Browsing by Subject "Medical care--Utilization--Economic aspects--United States"
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Item The effects of gender, ethnicity and socio-economic status on coping with HIV(2008-05) Oppenheimer, Marian Ehrich, 1969-; McCarthy, ChrisThe study examined the correlations between gender, ethnicity, socio-economic status, self-reported mode of exposure to HIV, the types of coping strategies utilized, social support, perceived stress, preventive resources, depression, and disease progression among 79 HIV+ patients, eleven of which were Spanish speaking, seen at a federally and city funded HIV/AIDS clinic. The first aim was to demonstrate that there is a linear relationship between gender, ethnicity, the manner in which one copes with the HIV infection (utilizing problem-focused strategies versus emotion-focused strategies), and the progression of HIV as measured by each participant’s CD4 count. The second aim of the study was to show that the higher the frequency of seeking medical support at the HIV/AIDS clinic, the lower the rate of HIV progression as measured by the CD4 count. The third aim of the study was to demonstrate that there is a significant difference in the types of coping strategies utilized by differing ethnicities to combat the stress related to HIV. Findings indicated that among the 78 participants who completed the surveys, housing status (homeless versus having a home), intravenous drug use (IVDU), Escape-Avoidance behavior, Positive Reappraisal, the perception of having familial support, and the perception of mastery were all significantly correlated with the difference in the CD4 count initially obtained at the time of the interview and the CD4 count that was obtained again 3 through 15 months later. Of the 17 of the total 78 participants who did not return to the clinic consistently, housing status was found to be significantly correlated with the difference in the CD4 count initially obtained at the time of the interview and the CD4 count that was obtained again 3 through 8 months later. Of the 61 of the 78 participants who did return to the clinic consistently, IVDU, the perception of family as supportive, the perception of having sources of comfort, the perception of the ability to scan the environment as a resource, the perception that one recognizes the opportunity to prevent stress, perceived control, the perception that one has control, the perception that one has efficacy, the perception that one can master tasks, and the perception that one can maintain self-direction were all significantly correlated with the difference in the CD4 count initially obtained at the time of the interview and the CD4 count that was obtained again 9 through 15 months later. Therefore, there was a significant difference between those patients who returned for consistent medical treatment at the clinic versus those who attended the clinic infrequently. The issues pertaining to the adherence of medical treatment as well as attempts to buffer the positive coping strategies that facilitate adherence are of critical importance to current prevention measures. In addition, it was found that there were significant differences in the manner in which differing ethnicities coped with the stressors related to HIV. The study revealed that among the 25 black men and women, coping by accepting responsibility, and coping by positively reappraising situations were predictive of ethnicity. Among the 21 Hispanic men and women and the 31 white men and women who participated in the study, none of the coping strategies were predictive of ethnicity. The identification of the differential manners in which each ethnicity copes with the stressors related to HIV has the potential to bolster both HIV treatment and prevention efforts. Further research needs to be conducted in order to further explore these important issues.