West Nora S, Nakubulwa Rosette, Murray Sarah M, Ddaaki William, Mayambala Denis, Nakyanjo Neema, Nalugoda Fred, Hutton Heidi E, Surkan Pamela J, Kennedy Caitlin E
Department of Medicine, Division of Pulmonary, Critical Care, Allergy and Sleep Medicine.
Rakai Health Sciences Program.
Res Sq. 2024 Jul 2:rs.3.rs-4656465. doi: 10.21203/rs.3.rs-4656465/v1.
Health and illness experiences are positioned within social and cultural contexts. Understanding the mental health and psychological distress of people living with HIV in highly affected communities is critical to addressing their needs and to ensure programming and interventions are targeted and appropriate.
Grounded in the ethnomedical theoretical perspective, we conducted qualitative interviews to understand the experience and expression of psychological distress by people living with HIV in Rakai, Uganda. Participants included adults living with HIV (n=20), health workers (counselors, peer health workers, nurses, n=10), and key informants (n=12). Interviews were audio recorded, transcribed/translated, coded, and analyzed using thematic analysis.
Two idioms of distress, (worry/apprehension) and okwenyamira (deep/manythoughts/lots of thoughts) were described as impacting people living with HIV. Both idioms were said to be alleviated by social support or counseling, but if left unaddressed could lead to more severe mental health problems and poor ART adherence.
People living with HIV understand their psychological distress through culturally specific idioms; such distress can have deleterious impacts on well-being. Incorporating idioms of distress into screening and treatment for people living with HIV may improve identification of individuals in need and overall health services to address this need.
健康与疾病经历处于社会和文化背景之中。了解受艾滋病影响严重社区中艾滋病毒感染者的心理健康和心理困扰，对于满足他们的需求以及确保规划和干预措施具有针对性且恰当至关重要。
基于民族医学理论视角，我们进行了定性访谈，以了解乌干达拉凯地区艾滋病毒感染者心理困扰的经历和表现。参与者包括成年艾滋病毒感染者（n = 20）、卫生工作者（咨询师、同伴卫生工作者、护士，n = 10）以及关键信息提供者（n = 12）。访谈进行了录音，随后进行转录/翻译、编码，并采用主题分析法进行分析。
两种困扰的表述方式，即“担心/忧虑”和“奥克韦尼亚米拉”（意为“深沉/诸多想法/许多想法”）被描述为对艾滋病毒感染者产生影响。据说这两种表述方式均可通过社会支持或咨询得到缓解，但如果得不到解决，可能会导致更严重的心理健康问题以及对抗逆转录病毒治疗的依从性差。
艾滋病毒感染者通过特定文化的表述方式来理解他们的心理困扰；这种困扰可能对幸福感产生有害影响。将困扰的表述方式纳入艾滋病毒感染者的筛查和治疗中，可能会改善对有需求者的识别，并提升满足这一需求的整体卫生服务水平。
