University of Illinois at Chicago, USA.
Behav Modif. 2012 Mar;36(2):123-45. doi: 10.1177/0145445511425231. Epub 2011 Nov 16.
The authors suggest a theoretical model of pathways of HIV progression, with a focus on the contributions of depression-as well as secondary, behavioral and emotional variables. Literature was reviewed regarding (a) comorbid depression and the direct physiological effects on HIV progression and (b) intermediary factors between HIV and disease progression. Intermediary factors included (a) substance use, (b) social support, (c) hopelessness, (d) medication nonadherence, and (e) risky sexual behavior and the contraction of secondary infections. The authors suggest direct physiological pathways from depression to HIV progression and indirect pathways (e.g., behavioral, social, and psychological). In addition to depression, substance use, poor social support, hopelessness, medication nonadherence, and risky sexual behavior seem to be integral in HIV progression. Based on the individual relationships of these variables to depression and HIV progression, a comprehensive multipath model, incorporating all factors, serves to explain how severe emotional distress may lead to accelerated progression to AIDS.
作者提出了一个 HIV 进展的理论模型，重点关注抑郁以及次要的、行为和情绪变量的贡献。文献综述涉及（a）共病抑郁与对 HIV 进展的直接生理影响，以及（b）HIV 与疾病进展之间的中介因素。中介因素包括（a）物质使用，（b）社会支持，（c）绝望，（d）药物不依从，以及（e）危险性行为和继发性感染的发生。作者提出了抑郁到 HIV 进展的直接生理途径和间接途径（例如，行为、社会和心理途径）。除了抑郁，物质使用、不良的社会支持、绝望、药物不依从和危险性行为似乎是 HIV 进展的重要因素。基于这些变量与抑郁和 HIV 进展的个体关系，一个综合的多路径模型，纳入所有因素，有助于解释严重的情绪困扰如何导致艾滋病的加速进展。
