2018 年莫桑比克两个省份医疗机构中精神障碍与抗逆转录病毒治疗依从性的相关性:一项横断面研究。

Association between mental disorders and adherence to antiretroviral treatment in health facilities in two Mozambican provinces in 2018: a cross-sectional study.

机构信息

Department of Mental Health, Ministry of Health, Eduardo Mondlane Avenue, nr 1008, Postal Code 264, Maputo, Mozambique.

Department of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil.

出版信息

BMC Psychiatry. 2023 Apr 20;23(1):274. doi: 10.1186/s12888-023-04782-0.

Abstract

INTRODUCTION

Lower adherence to antiretroviral treatment (ART) has been found among people with HIV (PWH) who have comorbid mental disorders like depression and alcohol use in Sub-Saharan African. However, there has been less exploration with regards to other mental disorders.

METHODS

This study assessed the association of multiple mental disorders and adherence to ART based on the data from primary/tertiary health care facilities in Maputo and Nampula, Mozambique. We administered a sociodemographic questionnaire, Mini International Neuropsychiatric Interview (MINI) Plus 4.0.0 adapted for use in Mozambique to assess mental conditions, and a 3-item self-report to measure ART adherence.

RESULTS

395 HIV-positive (self-report) participants on ART, with an average age of 36.7 years (SD = 9.8), and 30.4% were male. The most common mental disorders were major depressive disorder (27.34%) followed by psychosis (22.03%), suicidal ideation/behavior (15.44%), and alcohol-use disorder (8.35%). Higher odds of missing at least one dose in the last 30 days (OR = 1.45, 95% CI: 1.01, 2.10) were found in participants with any mental disorder compared to those without a mental disorder. The highest levels of non-adherence were observed among those with drug use disorders and panic disorder.

CONCLUSIONS

In Mozambique, PWH with any co-occurring mental conditions had a lower probability of ART adherence. Integrating comprehensive mental health assessment and treatment and ART adherence interventions tailored to PWH with co-occurring mental disorders is necessary to attain optimal ART adherence and reach the UNAIDS ART target.

摘要

简介

在撒哈拉以南非洲,患有合并精神障碍(如抑郁症和酒精使用障碍)的艾滋病毒感染者(PLHIV)的抗逆转录病毒治疗(ART)依从性较低。然而,对于其他精神障碍的研究较少。

方法

本研究根据莫桑比克马普托和楠普拉的初级/三级保健机构的数据,评估了多种精神障碍与 ART 依从性的关系。我们采用了一份社会人口学问卷、经过改编适用于莫桑比克的迷你国际神经精神访谈(MINI)Plus 4.0.0 版,以评估精神状况,以及一份 3 项自我报告来衡量 ART 依从性。

结果

395 名接受 ART 治疗的 HIV 阳性(自我报告)参与者,平均年龄为 36.7 岁(标准差=9.8),30.4%为男性。最常见的精神障碍是重度抑郁症(27.34%),其次是精神病(22.03%)、自杀意念/行为(15.44%)和酒精使用障碍(8.35%)。与没有精神障碍的参与者相比,在过去 30 天内至少漏服一剂药物的参与者出现这种情况的可能性更高(OR=1.45,95%CI:1.01,2.10)。在那些有药物使用障碍和惊恐障碍的患者中,观察到的不依从率最高。

结论

在莫桑比克,患有任何合并精神疾病的 PLHIV 的 ART 依从性较低。有必要整合全面的心理健康评估和治疗以及针对合并精神障碍的 PLHIV 的 ART 依从性干预措施,以实现最佳的 ART 依从性并达到联合国艾滋病规划署的 ART 目标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/68e8/10116733/ae873053d18a/12888_2023_4782_Fig1_HTML.jpg

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