HIV Center for Clinical and Behavioral Studies, NY State Psychiatric Institute and Columbia University, New York, New York.
NIMH Division of AIDS Research, Bethesda, Maryland, USA.
AIDS. 2019 Jul 15;33(9):1411-1420. doi: 10.1097/QAD.0000000000002227.
: Tremendous biomedical advancements in HIV prevention and treatment have led to aspirational efforts to end the HIV epidemic. However, this goal will not be achieved without addressing the significant mental health and substance use problems among people living with HIV (PLWH) and people vulnerable to acquiring HIV. These problems exacerbate the many social and economic barriers to accessing adequate and sustained healthcare, and are among the most challenging barriers to achieving the end of the HIV epidemic. Rates of mental health problems are higher among both people vulnerable to acquiring HIV and PLWH, compared with the general population. Mental health impairments increase risk for HIV acquisition and for negative health outcomes among PLWH at each step in the HIV care continuum. We have the necessary screening tools and efficacious treatments to treat mental health problems among people living with and at risk for HIV. However, we need to prioritize mental health treatment with appropriate resources to address the current mental health screening and treatment gaps. Integration of mental health screening and care into all HIV testing and treatment settings would not only strengthen HIV prevention and care outcomes, but it would additionally improve global access to mental healthcare.
: 在艾滋病毒预防和治疗方面取得了巨大的医学进步，这促使人们努力实现终结艾滋病流行的目标。然而，如果不能解决艾滋病毒感染者和易感染艾滋病毒人群中存在的严重精神健康和药物使用问题，这一目标就无法实现。这些问题加剧了人们获得充足和持续医疗保健的许多社会和经济障碍，也是实现终结艾滋病流行目标最具挑战性的障碍之一。与一般人群相比，易感染艾滋病毒的人和艾滋病毒感染者中出现精神健康问题的比例更高。精神健康损害增加了艾滋病毒感染者在艾滋病毒护理连续体的每一步中获得艾滋病毒的风险以及对其健康产生负面影响的风险。我们有必要的筛查工具和有效的治疗方法来治疗艾滋病毒感染者和易感染艾滋病毒人群的精神健康问题。然而，我们需要优先考虑精神健康治疗，投入适当的资源来解决当前精神健康筛查和治疗方面的差距。将精神健康筛查和护理纳入所有艾滋病毒检测和治疗场所，不仅将加强艾滋病毒预防和护理的效果，还将进一步改善全球获得精神卫生保健的机会。
