Vreeman Rachel C, McCoy Brittany M, Lee Sonia
Indiana University School Medicine, Department of Pediatrics, Indianapolis, Indiana, USA.
Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya.
J Int AIDS Soc. 2017 May 16;20(Suppl 3):21497. doi: 10.7448/IAS.20.4.21497.
Mental health is a critical and neglected global health challenge for adolescents infected with HIV. The prevalence of mental and behavioural health issues among HIV-infected adolescents may not be well understood or addressed as the world scales up HIV prevention and treatment for adolescents. The objective of this narrative review is to assess the current literature related to mental health challenges faced by adolescents living with HIV, including access to mental health services, the role of mental health challenges during transition from paediatric to adult care services and responsibilities, and the impact of mental health interventions.
For each of the topics included in this review, individual searches were run using Medline and PubMed, accompanied by scans of bibliographies of relevant articles. The topics on which searches were conducted for HIV-infected adolescents include depression and anxiety, transition from paediatric to adult HIV care and its impact on adherence and mental health, HIV-related, mental health services and interventions, and the measurement of mental health problems. Articles were included if the focus was consistent with one of the identified topics, involved HIV-infected adolescents, and was published in English.
Mental and behavioural health challenges are prevalent in HIV-infected adolescents, including in resource-limited settings where most of them live, and they impact all aspects of HIV prevention and treatment. Too little has been done to measure the impact of mental health challenges for adolescents living with HIV, to evaluate interventions to best sustain or improve the mental health of this population, or to create healthcare systems with personnel or resources to promote mental health.
Mental health issues should be addressed proactively during adolescence for all HIV-infected youth. In addition, care systems need to pay greater attention to how mental health support is integrated into the care management for HIV, particularly throughout lifespan changes from childhood to adolescence to adulthood. The lack of research and support for mental health needs in resource-limited settings presents an enormous burden for which cost-effective solutions are urgently needed.
心理健康是感染艾滋病毒青少年面临的一项严峻且被忽视的全球健康挑战。随着全球扩大针对青少年的艾滋病毒预防和治疗工作，艾滋病毒感染青少年中精神和行为健康问题的患病率可能尚未得到充分了解或解决。本叙述性综述的目的是评估与感染艾滋病毒青少年所面临的心理健康挑战相关的现有文献，包括获得心理健康服务的情况、从儿科护理向成人护理服务过渡期间心理健康挑战的作用及责任，以及心理健康干预措施的影响。
对于本综述所涵盖的每个主题，分别使用Medline和PubMed进行检索，并对相关文章的参考文献进行筛选。针对感染艾滋病毒青少年进行检索的主题包括抑郁和焦虑、从儿科艾滋病毒护理向成人护理的过渡及其对依从性和心理健康的影响、与艾滋病毒相关的心理健康服务和干预措施，以及心理健康问题的测量。如果文章的重点与确定的主题之一一致、涉及感染艾滋病毒的青少年且以英文发表，则纳入该文章。
精神和行为健康挑战在感染艾滋病毒的青少年中普遍存在，包括在他们大多数人生活的资源有限环境中，并且这些挑战影响着艾滋病毒预防和治疗的各个方面。对于评估感染艾滋病毒青少年心理健康挑战的影响、评估旨在最佳维持或改善该人群心理健康的干预措施，或创建配备人员或资源以促进心理健康的医疗保健系统，所做的工作太少。
对于所有感染艾滋病毒的青少年，应在青春期积极解决心理健康问题。此外，护理系统需要更加关注如何将心理健康支持纳入艾滋病毒护理管理中，特别是在从儿童期到青春期再到成年期的整个生命阶段变化过程中。资源有限环境中对心理健康需求缺乏研究和支持带来了巨大负担，迫切需要具有成本效益的解决方案。
