le Roux Jean-Marie, Groenewald Lina, Moxley Karis, Koen Liezl
Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
South Afr J HIV Med. 2021 Mar 16;22(1):1159. doi: 10.4102/sajhivmed.v22i1.1159. eCollection 2021.
There is a paucity of research on the clinical profile of women living with human immunodeficiency virus (HIV) (WLWH) admitted with acute mental health illness. Existing studies are small and did not look at factors that could have an impact on medication adherence. As a first step to inform service delivery for this vulnerable population, a thorough understanding of the composition and needs of these patients should be identified.
To describe the socio-demographic and clinical profile that could have an influence on the antiretroviral therapy (ART) adherence of WLWH at an inpatient psychiatric unit.
In this retrospective audit, the medical records of all WLWH (18-59 years of age), discharged from the acute unit at Stikland Psychiatric Hospital, were reviewed over a 12-month period.
Of the 347 female patients discharged, 55 patients were positive for HIV (15.9%). The majority of them were unmarried (78.2%), unemployed (92.7%), had a secondary level of education (Grade 8-10) (58.2%), lived with a family member (83.6%) and had children (61.8%). The most common psychiatric diagnosis on discharge was substance use disorder with 78.2% of patients being categorised as substance users. Interpersonal violence was only reported by 5.5% of patients. Although most patients performed poorly on the Montreal Cognitive Assessment (MoCA) and International HIV Dementia Scale (IHDS), only 12% of patients received a diagnosis of HIV-associated neurocognitive disorder (HAND) upon discharge. Antiretroviral therapy (ART) was initiated in 21.8% of patients. Only eight patients had a viral load of < 200 copies/mL, indicating viral suppression.
Our findings may inform service planning and emphasise the need for targeted intervention strategies to improve treatment outcomes in this vulnerable group.
关于感染人类免疫缺陷病毒(HIV)的女性(WLWH)合并急性精神疾病入院时的临床特征,相关研究较少。现有研究规模较小,且未考察可能影响药物依从性的因素。作为为这一弱势群体提供服务的第一步,应全面了解这些患者的构成和需求。
描述可能影响住院精神科病房中WLWH抗逆转录病毒疗法(ART)依从性的社会人口学和临床特征。
在这项回顾性审计中,对斯特克兰德精神病院急性病房出院的所有年龄在18至59岁之间的WLWH的病历进行了为期12个月的审查。
在347名出院的女性患者中,55名HIV检测呈阳性(15.9%)。她们中的大多数未婚(78.2%)、失业(92.7%)、接受过中等教育(8至10年级)(58.2%)、与家庭成员同住(83.6%)且育有子女(61.8%)。出院时最常见的精神科诊断是物质使用障碍,78.2%的患者被归类为物质使用者。只有5.5%的患者报告遭受人际暴力。尽管大多数患者在蒙特利尔认知评估(MoCA)和国际HIV痴呆量表(IHDS)上表现不佳,但出院时只有12%的患者被诊断为HIV相关神经认知障碍(HAND)。21.8%的患者开始接受抗逆转录病毒疗法(ART)。只有8名患者的病毒载量<200拷贝/毫升,表明病毒得到抑制。
我们的研究结果可为服务规划提供参考,并强调需要采取有针对性的干预策略,以改善这一弱势群体的治疗效果。