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莫桑比克新诊断 HIV 患者中由非专业顾问提供的跨诊断心理健康干预的示范项目。

Demonstration project of a lay counselor delivered trans-diagnostic mental health intervention for newly diagnosed HIV patients in Mozambique.

机构信息

Department of Global Health, University of Washington, Seattle, WA, USA.

Health Alliance International, Seattle, WA, USA.

出版信息

AIDS Care. 2023 Jan;35(1):1-6. doi: 10.1080/09540121.2022.2039356. Epub 2022 Mar 29.

Abstract

Common mental disorders (CMDs) are associated with poor HIV outcomes in low- and middle-income countries. The present study implemented a psychological therapy delivered in routine HIV care and examined its effects on HIV outcomes in Mozambique. The Common Elements Treatment Approach (CETA) was integrated into routine HIV care in Sofala, Mozambique for all newly-diagnosed HIV+ patients with CMD symptoms. HIV treatment initiation and retention were compared to overall facility averages (those enrolled in CETA + those not enrolled). Of 250 patients screened, 59% (n = 148 met the criteria for CETA enrollment, and 92.6 (n = 137) enrolled in CETA. After four CETA visits, CMD symptoms decreased >50% and suicidal ideation decreased 100%. Patients enrolling in CETA had an antiretroviral therapy initiation rate of 97.1%, one-month retention of 69.2%, and three-month retention of 82.4%. Patients in the comparison group had one-month retention of 66.0% and three-month retention of 68.0%. CETA may be a promising approach to reduce symptoms of CMDs and improve HIV care cascade outcomes in areas with high HIV prevalence.

摘要

常见精神障碍(CMDs)与中低收入国家的 HIV 不良结局相关。本研究在常规 HIV 护理中实施了一种心理治疗,并检查了其在莫桑比克对 HIV 结局的影响。通用要素治疗方法(CETA)已在莫桑比克索法拉常规 HIV 护理中为所有新诊断出的 HIV+伴有 CMD 症状的患者提供。将 HIV 治疗开始和保留率与整体设施平均值(参加 CETA 的人+未参加 CETA 的人)进行比较。在筛查的 250 名患者中,59%(n=148)符合 CETA 入组标准,92.6%(n=137)参加了 CETA。经过四次 CETA 访视,CMD 症状减轻了>50%,自杀意念减少了 100%。参加 CETA 的患者抗逆转录病毒治疗开始率为 97.1%,一个月保留率为 69.2%,三个月保留率为 82.4%。对照组一个月保留率为 66.0%,三个月保留率为 68.0%。CETA 可能是一种有前途的方法,可以减少高 HIV 流行地区 CMDs 的症状,并改善 HIV 护理级联结局。

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