Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia.
Department of Community Health Sciences, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia.
PLoS One. 2022 Mar 14;17(3):e0264636. doi: 10.1371/journal.pone.0264636. eCollection 2022.
Men who have sex with men (MSM) living with HIV are more likely to be depressed than MSM without HIV. The AIDS epidemic will not end if the needs of people living with HIV and the determinants of health are not being addressed. Compared to HIV individuals without depression, depressed HIV individuals have worse clinical outcomes and higher mortality risk. Depression is caused by a complex combination of social, psychological, and biological variables. This systematic review, thereby motivated by the need to address this gap in the literature, aims to articulate determinants of depression among MSM living with HIV according to the biopsychosocial approach.
We systematically searched four databases from 2011 to 2021. We searched for observational studies on determinants of depression among MSM living with HIV. The outcome is depression based on the categorical or numerical outcome. Two reviewers independently extracted data and assessed study risks of bias. Any disagreements are consulted with the third reviewer.
We identified 533 articles, of which only eight studies are included. A total of 3,172 MSMs are included in the studies. We found the determinants of depression and categorized them according to biological, psychological, and social approaches.
The determinants of depression with the strongest evidence across studies were enacted HIV-related stigma, unemployment, sleep disturbance, current smoker, black ethnicity, born overseas, ART initiation, and access to mental health care. Despite weaker evidence, the other relevant determinants to be included were older age, internalized stigma, self-efficacy, and social support. Efforts to improve or prevent depression among MSM living with HIV could benefit from addressing the determinants of depression based on the biopsychosocial approach immediately after HIV diagnosis. Integrating mental health screening and care into HIV treatment settings would strengthen HIV prevention and care outcomes and improve access to mental healthcare.
与未感染 HIV 的男性相比，感染 HIV 的男男性行为者（MSM）更有可能抑郁。如果不解决 HIV 感染者的需求和健康决定因素，艾滋病流行就不会结束。与没有抑郁的 HIV 个体相比，抑郁的 HIV 个体临床结局更差，死亡风险更高。抑郁是由社会、心理和生物变量的复杂组合引起的。本系统综述旨在根据生物心理社会方法阐明感染 HIV 的 MSM 抑郁的决定因素，因此需要解决文献中的这一差距。
我们系统地从 2011 年到 2021 年搜索了四个数据库。我们搜索了关于感染 HIV 的 MSM 抑郁决定因素的观察性研究。结果是基于分类或数值结果的抑郁。两名审查员独立提取数据并评估研究偏倚风险。任何分歧都与第三位审查员协商。
我们确定了 533 篇文章，其中只有 8 项研究被纳入。共有 3172 名 MSM 纳入研究。我们发现了抑郁的决定因素，并根据生物、心理和社会方法对其进行了分类。
具有最强证据的抑郁决定因素是艾滋病相关耻辱感、失业、睡眠障碍、当前吸烟者、黑人种族、海外出生、抗逆转录病毒治疗（ART）开始和获得精神卫生保健。尽管证据较弱，但其他相关的决定因素包括年龄较大、内化耻辱感、自我效能感和社会支持。在 HIV 诊断后立即根据生物心理社会方法解决 MSM 感染 HIV 后抑郁的决定因素，可能有助于改善或预防抑郁。将心理健康筛查和护理纳入 HIV 治疗环境将加强 HIV 预防和护理结果，并改善获得精神保健的机会。
