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乌干达抗逆转录病毒治疗患者中抑郁症及抗抑郁药对身体和工作机能影响的定性分析

A qualitative analysis of the effects of depression and antidepressants on physical and work functioning among antiretroviral therapy clients in Uganda.

作者信息

Ngo Victoria K, Wagner Glenn J, Huynh Alexis, Ryan Gery, Musisi Seggane

机构信息

RAND Corporation, Santa Monica, CA, USA.

出版信息

J Int Assoc Provid AIDS Care. 2013 Nov-Dec;12(6):414-22. doi: 10.1177/2325957412471992. Epub 2013 Feb 26.

Abstract

Depression is common among people living with HIV/AIDS in sub-Saharan Africa. Yet, little is known about how depression influences physical health and socioeconomic well-being in the context of antiretroviral therapy (ART). Semistructured interviews with 40 adult HIV clients receiving ART in Uganda were conducted to assess experiences prior to and after HIV diagnosis and initiation of ART. Content analysis revealed themes that were suggestive of the following patterns: (1) functioning decreased after patients were diagnosed with HIV, but improved following ART, (2) depression is associated with lower physical health functioning and work status levels after both HIV diagnosis and ART, and (3) antidepressant medication is associated with better functioning compared with patients with depression not receiving depression treatment. These findings suggest that depression plays a role in the deleterious effects of HIV on functioning, and that antidepressant treatment provided alongside ART may serve to help individuals regain functioning, particularly employment. These findings highlight the potential value of integrating depression treatment into HIV care.

摘要

抑郁症在撒哈拉以南非洲感染艾滋病毒/艾滋病的人群中很常见。然而,在抗逆转录病毒疗法(ART)背景下,抑郁症如何影响身体健康和社会经济福祉却鲜为人知。对乌干达40名接受抗逆转录病毒治疗的成年艾滋病毒感染者进行了半结构化访谈,以评估艾滋病毒诊断和开始抗逆转录病毒治疗之前及之后的经历。内容分析揭示了以下几种模式的主题:(1)患者被诊断出感染艾滋病毒后功能下降,但在接受抗逆转录病毒治疗后有所改善;(2)抑郁症与艾滋病毒诊断和抗逆转录病毒治疗后较低的身体健康功能和工作状态水平相关;(3)与未接受抑郁症治疗的抑郁症患者相比,抗抑郁药物与更好的功能相关。这些发现表明,抑郁症在艾滋病毒对功能的有害影响中起作用,并且与抗逆转录病毒治疗同时提供的抗抑郁治疗可能有助于个体恢复功能,特别是就业功能。这些发现凸显了将抑郁症治疗纳入艾滋病毒护理的潜在价值。

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