Nomoto Silmara Harumi, Longhi Renata Marrona Praça, de Barros Bruna Paes, Croda Julio, Ziff Edward Benjamin, Castelon Konkiewitz Elisabete
a Department of Medicine , University Hospital, Federal University of Grande , Dourados , Brazil.
AIDS Care. 2015;27(8):979-85. doi: 10.1080/09540121.2015.1017442. Epub 2015 Mar 5.
Depression is the most common psychiatric co-morbidity among people living with HIV (PLHIV), with prevalence rates ranging from 25% to 36%. Depression impacts negatively upon adherence and response to combined antiretroviral therapy (CART) and the transmission of HIV infection through increased sexually risky behavior. This cross-sectional study presents data from a reference HIV-outpatient service in Dourados (Brazil) that evaluated the association between depressive symptoms, health-related quality of life, and clinical, socioeconomic, and demographic factors in newly diagnosed HIV/AIDS patients. Using the Beck Depression Inventory (BDI), the prevalence of depressive symptoms was 61% with a predominance of self-deprecating and cognitive-affective factors. Depressive symptoms were associated with lower income (p=0.019) and disadvantaged social class (p=0.005). Poorer quality of life was related to depressive symptoms (p<0.0001), low educational level (p=0.05), and lower income (p=0.03). These data suggest that socioeconomic factors, including level of income and education, are mediating the risk of depression and poor quality of life of PLHIV. Possible explanations for this effect are discussed, including the possible role of stigma.
抑郁症是艾滋病毒感染者（PLHIV）中最常见的精神疾病合并症，患病率在25%至36%之间。抑郁症会对联合抗逆转录病毒疗法（CART）的依从性和疗效产生负面影响，并通过增加性行为风险行为导致艾滋病毒感染传播。这项横断面研究展示了来自巴西多拉杜斯一家参考艾滋病毒门诊服务机构的数据，该研究评估了新诊断的艾滋病毒/艾滋病患者抑郁症状、健康相关生活质量与临床、社会经济和人口统计学因素之间的关联。使用贝克抑郁量表（BDI），抑郁症状的患病率为61%，以自我贬低和认知情感因素为主。抑郁症状与低收入（p=0.019）和社会阶层不利（p=0.005）相关。生活质量较差与抑郁症状（p<0.0001）、低教育水平（p=0.05）和低收入（p=0.03）有关。这些数据表明，包括收入和教育水平在内的社会经济因素在介导艾滋病毒感染者患抑郁症的风险和生活质量差方面发挥着作用。本文讨论了这种影响的可能解释，包括耻辱感可能起到的作用。
