Weiser Sheri D, Wolfe William R, Bangsberg David R
Epidemiology and Prevention Interventions Center, San Francisco General Hospital, San Francisco, CA 94143, USA.
Curr HIV/AIDS Rep. 2004 Dec;1(4):186-92. doi: 10.1007/s11904-004-0029-4.
People with depression and other mental illness comprise a growing proportion of individuals living with HIV in the United States; at the same time, the prevalence of HIV among mentally ill individuals is at least seven times higher than in the general population. Individuals with mental illness are particularly vulnerable to infection with HIV because of several factors, including the higher prevalence of poverty, homelessness, high-risk sexual activities, drug abuse, sexual abuse, and social marginalization found in this population. Nevertheless, mentally ill individuals are often not screened for HIV and may not be appropriately targeted in current HIV prevention efforts. Moreover, despite widespread access to antiretroviral treatment in the United States, HIV outcomes among mentally ill individuals continue to be poor. This disparity can be explained by several interrelated factors, including lower rates of highly active antiretroviral therapy (HAART) utilization, lower rates of adherence to HAART, and immunologic changes associated with mental illness itself. We need to improve our design of prevention, screening, and treatment programs to better reach individuals with comorbid HIV and mental illness.
在美国，患有抑郁症和其他精神疾病的人在感染艾滋病毒的人群中所占比例越来越大；与此同时，精神疾病患者中艾滋病毒的患病率至少比普通人群高七倍。由于多种因素，包括该人群中贫困、无家可归、高危性行为、药物滥用、性虐待和社会边缘化的发生率较高，精神疾病患者特别容易感染艾滋病毒。然而，精神疾病患者往往没有接受艾滋病毒筛查，在当前的艾滋病毒预防工作中可能也没有得到适当的关注。此外，尽管在美国抗逆转录病毒治疗已广泛普及，但精神疾病患者的艾滋病毒治疗效果仍然很差。这种差异可以由几个相互关联的因素来解释，包括高效抗逆转录病毒治疗（HAART）使用率较低、对HAART的依从率较低以及与精神疾病本身相关的免疫变化。我们需要改进预防、筛查和治疗方案的设计，以便更好地惠及同时患有艾滋病毒和精神疾病的患者。
