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.
[Photo: Dr. Shan Qiao]
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.
University of South Carolina Assistant Professor Dr. Shan Qiao, in the Arnold School of Public Health’s 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 Dr. Xiaoming Li have been investigating HIV/AIDS with NIH funds for years.
With this newly established cohort, Dr. 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, Dr. 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,” Dr. 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.”