Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, Sandler Neurosciences Bldg., Rm 510, 675 Nelson Rising Lane, San Francisco, CA, 94143, USA.
Department of Medicine, Division of General Internal Medicine, University of California, San Francisco, San Francisco, CA, USA.
Sci Rep. 2024 Aug 2;14(1):17919. doi: 10.1038/s41598-024-68908-4.
As a proposed mediator between stigma-related stressors and negative mental health outcomes, HIV-related shame has been predictive of increased rates of substance use and difficulties adhering to antiretroviral treatment among people with HIV. These downstream manifestations have ultimately impeded progress toward national goals to End the HIV Epidemic, in part due to limited success of conventional psychotherapies in addressing HIV-related shame. In a pilot clinical trial (N = 12), receipt of psilocybin-assisted group therapy was associated with a large pre-post decrease in HIV-related shame as measured by the HIV and Abuse Related Shame Inventory, with a median (IQR) change of - 5.5 (- 6.5, - 3.5) points from baseline to 3-months follow-up (Z = - 2.6, p = 0.009, r = - 0.75). A paradoxical exacerbation of sexual abuse-related shame experienced by two participants following receipt of psilocybin raises critical questions regarding the use of psilocybin therapy among patients with trauma. These preliminary findings carry potential significance for the future of HIV care.
作为与污名相关压力源和负面心理健康结果之间的拟议中介，HIV 相关羞耻感已被预测为 HIV 感染者中增加物质使用和抗逆转录病毒治疗依从性困难的原因。这些下游表现最终阻碍了实现国家终结艾滋病流行目标的进展，部分原因是传统心理疗法在解决 HIV 相关羞耻感方面的效果有限。在一项试点临床试验（N=12）中，接受迷幻蘑菇辅助小组治疗与 HIV 相关羞耻感的大量前后变化相关，使用 HIV 和与滥用相关的羞耻感量表测量，从基线到 3 个月随访的中位数（IQR）变化为-5.5（-6.5，-3.5）点（Z=-2.6，p=0.009，r=-0.75）。两名参与者在接受迷幻蘑菇后经历了性虐待相关羞耻感的悖论性加剧，这引发了关于在创伤患者中使用迷幻蘑菇疗法的关键问题。这些初步发现对未来的 HIV 护理具有潜在意义。
