Gill A, Ranasinghe Awip, Sumathipala A, Fernando K A
Cobridge Community Health Centre, Midlands Partnership NHS Foundation Trust, Stoke-on-Trent, UK.
Faculty of Medicine & Health Sciences, School of Primary, Community and Social Care, Keele University, Staffordshire, UK.
Int J STD AIDS. 2020 Jun;31(7):619-626. doi: 10.1177/0956462420904299. Epub 2020 May 5.
Mental health conditions (MHCs) are often unrecognised which can result in detrimental physical health outcomes and poor quality of life. This can be compounded by the impact of deprivation. People living with human immunodeficiency virus (PLWH) are more likely to be affected by MHCs which if untreated, may result in both clinical and psychosocial adversities. To ascertain the prevalence of and factors associated with MHCs in the human immunodeficiency virus cohort of Stoke-on-Trent, which is the 13th most deprived locality in England, we conducted a cross-sectional service evaluation using electronic records of 302 PLWH attending the service between October 2018 and January 2019. The prevalence of MHCs amongst PLWH was 33.4% (101/302). Depression was the most prevalent MHC affecting 17.2% (52/302). Those of white ethnicity were at higher risk (odds ratio [OR] = 3.14; p < 0.01) of MHCs compared to black Asian and minority ethnic groups. Women were at higher risk of having an MHC (OR = 3.15; p < 0.01), and recreational drug use was also a significant factor (OR = 16.18; p = 0.01) associated with MHCs. There is sub-optimal access and heterogeneity in the modes of referral to mental health support services. Commissioning constraints will further detrimentally affect our ability to provide support in an already deprived area, thus widening health inequalities affecting the most vulnerable.
心理健康状况(MHCs)常常未被识别,这可能导致有害的身体健康结果和生活质量低下。贫困的影响会使情况更加复杂。感染人类免疫缺陷病毒(HIV)的人(PLWH)更容易受到MHCs的影响,如果不加以治疗,可能会导致临床和心理社会方面的不利情况。为了确定在英格兰第13个最贫困地区特伦特河畔斯托克的人类免疫缺陷病毒队列中MHCs的患病率及其相关因素,我们利用2018年10月至2019年1月期间就诊的302名PLWH的电子记录进行了一项横断面服务评估。PLWH中MHCs的患病率为33.4%(101/302)。抑郁症是最常见的MHC,影响了17.2%(52/302)的人。与黑人和少数族裔群体相比,白人患MHCs的风险更高(优势比[OR]=3.14;p<0.01)。女性患MHC的风险更高(OR=3.15;p<0.01),使用消遣性药物也是与MHCs相关的一个重要因素(OR=16.18;p=0.01)。在转介到心理健康支持服务的方式上,存在获取不足和异质性的问题。委托方面的限制将进一步不利地影响我们在一个已经贫困的地区提供支持的能力,从而扩大影响最弱势群体的健康不平等。