Faculty of Humanities and Social Sciences, Center for African Studies, University of Basel, Basel, Switzerland
Research, Zvandiri, Harare, Zimbabwe.
BMJ Glob Health. 2023 Aug;8(8). doi: 10.1136/bmjgh-2023-012671.
The role of religion and spirituality as social determinants of health has been widely discussed. Studies among people living with HIV describe positive and negative influences of religion and spirituality on health outcomes. With a HIV prevalence of 14.8% for females and 8.6% for males, and 22 000 AIDS-related deaths in 2020, HIV infection remains a life-threatening condition in Zimbabwe, especially in young people. The aim of this research was to measure the influence of religion and spirituality on the health outcomes of young people living with HIV in Zimbabwe.
A quantitative questionnaire with three different validated measures of religion and spirituality (Belief into Action Scale, Brief Religious Coping Index, Religious and Spiritual Struggles Scale), demographic, cultural, behavioural and health questions was administered to 804 young Zvandiri programme clients in rural, urban and peri-urban Zimbabwe between July and October 2021. Regression analysis established significant relations between the result of the three different measures and mental health and viral load results.
Religious coping significantly reduced the probability of common mental disorder, while high religious activity increased the risk. The Religious and Spiritual Struggles Scale proved to be a reliable indicator of higher viral loads, risk for treatment failure and the probability of common mental disorder.
All three measures of religion and spirituality related to health outcomes. More research is needed to generalise and further explore these findings. Because the Religious and Spiritual Struggles Scale was a strong indicator for both, higher viral loads and common mental disorder, we suggest that it should be used and validated in other sub-Saharan contexts. It could serve as a new diagnostic tool for the early detection and prevention of treatment failure as well as of common mental disorder.
宗教和精神信仰作为健康的社会决定因素的作用已被广泛讨论。在艾滋病毒感染者中进行的研究描述了宗教和精神信仰对健康结果的积极和消极影响。津巴布韦的艾滋病毒流行率为女性 14.8%，男性 8.6%，2020 年有 22000 人死于艾滋病，因此艾滋病毒感染仍然是一种危及生命的疾病，尤其是在年轻人中。本研究旨在衡量宗教和精神信仰对津巴布韦感染艾滋病毒的年轻人健康结果的影响。
在 2021 年 7 月至 10 月期间，对津巴布韦农村、城市和城乡结合部的 804 名 Zvandiri 项目的年轻艾滋病毒感染者进行了一项问卷调查，其中包括三个不同的宗教和精神信仰的验证性衡量标准（信仰转化行动量表、简短宗教应对指数、宗教和精神挣扎量表）、人口统计学、文化、行为和健康问题。回归分析确定了三个不同衡量标准的结果与心理健康和病毒载量结果之间的显著关系。
宗教应对显著降低了常见精神障碍的可能性，而高宗教活动则增加了风险。宗教和精神挣扎量表被证明是病毒载量较高、治疗失败风险和常见精神障碍概率的可靠指标。
宗教和精神信仰的所有三个衡量标准都与健康结果有关。需要进一步的研究来推广和进一步探讨这些发现。由于宗教和精神挣扎量表是较高病毒载量和常见精神障碍的强有力指标，我们建议在其他撒哈拉以南非洲地区使用和验证该量表。它可以作为一种新的诊断工具，用于早期发现和预防治疗失败以及常见精神障碍。
