West Nora, Schwartz Sheree, Mudavanhu Mutsa, Hanrahan Colleen, France Holly, Nel Jeremy, Mutunga Lillian, Bernhardt Shelley, Bassett Jean, Van Rie Annelies
a Department of Epidemiology , Johns Hopkins School of Public Health , Baltimore , MD , USA.
b Witkoppen Health and Welfare Centre , Johannesburg , South Africa.
AIDS Care. 2019 Jan;31(1):117-124. doi: 10.1080/09540121.2018.1533222. Epub 2018 Oct 10.
We examined the prevalence of mental health conditions, social support, and associated factors among adolescents living with HIV. We conducted a cross-sectional analysis with adolescents (ages 9-19) attending a primary care clinic in Johannesburg, South Africa. We analyzed the results of four self-report tools: Children's Depression Inventory-Short, Revised Manifest Anxiety Scale, Child Post-Traumatic Stress Disorder (PTSD) Checklist, and a modified version of the Medical Outcomes Study Social Support Scale. We used robust Poisson regression to quantify the association between social support and mental health. Among 278 adolescents, the majority were perinatally infected with HIV (92%), and had at least one deceased parent (59%). Depression symptom threshold scores were found among 8% of adolescents, and 7% screened positive for symptoms of anxiety. Few (1%) met the criteria for PTSD. Overall, 12% of adolescents screened positive for symptoms of depression, anxiety or PTSD. Older adolescents reported less social support than younger adolescents. Adolescents were less likely to have mental health symptoms if they had higher measures of social support (adjusted Prevalence Ratio 0.38, 95% CI 0.20-0.73). Attention should be paid to social support for adolescents living with HIV as this may play an important role in their mental health.
我们调查了感染艾滋病毒的青少年的心理健康状况、社会支持及相关因素。我们对在南非约翰内斯堡一家初级保健诊所就诊的青少年（9至19岁）进行了横断面分析。我们分析了四种自我报告工具的结果：儿童抑郁量表简版、修订版显性焦虑量表、儿童创伤后应激障碍（PTSD）检查表以及医学结局研究社会支持量表的一个修改版本。我们使用稳健泊松回归来量化社会支持与心理健康之间的关联。在278名青少年中，大多数是围产期感染艾滋病毒（92%），并且至少有一位父母去世（59%）。8%的青少年达到抑郁症状阈值分数，7%的青少年焦虑症状筛查呈阳性。很少有人（1%）符合创伤后应激障碍的标准。总体而言，12%的青少年抑郁、焦虑或创伤后应激障碍症状筛查呈阳性。年龄较大的青少年报告的社会支持比年龄较小的青少年少。如果青少年获得更高水平的社会支持，他们出现心理健康症状的可能性较小（调整后的患病率比为0.38，95%置信区间为0.20 - 0.73）。应关注感染艾滋病毒青少年的社会支持，因为这可能在他们的心理健康中发挥重要作用。
