Public Health, Societies, and Belonging Division, Human Sciences Research Council, Pretoria, South Africa.
School of Nursing and Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
Front Public Health. 2024 May 23;12:1387878. doi: 10.3389/fpubh.2024.1387878. eCollection 2024.
Psychological distress is a growing public health challenge among people living with HIV. This study investigated the prevalence of psychological distress among individuals who know their HIV positive or negative serostatus in South Africa using 2017 data from a nationwide cross-sectional household-based population survey.
The data for this secondary analysis was collected using a multi-stage stratified cluster randomized sampling design. Multivariable backward stepwise generalized linear regression models were fitted to determine factors associated with psychological distress as measured by the Kessler Scale (K10) among HIV-positive and HIV-negative individuals who know their serostatus in South Africa.
Of 18,662 participants, psychological distress was 27.4% (95% CI: 25.3-29.7) among those HIV-positive and 20.1% (95% C: 18.8-21.4) among those HIV-negative. The odds of psychological distress were significantly higher among HIV-positive individuals who rated their health as fair/poor [AOR = 1.22 (95% CI: 1.09-1.35), < 0.001], and the odds were lower among those residing in rural formal/farm areas [AOR = 0.85 (95% CI: 0.78-0.93), < 0.001], and those with tertiary education level [AOR = 0.88 (95% CI: 0.78-0.99), = 0.033]. The odds of psychological distress in HIV-negative individuals were significantly higher among females than males [AOR = 1.09 (95% CI: 1.05-1.14), < 0.001], high-risk alcohol drinkers [AOR = 1.26 (95% CI: 1.02-1.57), = 0.035] and hazardous alcohol drinkers [AOR = 1.09 (95% CI: 1.01-1.18), = 0.028] than abstainers and those who rated their health as fair/poor rather than excellent/good [AOR = 1.18 (95% CI: 1.10-1.26), < 0.001].
The study underscores the importance of addressing, alcohol misuse and socio-structural inequalities linked to gender and race-based disparities, such as low educational attainment and unemployment, as critical factors associated with psychological distress in the study population.
在 HIV 感染者中，心理困扰是一个日益严重的公共卫生挑战。本研究使用 2017 年全国横断面家庭为基础的人口调查数据，调查了南非知道 HIV 阳性或阴性血清状态的个体中心理困扰的流行情况。
这项二次分析的数据是使用多阶段分层聚类随机抽样设计收集的。使用多变量向后逐步广义线性回归模型来确定与南非知道其血清状态的 HIV 阳性和 HIV 阴性个体中 Kessler 量表（K10）测量的心理困扰相关的因素。
在 18662 名参与者中，HIV 阳性者的心理困扰率为 27.4%（95%CI：25.3-29.7），HIV 阴性者为 20.1%（95%CI：18.8-21.4）。与健康自评不佳/差的 HIV 阳性个体相比，心理困扰的可能性显著更高[调整比值比（AOR）=1.22（95%CI：1.09-1.35），<0.001]，与居住在农村正规/农场地区的个体相比，可能性较低[AOR=0.85（95%CI：0.78-0.93），<0.001]，与具有高等教育水平的个体相比，可能性也较低[AOR=0.88（95%CI：0.78-0.99），=0.033]。与男性相比，女性 HIV 阴性个体的心理困扰可能性显著更高[AOR=1.09（95%CI：1.05-1.14），<0.001]，高危饮酒者[AOR=1.26（95%CI：1.02-1.57），=0.035]和危险饮酒者[AOR=1.09（95%CI：1.01-1.18），=0.028]的可能性更高，而戒酒者和自评健康状况良好/差的个体的可能性较低[AOR=1.18（95%CI：1.10-1.26），<0.001]。
该研究强调了必须解决与性别和基于种族的差异相关的酒精滥用和社会结构不平等问题，例如教育程度低和失业等关键因素，这些因素与研究人群中的心理困扰密切相关。
