Centre for Development Support, University of the Free State, Bloemfontein, South Africa.
BMC Public Health. 2012 Mar 27;12:244. doi: 10.1186/1471-2458-12-244.
HIV/AIDS and depression are projected to be the two leading causes of disability by 2030. HIV/AIDS and anxiety/depression are interlinked. People suffering from depression may be more likely to engage in risky sexual behaviour, and therefore at greater risk of contracting HIV. An HIV + diagnosis may trigger symptoms of anxiety and depression, which may in turn result in risky sexual behaviour and the spread of HIV. This study explores correlates of anxiety and depression in patients enrolled in a public sector ART programme in South Africa.
Interviews were conducted with 716 patients initiating ART at twelve public health care facilities in the Free State. Symptoms of anxiety and depression were measured using the Hospital Anxiety and Depression Scale (HADS). An 8+ cut-off was used to identify possible cases of anxiety and depression. Multivariate logistic regression analysis, using STATA Version 11, was performed to identify correlates of anxiety and depression.
The prevalence of symptoms of respectively anxiety and depression amongst this study population in the Free State was 30.6% and 25.4%. The multivariate logistic regression analyses identified five correlates of symptoms of anxiety and depression. Disruptive side effects (OR = 3.62, CI 1.95-6.74) and avoidant coping (OR = 1.42, CI 1.22-1.65) were associated with a greater number of symptoms of anxiety. Stigma was associated with an increase in symptoms of anxiety (OR = 1.14, CI 1.07-1.21) and of depression (OR = 1.13, CI 1.06-1.20), while being a widow (OR = 0.30, CI 0.13-0.69) and participating in a support group (OR = 0.21, CI 0.05-0.99) were associated with decreased symptoms of depression.
The findings from the study provide valuable insights into the psychosocial aspects of the Free State public-sector ART programme. Combined with the literature on the intricate link between mental health problems and treatment outcomes our results emphasise firstly, the necessity that resources be allocated for both screening and treating mental health problems and, secondly, the need for interventions that will encourage support-group participation, address ART side effects, reduce maladaptive coping styles, and minimise the stigma associated with symptoms of anxiety and/or depression.
预计到 2030 年，艾滋病病毒/艾滋病和抑郁症将成为导致残疾的两个主要原因。艾滋病病毒/艾滋病和焦虑/抑郁是相互关联的。患有抑郁症的人可能更有可能从事危险的性行为，因此感染艾滋病毒的风险更大。艾滋病毒阳性诊断可能会引发焦虑和抑郁症状，这可能反过来导致危险的性行为和艾滋病毒的传播。本研究探讨了在南非一个公立部门艾滋病治疗方案中接受治疗的患者中焦虑和抑郁的相关因素。
在自由州的 12 个公共卫生保健机构中，对 716 名开始接受艾滋病治疗的患者进行了访谈。使用医院焦虑和抑郁量表（HADS）测量焦虑和抑郁症状。采用 8+的截断值来确定可能的焦虑和抑郁病例。采用 STATA 版本 11 进行多变量逻辑回归分析，以确定焦虑和抑郁的相关因素。
在自由州的研究人群中，焦虑和抑郁症状的患病率分别为 30.6%和 25.4%。多变量逻辑回归分析确定了五个与焦虑和抑郁症状相关的因素。药物的不良反应（OR=3.62，CI 1.95-6.74）和回避应对（OR=1.42，CI 1.22-1.65）与更多的焦虑症状相关。耻辱感与焦虑（OR=1.14，CI 1.07-1.21）和抑郁（OR=1.13，CI 1.06-1.20）症状的增加有关，而丧偶（OR=0.30，CI 0.13-0.69）和参加支持小组（OR=0.21，CI 0.05-0.99）与抑郁症状的减少有关。
该研究的结果提供了有关自由州公立部门艾滋病治疗方案的社会心理方面的有价值的见解。结合关于心理健康问题与治疗结果之间复杂联系的文献，我们的研究结果首先强调了必须为筛查和治疗心理健康问题分配资源，其次需要采取干预措施，鼓励参加支持小组，解决抗逆转录病毒药物的不良反应，减少适应不良的应对方式，并最大限度地减少与焦虑和/或抑郁症状相关的耻辱感。
