Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA.
College of Health Solutions, Arizona State University, Health North building, Suite 501, 550 N 3rd St, Phoenix, AZ, 85004, USA.
BMC Public Health. 2024 Sep 27;24(1):2622. doi: 10.1186/s12889-024-19966-w.
Poor psychological well-being, including depression, anxiety, and low self-esteem, is both prevalent among young South Africans living with HIV and associated with poor HIV clinical outcomes. By impacting food insecurity and employment, the COVID-19 pandemic may have influenced psychological well-being in this population. This analysis sought to examine whether food insecurity and unemployment mediated the relationship between study cohort (pre- versus during-pandemic) and psychological well-being in our sample of young South Africans living with HIV.
This was a secondary analysis comparing baseline data from two cohorts of young South Africans ages 18-24 from the Cape Town and East London metro areas who tested positive for HIV at clinics (or mobile clinics) either before or during the COVID-19 pandemic. Baseline sociodemographic, economic, and psychological outcomes were analyzed through a series of bivariate logistic regression and mediation analyses. All data were analyzed in 2023 and 2024.
Reported food anxiety, insufficient food quality, and insufficient food quantity were lower in the cohort recruited during the COVID-19 pandemic than those recruited before the pandemic (p < 0.001). Higher levels of food insecurity predicted higher depressive and anxiety symptoms and lower self-esteem. Food anxiety, insufficient food quality, and insufficient food quantity, but not unemployment, mediated the relationship between study cohort and depressive symptoms, anxiety symptoms, and self-esteem.
Food insecurity may have decreased amongst our sample of young people during the COVID-19 pandemic. Our findings build on our understanding of how the psychological well-being of young people living with HIV was affected by the COVID-19 pandemic and may lend support to interventions targeting food insecurity to improve psychological well-being in this population.
在南非艾滋病毒感染者中，心理健康不良（包括抑郁、焦虑和低自尊）普遍存在，并且与艾滋病毒临床结局不良有关。由于新冠肺炎疫情的影响，可能会影响到这一人群的心理健康，从而导致食品不安全和失业。本分析旨在探讨食品不安全和失业是否在南非艾滋病毒感染者这一年轻人群中，在研究队列（疫情前与疫情期间）与心理健康之间起到中介作用。
这是一项对来自南非开普敦和东伦敦大都市区的 18-24 岁艾滋病毒检测呈阳性的年轻人群的两个队列的基线数据进行的二次分析。这些队列分别在新冠肺炎疫情之前或期间在诊所（或流动诊所）中招募。通过一系列单变量逻辑回归和中介分析，对基线社会人口经济学和心理结局进行了分析。所有数据均在 2023 年和 2024 年进行分析。
与疫情前招募的队列相比，在疫情期间招募的队列报告的食物焦虑、食物质量不足和食物数量不足的情况较低（p<0.001）。较高的食物不安全程度预测了较高的抑郁和焦虑症状以及较低的自尊。食物焦虑、食物质量不足和食物数量不足，但不是失业，在研究队列与抑郁症状、焦虑症状和自尊之间起到了中介作用。
在我们的年轻人群样本中，在新冠肺炎疫情期间，食物不安全程度可能有所降低。我们的研究结果加深了我们对新冠肺炎疫情如何影响艾滋病毒感染者的年轻人心理健康的理解，并可能为针对食物不安全的干预措施提供支持，以改善这一人群的心理健康。
