埃塞俄比亚西北部新诊断的艾滋病毒感染者的心理困扰及其相关因素：有序逻辑回归分析
Psychological Distress and Its Correlates among Newly Diagnosed People Living with HIV in Northwest Ethiopia: Ordinal Logistic Regression Analyses.
作者信息
Moges Nurilign Abebe, Adesina Olubukola Adeponle, Okunlola Micheal A, Berhane Yemane, Akinyemi Joshua Odunayo
机构信息
Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia.
Pan African University, Life and Earth Sciences Including Health and Agriculture Institute (PAULESI), University of Ibadan, Ibadan, Nigeria.
出版信息
Infect Dis (Auckl). 2021 Feb 14;14:1178633721994598. doi: 10.1177/1178633721994598. eCollection 2021.
BACKGROUND
Although there is a high burden of HIV in sub-Saharan Africa (SSA), studies on mental health issues among people living with HIV are scarce. The study addressed the transition to "test and treat" guidelines for HIV, which makes it unique regarding its evaluation of psychological distress amongst newly initiated people living with HIV in the test and treat era.
METHODS
We conducted a cross-sectional survey of 689 people newly diagnosed with HIV. Symptoms of psychological distress were measured using the Kessler-10 psychological distress assessment scale. Factors associated with psychological distress were captured using interviewer-administered questionnaires. Ordinal logistic regression analyses were employed to identify predictors of psychological distress.
RESULTS
The magnitude of psychological distress was 58.63% (95% CI = 55.2%-62.3%). The severity of the psychological distress of which, 17.42% had severe distress. Psychological distress was observed more among female patients (β = 0.47, AOR = 1.59, 95% CI = 1.12, 2.27), patients presented with opportunistic infections (β = 0.50, AOR = 1.65, 95% CI = 1.03, 2.66) and being non-working functional status (β = 0.99, AOR = 2.70, 95% CI = 1.64, 4.45). Moreover, patients who were malnourished (β = 0.46, AOR = 1.58, 95% CI = 1.09, 2.26), having good level of knowledge on HIV prevention (β = 0.59, 95% CI = 0.55, 0.39, 0.78), presented with sexually transmitted infection (β = 0.48, AOR = 1.61, 95% CI = 1.01, 2.58), history of alcohol use (β = 0.44, AOR = 1.55, 95% CI = 1.09, 2.21), perceived stigma (β = 0.08, AOR = 1.09 95% CI = 1.04, 1.15) and treated in health centers (β = 0.55, AOR = 1.74, 95% CI = 1.25, 2.41) had higher odds of psychological distress.
CONCLUSION
The large majority of newly diagnosed HIV patients suffered from psychological distress. An increased vulnerability was observed among females, those with opportunistic and sexually transmitted infections, those having poor functional status and malnourished. Furthermore, HIV patients treated in health centers, those who had history of alcohol use and patients with high level of HIV related stigma are more negatively affected by the HIV diagnosis. Hence, all intervention strategies should target all the identified predictors.
背景
尽管撒哈拉以南非洲地区（SSA）的艾滋病毒负担沉重，但关于艾滋病毒感染者心理健康问题的研究却很匮乏。该研究探讨了向艾滋病毒“检测与治疗”指南的转变，这使得其在评估检测与治疗时代新确诊的艾滋病毒感染者的心理困扰方面具有独特性。
方法
我们对689名新确诊的艾滋病毒感染者进行了横断面调查。使用凯斯勒10项心理困扰评估量表测量心理困扰症状。通过访谈员管理的问卷收集与心理困扰相关的因素。采用有序逻辑回归分析来确定心理困扰的预测因素。
结果
心理困扰的程度为58.63%（95%置信区间 = 55.2% - 62.3%）。其中，17.42%有严重困扰。女性患者（β = 0.47，调整后比值比[AOR] = 1.59，95%置信区间 = 1.12，2.27）、出现机会性感染的患者（β = 0.50，AOR = 1.65，95%置信区间 = 1.03，2.66）以及无工作功能状态的患者（β = 0.99，AOR = 2.70，95%置信区间 = 1.64，4.45）中观察到更多的心理困扰。此外，营养不良的患者（β = 0.46，AOR = 1.58，95%置信区间 = 1.09，2.26）、对艾滋病毒预防知识了解程度高的患者（β = 0.59，95%置信区间 = 0.55，0.39，0.78）、患有性传播感染的患者（β = 0.48，AOR = 1.61，95%置信区间 = 1.01，2.58）、有饮酒史的患者（β = 0.44，AOR = 1.55，95%置信区间 = 1.09，2.21）、感知到耻辱感的患者（β = 0.08，AOR = 1.09，95%置信区间 = 1.04，1.15）以及在健康中心接受治疗的患者（β = 0.55，AOR = 1.74，95%置信区间 = 1.25，2.41）出现心理困扰的几率更高。
结论
绝大多数新确诊的艾滋病毒患者存在心理困扰。在女性、患有机会性和性传播感染的患者、功能状态差和营养不良的患者中观察到易感性增加。此外，在健康中心接受治疗的艾滋病毒患者、有饮酒史的患者以及艾滋病毒相关耻辱感高的患者受艾滋病毒诊断的负面影响更大。因此，所有干预策略都应针对所有已确定的预测因素。
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