Department of Public Health, Center for Global Health, Aarhus University, Aarhus, Denmark.
Rwanda Biomedical Centre (RBC), Kigali, Rwanda.
AIDS Behav. 2024 Aug;28(8):2666-2682. doi: 10.1007/s10461-024-04358-3. Epub 2024 May 12.
While life expectancy of people living with HIV is increasing, their burden of non-communicable diseases, including mental health disorders, is growing as well. The aim of this study is to investigate the prevalence and identify the risk factors associated with mental health disorders among this population in Rwanda. This cross-sectional study enrolled people living with HIV from 12 HIV clinics across Rwanda using random sampling. Trained HIV nurses conducted the Mini International Neuropsychiatric Interview to estimate the prevalence of major depressive episode, post-traumatic stress disorder, and generalized anxiety disorder. Sociodemographic, psychosocial, and HIV-related data were also collected. Associated risk factors for being diagnosed with one of the mental health disorders were assessed using modified Poisson regression with robust error variance. Of 428 participants, 70 (16.4%) had at least one mental health disorder with major depressive episode being most prevalent (n = 60, 14.0%). Almost all participants were adherent to antiretroviral therapy (n = 424, 99.1%) and virally suppressed (n = 412, 96.9%). Of those diagnosed with a mental health disorder, only few were aware of (n = 4, 5.7%) or under treatment for this mental health disorder (n = 5, 7.2%). Mental health disorders were associated with experiences of HIV-related stigma and discrimination (aRR = 2.14, 95%CI 1.30-3.53, p = 0.003). The results demonstrate underdiagnosis and undertreatment of mental health disorders among Rwandan People Living with HIV. Using HIV nurses to diagnose mental health disorders could serve as a low-cost strategy for integrating mental health care with existing HIV services and could inspire the implementation in other low-resource settings.
虽然感染艾滋病毒的人的预期寿命在增加，但他们患非传染性疾病的负担也在增加，包括心理健康障碍。本研究旨在调查卢旺达这一人群中心理健康障碍的患病率，并确定与之相关的危险因素。本横断面研究采用随机抽样的方法，从卢旺达 12 个艾滋病毒诊所招募了艾滋病毒感染者。经过培训的艾滋病毒护士进行了迷你国际神经精神访谈，以评估主要抑郁发作、创伤后应激障碍和广泛性焦虑障碍的患病率。还收集了社会人口统计学、心理社会和艾滋病毒相关数据。使用修正泊松回归和稳健误差方差评估与诊断为一种心理健康障碍相关的危险因素。在 428 名参与者中，有 70 名（16.4%）至少有一种心理健康障碍，其中最常见的是重度抑郁发作（n=60，14.0%）。几乎所有的参与者都坚持接受抗逆转录病毒治疗（n=424，99.1%）和病毒抑制（n=412，96.9%）。在被诊断为心理健康障碍的患者中，只有少数人意识到（n=4，5.7%）或正在接受这种心理健康障碍的治疗（n=5，7.2%）。心理健康障碍与艾滋病毒相关的耻辱和歧视经历有关（ARR=2.14，95%CI 1.30-3.53，p=0.003）。研究结果表明，卢旺达艾滋病毒感染者中心理健康障碍的诊断和治疗不足。利用艾滋病毒护士来诊断心理健康障碍可以作为将心理健康护理与现有的艾滋病毒服务相结合的一种低成本策略，并可以激发在其他资源匮乏环境中的实施。
