Network analysis of illness perception, stigma, and resilience with cognition in old people living with HIV

Yunzhe Fan; Bin Yu; Hongyun Liu; Hua Ma; Chunlan Ma; Yuchen Li; Chuanteng Feng; Peng Jia; Shujuan Yang

doi:10.1016/j.jpsychores.2023.111565

Network analysis of illness perception, stigma, and resilience with cognition in old people living with HIV

J Psychosom Res. 2024 Feb:177:111565. doi: 10.1016/j.jpsychores.2023.111565. Epub 2023 Dec 11.

Authors

Yunzhe Fan¹, Bin Yu², Hongyun Liu¹, Hua Ma¹, Chunlan Ma¹, Yuchen Li³, Chuanteng Feng⁴, Peng Jia⁵, Shujuan Yang⁶

Affiliations

¹ West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.
² West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China; Institute for Disaster Management and Reconstruction, Sichuan University-The Hong Kong Polytechnic University, Chengdu, China; Sichuan Research Center of Sexual Sociology and Sex Education, Chengdu, China.
³ MRC Epidemiology Unit, University of Cambridge, Cambridge, UK; Department of Geography, the Ohio State University, Columbus, OH, USA; International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan, China.
⁴ West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China; Institute for Disaster Management and Reconstruction, Sichuan University-The Hong Kong Polytechnic University, Chengdu, China.
⁵ International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan, China; School of Resource and Environmental Sciences, Wuhan University, Wuhan, China; Hubei Luojia Laboratory, Wuhan, China; School of Public Health, Wuhan University, Wuhan, China.
⁶ West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China; International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan, China; Department of Clinical Medical College, Affiliated Hospital of Chengdu University, Chengdu, China. Electronic address: rekiny@126.com.

PMID: 38128387
DOI: 10.1016/j.jpsychores.2023.111565

Abstract

Objectives: Old people living with HIV (PLWH) are highly susceptible to HIV-related psychological and neurocognitive disorders, which are multidimensional and inseparably intertwined. Despite this, few studies have investigated the interrelationship between these disorders. We aimed to estimate the detailed associations and identify potential intervention points between HIV-related psychological factors and cognitive function in old PLWH.

Methods: This cross-sectional study drew on the Older People with HIV Infections Cohort from 65 communities in Sichuan, China. Three HIV-related psychological factors, including illness perception, HIV stigma perception and resilience, were collected using a self-reported questionnaire. Cognitive function was measured using the MoCA-B scale. Network analysis was used to estimate the interrelationships between HIV-related psychological factors and cognitive function dimensions in old PLWH, and to identify factors that act as bridges in connecting these factors in the network.

Results: Of the 1587 old PLWH, 47.0% had mild or severe cognitive function impairment. Network analysis revealed that better visual perception was directly connected with poorer negative self-image (edge weight: 0.13), and poorer illness comprehensibility was connected with poor visual perception (-0.09) and executive functioning (-0.13). The cognitive illness perceptions (bridge strength: 0.41), illness comprehensibility (0.36) and negative self-image (0.39) were identified as bridges connecting HIV-related psychological and cognitive function.

Conclusions: The interconnection of HIV-related illness perception, stigma perception, and resilience with cognition may be achieved through the links of negative self-image, illness comprehensibility and cognitive illness perceptions. These factors may serve as potential non-pharmaceutical action points to improve psychological and cognitive health among old PLWH.

Keywords: Cognitive function; Network analysis; Old people living with HIV; Psychological factors.

MeSH terms

Aged
Cognition
Cross-Sectional Studies
HIV Infections* / complications
HIV Infections* / psychology
Humans
Perception
Resilience, Psychological*
Social Stigma
Surveys and Questionnaires