Brouillette Marie-Josee, Koski Lisa, Scott Susan, Austin-Keiller Amanda, Fellows Lesley K, Mayo Nancy E
Department of Psychiatry, McGill University, Montreal, Canada.
Chronic Viral Illness Service, McGill University Health Centre (MUHC), Montreal, Canada.
AIDS Res Hum Retroviruses. 2022 May;38(5):421-430. doi: 10.1089/AID.2021.0024. Epub 2021 Dec 10.
Older adults living with HIV may be at increased risk of experiencing distress during the coronavirus disease 2019 (COVID-19) pandemic. We took advantage of a cohort study in older adults living with HIV in Canada (The Positive Brain Health Now [+BHN]) to study the psychological impact of the first wave of the COVID-19 pandemic. A longitudinal study was conducted in which participants in the +BHN study who had access to the internet and agreed to be contacted were queried on symptoms of psychological distress and its predictors each week between mid-April and the end of June 2020. Evolution of distress, measured with the Hospital Anxiety and Depression Scale (HADS), was modeled using Group Based Trajectory Analysis and logistic regression was used to identify factors predictive of psychological distress in the clinical range. The study was approved by the Research Ethics Board of the McGill University Health Center and all participants provided informed consent. The 77 +BHN participants who took part in this study were mostly men (92%) and on average 57.3 years of age. Over the study period, 32.5% experienced psychological distress in the clinical range at one or more weekly surveys. In the transition between the pre-COVID-19 and the COVID-19 periods, the HADS scores followed five distinct trajectories: (1) 39.5 % of the sample, with normal HADS scores in the several months preceding the pandemic, experienced an increase in HADS scores; (2) 30.6% of the sample had normal prepandemic HADS scores, remained stable; and (3) 29.9%, with prepandemic presence of distress, had a decrease in HADS scores. During the first wave of COVID-19, some attenuation in distress was seen over time. Feeling lonely and financial insecurity were associated with distress. Presence of psychological distress during the first wave of the COVID-19 pandemic was not universal among older adults with HIV, with as many as one third of the participants reporting an improvement in mental health. Distress was predicted by loneliness and financial insecurity.
感染艾滋病毒的老年人在2019年冠状病毒病（COVID-19）大流行期间可能会有更高的心理困扰风险。我们利用加拿大一项针对感染艾滋病毒的老年人的队列研究（“积极大脑健康现在”[+BHN]）来研究COVID-19大流行第一波的心理影响。开展了一项纵向研究，在2020年4月中旬至6月底期间，每周对+BHN研究中能够上网并同意被联系的参与者询问心理困扰症状及其预测因素。使用基于群组的轨迹分析对用医院焦虑抑郁量表（HADS）测量的困扰演变进行建模，并使用逻辑回归来确定临床范围内心理困扰的预测因素。该研究获得了麦吉尔大学健康中心研究伦理委员会的批准，所有参与者均提供了知情同意书。参与本研究的77名+BHN参与者大多为男性（92%），平均年龄57.3岁。在研究期间，32.5%的参与者在一项或多项每周调查中出现临床范围内的心理困扰。在COVID-19之前和COVID-19期间的过渡阶段，HADS评分呈现出五种不同的轨迹：（1）39.5%的样本在大流行前几个月HADS评分正常，但在大流行期间HADS评分增加；（2）30.6%的样本在大流行前HADS评分正常，且保持稳定；（3）29.9%的样本在大流行前存在困扰，但HADS评分下降。在COVID-19第一波期间，随着时间推移，困扰有所减轻。感到孤独和经济不安全与困扰相关。在感染艾滋病毒的老年人中，COVID-19大流行第一波期间心理困扰并非普遍存在，多达三分之一的参与者报告心理健康有所改善。孤独感和经济不安全可预测困扰。
