(3), 227-237.

"This selective review of the growing developmental psychopathology literature and the authors' clinical work at a pediatric HIV program in Harlem, NY provide an overview of how developmental psychopathology offers an integrative framework that elucidates how autonomy, peer relationships, and self-concept evolve among 13-21 year old adolescents. This paper highlights the importance of considering influences of both perinatal HIV and the culture of poverty on adolescent development, and of adopting multilevel interventions and research to address how interactions among biologic, environmental, and HIV-related stressors (serostatus disclosure, medical treatment adherence, illness stigma) influence the development of adolescents with perinatal HIV" (p. 227).
 

Maxwell, C., Aggleton, P., & Warwick, I. (2008). Involving HIV-positive people in policy and service development: Recent experiences in England. AIDS Care, 20(1), 72-79.
 
"A study was undertaken in three areas of England to establish the types of user involvement mechanisms in place for HIV-positive people to influence service and policy development. ... [A] range of (innovative) methods for facilitating HIV-positive people's greater participation in service planning and delivery [are identified], as well as some of the challenges encountered by people living with HIV and service providers when implementing ... [greater involvement]. The paper concludes by identifying some specific strategies for improving user involvement in HIV service provision" (p. 72).

Morgan, E.E., Woods, S.P., Scott, J.C., Childers, M., Beck, J.M., Ellis, R.J., Grant, I., Heaton, R.K., & the HIV Neurobehavioral Research Center (HNRC) Group. (2008). Predictive validity of demographically adjusted normative standards for the HIV Dementia Scale. Journal of Clinical & Experimental Neuropsychology, 30(1), 83-90.

"A brief and accessible cognitive screening measure for HIV-related cognitive impairment is a necessary tool for clinicians and researchers, especially in light of the potential increase in the prevalence of HIV-related neurocognitive disorders and the likelihood of presentation with subtle effects in the HAART [(highly active antiretroviral therapy)] era" (p. 89). "In comparison to the traditional HDS [(HIV Dementia Scale)] cut score (raw score total < 10), [the] use of ... demographically adjusted normative standards significantly improved the sensitivity ... and overall classification accuracy ... of the HDS for identifying participants with HIV-1-associated neurocognitive disorders" (p. 83). "Table 4 [(p. 87)] provides a quick reference tool for approximating T-scores from scaled scores, which are grouped by broad age and education categories" (p. 86).

Nemeroff, C.J., Hoyt, M.A., Huebner, D.M., & Proescholdbell, R.J. (2008). The Cognitive Escape Scale: Measuring HIV-related thought avoidance. AIDS & Behavior, 12(2), 305-320.

"Cognitive escape provides a model for examining the cognitive processes involved in escaping from thoughts of HIV/AIDS in a population of men who have sex with men (MSM) .1 This investigation presents psychometric information and validation data on the Cognitive Escape Scale (CES), a measure of HIV-related cognitive avoidance. This study also examined the associations between the CES and self-report measures of theoretically related constructs, including HIV-related worry, sensation-seeking, depressive symptoms, perceived stress, and risky sexual behaviors. ... Exploratory and confirmatory factor analyses supported a 3-factor structure to the CES, suggesting three strategies of cognitive escape: fatalism/short-term thinking, thought suppression/distraction, and alcohol/drug use" (p. 305). "The CES is a convenient, brief self-report measure ... that may be usable for both HIV positive and negative men (with some caveats ...), and whose components are related to risky sexual behavior. As such, it may be of use to AIDS prevention programs, HIV testing counselors, healthcare practitioners, public health professionals, and researchers alike. In a clinical setting, the CES could potentially help direct intervention or educational efforts toward the appropriate target, be it depressive fatalism, patterns of substance use, or a sense of coping 'burnout'" (p. 317).

Senn, T.E., Carey, M.P., & Vanable, P.A. (2008). Childhood and adolescent sexual abuse and subsequent sexual risk behavior: Evidence from controlled studies, methodological critique, and suggestions for research. Clinical Psychology Review, 28(5), 711-735.

"In this paper, we review the literature investigating the relation between CSA [(childhood and adolescent sexual abuse)] and subsequent sexual risk behaviors among men and women. ... Suggestions for future research and implications for clinical practice are discussed" (p. 711).

Soroudi, N., Perez, G.K., Gonzalez, J.S., Greer, J.A., Pollack, M.H., Otto, M.W., & Safren, S.A. (2008). CBT for medication adherence and depression (CBT-AD) in HIV-infected patients receiving methadone maintenance therapy. Cognitive & Behavioral Practice, 15(1), 93-106.

"The present study describes the feasibility and outcome, in a case series approach, of cognitive behavioral therapy to improve adherence and depression (CBT-AD) among individuals with HIV and depression undergoing methadone maintenance treatment for heroin dependence. ... [I]n CBT-AD, patients first receive a cognitive behavioral intervention focusing on improving skills related to medication adherence. Each of the subsequent CBT modules (activity scheduling, cognitive restructuring, problem-solving training, and relaxation training/diaphragmatic breathing) is designed to address both self-care/adherence behaviors as well as depression" (p. 93).

Stepleman, L.M., Trezza, G.R., Santos, M., & Silberbogen, A.K. (2008). The integration of HIV training into internship curricula: An exploration and comparison of two models. Training & Education in Professional Psychology, 2(1), 35-41.

"It can be challenging to get HIV experience during graduate school, and few programs have faculty devoted to HIV endeavors. The authors propose the internship year as a reasonable time to develop HIV competencies within a broader internship curriculum. To explore this idea further, the authors examined two internships that offer specialized HIV training. To increase psychology's capacity to provide HIV training, recommendations are proposed for the application of these models to other internship sites" (p. 35).

 
Walkup, J., Blank, M.B., Gonzalez, J.S., Safren, S., Schwartz, R., Brown, L., Wilson, I., Knowlton, A., Lombard, F., Grossman, C., Lyda, K., & Schumacher, J.E. (2008). The impact of mental health and substance abuse factors on HIV prevention and treatment. Journal of Acquired Immune Deficiency Syndromes, 47(Suppl. 1), S15-S19.

"Syndemic health problems occur when linked health problems involving 2 or more afflictions interact synergistically and contribute to the excess burden of disease in a population. ... This article describes a research agenda for beginning to understand the complex relations among [mental illness], [substance abuse], and HIV ..." (p. S15).

Wingood, G.M., & DiClemente, R.J. (2008). The ADAPT-ITT model: A novel method of adapting evidence-based HIV interventions. Journal of Acquired Immune Deficiency Syndromes, 47(Suppl. 1), S40-S46.

"Given the time and cost associated with the development, implementation and evaluation of efficacious HIV interventions, adapting existing evidence-based interventions (EBIs) to be appropriate for a myriad of at-risk populations may facilitate the efficient development of new EBIs. Unfortunately, few models of theoretic frameworks exist to guide the adaptation of EBIs. Over the past few years, the authors have systematically developed a framework for adapting HIV-related EBIs, known as the 'ADAPT-ITT' model. The ADAPT-ITT model consists of 8 sequential phases that inform HIV prevention providers and researchers of a prescriptive method for adapting EBIs. The current article summarizes key components of the ADAPT-ITT model and illustrates the use of the model in several case studies" (p. S40).

Wong, W.K.T., & Ussher, J. (2008). How do subjectively-constructed meanings ascribed to anti-HIV treatments affect treatment-adherent practice? Qualitative Health Research, 18(4), 458-468.
 
"Findings from research studies into treatment (non)adherence have positioned the act as a medical issue that could be remedied by behavioral strategies. The present study, conducted in Sydney, Australia, aims to examine treatment-(non)adherent practice as a subjective expression of meanings ascribed to treatments ... . The findings indicate that people with HIV negotiate and position treatments in particular ways that lead to multiple and varied understanding of treatments. The ways treatments are positioned in their everyday lives suggest that meanings ascribed to treatments impact on the way individuals negotiate demands embedded in the medically-constructed practice of adherence" (p. 458).

– Compiled by Abraham Feingold, Psy.D.

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 1 See the Tool Box on "New Thinking on Not Thinking About HIV Risk" in the Fall 2006 issue of mental health AIDS for more information on explanatory models of HIV-related risk taking.

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