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Divinity and Distress: The Impact of Religion and Spirituality on the Mental Health of HIV-Positive Adults in Tanzania

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Abstract

This study examined the relationship between religiosity, spirituality and mental health in the context of a stress–coping framework. Participants were 135 rural, low-income HIV-positive adults in Iringa, Tanzania. The relationships between religiosity, spirituality, coping responses, social support, and psychological distress (depression, anxiety, and stress) were examined using structural equation modeling. Religiosity was related to decreased avoidant coping and increased social support, which in turn were related to psychological distress. Spirituality was positively related to active coping and social support. Results suggest that coping strategies and social support may mediate the relationship between religiosity and spirituality and psychological distress. Interventions to reduce psychological distress among HIV-positive individuals in Tanzania might incorporate strategies to reduce avoidant coping and increase social support. According to the present findings, this may be accomplished through faith-based approaches that incorporate religious and spiritual activities into HIV prevention programs.

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References

  1. UNAIDS report on the global AIDS epidemic; 2010.

  2. Epidemiological fact sheet on HIV and AIDS, United Republic of Tanzania; 2008.

  3. Simoni JM, et al. Spirituality and psychological adaptation among women with HIV/AIDS: implications for counseling. J Counsel Psychol. 2002;49(2):139–47.

    Article  Google Scholar 

  4. Woods TE, et al. Religiosity is associated with affective status in symptomatic HIV-infected African American women. J Health Psychol. 1999;4(3):317–26.

    Article  PubMed  CAS  Google Scholar 

  5. Morse EV, et al. The use of religion among HIV-infected African American women. J Relig Health. 2000;39(3):261–76.

    Article  Google Scholar 

  6. Levin JS, et al. Religious effects on health status and life satisfaction among Black Americans. J Gerontol Psychol Sci Soc Sci. 1995;50(3):154–63.

    Article  Google Scholar 

  7. Simoni JM, Ortiz MZ. Mediational models of spirituality and depressive symptomatology among HIV-positive Puerto Rican women. Cult Divers Ethn Minor Psychol. 2003;9(1):3–15.

    Article  Google Scholar 

  8. Ironson G, et al. The Ironson–Woods spirituality/religiousness index is associated with long survival, health behaviors, less distress, and low cortisol in people with HIV/AIDS. Ann Behav Med. 2002;24(1):34–48.

    Article  PubMed  Google Scholar 

  9. Ross CE. Religion and psychological distress. J Sci Study Relig. 1990;29(2):236–45.

    Article  Google Scholar 

  10. Koenig HG. Use of acute hospital services and mortality among religious and non-religious copers with medical illness. J Relig Gerontol. 1995;9(3):1–21.

    Article  Google Scholar 

  11. Flannelly LT, Inouye J. Relationships of religion, health status, and socioeconomic status to the quality of life of individuals who are HIV positive. Issues Ment Health Nurs. 2001;22(3):253–72.

    Article  PubMed  CAS  Google Scholar 

  12. Mattis JS. African American women’s definitions of spirituality and religiosity. J Black Psychol. 2000;26(1):101–22.

    Article  Google Scholar 

  13. Miller WR, Thoresen CE. Spirituality, religion, and health: an emerging research field. Am Psychol. 2003;58(1):24–35.

    Article  PubMed  Google Scholar 

  14. National Bureau of Statistics (NBS) [Tanzania] and ORC Macro. Tanzania Demographic and Health Survey 2003–04. Dar es Salaam, Tanzania: National Bureau of Statistics and ORC Macro; 2004.

  15. Pargament KI, et al. Patterns of positive and negative religious coping with major life stressors. J Sci Study Relig. 1998;37(4):710–24.

    Article  Google Scholar 

  16. Prado G, et al. Religious involvement, coping, social support, and psychological distress in HIV-seropositive African American mothers. AIDS Behav. 2004;8(3):221–35.

    Article  PubMed  Google Scholar 

  17. Siegel K, Schrimshaw EW. The perceived benefits of religious and spiritual coping among older adults living with HIV/AIDS. J Sci Study Relig. 2002;41(1):91–102.

    Article  Google Scholar 

  18. Lazarus RS, Folkman S. Stress, appraisal and coping. New York: Springer; 1984.

    Google Scholar 

  19. Schmitz MF, Crystal S. Social relations, coping, and psychological distress among persons with HIV/AIDS. J Appl Soc Psychol. 2000;30(4):665–83.

    Article  Google Scholar 

  20. Hoffman MA. Counseling clients with HIV disease. New York: Guilford Press; 1996.

    Google Scholar 

  21. Namir S, et al. Coping with AIDS: psychological and health implications. J Appl Soc Psychol. 1987;17(3):309–28.

    Article  Google Scholar 

  22. Nicholson WD, Long BC. Self-esteem, social support, internalized homophobia, and coping strategies of HIV gay men. J Consult Clin Psychol. 1990;58(6):873–6.

    Article  PubMed  CAS  Google Scholar 

  23. Reed GM et al. Coping responses and psychological adjustment in gay men with AIDS: a longitudinal analysis. In: Paper presented at the sixth international conference on AIDS, San Francisco, CA; 1990.

  24. Wolf TM, et al. Relationship of coping to affective state and perceived social support in asymptomatic and symptomatic HIV infected persons: implications for clinical management. J Clin Psychol. 1991;52(4):171–3.

    CAS  Google Scholar 

  25. DeGenova MK, et al. Ways of coping among HIV-infected individuals. J Soc Psychol. 1994;134(5):655–63.

    Article  PubMed  CAS  Google Scholar 

  26. Moneyham L, et al. The effectiveness of coping strategies used by HIV-seropositive women. Res Nurs Health. 1998;21(4):351–62.

    Article  PubMed  CAS  Google Scholar 

  27. Lutgendorf S, et al. Psychosocial counseling to improve quality of life in HIV infection. Patient Educ Couns. 1994;24(3):217–35.

    Article  PubMed  CAS  Google Scholar 

  28. Pargament KI, et al. Religious coping among the religious: the relationship between religious coping and well-being in a national sample of Presbyterian clergy, elders, and members. J Sci Study Relig. 2001;40(3):497–513.

    Article  Google Scholar 

  29. Wright SD, et al. Spiritual support for caregivers of dementia patients. J Relig Health. 1985;24(1):31–8.

    Article  Google Scholar 

  30. Pfeiffer E. A short portable mental status questionnaire for the assessment of organic brain deficit in elderly patients. J Am Geriatric Soc. 1975;23(10):433–41.

    CAS  Google Scholar 

  31. Koenig HG, et al. Religion index for psychiatric research: a 5-item measure for use in health outcome studies. Am J Psychiatry. 1997;154(6):885–6.

    PubMed  CAS  Google Scholar 

  32. Peterman AH, et al. Measuring spiritual well-being in people with cancer: the functional assessment of chronic illness therapy—spiritual well-being scale (FACIT-Sp). Ann Behav Med. 2002;24(1):49–58.

    Article  PubMed  Google Scholar 

  33. Sarason IG, et al. A brief measure of social support: practical and theoretical implications. J Social Pers Relat. 1987;4(4):497–510.

    Article  Google Scholar 

  34. Carver CS. You want to measure coping but your protocol’s too long: consider the Brief COPE. Int J Behav Med. 1997;4(1):92–100.

    Article  PubMed  CAS  Google Scholar 

  35. Blaney NT, et al. A psychosocial model of distress over time in early HIV-1 infection: the role of life stressors, social support and coping. Psychol Health. 1997;12(5):633–53.

    Article  Google Scholar 

  36. Feaster DJ, Szapocznik J. Interdependence of stress process among African American family members: influence of HIV serostatus and a new infant. Psychol Health. 2002;17(3):339–63.

    Article  PubMed  Google Scholar 

  37. Goodkin K, et al. Active coping style is associated with natural killer cell cytotoxicity in asymptomatic HIV-1 seropositive homosexual men. J Psychosom Res. 1992;36(7):635–50.

    Article  PubMed  CAS  Google Scholar 

  38. Lovibond PF, Lovibond SH. The structure of negative emotional states: comparison of the depression anxiety stress scales (DASS) with the Beck depression and anxiety inventories. Behav Res Therapy. 1995;3(3):335–43.

    Article  Google Scholar 

  39. Little TD, et al. To parcel or not to parcel: exploring the question, weighing the merits. Struct Equ Model. 2002;9(2):151–73.

    Article  Google Scholar 

  40. Jaccard J, Wan CK. LISREL approaches to interaction effects in multiple regression. Newbury Park: Sage; 1996.

    Google Scholar 

  41. Loehlin JC. Latent variable models: an introduction to factor, path, and structural analysis. 3rd ed. Hilldale: Lawrence Erlbaum; 1998.

    Google Scholar 

  42. Wallace JM, Forman TA. Religion’s role in promoting health and reducing risk among American youth. Health Educ Behav. 1998;25(6):721–41.

    Article  PubMed  Google Scholar 

  43. Strawbridge WJ, et al. Frequent attendance at religious services and mortality over 28 years. Am J Public Health. 1997;87(6):957–61.

    Article  PubMed  CAS  Google Scholar 

  44. Spinale J, et al. Spirituality, social support, and survival in hemodialysis patients. Clin J Am Soc Nephrol. 2008;3(6):1620–7.

    Article  PubMed  Google Scholar 

  45. Frydenberg E, Lewis R. Relation among well-being, avoidant coping, and active coping in a large sample of Australian adolescents. Psychol Rep. 2009;104(3):745–58.

    Article  PubMed  Google Scholar 

  46. Bryant RA, Harvey AG. Avoidant coping style and post-traumatic stress following motor vehicle accidents. Behav Res Therapy. 1995;33(6):631–5.

    Article  CAS  Google Scholar 

  47. Seiffge-Krenke I, Klessinger N. Long-term effects of avoidant coping on adolescents’ depressive symptoms. J Youth Adolesc. 2000;29(6):617–30.

    Article  Google Scholar 

  48. Stowell JR, et al. Perceived stress and cellular immunity: when coping counts. J Behav Med. 2001;24(4):323–39.

    Article  PubMed  CAS  Google Scholar 

  49. Bussing A, et al. Spirituality, religiosity, and dealing with illness in Arabic and German patients. Saudi Med J. 2007;28(6):933–42.

    PubMed  Google Scholar 

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Acknowledgments

We would like to thank the recruitment and data analysis staff who contributed to the present study. We would also like to thank the men and women who participated in this study. This work was supported by a Heaney Fellowship from the Yale School of Public Health and a Global Health Initiative Field Experience Award from Yale University to Jeremy Steglitz, Principal Investigator.

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Authors and Affiliations

  1. Social and Behavioral Sciences Division, Yale School of Public Health, New Haven, CT, 06511, USA

    Jeremy Steglitz, Reuben Ng & Trace Kershaw

  2. Primary Health Care Institute—Iringa, P.O. Box 235, Iringa, Tanzania

    John S. Mosha

  3. Yale School of Public Health, Room 415, 60 College, New Haven, CT, 06510, USA

    Jeremy Steglitz & Trace Kershaw

Authors
  1. Jeremy Steglitz
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  2. Reuben Ng
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  3. John S. Mosha
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  4. Trace Kershaw
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Correspondence to Trace Kershaw.

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Steglitz, J., Ng, R., Mosha, J.S. et al. Divinity and Distress: The Impact of Religion and Spirituality on the Mental Health of HIV-Positive Adults in Tanzania. AIDS Behav 16, 2392–2398 (2012). https://doi.org/10.1007/s10461-012-0261-7

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  • DOI: https://doi.org/10.1007/s10461-012-0261-7

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