Positive Women and Mental Health

posted: 15/10/2009

Positively Women's current issue looks at mental health of women living with HIV. Writing by around 15 different women gives this issue lots of fresh ways of looking at mental health for positive women.

Read about

• mental health and HIV
• prison and mental health
• post-natal depression
• HIV treatment and mental health
• dementia
• hypnotherapy, and more.

Mental health is a serious topic but the writing is thought-provoking and optimistic, with the emphasis on hope and recovery.

Positively Women is free to women living with HIV - if you are interested in subscribing to the magazine please call Anjie Mailey on 020 7713 0444.

The subscriptions webpage is here

You can read some sample pages of this latest issue on mental health here

Back issues of Positively Women you can download (free) as a pdf

Mental Health and HIV Survey

posted: 13/08/2009

NAM (National AIDS Manual) are involved in a survey to help understand better the mental health support needs of people living with HIV in the UK.

If you are interested in taking part in this survey, it is online here. The survey is anonymous and confidential. It will take about 15 minutes.
 

In French too

Ce questionaire est disponible en Français.

NAM (and we) thank you for your help. Hearing about your experiences is very valuable for organisations providing support and information services.

Mental Health and HIV booklet

NAM's Mental Health and HIV booklet is here.

HIV Stigma Blamed for Clinic Drop Out

posted: 13/08/2009

People who feel stigmatised because they have HIV don’t go to their clinic as often as they should, American researchers have found. This reinforces George House Trust's own findings on the hundreds of people in NW England who have stopped using HIV clinics, or who have never used any clinic in the NW since diagnosis. 

The next issue of Insight  has a detailed investigation into what is going on and what needs to be done. It will be published on Thursday 20 August.

3 out of 4 have poor clinic attendance, and 2 out of 5 don't take treatment properly

The USA study showed that 77% of people had poor access to healthcare and 43% didn’t take their HIV treatment properly. People who reported feeling stigmatised were much less likely to visit their HIV clinic regularly than people who did not report feelings of stigma. The research also showed that poor mental health was associated with not taking HIV treatment properly.
 

Internalised stigma leads to fall in clinic use

“Our study provides important information about the association between internalized stigma and self-reported access to medical care”, comment the investigators.

There have been dramatic improvements in HIV treatment, and now the life outlook for many people living with HIV is considered almost normal. Nevertheless, HIV remains a stigmatised illness and this threatens the emotional, mental and physical health of all people living with HIV.

Stigma is a complex idea, but it is basically the shaming and blaming that is heaped on anyone who is thought to have broken the values and social norms of their community or wider society. Becoming HIV positive is socially disapproved of - like getting other sexually transmitted infections is disapproved of, but far worse.

Internalising the shame and blame

Most behaviour that society disapproves of leads to people absorbing and adopting some of the stigma - we come to believe some, or all of it, is true about us. We are surrounded by HIV stigma and it is hard to resist and feel good about yourself. This is internalised stigma and it is damaging to mental and physical health. Internalised HIV stigma is a bit like how some people who are gay (or female, or of an ethnic minority background, or with a disability etc.) come to self-hate themselves and believe the negative attitudes about gay (female, ethnic minority, disabled, etc) people that surround them. 

What they studied and found

Investigators from Los Angeles (LA) thought that internalised HIV stigma would be associated with three key aspects of HIV care:

• using HIV clinics 
• regularly going to clinics for HIV care
• taking HIV treatment properly - adherence.

202 people were surveyed from LA HIV clinics and support services. The research was undertaken in 2007.

Most (56%) were women and an equal proportion African American. The mean age was 43 years and 31% were gay men.

Measuring internalised HIV stigma - 1 in 3 endure significant stigma

Internalised stigma was assessed using a questionnaire which scored people’s responses on a scale of 0 to 100. The overall score was 41, suggesting that well over a third of participants had significant internalised HIV-associated stigma.

Overall, 77% of individuals reported having poor access to healthcare, 11% having no regular source of HIV care, and 43% poor adherence to their HIV treatment.

The investigators’ first set of statistical analyses showed that individuals reporting a high level of internalised stigma were much more likely to report poor access to HIV care, to lack a regular source of HIV care, and to have low levels of adherence to their HIV medication (the detailed statistics are in the journal article).

Internalised HIV stigma - four times more people drop out of HIV care

However, when the investigators allowed for other possible explanations, they found that internalised stigma was only really linked with poor access to HIV care. They also found that poor mental health, rather than internalised stigma itself, explained people not taking their HIV drugs properly.

1 in 3 report high levels of stigma

“Approximately one-third of participants reported experiencing high levels of internalized HIV stigma”, comment the investigators, adding “we found that respondents experiencing high levels of stigma had over four times the odds of reporting poor access to care.”

They note that their study was limited by its design and that more studies are needed to better understand what the relationship is between stigma and using HIV clinics.

“Such studies could enable us to examine changes in stigma and its contribution to health care and health outcomes throughout the disease trajectory”, conclude the researchers.

Stigma and mental health booklets

NAM produces two useful booklets on HIV & Stigma, and HIV & Mental Health. They are available free to people with HIV in the UK , as well as on their website, at George House Trust, and through HIV clinics.

Reference - full article is available free, either as a pdf file, or on a web page.

Sayles JN et al. The association of stigma with self-reported access to medical care and antiretroviral therapy adherence in persons living with HIV/AIDS (pdf). J Gen Intern Med (webpage online edition), 2009.

Source

High Stigma and Consequences

posted: 10/07/2009

People with HIV face high levels of stigma, and this is consistently associated with lack of social support, poor physical and mental health, poverty, and younger age, according to the results of a study of all the studies published in the June AIDS Care.

A total of 24 studies conducted since 2000, involving a wide range of people with HIV, were included in the analysis.

The authors suggest “health professionals caring for people living with HIV as well as HIV-related stigma interventions and support programmes could benefit from an enhanced understanding of correlates of HIV-related stigma.”

Stigma has been associated with HIV since the beginnings of the epidemic and is experienced by individuals in different ways. HIV-positive people are often blamed for their infection, on occasion even by healthcare providers.

HIV also disproportionately affects groups that are already stigmatised, including gay men, injecting drugs users and migrant populations.

Earlier research has shown that HIV-related stigma is associated with mental health needs, social exclusion, lower quality of life, and poor physical health. Moreover, studies have also indicated that age, gender, income, race/ethnicity, and sexual orientation are associated with stigma.

However, studies examining HIV-related stigma have varied by their sample size and population, measures of stigma, data collection and statistical analysis. It has therefore been difficult to compare their findings, or generalise them to wider populations of individuals living with HIV.

Investigators therefore conducted a meta-analysis of recently published studies that measured HIV-related stigma. Their aims were to establish the strength and direction of the association between HIV-related stigma and physical, mental and emotional health, and also to determine the associations between stigma and a number of demographic characteristics.

A total of 24 studies published in peer-reviewed journals since 2000 were included in this analysis. These studies involved a total of 5600 HIV-positive individuals from diverse backgrounds. The investigators found that a wide variety of factors were associated with stigma.

Stigma PLUS

The other factors associated with HIV stigma included

• having more advanced HIV disease  
• poorer physical health 
• poorer mental health 
• experiencing discrimination
• younger age
• lower income

Stigma LESS

However, adequate social support and good mental health were both significantly associated with less reported stigma.

Stigma has strong links with lack of social support, poor physical health, poor mental health, lower income and younger age

Although there was considerable variability in the way the included studies assessed individuals’ experiences of stigma and their health and well-being, the investigators nevertheless found that “high stigma levels were consistently and significantly associated with lack of social support, poor physical health, poor mental health, lower income and younger age.”

Recommended

The authors recommend that “effective interventions to challenge HIV-related stigma should operate on multiple levels and target several populations.” Wider-ranging structural interventions are also needed, and the authors suggest these should provide “legal protection from HIV-related stigma and discrimination as well as address poverty through increasing access to employment for people living with HIV and ensuring adequate disability insurance”.

Source and reference details

Men - Get it Off Your Chest

posted: 27/05/2009

Men know what's just expected and usually perform too - He's  the strong and silent type, Be a man, Boys don’t cry.
But men are people not machines. Our upbringing as boys involves harsh 'toughening up' and we see a lot of abuse and mockery if any male 'weakens' and shows feelings. So it is no surprise at all that men often find it really difficult to talk about their feelings. But it's confusing - we are blamed for doing what's been demanded of us since we were babies in arms - Big Boys Don't Cry - but  now we are told we are 'emotionally stunted' or and unable to show any feelings. Men can show feelings just fine - watch the crowd at any soccer game.

But everyone can feel low sometimes, and anyone can have a mental health problem. That’s why Mind, the mental health charity, is now telling men to Get it off your chest .
 

Mind have launched important new research into men and mental health. The findings paint a troubling picture:

• 37 per cent of men are feeling worried or low
• men account for 75 per cent of suicides
• only 23 per cent of men would see their GP if they felt low for over a fortnight
• men were only half as likely to talk to friends about problems as women
• 31 per cent of men would feel embarrassed about seeking help for mental distress.

Mind put a spotlight on this important issue that has been hiding in plain sight for too long. Mind wants the government to develop the first mental health strategy for men – as a women’s strategy has already been published. This new men's mental health strategy must consider the different ways men experience mental distress, and the different ways men prefer to find help.

Click the image to download and read the report

You can read Derek's account of how he got out of his 3 year long depression, and other men telling their own stories.

You can also read a former Chelsea football player's story of the injury which ended his career at just 24 and his descent into depression, after heavy drug use and watching the death of his baby son.

HIV and mental health

Mental health problems among men are much more common than people realise - often we hide things too well because we are taught to be the strong and silent type - and with HIV, at least 1 in 3 men (and women) report depression and other mental health struggles. It's smart to recognise we will often need help and it's never weak to talk about feelings. It's just human.

There is a choice of help - and helpers, including George House Trust - call our support team 0161 274 4499 or email

We also have some useful links to outside websites you may find helpful