Durbin Anna, Sirotich Frank, Antoniou Tony, Roesslein Kay, Durbin Janet, Lunsky Yona
a Canadian Mental Health Association - Toronto Branch (CMHA) , Toronto , ON , Canada.
b Inwentash Faculty of Social Work , University of Toronto , Toronto , ON , Canada.
AIDS Care. 2016 Jul;28(7):878-83. doi: 10.1080/09540121.2016.1154133. Epub 2016 Mar 13.
While community-based mental health services play an important role in caring for persons with HIV (human immunodeficiency virus) and co-existing mental health disorders, the extent to which their support needs are addressed in this setting is unknown. Accordingly, we examined if HIV infection was associated with unmet support needs among men living with and without HIV receiving community mental health care. This cross-sectional study examined 215 men (135 living with HIV and 80 without HIV) receiving case management services in urban Ontario. Using the Camberwell Assessment of Need, we ascertained the prevalence of support needs in 13 domains grouped into three clusters: Basic needs (accommodation, food, benefits, and money management); self-care/functional needs (daytime activities, self-care, and looking after the home); and health/safety needs (physical, psychological distress, psychotic symptoms, safety to self, and safety to others). We used generalized estimating equations with a logit link to examine the association between HIV and unmet need in each domain. Compared to HIV-negative men, men with HIV were more likely to have mood and concurrent disorders, and intellectual and developmental disabilities. Following multivariable analyses, men with HIV had greater unmet needs related to food (odds ratio + 95% confidence interval: 9.36 (4.03, 21.75), p < 0.001); money (OR: 1.90 (1.04, 3.47), p = 0.036) [basic need domains]; psychological distress (OR: 2.39 (1.68, 3.41), p < 0.001); drug use (OR: 5.10 (2.16, 12.08) p < 0.001); and safety to self (OR: 3.35 (1.51, 7.52), p < 0.003) [health and safety domains]. Despite living in a setting with universal health insurance, men with HIV receiving community mental health support had greater unmet need in basic and health domains than HIV-negative men receiving such support. Further research is required to develop and evaluate interventions to best support community-dwelling persons with HIV and mental health disorders.
虽然基于社区的心理健康服务在照顾感染人类免疫缺陷病毒（HIV）且并存心理健康障碍的患者方面发挥着重要作用，但在此环境中其支持需求得到满足的程度尚不清楚。因此，我们研究了在接受社区心理健康护理的感染HIV和未感染HIV的男性中，HIV感染是否与未满足的支持需求相关。这项横断面研究调查了安大略省城市地区接受病例管理服务的215名男性（135名感染HIV，80名未感染HIV）。使用坎伯韦尔需求评估法，我们确定了13个领域的支持需求患病率，这些领域分为三个类别：基本需求（住宿、食物、福利和财务管理）；自我护理/功能需求（日间活动、自我护理和照顾家庭）；以及健康/安全需求（身体、心理困扰、精神病症状、自身安全和他人安全）。我们使用具有logit链接的广义估计方程来研究HIV与每个领域未满足需求之间的关联。与未感染HIV的男性相比，感染HIV的男性更有可能患有情绪和并发障碍，以及智力和发育障碍。经过多变量分析，感染HIV的男性在食物（优势比 + 95%置信区间：9.36（4.03，21.75），p < 0.001）、金钱（OR：1.90（1.04，3.47），p = 0.036）[基本需求领域]、心理困扰（OR：2.39（1.68，3.41），p < 0.001）、药物使用（OR：5.10（2.16，12.08）p < 0.001）以及自身安全（OR：3.35（1.51，7.52），p < 0.003）[健康和安全领域]方面有更大的未满足需求。尽管生活在拥有全民健康保险的环境中，但接受社区心理健康支持的感染HIV的男性在基本和健康领域的未满足需求比接受此类支持的未感染HIV的男性更大。需要进一步研究来开发和评估干预措施，以最好地支持社区中感染HIV且患有心理健康障碍的人群。
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