Power R, Tate H L, McGill S M, Taylor C
Royal Free and University College Medical School, London, UK.
Sex Transm Infect. 2003 Apr;79(2):137-41. doi: 10.1136/sti.79.2.137.
To investigate the psychosocial impact of lipodystrophy on the lifestyles of HIV positive patients on highly active antiretroviral therapy (HAART).
In-depth interviews were conducted with 14 HIV positive patients on HAART at an outpatient sexually transmitted infections (STI) and HIV clinic in central London. Qualitative data from interview transcripts were analysed using grounded theory to elicit key categories and subcategories.
Three main themes relating to lipodystrophy emerged: effect on the individual; impact on the social world of the individual; responses of the individual. Lipodystrophy had physical and psychological effects, ranging from bodily discomfort to low self esteem and depression. Owing to its physical manifestations it was viewed as a visible marker of HIV disease. At the level of social functioning, lipodystrophy led to problems with personal and family relationships, although having a partner was protective. Individuals reported narrowing their social world, in some cases to degrees of social isolation. Individual responses included changes in diet, increased exercise regimes, steroid use and plastic surgery (mainly collagen injections to the face). For those who had experienced serious illness related to HIV, there was a more sanguine acceptance of lipodystrophy as an unfortunate consequence of longevity and drug therapy
Health professionals need to address the psychosocial implications of lipodystrophy, including the ways in which it may affect different groups and their adherence to therapy. Formative evaluations are needed to assess the potential for targeted interventions.
调查脂肪代谢障碍对接受高效抗逆转录病毒疗法（HAART）的HIV阳性患者生活方式的心理社会影响。
在伦敦市中心一家性传播感染（STI）和HIV门诊，对14名接受HAART的HIV阳性患者进行了深入访谈。使用扎根理论对访谈记录中的定性数据进行分析，以得出关键类别和子类别。
出现了与脂肪代谢障碍相关的三个主要主题：对个体的影响；对个体社会世界的影响；个体的反应。脂肪代谢障碍产生了生理和心理影响，从身体不适到自卑和抑郁不等。由于其身体表现，它被视为HIV疾病的一个明显标志。在社会功能层面，脂肪代谢障碍导致个人和家庭关系出现问题，不过有伴侣具有保护作用。个体报告称其社交圈子缩小，在某些情况下甚至达到社会隔离的程度。个体的反应包括饮食变化、增加锻炼、使用类固醇和进行整形手术（主要是面部注射胶原蛋白）。对于那些经历过与HIV相关严重疾病的人来说，他们对脂肪代谢障碍更为乐观地接受，将其视为长寿和药物治疗的不幸后果。
卫生专业人员需要关注脂肪代谢障碍的心理社会影响，包括其可能影响不同群体的方式以及他们对治疗的依从性。需要进行形成性评估以评估针对性干预措施的潜力。
