Body image in women with HIV: a cross-sectional evaluation
Tóm tắt
HIV lipodystrophy syndrome is a recognized complication of potent antiretroviral therapy and is characterized by often dramatic changes in various body fat stores, both central and peripheral. Given prior findings of heightened body image dysphoria among HIV-infected men with lipodystrophy as compared to HIV-infected men without lipodystrophy, we sought to determine body image among HIV-infected and HIV-negative women and to determine the relationship of HIV and lipodystrophy with body image. Our a priori hypothesis was that women with HIV and lipodystrophy would have significantly poorer body image as compared to women without HIV and to women with HIV without lipodystrophy. 116 women responded to two previously validated self-report instruments (Body Image Quality of Life Index (BIQLI) and the Situational Inventory of Body-Image Dysphoria – Short Form (SIBID-S)) on body image. 62 (53% subjects) HIV-infected women were recruited at the university-based HIV clinic. 54 (47% subjects) HIV-negative female controls were recruited from another study evaluating bone density in otherwise healthy controls. 96% identified their sexual orientation as women having sex with men. Among the HIV-infected group, 36 reported the presence of lipodystrophic characteristics and 26 reported no lipodystrophic changes. Agreement regarding the presence of lipodystrophy between physician and subject was 0.67 as measured by the kappa coefficient of agreement. Compared to HIV-negative women, HIV-positive women demonstrated poor body image as measured by BIQLI (p = 0.0009). Compared with HIV-infected women who denied lipodystrophy, HIV-infected women with self-reported lipodystrophy demonstrated poor body image as measured by BIQLI (p = 0.02) and SIBID-S scales (p = 0.001). We demonstrate that HIV and lipodystrophy status among women is associated with poor body image. Universal efforts should be made in the HIV medical community to recognize body image issues particularly among persons affected by lipodystrophy so that appropriate intervention and support may be provided.
Tài liệu tham khảo
Lichtenstein KA: Redefining lipodystrophy syndrome: risks and impact on clinical decision making. J AcquirImmune Defic Syndr. 2005, 39 (4): 395-400. 10.1097/01.qai.0000167478.28051.3a.
Nolan D, Mallal S: Antiretroviral-therapy-associated lipoatrophy: current status and future directions. Sex Health. 2005, 2 (3): 153-63. 10.1071/SH04058
Martinez SM, Kemper CA, Diamond C, Wagner G: Body Image in Patients with HIV/AIDS:Assessment of a new psychometric measure and its medical correlates. AIDS Patient Care STDS. 2005, 19 (3): 150-6. 10.1089/apc.2005.19.150
Blanch J, Rousand A, Martinez E: Factors associated with severe impact of lipodystrophy on the quality of life of patients infected with HIV-1. Clin Infect Dis. 2004, 38: 1464-70. 10.1086/383573
Goetzenich A, Carzillius M, Mauss S: Impact of lipodystrophy on quality of life [abstract]. Program andabstracts of the 13th International AIDS Conference (Durban, South Africa). 2000, Stockholm: International AIDS Society
Schrooten W, Colebunders R, Youle M: Sexual dysfunction associated with protease inhibitor containing highly active antiretroviral treatment. AIDS. 2001, 15: 1019-23. 10.1097/00002030-200105250-00010
Dukers N, Stolte IG, Albrecht N, Coutinho RA, de Wit JB: The impact of experiencing lipodystrophy on the sexual behavior and well-being among HIV-infected homosexual men. AIDS. 2001, 15: 812-13. 10.1097/00002030-200104130-00025
Huang JS, Lee D, Becerra K, Santos R, Barber E, Mathews WC: Body Image in Men with HIV. AIDS Pt Care STDs. 1/06
Anderson CB, Bulik CM: Gender differences in compensatory behaviors, weight and shape salience, and drive for thinness. EatBehav. 2004, 5: 1-11.
Lokken K, Ferraro FR, Kirchner T, Bowling M: Gender differences in body size dissatisfaction among individuals with low, medium, or high levels of body focus. J Gen Psychol. 2003, 130: 305-10.
Mintz LB, Bentz NE: Sex differences in the nature, realism, and correlates of body image. Sex Roles. 1986, 15: 185-195. 10.1007/BF00287483.
Cash TF, Fleming EC: The impact of body-image experiences: Development of the Body Image Quality of Life Inventory. Int J Eat Disord. 2002, 31: 455-460. 10.1002/eat.10033
Cash TF: Body image: past, present, and future. Body Image. 2004, 1: 1-5. 10.1016/S1740-1445(03)00011-1.
Kralik D: The quest for ordinariness: transition experienced by midlife women living with chronic illness. J Adv Nurs. 2002, 39: 146-54. 10.1046/j.1365-2648.2000.02254.x
Roubenoff R: Acquired immunodeficiency syndrome wasting, functional performance, and quality of life. Am J Manag Care. 2000, 6: 1003-16.
Cash TF, Henry E: Women's body images: the results of a national survey in the USA. Sex Roles. 1995, 33: 19-28. 10.1007/BF01547933.
Stewart AD, Benson PJ, Michanikou EG, Tsiota DG, Karli MK: Body image perception, satisfaction and somatotype in male and female athletes and non-athletes: results using a novel morphing technique. J Sports Sci. 2003, 21: 815-823. 10.1080/0264041031000140338
Tom G, Chen A, Liao H, Shao J: Body image, relationships and time. J Psychol. 2005, 139: 458-68.
Broughton G, Horton B, Lipschitz A, Kendel JM, Brown S, Rohrich RJ: Lifestyle outcomes, satisfaction, and attitudes of patients after liposuction: a Dallas experience. Plast Reconstr Surg. 2006, 117: 1738-49. 10.1097/01.prs.0000218986.02861.3f
Crago M, Shisslak CM, Estes LS: Eating disturbances among American minority groups: a review. Int J Eat Disord. 1996, 19: 239-48. 10.1002/(SICI)1098-108X(199604)19:3<239::AID-EAT2>3.0.CO;2-N
Cachelin FM, Rebeck RM, Chung GH, Pelayo E: Does ethnicity influence body-size preference? A comparison of body image and body size. Obes Res. 2002, 10: 158-66.
Akan GE, Grilo CM: Sociocultural influences on eating attitudes and behaviors, body image, and psychological functioning: a comparison of African-American, Asian-American, and Caucasian college women. Int J Eat Disord. 1995, 18: 181-7.
Mintz LB, Kashubeck S: Body image and disordered eating among Asian American and Caucasian college students. Psychol Women Quart. 1999, 23: 781-96. 10.1111/j.1471-6402.1999.tb00397.x.
Tsai CY, Hoerr SL, Song WO: Dieting behavior of Asian college women attending a U.S. university. J Am College Health. 1998, 46: 163-70.
Oette M, Juretzko P, Kroidl A: Lipodystrophy syndrome and self-assessment of well-being and physical appearance in HIV-positive patients. AIDS Patient Care STDS. 2002, 16: 413-7. 10.1089/108729102760330254
Alonzo AA, Reynolds NR: Stigma, HIV and AIDS: An exploration and elaboration of a stigma trajectory. Soc Sci Med. 1995, 41: 303-315. 10.1016/0277-9536(94)00384-6
Paxton S: Public disclosure of serostatus – the impact on HIV-positive people. Sex Health Exch. 2000, 9: 13-14.
Kang E, Rapkin BD, Remien RH, Mellins CA, Oh A: Multiple dimensions of HIV stigma and psychological distress among Asians and Pacific Islanders living with HIV illness. AIDS Behav. 2005, 9: 145-154. 10.1007/s10461-005-3896-9
Valdiserri RO: HIV/AIDS stigma: An impediment to public health. Am J Public Health. 2002, 92: 341-42.
Lichtenstein B, Laska MK, Clair JM: Chronic sorrow in the HIV-positive patient: issues of race, gender, and social support. AIDS Patient Care STDs. 2002, 16: 27-38. 10.1089/108729102753429370
Petrak JA, Doyle AM, Smith A, Skinner C, Hedge B: Factors associated with self-disclosure of HIV serostatus to significant others. Br J Health Psychol. 2001, 6: 69-79. 10.1348/135910701169061
Chandra PS, Deepthivarma S, Manjula V: Disclosure of HIV infection in south India: patterns, reasons, and reactions. AIDS Care. 2003, 15: 207-15. 10.1080/0954012031000068353
Derlega VJ, Winstead BA, Greene K, Serovich J, Elwood WJ: Perceived HIV-related stigma and HIV disclosure to relationship partners after finding out about the seropositive diagnosis. J Health Psychol. 2002, 7: 415-432. 10.1177/1359105302007004330.
Sansone RA, Sansone LA, Gaither GA, Morris JL: Patient attitudes toward weight gain with medications. Gen Hosp Psychiatry. 2004, 26: 487-489. 10.1016/j.genhosppsych.2004.06.006
Ammassarri A, Antinori A, Cozzi-Lepri A: Relationship between HAART adherence and adipose tissue alterations. J Acquir Immune Defic Syndr. 2001, 31: S140-S144.
Duran S, Saves M, Spire B: Failure to maintain long-term adherence to highly active antiretroviral therapy: the role of lipodystrophy. AIDS. 2001, 15: 2441-44. 10.1097/00002030-200112070-00012
Silversides A: Protease inhibitors raising quality-of-life issues for HIV patients. CMAJ. 1999, 160: 894-
Cash TF, Jakatdar TA, Williams EF: The Body Image Quality of Life Inventory: further validation with college men and women. Body Image. 2004, 1: 279-87. 10.1016/S1740-1445(03)00023-8.
Cash TF: The situational inventory of body-image dysphoria: contextual assessment of a negative body image. The Behavior Therapist. 1994, 17: 133-34.
Muth JL, Cash TF: Body-image attitudes: what difference does gender make?. J Appl Soc Psychol. 1997, 27: 1438-52. 10.1111/j.1559-1816.1997.tb01607.x.
Grant JR, Cash TF: Cognitive behavioral body-image therapy: Comparative efficacy of group and modest-contact treatments. Behav Ther. 1995, 26: 69-84. 10.1016/S0005-7894(05)80083-8.
Cash TF, Lavalee DM: Cognitive-behavioral body-image therapy: Further evidence of the efficacy of a self-directed program. J Rational-Emotive and Cognitive-Behavior Therapy. 1997, 15: 281-94. 10.1023/A:1025041926081.
Cash TF: The situational inventory of body-image dysphoria: psychometric evidence and development of a short form. Int J Eat Disord. 2002, 32 (3): 362-6. 10.1002/eat.10100
Simes RJ: An improved Bonferroni procedure for multiple tests of significance. Biometrika. 1986, 73: 751-4. 10.2307/2336545.