Department of Psychology, College of Arts and Sciences, University of South Carolina, Columbia, SC 29208, USA.
South Carolina Smart State Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA.
Int J Environ Res Public Health. 2021 Oct 30;18(21):11431. doi: 10.3390/ijerph182111431.
Men who have sex with men and transgender women in the United States are at increased risk for HIV and may benefit from pre-exposure prophylaxis (PrEP), a once-a-day pill to prevent HIV. Due to stigma and discrimination, sexual and gender minority (SGM) populations are also at risk for depression and anxiety. This scoping review sought to identify literature addressing relationships between the PrEP care continuum, depression, and anxiety among SGM individuals and others at high risk for HIV. We conducted a systematic review of four databases (i.e., PubMed, PsycInfo, Web of Science, Google Scholar) and identified 692 unique articles that were screened for inclusion criteria, with 51 articles meeting the final inclusion criteria. Data were extracted for key study criteria (e.g., geographic location, participant demographics, study design, main findings). Results suggest that while depression and anxiety are not associated with PrEP awareness or willingness to use, they can be barriers to seeking care and to PrEP adherence. However, empirical studies show that taking PrEP is associated with reductions in anxiety. Findings suggest the need to implement mental health screenings in PrEP clinical care. In addition, addressing systemic and structural issues that contribute to mental health disorders, as well as PrEP-related barriers, is critical.
美国的男男性行为者和跨性别女性感染艾滋病毒的风险较高，他们可能受益于暴露前预防（PrEP），即一种每天服用一次的药丸，以预防艾滋病毒。由于耻辱感和歧视，性少数群体（SGM）和其他感染艾滋病毒风险较高的人群也面临着抑郁和焦虑的风险。本范围综述旨在确定文献中关于 SGM 个体和其他艾滋病毒高危人群的 PrEP 护理连续体、抑郁和焦虑之间关系的研究。我们对四个数据库（即 PubMed、PsycInfo、Web of Science、Google Scholar）进行了系统综述，共识别出 692 篇独特的文章，对这些文章进行了纳入标准的筛选，最终有 51 篇文章符合纳入标准。提取了数据以获取关键研究标准（例如地理位置、参与者人口统计学、研究设计、主要发现）。结果表明，虽然抑郁和焦虑与 PrEP 的认知或使用意愿无关，但它们可能是寻求护理和 PrEP 坚持的障碍。然而，实证研究表明，服用 PrEP 与焦虑的减少有关。研究结果表明，需要在 PrEP 临床护理中实施心理健康筛查。此外，解决导致心理健康障碍的系统性和结构性问题，以及与 PrEP 相关的障碍，是至关重要的。
