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Background: Depression is one of the greatest public health problems worldwide. The potential benefit of social participation (SP) on mental health has been widely acknowledged. Nevertheless, a few studies have used propensity score matching (PSM) to reduce the influence of data bias and confounding variables. This study explored the effect of social participation on depression among middle-aged and older Chinese persons through a PSM method, considering the frequency, type, and quantity of SP. Effects were compared among different age groups, genders, and places of residence. Methods: The datasets were obtained from the 2018 wave of the China Health and Retirement Longitudinal Study. A total of 9,404 respondents aged 45 and above were included in the study. PSM and ordinary least squares methods were used to estimate the effect of social participation on depression. Results: PSM estimation results showed that SP had a significantly positive effect on decreasing depression scores (p < 0.001) by 0.875–0.898 compared with persons without SP. All types of SP had a significantly positive effect (p < 0.001), and participating in community activities had the largest effect (β = −1.549 to −1.788, p < 0.001). Higher frequency of participation and more types of SP promoted lower depression scores; subgroup analyses revealed that the promotion effect was significantly greater among women, those aged ≥75 years, and those living in urban areas. Conclusion: PSM indicated that SP could alleviate the depression of middle-aged and older Chinese persons. Targeted measures should be adopted to promote SP and thereby improve mental health and promote healthy and active aging. [ABSTRACT FROM AUTHOR]

Standards of HIV/AIDS prevention and control in some areas of China are still poor. People live longer with the use of therapeutic drugs, which may lead to an increase in the number of HIV-associated neurocognitive disorders (HAND). However, only a few multicenter and large-scale studies investigating the prevalence and incidence of HAND have been undertaken in China. While the number of HIV/AIDS cases in China is still large, the prevalence of HAND is remains unclear. The diagnosis of HAND in China is mainly based on the international diagnostic scale, to which Chinese features are added. At present, five classes of antiretroviral therapy drugs widely used in China: nucleoside reverse transcriptase inhibitors (NRTIs), non-NRTIs (NNRTIs), protease inhibitors, integrase inhibitors, and membrane fusion inhibitors (FIs). There is no specific treatment or drug for HAND in China. Efforts are needed in the following aspects: trying to understand more epidemic features of HAND in China; formulating a unified neuropsychological scale with Chinese characteristics to diagnose HAND and adopt new approaches to identify different stages of HAND; early stage (reversible) accurate hierarchical prediction and diagnosis, combined with artificial intelligence to improve the work efficiency of doctors, and to solve the failure of outpatient diagnosis cases (asymptomatic patients); and exploring and establishing a perfect system for target treatment with HAND.( [ABSTRACT FROM AUTHOR]

Exposure to nicotine among people living with HIV (PLWH) may impact physical health as indicated by experienced symptoms. Yet, the empirical evidence documenting the relations between tobacco use and symptom experiences among PLWH remains limited. This study aims to assess the relationships between tobacco use and HIV symptoms through a cross-sectional survey conducted in Beijing and Shanghai. The WHO ASSIST screening test was used for frequency of tobacco use. Sixty-four items from the revised signs and symptoms checklist for persons with HIV disease (SSC-HIVrev) were used. "Total number of symptoms" was created by summing all the binary coded and "Maximal symptom severity" was created by taking the maximal severity level across all symptoms for each participant. After controlling for confounding variables, tobacco use was not associated with the total number of symptom, yet was associated with the maximal symptom severity. This study documents the link between tobacco use and experienced symptoms among PLWH by demonstrating that higher frequency of tobacco use is associated with greater odds of reporting more severe symptoms. Smoking cessation strategies should be integrated into symptom management interventions for PLWH to optimize their effectiveness. [ABSTRACT FROM AUTHOR]

Unemployment is associated with depression in people living with HIV (PLWH). However, few studies have examined the effects of unemployment on PLWH with different levels of depression. The current study explores the plausible differential effects of unemployment on the different percentiles of depression in PLWH employing a quantile regression (QR) approach, based on a recent survey of 411 PLWH in China. Among participants, 47.7% had elevated depressive symptoms, and 23.8% were unemployed. The effects of unemployment on depression were statistically significant with a trend of initial increase followed by a decline at the quantile levels of 0.51–0.90 of depression. The maximum effect of unemployment status on depression was statistically significant at the 70th and 75th percentiles of depression (coefficient = 7.0, p <.01). Tailored strategies and interventions should be implemented to address the differential needs of PLWH with various levels of depressive symptoms. [ABSTRACT FROM AUTHOR]

HIV-infected (HIV+) women may be more vulnerable to neurocognitive impairment (NCI) due to psychological and physiological factors but previous studies show mixed findings. We investigated the neurocognitive performances in HIV+ versus HIV− women and men. This cross-sectional analysis included 669 HIV+ patients (223 women) and 1338 HIV-uninfected (HIV−) controls (446 women) which were frequency matched on sex, education, and 5-year age categories. NCI was screened using the Mini-mental State Examination. Psychomotor speed was assessed using timed alternating hand sequence test. Prevalence of NCI was higher among women versus men in the HIV+ group (16.1% vs 10.5%) but not the HIV− group (4.3% vs 3.5%). HIV+ women performed worse compared to men on psychomotor speed, orientation, attention, and calculation, whereas HIV− women performed worse compared to men on attention and calculation. Adjusted interaction effects of HIV status × sex (women vs men) were significant on orientation, attention, and calculation, and marginally significant on psychomotor speed (p = 0.053). In multivariable models, among both HIV+ women and men, less years of education and depressive symptoms were associated with NCI. Waist-to-hip ratio above the cut-off was strongly associated with NCI among HIV+ women. HIV+ women perform worse on cognitive measures compared to HIV+ men. The association of central obesity with NCI in HIV+ women should be noted. [ABSTRACT FROM AUTHOR]

The human immunodeficiency virus (HIV) epidemic in China has expanded rapidly in recent years, but little is known about the prevalence and features of HIV-associated neurocognitive disorders (HANDs) in this part of the world. We administered a comprehensive Western neuropsychological (NP) test battery to 203 HIV+ and 198 HIV − former plasma donors in the rural area of Anhui province. They found that 26% of the HIV − samples, and 46% of the HIV+ samples, were infected with hepatitis C virus (HCV), which can also have central nervous system (CNS) effects. To classify NP impairment, we developed demographically corrected test norms based upon individuals free of both infections (N=141). Using a global summary score, NP impairment was found in 34.2% of the HIV-monoinfected group and 39.7% of the coinfected group, as compared to 12.7% of the uninfected controls ( P <.001). HIV+ participants with acquired immunodeficiency syndrome (AIDS) were more likely to be impaired (43%) than non-AIDS individuals (29%; P <.05). Lastly, when all infection groups were combined, participants with NP impairment reported more cognitive complaints ( P <.01) and increased dependence in everyday functioning ( P=.01). In sum, NP impairment in this large rural Chinese sample was associated with both HIV and HCV infections, and the impairment's prevalence, severity, and pattern were similar to those reported by Western studies. Clinical significance of NP impairment in this population is suggested by the participants' reports of reduced everyday functioning. These findings indicate that HAND is likely to be an important feature of HIV infection in developing countries, underscoring the need for international efforts to develop CNS-relevant treatments. [ABSTRACT FROM AUTHOR]