Advertisement

AIDS and Behavior

, Volume 22, Issue 6, pp 1792–1801 | Cite as

Religion, Spirituality, and HIV Clinical Outcomes: A Systematic Review of the Literature

  • B. R. Doolittle
  • A. C. Justice
  • D. A. Fiellin
Substantive Review

Abstract

This systematic review evaluates the association between religion, spirituality and clinical outcomes in HIV-infected individuals. A systematic literature review was conducted for all English language articles published between 1980 and 2016 in relevant databases. Six hundred fourteen studies were evaluated. 15 met inclusion criteria. Ten (67%) studies reported a positive association between religion or spirituality and a clinical HIV outcome. Two (13%) studies failed to detect such an association; and two (13%) demonstrated a negative association. One study (7%) identified features of religiosity and spirituality that had both negative and positive associations with HIV clinical outcomes. Recognizing the religious or spiritual commitments of patients may serve as an important component of patient care. Further longitudinal studies and interventions might be required to further clarify the potential impact of religion and spirituality on HIV clinical outcomes.

Keywords

Religion Spirituality HIV CD4 cell count Viral load 

Resumen

Esta revisión sistemática evalúa la asociación entre religión, espiritualidad y resultados clínicos en individuos infectados por el VIH. Se realizó una revisión sistemática de la literatura para todos los artículos en inglés publicados entre 1980 y 2016 en bases de datos relevantes. Se evaluaron seiscientos catorce estudios. 15 cumplieron los criterios de inclusión. Diez (67%) estudios informaron una asociación positiva entre religión o espiritualidad y un resultado clínico del VIH. Dos (13%) estudios no detectaron tal asociación; dos (13%) demostraron una asociación negativa. Un estudio (7%) identificó características de religiosidad y espiritualidad que tenían asociaciones negativas y positivas con los resultados clínicos del VIH. Reconocer los compromisos religiosos o espirituales de los pacientes puede servir como un componente importante de la atención al paciente. Es posible que se necesiten más estudios e intervenciones longitudinales para aclarar más el posible impacto de la religión y la espiritualidad sobre los resultados clínicos del VIH.

Notes

Acknowledgements

The authors wish to thank Mark Gentry and Janice Glover for their thorough, comprehensive guidance in the literature search.

Compliance with Ethical Standards

Conflict of interest

The authors declares that they have no conflict of interest.

Ethical Approval

This article does not contain any studies with human participants or animals performed by any of the authors.

References

  1. 1.
    Lorenz KA, Hays RD, Shapiro MF, et al. Religiousness and spirituality among HIV-infected Americans. J Palliat Med. 2005;8(4):774–81.CrossRefPubMedGoogle Scholar
  2. 2.
    Litwinczuk KM, Groh CJ. The relationship between spirituality, purpose in life, and well-being in HIV-positive persons. J Assoc Nurses AIDS Care. 2007;18(3):13–22.CrossRefPubMedGoogle Scholar
  3. 3.
    Siegel K, Schrimshaw EW. The perceived benefits of religious and spiritual coping among older adults living with HIV/AIDS. J Sci Study Relig. 2002;41:91–102.CrossRefGoogle Scholar
  4. 4.
    Szaflarski M, Neal Ritchey P, Leonard AC, et al. Modeling the effects of spirituality/religion on patients’ perceptions of living with HIV/AIDS. J Gen Intern Med. 2006;21(S5):S28–38.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Hill PC, Pargament KI. Advances in the conceptualization and measurement of religion and spirituality: implications for physical and mental health research. Am Psychol. 2008;58(1):64–74.CrossRefGoogle Scholar
  6. 6.
    Miller WR, Thoresen CE. Spirituality, religion, and health: an emerging research field. Am Psychol. 2003;58(1):24.CrossRefPubMedGoogle Scholar
  7. 7.
    Chida Y, Steptoe A, Powell LH. Religiosity/spirituality and mortality. Psychother Psychosom. 2009;78(2):81–90.CrossRefPubMedGoogle Scholar
  8. 8.
    Hummer RA, Rogers RG, Nam CB, Ellison CG. Religious involvement and U.S. adult mortality. Demography. 1999;36:273–85.CrossRefPubMedGoogle Scholar
  9. 9.
    Oman D, Kurata JH, Strawbridge WJ, Cohen RD. Religious attendance and cause of death over 31 years. Int J Psychiatry Med. 2002;32:69–89.CrossRefPubMedGoogle Scholar
  10. 10.
    Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(6):e1000097.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Endnote X7. Thomson Reuter; 2016.Google Scholar
  12. 12.
    Fitzpatrick AL, Standish LJ, Berger J, Kim JG. Survival in HIV-1-positive adults practicing psychological or spiritual activities for one year. Altern Ther Health Med. 2007;13(5):18.PubMedGoogle Scholar
  13. 13.
    Ironson G, Stuetzle R, Fletcher MA. An increase in religiousness/spirituality occurs after HIV diagnosis and predicts slower disease progression over 4 years in people with HIV. J Gen Intern Med. 2006;21(S5):S62–8.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Ironson G, Stuetzle R, Ironson D, et al. View of God as benevolent and forgiving or punishing and judgmental predicts HIV disease progression. J Behav Med. 2011;34(6):414–25.CrossRefPubMedGoogle Scholar
  15. 15.
    Ironson G, Kremer H, Lucette A, Relationship between spiritual coping and survival in patients with HIV. In: JGIM, published online, 5 May 2016.Google Scholar
  16. 16.
    Kremer H, Ironson G, Kaplan L, et al. Spiritual coping predicts CD4-cell preservation and undetectable viral load over four years. AIDS Care. 2015;27(1):71–9.CrossRefPubMedGoogle Scholar
  17. 17.
    Trevino KM, Pargament KI, Cotton S, et al. Religious coping and physiological, psychological, social, and spiritual outcomes in patients with HIV/AIDS: cross-sectional and longitudinal findings. AIDS Behav. 2010;14:379–89.CrossRefPubMedGoogle Scholar
  18. 18.
    Ironson G, Solomon GF, Balbin EG, 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.CrossRefPubMedGoogle Scholar
  19. 19.
    Ironson G, Kremer H. Spiritual transformation, psychological well-being, health, and survival in people with HIV. Int J Psychiatry Med. 2009;39(3):263–81.CrossRefPubMedGoogle Scholar
  20. 20.
    Marconi VC, Wu B, Hampton J, et al. Early warning indicators for first-line virologic failure independent of adherence measures in a South African urban clinic. AIDS Patient Care STDS. 2013;27(12):657–68.CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Dalmida SG, Holstad MM, Diiorio C, Laderman G. Spiritual well-being, depressive symptoms, and immune status among women living with HIV/AIDS. Women Health. 2009;49(2–3):119–43.CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Ramer L, Johnson D, Chan L, Barrett MT. The effect of HIV/AIDS disease progression on spirituality and self-transcendence in a multicultural population. J Transcult Nurs. 2006;17(3):280–9.CrossRefPubMedGoogle Scholar
  23. 23.
    Mellins CA, Havens JF, McDonnell C, et al. Adherence to antiretroviral medications and medical care in HIV-infected adults diagnosed with mental and substance abuse disorders. AIDS Care. 2009;21(2):168–77.CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Van Wagoner N, Mugavero M, Westfall A, et al. Church attendance in men who have sex with men diagnosed with HIV is associated with later presentation for HIV care. Clin Infect Dis. 2004;58(2):295–9.CrossRefGoogle Scholar
  25. 25.
    Woods TE, Antoni MH, Ironson GH, et al. Religiosity is associated with affective status in symptomatic HIV-infected African-American women. J Health Psychol. 1999;4(3):317–26.CrossRefPubMedGoogle Scholar
  26. 26.
    Woods TE, Antoni MH, Ironson GH, et al. Religiosity is associated with affective and immune status in symptomatic HIV-infected gay men. J Psychosom Res. 1999;46(2):165–76.CrossRefPubMedGoogle Scholar
  27. 27.
    Ferrans CE, Powers M. Quality of life index: development and psychometric properties. Adv Nurs Sci. 1985;8(1):15–24.CrossRefGoogle Scholar
  28. 28.
    Reed PG. Religiousness among terminally ill and healthy adults. Res Nurs Health. 1986;9:35–41.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • B. R. Doolittle
    • 1
  • A. C. Justice
    • 2
  • D. A. Fiellin
    • 2
  1. 1.Internal Medicine & PediatricsYale University School of MedicineNew HavenUSA
  2. 2.Internal MedicineYale University School of MedicineNew HavenUSA

Personalised recommendations