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越南 HIV 感染者中的抑郁状况和应对策略:一项定性研究。

Depression and coping strategies among Vietnamese women living with HIV: A qualitative study.

机构信息

Department of Obstetrics and Gynecology, Hospital University Pennsylvania, Philadelphia, PA, USA.

Department of Health Behavior, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA.

出版信息

Glob Public Health. 2020 Jul;15(7):1050-1061. doi: 10.1080/17441692.2020.1731566. Epub 2020 Feb 28.

Abstract

Women living with HIV (WLWH) are more likely to suffer from depression than seronegative women and are also more likely to suffer from depression than men living with HIV. There is limited depression research with WLWH in Vietnam. Twenty in-depth interviews with WLWH were conducted to identify pathways leading to depression and coping strategies for depression. Participants were recruited from an antiretroviral treatment clinic in northern Vietnam. Audio-recorded interviews were transcribed, translated, and analysed to identify key themes. All participants reported sudden loss of social support, debilitating depression, and suicidal ideation in the first six months after HIV diagnosis. While some were able to cope with their status after several months, others continued to struggle due to HIV-related stigma that was perceived as more isolating for WLWH than for men. Women who were able to effectively cope with depression found ways to re-establish connections to family and community. Interventions to improve mental wellbeing should link WLWH to mental health services immediately after diagnosis and address loss of support and stigma, as they contributed to the onset and persistence of depression after HIV diagnosis. Community-level HIV stigma reduction interventions may also help repair broken social bonds and foster new ones.

摘要

与 HIV 阴性女性相比,感染 HIV 的女性(WLWH)更易患抑郁症,与感染 HIV 的男性相比,她们也更易患抑郁症。越南对 WLWH 的抑郁症研究有限。研究人员对来自越南北部的抗逆转录病毒治疗诊所的 20 名 WLWH 进行了深入访谈,以确定导致抑郁症的途径和应对抑郁症的策略。参与者招募自一个艾滋病治疗诊所。对录音采访进行了转录、翻译和分析,以确定关键主题。所有参与者都报告说,在 HIV 诊断后的头六个月,他们突然失去了社会支持,感到极度沮丧,甚至有自杀念头。虽然有些人在几个月后能够应对自己的状况,但其他人仍在苦苦挣扎,因为他们认为 HIV 带来的耻辱感对 WLWH 的隔离比男性更严重。能够有效应对抑郁症的女性找到了重新与家人和社区联系的方法。改善心理健康的干预措施应在诊断后立即将 WLWH 与心理健康服务联系起来,并解决支持和耻辱感的丧失问题,因为这些问题导致了 HIV 诊断后抑郁症的发生和持续。社区层面的 HIV 耻辱感减少干预措施也可能有助于修复破裂的社会关系并培养新的关系。

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