Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK.
Health Systems Research Unit, South African Medical Research Council, Francie van Zijl Drive, Parow Valley, PO Box 19070, Tygerberg, 7501, South Africa.
Health Qual Life Outcomes. 2020 May 5;18(1):120. doi: 10.1186/s12955-020-01352-w.
Young people living with HIV (YPLHIV) in sub-Saharan Africa (SSA) are at high risk of having a poor quality of life. Addressing wellbeing explicitly within HIV/AIDS policies could assist mitigation efforts. However, guidance on wellbeing measures to evaluate policies for YPLHIV is scarce. The aims of this mixed-methods review were to identify: i) key dimensions of wellbeing and ii) wellbeing measures that align to these dimensions among YPLHIV (15-24 years) in SSA. We searched six social science and medical databases, including grey literature. We included studies that examined correlates and lived experiences of wellbeing, among YPLHIV in SSA, from January 2000 to May 2019. Two reviewers independently screened abstracts and full texts and assessed methodological quality of included articles. We analysed quantitative and qualitative data using descriptive and meta-ethnographic approaches, respectively. Thereafter, we integrated findings using a framework approach. We identified 6527 citations. Of these, 10 quantitative and 30 qualitative studies were included. Being male, higher educational status, less stigma and more social support were likely correlates of wellbeing. Themes that shaped experiences suggestive of wellbeing were: 1) acceptance and belonging- stigma, social support; 2) coping; 3) standard of living. Our final synthesis found that the following dimensions potentially characterise wellbeing: self-acceptance, belonging, autonomy; positive relations, environmental mastery, purpose in life. Wellbeing for YPLHIV is multi-dimensional and relational. Relevant measures include the Personal Wellbeing Index, Ryff's Psychological Wellbeing Scale and Mental Health Continuum Short Form. However, psychometric evaluations of these scales among YPLHIV in SSA are needed.
撒哈拉以南非洲（SSA）的艾滋病毒感染者青年（YPLHIV）生活质量较差。在艾滋病毒/艾滋病政策中明确解决福祉问题，可以协助缓解这一问题。然而，用于评估 YPLHIV 政策的福祉措施指南却十分缺乏。本混合方法综述的目的是确定：i）福祉的关键维度；ii）SSA 中 YPLHIV（15-24 岁）的福祉维度相匹配的福祉措施。我们在六个社会科学和医学数据库中进行了搜索，包括灰色文献。我们纳入了研究 YPLHIV 在 SSA 中的幸福感相关性和生活体验的研究，这些研究的时间从 2000 年 1 月到 2019 年 5 月。两名审查员独立筛选摘要和全文，并评估纳入文章的方法学质量。我们使用描述性和元民族学方法分别对定量和定性数据进行分析。然后，我们使用框架方法整合研究结果。我们确定了 6527 个引用。其中，有 10 项定量研究和 30 项定性研究被纳入。男性、更高的教育程度、较少的耻辱感和更多的社会支持可能与幸福感相关。塑造幸福感体验的主题包括：1）接受和归属感-耻辱感，社会支持；2）应对；3）生活水平。我们的最终综合研究结果发现，以下维度可能是幸福感的特征：1）自我接纳、归属感、自主性；2）积极关系、环境掌控、生活目的。YPLHIV 的幸福感是多维度和关系型的。相关措施包括个人幸福感指数、Ryff 的心理幸福感量表和心理健康连续体短表。然而，需要在 SSA 的 YPLHIV 中对这些量表进行心理测量评估。
