Mayston Rosie, Patel Vikram, Abas Melanie, Korgaonkar Priya, Paranjape Ramesh, Rodrigues Savio, Prince Martin
Health Service & Population Research Department, Kings College London, London, UK.
Trop Med Int Health. 2015 Mar;20(3):397-406. doi: 10.1111/tmi.12435. Epub 2014 Dec 22.
To investigate associations between background characteristics (psychosocial adversity, risk behaviours/perception of risk and HIV-related knowledge, perceptions and beliefs) and psychological and cognitive morbidity among people coming for testing for HIV/AIDS in Goa, India.
Analysis of cross-sectional baseline data (plus HIV status) from a prospective cohort study. Participants were recruited at the time of coming for HIV testing.
Consistent with associations found among general population samples, among our sample of 1934 participants, we found that indicators of psychosocial adversity were associated with CMD (common mental disorder - major depression, generalised anxiety and panic disorder) among people coming for testing for HIV. Similarly, perpetration of intimate partner violence was associated with AUD (alcohol use disorder). Two STI symptoms were associated with CMD, and sex with a non-primary partner was associated with AUD. Suboptimal knowledge about HIV transmission and prevention was associated with low cognitive test scores. In contrast with other studies, we found no evidence of any association between stigma and CMD. There was no evidence of modification of associations by HIV status.
Among people coming for testing for HIV/AIDS in Goa, India, we found that CMD occurred in the context of social and economic stressors (violence, symptoms of STI, poor education and food insecurity) and AUD was associated with violence and risky sexual behaviour. Further research is necessary to understand the role of gender, stigma and social norms in determining the relationship between sexual and mental health. Understanding associations between these background characteristics and psychological morbidity may help inform the design of appropriate early interventions for depression among people newly diagnosed HIV/AIDS.
调查印度果阿邦前来进行艾滋病毒/艾滋病检测的人群的背景特征（心理社会逆境、风险行为/风险认知及与艾滋病毒相关的知识、认知和信念）与心理及认知疾病之间的关联。
对一项前瞻性队列研究的横断面基线数据（加上艾滋病毒感染状况）进行分析。参与者在前来进行艾滋病毒检测时招募。
与在一般人群样本中发现的关联一致，在我们1934名参与者的样本中，我们发现心理社会逆境指标与前来进行艾滋病毒检测的人群中的常见精神障碍（主要抑郁症、广泛性焦虑症和恐慌症）相关。同样，亲密伴侣暴力行为与酒精使用障碍相关。两种性传播感染症状与常见精神障碍相关，与非主要伴侣发生性行为与酒精使用障碍相关。对艾滋病毒传播和预防的了解不足与认知测试得分低相关。与其他研究不同，我们没有发现耻辱感与常见精神障碍之间存在任何关联的证据。没有证据表明艾滋病毒感染状况会改变这些关联。
在印度果阿邦前来进行艾滋病毒/艾滋病检测的人群中，我们发现常见精神障碍发生在社会和经济压力源（暴力、性传播感染症状、教育程度低和粮食不安全）的背景下，酒精使用障碍与暴力和危险性行为相关。有必要进一步研究以了解性别、耻辱感和社会规范在决定性健康与心理健康关系中的作用。了解这些背景特征与心理疾病之间的关联可能有助于为新诊断出艾滋病毒/艾滋病的人群设计适当的抑郁症早期干预措施。
