Behavioral Medicine Program, Department of Psychiatry, Massachusetts General Hospital, One Bowdoin Sq, 7th Floor, Boston, MA, 02114, USA.
Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
AIDS Behav. 2023 Jun;27(6):1741-1756. doi: 10.1007/s10461-022-03906-z. Epub 2022 Oct 30.
In South Africa, little is known about interrelationships between syndemic problems among people with HIV (PWH). A better understanding of syndemic problems may yield important information regarding factors amenable to mitigation. We surveyed 194 PWH in Khayelitsha, outside of Cape Town, South Africa. We used network analysis to examine the frequency of 10 syndemic problems and their interrelationships. Syndemic problems among PWH in South Africa were common; 159 (82.8%) participants reported at least 2 co-occurring syndemic problems and 90 (46.9%) endorsed 4 or more. Network analysis revealed seven statistically significant associations. The most central problems were depression, substance use, and food insecurity. Three clusters of syndemics were identified: mood and violence; structural factors; and behavioral factors. Depression, substance use, and food insecurity commonly co-occur among PWH in sub-Saharan Africa and interfere with HIV outcomes. Network analysis can identify intervention targets to potentially improve HIV treatment outcomes.
在南非，人们对艾滋病毒感染者（PLWH）中并存的多种健康问题之间的相互关系知之甚少。更好地了解并存的健康问题可能会提供有关可减轻的因素的重要信息。我们调查了南非开普敦郊外的 Khayelitsha 的 194 名 PLWH。我们使用网络分析来检查 10 种并存健康问题及其相互关系的频率。南非 PLWH 中的并存健康问题很常见；159 名（82.8%）参与者报告至少有 2 种同时发生的并存健康问题，90 名（46.9%）报告有 4 种或更多种并存健康问题。网络分析显示了七个具有统计学意义的关联。最核心的问题是抑郁、物质使用和食物不安全。确定了三个并存问题簇：情绪和暴力；结构性因素；以及行为因素。抑郁、物质使用和食物不安全在撒哈拉以南非洲的 PLWH 中经常同时发生，并且会干扰 HIV 治疗结果。网络分析可以确定干预目标，以潜在改善 HIV 治疗结果。
