Spirituality and religion in patients with HIV/AIDS.
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.
Cotton
Sian
S
Health Services Research & Development, VA Medical Center, Cincinnati, OH, USA. sian.cotton@uc.edu
Puchalski
Christina M
CM
Sherman
Susan N
SN
Mrus
Joseph M
JM
Peterman
Amy H
AH
Feinberg
Judith
J
Pargament
Kenneth I
KI
Justice
Amy C
AC
Leonard
Anthony C
AC
Tsevat
Joel
J
D000223:Adaptation, Psychological; D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000453:epidemiology* / Q000523:psychology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D010549:Personal Satisfaction; D012069:Religion and Psychology; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012649:Self Concept; D012944:Social Support; D029181:Spirituality; D014481:United States / Q000453:epidemiology