Religion, Spirituality, and HIV Clinical Outcomes: A Systematic Review of the Literature
Benjamin Doolittle, M.D., Associate Professor, Yale University
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 2015 in relevant databases, including Medline (medicine), ATLA (religion), psychology (PSYCHinfo), CINAHL (nursing), Sociological Abstracts (sociology), and the Cochrane Central Register of Controlled Clinical Trials. Search terms included: spirituality, religion, HIV/AIDS, T-cells, CD4 cells, viral load, outcomes, morbidity, and mortality. Eligible studies reported on the association between a measure of religion or spirituality and a measurable HIV clinical or biological outcome.
Five hundred and forty-eight studies were evaluated. 15 met our inclusion criteria. The median number of enrolled individuals was 147 with a range of 33 - 1,138. Eleven (73%) studies used cohort or convenience samples. Four (27%) were longitudinal. Not all studies adjusted for confounding variables and the heterogeneity of the studies precluded aggregate analysis. Eleven (73%) studies reported a positive association between religion or spirituality and a clinical HIV outcome, including lower viral loads, greater T cell counts, delayed HIV-disease progression of illness, and better overall physical health. Two (8%) studies failed to detect such an association and 2 (8%) demonstrated a negative association between religion or spirituality and an HIV clinical outcome.
Most studies demonstrate a positive association between measures of religion or spirituality and HIV clinical outcomes. Recognizing the religious or spiritual commitments of patients may serve as an important component of patient care. More longitudinal studies that adjust for confounding variables and interventions might be required to further clarify the potential impact of religion and spirituality on HIV clinical outcomes.
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 2015 in relevant databases, including Medline (medicine), ATLA (religion), psychology (PSYCHinfo), CINAHL (nursing), Sociological Abstracts (sociology), and the Cochrane Central Register of Controlled Clinical Trials. Search terms included: spirituality, religion, HIV/AIDS, T-cells, CD4 cells, viral load, outcomes, morbidity, and mortality. Eligible studies reported on the association between a measure of religion or spirituality and a measurable HIV clinical or biological outcome.
Five hundred and forty-eight studies were evaluated. 15 met our inclusion criteria. The median number of enrolled individuals was 147 with a range of 33 - 1,138. Eleven (73%) studies used cohort or convenience samples. Four (27%) were longitudinal. Not all studies adjusted for confounding variables and the heterogeneity of the studies precluded aggregate analysis. Eleven (73%) studies reported a positive association between religion or spirituality and a clinical HIV outcome, including lower viral loads, greater T cell counts, delayed HIV-disease progression of illness, and better overall physical health. Two (8%) studies failed to detect such an association and 2 (8%) demonstrated a negative association between religion or spirituality and an HIV clinical outcome.
Most studies demonstrate a positive association between measures of religion or spirituality and HIV clinical outcomes. Recognizing the religious or spiritual commitments of patients may serve as an important component of patient care. More longitudinal studies that adjust for confounding variables and interventions might be required to further clarify the potential impact of religion and spirituality on HIV clinical outcomes.