Department of Psychology, University of Miami, Coral Gables, FL, USA.
Curr HIV/AIDS Rep. 2021 Aug;18(4):377-390. doi: 10.1007/s11904-021-00559-w. Epub 2021 May 20.
People with HIV (PWH) are more likely to experience depression than those without HIV. Depression is not only distressing and interfering in and of itself, but it is also consistently associated with non-adherence to antiretroviral treatment (ART). Accordingly, research and clinical priorities require updated knowledge about interventions that address depression in PWH.
Twenty efficacy trials and nine pilot studies since a 2009 review emerged in the literature review search. Of these, 11 and 6 respectively had a depression-related inclusion criterion. The intervention strategies included individual psychotherapy (n=6), group therapy (n=6), telehealth (n=3), and antidepressant medication (n=5). Generally, these interventions demonstrated acute efficacy for improving depression symptoms in PWH, with some also addressing ART non-adherence. However, not all studies collected follow-up data. Furthermore, trials that addressed depression but did not specifically address non-adherence did not also show adherence improvements. Existing interventions for depression have demonstrated efficacy in PWH, and these may have both positive mental and physical health outcomes. Future trials should measure and boost longer-term effects. It would be useful to incorporate adherence interventions into depression treatment to improve self-care behaviors and health outcomes.
与未感染 HIV 的人群相比,HIV 感染者(PWH)更易出现抑郁。抑郁不仅本身令人痛苦并对生活造成干扰,而且与抗逆转录病毒治疗(ART)的不依从密切相关。因此,研究和临床重点需要更新有关干预措施的知识,以解决 PWH 的抑郁问题。
自 2009 年的综述发表以来,文献检索中出现了 20 项疗效试验和 9 项试点研究。其中,分别有 11 项和 6 项研究有与抑郁相关的纳入标准。干预策略包括个体心理治疗(n=6)、团体心理治疗(n=6)、远程医疗(n=3)和抗抑郁药物(n=5)。这些干预措施总体上显示出对改善 PWH 抑郁症状的急性疗效,其中一些还解决了 ART 不依从的问题。然而,并非所有研究都收集了随访数据。此外,针对抑郁但未特别针对不依从问题的试验也没有显示出依从性的改善。现有的针对抑郁的干预措施在 PWH 中已显示出疗效,这些措施可能对心理健康和身体健康都有积极影响。未来的试验应测量并增强长期效果。将依从性干预措施纳入抑郁治疗中以改善自我保健行为和健康结果将是有益的。