Pampaka Despina, Pantavou Katerina, Giallouros George, Pavlitina Eirini, Williams Leslie D, Piovani Daniele, Bonovas Stefanos, Nikolopoulos Georgios K
Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol 3041, Cyprus.
Medical School, University of Cyprus, Nicosia 2029, Cyprus.
J Clin Med. 2021 Mar 12;10(6):1181. doi: 10.3390/jcm10061181.
Poor mental health among human immunodeficiency virus (HIV)-positive people who inject drugs (PWID) may contribute to stigma, and together they act as barriers to medical care. This analysis aims to examine factors associated with the mental health of PWID and their network contacts, and the association of poor mental health with the experience of HIV-related stigmatizing events, with HIV-related social support, and with perceived access to care. Data were collected during the Transmission Reduction Intervention Project (TRIP) conducted in Athens, Greece (2013-2015). PWID ( = 292; = 122 HIV-positive) were interviewed both at baseline and follow-up. Items of depression, anxiety, and general positive affect subscales of the Mental Health Inventory were used to explore the psychological distress and well-being of participants at follow-up. Items of the Access to Care Scale were used to evaluate perceived access to medical care at baseline and follow-up. Linear regression showed that unemployment was positively related to depression (β = 1.49, = 0.019), while injecting drug use was a risk factor for a low general positive affect score (β = -3.21, = 0.015). Poor mental health was not linked to HIV-related stigma or social support. Positive perception of access to care was associated in multivariable analyses with low depression (β = -0.22, = 0.049). The perceived access to care score improved from baseline to follow-up ( = 0.019) and HIV-positive participants had a higher score than HIV-negative participants. Future interventions should include targets to improve the mental well-being of participants, reduce psychosocial distress, and minimize perceived barriers to accessing medical care.
在注射毒品的艾滋病毒（HIV）阳性人群（PWID）中，心理健康状况不佳可能会导致耻辱感，而耻辱感又会共同成为医疗保健的障碍。本分析旨在研究与PWID及其社交网络联系人心理健康相关的因素，以及心理健康不佳与HIV相关耻辱事件经历、HIV相关社会支持以及感知到的医疗服务可及性之间的关联。数据收集于在希腊雅典开展的减少传播干预项目（TRIP，2013 - 2015年）期间。对PWID（n = 292；其中n = 122为HIV阳性）在基线和随访时均进行了访谈。使用心理健康量表中抑郁、焦虑和总体积极情感子量表的项目来探究随访时参与者的心理困扰和幸福感。使用医疗服务可及性量表的项目来评估基线和随访时感知到的医疗服务可及性。线性回归显示，失业与抑郁呈正相关（β = 1.49，p = 0.019），而注射毒品是总体积极情感得分较低的一个风险因素（β = -3.21，p = 0.015）。心理健康不佳与HIV相关耻辱或社会支持无关。在多变量分析中，对医疗服务可及性的积极认知与低抑郁相关（β = -0.22，p = 0.049）。从基线到随访，感知到的医疗服务可及性得分有所改善（p = 0.019），且HIV阳性参与者的得分高于HIV阴性参与者。未来的干预措施应包括旨在改善参与者心理健康、减轻心理社会困扰以及尽量减少感知到的医疗服务获取障碍的目标。
