alexa Culturally Sensitive Approaches to Identification and Treatment of Depression among HIV Infected African American Adults: A Qualitative Study of Primary Care Providers Perspectives
ISSN: 2167-1044

Journal of Depression and Anxiety
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Research Article

Culturally Sensitive Approaches to Identification and Treatment of Depression among HIV Infected African American Adults: A Qualitative Study of Primary Care Providers Perspectives

Huynh-Nhu Le1, Maria Mananita S Hipolito2*, Sharon Lambert1, Flora Terrell-Hamilton3, Narayan Rai2, Charlee McLean2, Suad Kapetanovic4 and Evaristus Nwulia2
1Department of Psychology, George Washington University, Washington, D.C., USA
2Translational Neuroscience Laboratory, Department of Psychiatry, Howard University, Washington, D.C., USA
3Family and Medical Counseling Service, Inc. Washington, D.C. USA
4University of Southern California, Los Angeles, California, USA
*Corresponding Author : Maria Mananita S Hipolito, MD
Translational Neuroscience Laboratory
Howard University Hospital
Rm. 6B20, 2041 Georgia Avenue
NW Washington, D.C., 20060, USA
Tel: 202-865-1751
E-mail: [email protected]
Received: March 10, 2016; Accepted: March 30, 2016; Published: April 03, 2016
Citation: Le HN, Hipolito MMS, Lambert S, Terrell-Hamilton F, Rai N, et al. (2016) Culturally Sensitive Approaches to Identification and Treatment of Depression among HIV Infected African American Adults: A Qualitative Study of Primary Care Providers’ Perspectives. J Depress Anxiety 5:223. doi:10.4172/2167-1044.1000223
Copyright: © 2016 Le H, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
 

Abstract

Background: Major depressive disorder (MDD) is highly prevalent among HIV-infected (HIV+) individuals, and is associated with non-adherence to antiretroviral therapy (ART), and accelerated disease progression. MDD is underdiagnosed and undertreated among low-income African Americans, who are disproportionately impacted by the HIV epidemic. To improve detection and treatment of depression among African Americans living with HIV/AIDS, it is important to understand culturally and contextually relevant aspects of MDD and attitudes about mental health treatment. Methods: A focus group session was conducted with seven providers and staff at a primary care center that serves a largely African-American community heavily impacted by the HIV epidemic in Washington, DC. Data were analyzed using an inductive approach to distill prominent themes, perspectives, and experiences among participating providers. Results: Five themes emerged to characterize the lived experiences of HIV+ African-American patients: (a) Changes in perceptions of HIV over time; (b) HIV is comorbid with mental illness, particularly depression and substance abuse; (c) Stigma is associated with both HIV and depression; (d) Existing mental health services vary and are insufficient and (e) Suggestions for optimal treatment for comorbid HIV and depression. Limitation: This study reflects the views of providers from one clinic in this community. Conclusion: Substantial economic disadvantage, pervasive childhood adversity, limited education and limited resources jointly put members of this community at risk for acquisition of HIV and for development of depression and addictions. These contextual factors provide an important reminder that any patient-level depression identification or intervention in this community will have to be mindful of such circumstances.

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