April 18, 2016 | Erin Bluvas, [email protected]
As a result of scientists and other health experts battling the human immunodeficiency virus (HIV), new infections of this disease have decreased by 38 percent globally since 2001. However, HIV remains one of the most serious health problems for populations around the world. And the challenges of living with HIV or acquired immune deficiency syndrome (AIDS), the last and most serious stage of HIV, continue to create difficulties for those living with HIV or AIDS as well as their families. This is particularly the case for people living in low- and middle-income countries.
An important part of living with HIV/AIDS is disclosing the condition within medical, familial and social contexts. Previous research indicates that disclosure has positive effects on infected individuals’ management of the disease by facilitating social support, access and adherence to medical treatment, and stress reduction. However, these studies have not fully explored how disclosure impacts clinical outcomes, such as viral load and disease progression.
Assistant Professor Shan Qiao, Department of Health Promotion, Education, and Behavior (HPEB), will use her recently awarded $362K R21, two-year grant from the National Institute of Allergy and Infectious Diseases to help fill this gap in the research. She and her team will examine the effects of disclosure on the clinical outcomes of 400 newly diagnosed HIV patients in Guangxi, China, where she and mentor Xiaoming Li have been investigating HIV/AIDS with NIH funds for years.
With this newly established cohort, Qiao will be able to investigate long-term effects, which is another aspect that has not been adequately examined until now, of disclosure on clinical outcomes. Another unique feature of her study is that it will assess how pathways play a role in these outcomes. Recent research, which is still largely hypothetical, suggests two potential pathways: biological (e.g., affecting the neuroendocrine and sympathetic nervous response to chronic stress) and behavioral (e.g., affecting the behaviors that are crucial to medication adherence). In addition, Qiao’s measures will go beyond the typical self-reported data that has been primarily used in previous studies to include objective biomedical measures as well.
“This study addresses the importance of investigating how positive psychosocial and behavioral factors, such as HIV disclosure, may ‘get under the skin’ to influence physical health,” Qiao explains. “We suspect that there are a number of factors, such as gender, age, disease stage, perceived social support, stigma and others, that may mediate the effects of HIV disclosure on clinical outcomes for people living with HIV. Our research aims to answer these questions more definitively.”
Li, who is an HPEB Professor as well as the Director of the S.C. SmartState Center for Healthcare Quality, has worked with Qiao on numerous projects related to HIV research, serving as a mentor along the way. “We are very excited about this grant, which is a logical extension and advancement of the work Shan has been doing since her post-doc years,” he says. “The success of this grant application is a good example of how a junior scholar can develop a research direction: build up and be persistent.”
The findings from this study will contribute to the knowledge base related to HIV disclosure and subsequently, prevention and treatment. “We will be able to use this information to enhance future HIV disclosure interventions,” says Qiao. “This will help maximize the benefits of HIV disclosure to people living with HIV and their families, as well as improve the quality of HIV treatment and care in China and other low-and middle-income countries.”
Research reported in this publication was supported by the National Institute Of Allergy And Infectious Diseases of the National Institutes of Health under Award Number R21AI122919. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.