中国 HIV 感染者抗逆转录病毒治疗相关经历与心理健康状况的相关性：一项前瞻性观察性队列研究。
Associations between antiretroviral therapy-related experiences and mental health status among people living with HIV in China: a prospective observational cohort study.
机构信息
Department of Medical Statistics, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, Guangdong, China.
JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China.
出版信息
AIDS Res Ther. 2021 Sep 9;18(1):60. doi: 10.1186/s12981-021-00370-y.
BACKGROUND
Mental health problems (e.g., depression and anxiety) are among the most commonly reported comorbidities of HIV. Antiretroviral therapy (ART) coverage has increased sharply. The purposes of this prospective cohort study were to investigate the ART-related experiences and whether they were associated with mental health problems among a sample of people living with HIV undergoing ART in China.
METHODS
The participants were 400 people living with HIV who had started ART for the first time in Guangzhou city. They were followed-up 1-year after ART initiation. Probable depression and moderate/severe anxiety were measured at baseline and Month 12, while experiences related to ART (e.g., side effects and regained self-confidence) were measured at Month 6. Univariate and multivariate logistic regressions were used to explore the associations between baseline characteristics, ART-related experiences and mental health status.
RESULTS
Among the 300 participants (75.0%) who completed all three surveys, a significant decline in prevalence of probable depression (23.0% at baseline vs. 14.0% at Month 12, P = 0.002) and moderate/severe anxiety (14.7% at baseline vs. 8.7% at Month 12, P = 0.023) was observed during the follow-up period. After adjustment for mental health status and potential confounders at baseline, a number of ART-related experiences at Month 6 were associated with probable depression and/or moderate/severe anxiety measured at Month 12. Improved physical health, relationships with sexual partners, and self-confidence were associated with decreased mental health issues, while the side effects of ART, AIDS-related symptoms, and inconvenience in daily life due to ART use were associated with increased mental health issues.
CONCLUSIONS
ART-related experiences were associated with mental health problems, tailored mental health promotion interventions targeting these experiences are needed.
背景
心理健康问题（例如抑郁和焦虑）是 HIV 最常见的合并症之一。抗逆转录病毒疗法（ART）的覆盖率急剧增加。本前瞻性队列研究的目的是调查与 ART 相关的经验，以及这些经验是否与在中国接受 ART 的 HIV 感染者样本中的心理健康问题有关。
方法
参与者是 400 名首次在广州市开始接受 ART 的 HIV 感染者。他们在开始 ART 后 1 年进行随访。在基线和第 12 个月测量可能的抑郁和中度/重度焦虑，而在第 6 个月测量与 ART 相关的经验（例如副作用和恢复自信）。使用单变量和多变量逻辑回归来探讨基线特征、与 ART 相关的经验与心理健康状况之间的关系。
结果
在完成所有三次调查的 300 名参与者（75.0%）中，观察到在随访期间，可能的抑郁（基线时为 23.0%，第 12 个月时为 14.0%，P=0.002）和中度/重度焦虑（基线时为 14.7%，第 12 个月时为 8.7%，P=0.023）的患病率显著下降。在校正基线时的心理健康状况和潜在混杂因素后，第 6 个月的一些与 ART 相关的经验与第 12 个月测量的可能的抑郁和/或中度/重度焦虑有关。改善的身体健康、与性伴侣的关系以及自信心与减少心理健康问题有关，而 ART 的副作用、艾滋病相关症状以及因使用 ART 而导致的日常生活不便与增加心理健康问题有关。
结论
与 ART 相关的经验与心理健康问题有关，需要针对这些经验制定有针对性的心理健康促进干预措施。
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