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COVID-19 大流行期间 HIV 感染者的抑郁状况:HIV/AIDS 污名化程度低和感知到的情绪支持度高是否是保护性资源?

Depression during the COVID-19 pandemic among people living with HIV: Are low HIV/AIDS stigma and high perceived emotional support protective resources?

机构信息

Faculty of Psychology, University of Warsaw, Warsaw, Poland.

Faculty of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland.

出版信息

Stress Health. 2023 Oct;39(4):884-893. doi: 10.1002/smi.3231. Epub 2023 Feb 7.

Abstract

This study has two objectives: first, to examine changes in depressive symptoms among people living with HIV (PLWH) during the COVID-19 pandemic and, second, to verify the role of HIV/AIDS stigma and perceived emotional support (PES) in the heterogeneity of these changes. The participants were 392 people with a medical diagnosis of HIV who have undergone antiretroviral therapy. Depression was measured at three time points with 6-month intervals using the Centre for Epidemiological Studies Depression Scale (CES-D). PES was evaluated with the Berlin Social Support Scales, and HIV/AIDS-related stigma was assessed with the Berger HIV Stigma Scale. Latent growth class modelling identified four trajectories of depression over the study period: three stable (very high, high, and very low) and one increasing. Both the very high and high stable trajectories had baseline values above the CES-D cut-off point for depression, suggesting that 57.6% of the sample was likely to be diagnosed with depression. After controlling for sociodemographic and clinical variables, stigma and PES were found to be significant covariates of the obtained trajectories; however, they did not protect against an increase in depression symptoms. There was no overall increase in depression symptoms among the PLWH participants during the pandemic, but this change in depression symptoms was heterogeneous. We observed the potential development of depression in initially well-functioning individuals despite their personal resources differing only slightly from those who remained resilient.

摘要

本研究有两个目的

第一,考察在 COVID-19 大流行期间 HIV 感染者(PLWH)的抑郁症状变化;第二,验证 HIV/AIDS 污名和感知情感支持(PES)在这些变化异质性中的作用。参与者为 392 名经医学诊断患有 HIV 并接受过抗逆转录病毒治疗的人。使用流行病学研究抑郁量表(CES-D),在 6 个月的间隔时间内分三个时间点测量抑郁。PES 通过柏林社会支持量表进行评估,HIV/AIDS 相关污名通过 Berger HIV 污名量表进行评估。潜在增长类模型确定了研究期间抑郁的四个轨迹:三个稳定(非常高、高和非常低)和一个增加。非常高和高稳定轨迹的基线值均高于 CES-D 抑郁临界值,这表明 57.6%的样本可能被诊断为抑郁症。在控制了社会人口统计学和临床变量后,污名和 PES 被发现是获得轨迹的重要协变量;然而,它们并不能防止抑郁症状的增加。在大流行期间,PLWH 参与者的抑郁症状总体没有增加,但这种抑郁症状的变化是异质的。我们观察到,尽管最初功能良好的个体的个人资源与保持弹性的个体仅略有不同,但他们仍有可能出现抑郁。

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