Spirituality and Religion in Patients with HIV/AIDS

doi:10.1111/j.1525-1497.2006.00642.x

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Wiley InterScience

Journal of General Internal Medicine

Volume 21 Issue S5, Pages S5 - S13

Published Online: 30 Oct 2006

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ORIGINAL ARTICLES

Spirituality and Religion in Patients with HIV/AIDS

Sian Cotton, PhD ^1,2,3 , Christina M. Puchalski, MD ^4,5 , Susan N. Sherman, DPA ^1,3 , Joseph M. Mrus, MD, MSc ⁶ , Amy H. Peterman, PhD ⁷ , Judith Feinberg, MD ⁸ , Kenneth I. Pargament, PhD ⁹ , Amy C. Justice, MD, PhD ^10,11 , Anthony C. Leonard, PhD ^1,3 , Joel Tsevat, MD, MPH ^1,3,8

¹ Health Services Research & Development, VA Medical Center, Cincinnati, OH, USA; ² Department of Family Medicine, University of Cincinnati Medical Center, Cincinnati, OH, USA; ³ Institute for the Study of Health, University of Cincinnati Medical Center, Cincinnati, OH, USA; ⁴ Department of Medicine, George Washington University Medical Center, Washington, DC, USA; ⁵ George Washington Institute for Spirituality and Health, Washington, DC, USA; ⁶ North American HIV Collaborative Studies, Infectious Diseases Medicine Development Center—HIV, GlaxoSmithKline, Research Triangle Park, NC, USA; ⁷ Center on Outcomes, Research and Education, Evanston Northwestern Healthcare, Evanston, IL, USA; ⁸ Division of General Internal Medicine, Department of Internal Medicine, University of Cincinnati Medical Center, Cincinnati, OH, USA; ⁹ Department of Psychology, Bowling Green University, Toledo, OH, USA; ¹⁰ Department of Medicine, Yale School of Medicine, New Haven, CT, USA; ¹¹ Section of General Medicine, VA Connecticut Healthcare System, West Haven, CT, USA.

Address correspondence and requests for reprints to Dr. Cotton: Department of Family Medicine and the Institute for the Study of Health, University of Cincinnati Medical Center, PO Box 670840, Cincinnati, OH 45267-0840 (e-mail: sian.cotton@uc.edu).

None of the authors have any conflicts of interest to declare.

KEYWORDS

religion • spirituality • HIV • AIDS

ABSTRACT

BACKGROUND: Spirituality and religion are often central issues for patients dealing with chronic illness. The purpose of this study is to characterize spirituality/religion in a large and diverse sample of patients with HIV/AIDS by using several measures of spirituality/religion, to examine associations between spirituality/religion and a number of demographic, clinical, and psychosocial variables, and to assess changes in levels of spirituality over 12 to 18 months.

METHODS: We interviewed 450 patients from 4 clinical sites. Spirituality/religion was assessed by using 8 measures: the Functional Assessment of Chronic Illness Therapy—Spirituality-Expanded scale (meaning/peace, faith, and overall spirituality); the Duke Religion Index (organized and nonorganized religious activities, and intrinsic religiosity); and the Brief RCOPE scale (positive and negative religious coping). Covariates included demographics and clinical characteristics, HIV symptoms, health status, social support, self-esteem, optimism, and depressive symptoms.

RESULTS: The patients' mean (SD) age was 43.3 (8.4) years; 387 (86%) were male; 246 (55%) were minorities; and 358 (80%) indicated a specific religious preference. Ninety-five (23%) participants attended religious services weekly, and 143 (32%) engaged in prayer or meditation at least daily. Three hundred thirty-nine (75%) patients said that their illness had strengthened their faith at least a little, and patients used positive religious coping strategies (e.g., sought God's love and care) more often than negative ones (e.g., wondered whether God has abandoned me; P<.0001). In 8 multivariable models, factors associated with most facets of spirituality/religion included ethnic and racial minority status, greater optimism, less alcohol use, having a religion, greater self-esteem, greater life satisfaction, and lower overall functioning (R²=.16 to .74). Mean levels of spirituality did not change significantly over 12 to 18 months.

CONCLUSIONS: Most patients with HIV/AIDS belonged to an organized religion and use their religion to cope with their illness. Patients with greater optimism, greater self-esteem, greater life satisfaction, minorities, and patients who drink less alcohol tend to be both more spiritual and religious. Spirituality levels remain stable over 12 to 18 months.

DIGITAL OBJECT IDENTIFIER (DOI)

10.1111/j.1525-1497.2006.00642.x About DOI