Browsing by Author "Rodriguez, Violeta J"

Now showing 1 - 4 of 4
  • Thumbnail Image
    Item
    Cumulative Burden of Mental Health Factors and Engagement in HIV Care in Argentina
    (2021-06) Sued, Omar; Cecchini, Diego; Abbamonte, John M; Rodriguez, Violeta J; Mandell, Lissa; Cristofari, Nicholas; Figueroa, Maria Inés; Cassetti, Isabel; Cahn, Pedro; Weiss, Stephen; Alcaide, Maria; Cahn, Florencia; Calanni, Liliana; Crinejo, Ana; David, Daniel; Lupo, Sergio; Pérez, Carolina; Pérez, Rufina; Rodriguez, Claudia; Rolón, María José; Sisto, Alicia; Trapé, Liliana; Jones, Deborah
    Background: Cumulative burden of multiple mental health conditions may worsen physical health outcomes in vulnerable populations. Accordingly, identifying cumulative burdens of mental health conditions that may affect HIV treatment and care can guide public health strategies to reduce their impact on HIV-related health outcomes. This study examined the relationship between the cumulative burden of mental health conditions and factors associated with engagement in HIV care in Argentina. Method: Data for this study was obtained at baseline from Conexiones y Opciones Positivas en la Argentina 2 (COPA2). Participants (N = 360) were cisgender patients living with HIV who were lost to care, recruited from seven clinics serving people living with HIV in four Argentine urban centers. Cumulative burden of mental health conditions (i.e., depressive symptoms, problematic substance use, unhealthy alcohol use, and psychotic symptoms) was assessed. Results: Every one-point increase in the number of mental health conditions present was associated with a decrement in patient-provider communication (b = - 0.22, p < .001), self-efficacy (b = - 0.13, p = .012), and motivation for adherence (b = - 0.11, p = .039). Conclusion: This study found cumulative burden of depression, problematic substance use, unhealthy alcohol use, and psychotic symptoms to be negatively associated with factors related to engagement in HIV care. Results highlight the importance of identification and treatment of challenges to mental health, in order to ameliorate their influence on engagement in HIV care.
  • Thumbnail Image
    Item
    Motivational Interviewing Training for HIV Care Physicians in Argentina: Uptake and Sustainability of an Effective Behavior Change Intervention
    (2021-06) Rodriguez, Violeta J; Abbamonte, John M; Alcaide, Maria Luisa; Rodriguez Yanes, Nicolle L; de la Rosa, Aileen; Sued, Omar; Cecchini, Diego; Weiss, Stephen M; Jones, Deborah L
    Motivational interviewing (MI) utilizes a patient-centered approach to address patient ambivalence about treatment and has been found to improve treatment ART adherence among patients living with HIV disengaged from care. This study examined MI training for clinicians, uptake, and sustainability over time. Clinics (n = 7) with N = 38 physicians were randomized to condition (MI, Enhanced Standard of Care). Physicians completed video- recorded patient consultations at baseline and 6, 12, and 18-month follow-up. MI condition physicians had greater relational and technical scores over time and were more likely to adhere to and sustain MI over time. Overall, physicians found the MI training highly acceptable and were able to sustain their skills. Results illustrate the feasibility of MI training, implementation, and sustainment over 18 months. Findings support previous research in Argentina in which trained physicians found MI useful with challenging patients. Broader implementation of MI among HIV care physicians in Argentina is merited.
  • Thumbnail Image
    Item
    Suicidal Ideation Among Adults Re-engaging in HIV Care in Argentina
    (2019-12) Lissa N, Mandell; Rodriguez, Violeta J; De La Rosa, Aileen; John M, Abbamonte; Sued, Omar; Cecchini, Diego; Cassetti, Isabel; Sued, Omar; Cecchini, Diego; Cassetti, Isabel; Cahn, Pedro; Weiss, Stephen M; Jones, Deborah L; COPA Study Group
    Argentina has one of the highest suicide rates in Latin America and the Caribbean. Though people living with HIV are at increased risk for suicidal behavior, little research on suicide risk has been conducted among HIV-positive people in this region. This study examined risk factors for suicidal ideation among HIV-infected adults (N = 360) re-engaging in care in Argentina. Overall, 21% of participants reported suicidal ideation in the past week. In adjusted logistic regression models, younger age, increased depressive symptomatology, and drug abuse were associated with suicidal ideation (p < 0.05); decreased motivation for adherence and fewer months since initiating antiretroviral therapy approached significance (p = 0.07). Suicidal ideation was common in this sample of HIV-positive patients in Argentina. Findings highlight the need for routine risk assessment and interventions integrated into the HIV care continuum, addressing depression, substance use, and suicidal behavior.
  • Thumbnail Image
    Item
    Suicidality among nonadherent patients living with HIV in Buenos Aires, Argentina: prevalence and correlates
    (2018-04-01) Rodriguez, Violeta J; Sued, Omar; Cecchini, Diego; Mandell, Lissa N; Bofill, Lina; Weiss, Stephen M; Cassetti, Isabel; Cahn, Pedro; Jones, Deborah L
    Of those in the general population hospitalized for suicidal ideation and suicide attempts in Argentina, many reattempt suicide and are readmitted. However, few studies in Argentina have examined suicidal ideation and suicide-related behaviors among people living with HIV (PLHIV) and none have examined these factors among nonadherent PLHIV, though the prevalence of suicidal ideation in this group may be higher than in the general population and also than in other groups of PLHIV. This study of PLHIV in Buenos Aires, Argentina, examined the correlates of suicidal ideation in nonadherent PLHIV. Nonadherent patients with HIV (N = 118) were recruited from two clinics providing outpatient healthcare services to PLHIV in Buenos Aires, Argentina. Participants completed assessments on demographic characteristics, depression and suicidality, stigma, and self-efficacy. Participants were HIV-infected men (51%) and women (49%) with a median age of 40 years (IQR = 11). About half had completed high school or more, two-thirds were employed, and had a mean monthly income of 4196.79 (SD = 3179.64) Argentine pesos (USD$221). Thirty-three (28% [95% CI 20.3, 37.3]) participants reported suicidal ideation in the past two weeks, and one-third (35.6% [27.1, 44.9]) reported lifetime suicidal ideation. In bivariate analyses, attending a public clinic, being female, younger, unemployed, and experiencing greater stigma and depression were associated with suicidal ideation. In multivariable logistic regression, stigma interacted with the number of years since HIV diagnosis to predict suicidal ideation. The impact of stigma on suicidal ideation decreased with time since HIV diagnosis, suggesting that suicidal ideation may arise following HIV diagnosis due to perception of HIV-related stigma. Interventions to reduce perceived stigma during the period following HIV diagnosis may reduce suicidal ideation in this population. Organizational initiatives that explore HIV stigma microagressions in the healthcare setting may be needed to optimize health outcomes.