Mburia-Mwalili Adel, Wagner Karla D, Kwobah Edith Kamaru, Atwoli Lukoye, Aluda Maurice, Simmons Brianna, Lewis-Kulzer Jayne, Goodrich Suzanne, Wools-Kaloustian Kara, Syvertsen Jennifer L
School of Public Health, University of Nevada, Reno, Nevada, United States of America.
Mental Health Department, Moi Teaching and Referral Hospital, Eldoret, Kenya.
PLOS Glob Public Health. 2023 Feb 28;3(2):e0000778. doi: 10.1371/journal.pgph.0000778. eCollection 2023.
As coronavirus disease (COVID-19) was declared a pandemic in 2020, countries around the world implemented various prevention strategies, such as banning of public and social gatherings, restriction in movement, etc. These efforts may have had a deleterious effect on already vulnerable populations, including people living with HIV (PLWH). PLWH were concerned about contracting COVID-19, the impact of COVID-19 on their social networks that provide social support, and the continued availability of antiretroviral medications during the pandemic. In addition, their mental health may have been exacerbated by the pandemic. The purpose of this study was to explore pandemic-related concerns among a cohort of PLWH in Kenya and investigate social support factors associated with symptoms of depression and anxiety. This study is part of a larger cohort study that recruited from two clinics in Western Kenya. Data are drawn from 130 PLWH who participated in two phone surveys about experiences during the pandemic in 2020 and 2021. Participants reported a variety of concerns over the course of the pandemic and we documented statistically significant increases in symptoms of depression and anxiety over time, which affected some participants' ability to adhere to their antiretroviral medication. However, a small but statistically significant group of participants reached out to expand their networks and mobilize support in the context of experiencing mental health and adherence challenges, speaking to the importance of social support as a coping strategy during times of stress. Our findings call for holistic approaches to HIV care that consider the broader political, economic, and social contexts that shape its effectiveness.
2020年冠状病毒病(COVID-19)被宣布为大流行病后,世界各国实施了各种预防策略,如禁止公共和社交聚会、限制行动等。这些措施可能对包括艾滋病毒感染者(PLWH)在内的本就脆弱的人群产生了有害影响。艾滋病毒感染者担心感染COVID-19、COVID-19对提供社会支持的社交网络的影响,以及大流行期间抗逆转录病毒药物的持续供应情况。此外,大流行可能还加剧了他们的心理健康问题。本研究的目的是探讨肯尼亚一群艾滋病毒感染者中与大流行相关的担忧,并调查与抑郁和焦虑症状相关的社会支持因素。本研究是一项更大规模队列研究的一部分,该队列研究从肯尼亚西部的两家诊所招募参与者。数据来自130名艾滋病毒感染者,他们参与了关于2020年和2021年大流行期间经历的两次电话调查。参与者报告了在大流行期间的各种担忧,我们记录到随着时间推移,抑郁和焦虑症状在统计学上有显著增加,这影响了一些参与者坚持服用抗逆转录病毒药物的能力。然而,一小部分但在统计学上有显著意义的参与者在面临心理健康和坚持治疗挑战时,主动拓展社交网络并动员支持,这表明社会支持作为压力时期应对策略的重要性。我们的研究结果呼吁采取整体的艾滋病毒护理方法,要考虑到影响其有效性的更广泛的政治、经济和社会背景。