Psychological factors in Nepali former commercial sex workers with HIV.

PURPOSE: To examine perceived stress, coping style, and symptoms of anxiety and depression in HIV-positive Nepali women who were formerly commercial sex workers (CSWs).
DESIGN: Descriptive, correlational study with a convenience sample of 98 Nepali women with HIV recruited from a nongovernmental organization (NGO) in Nepal.
METHODS: Investigator-administered questionnaires included a sociodemographic questionnaire, the Perceived Stress Scale (PSS), the Ways of Coping Questionnaire (WOC), the Center for Epidemiologic Studies Depression Scale (CES-D), and the Symptoms Checklist-90 (SCL-90) Anxiety Subscale. Analytical methods included descriptive statistics and hierarchical regression analysis.
FINDINGS: The level of perceived stress was similar to that observed in a healthy female population of similar age. The primary coping style was problem-focused, with the strategy of seeking social support used most. Depression measured with the entire CES-D was 3% but is was 18% on the somatic subscale. Twenty-two percent of the variance in depression was predicted by the combination of perceived stress and the coping strategy of escape avoidance. Twenty-four percent of the variance in anxiety was predicted by the combination of perceived stress and three coping strategies: problem solving, accepting responsibility, and distancing.
CONCLUSIONS: This sample had a low prevalence of psychological symptoms. Somatic symptoms, which may be more relevant than affective symptoms in non-Western populations, were the best indicator of depression. Future studies are needed to examine culturally relevant appraisals, coping style, and psychological symptoms. Knowledge of psychological factors can be used to develop interventions for this population that has no access to treatment for HIV disease.