Singh Nikita Prosad, Ntlantsana Vuyokazi, Tomita Andrew, Paruk Saeeda
Department of Psychiatry, School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.
KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP), College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.
S Afr J Psychiatr. 2024 Oct 8;30:2220. doi: 10.4102/sajpsychiatry.v30i0.2220. eCollection 2024.
Adverse childhood experiences (ACEs), substance use, depressive symptoms, and HIV outcomes in people living with HIV (PLWHIV) have not been comprehensively investigated within a single study.
The aim of this study was to investigate the prevalence and association of ACEs, substance use, depressive symptoms and human immunodeficiency virus (HIV) outcomes in PLWHIV accessing HIV care during the coronavirus disease 2019 (COVID-19) pandemic.
District hospital HIV clinic in South Africa.
A total of 196 PLWHIV completed a socio-demographic and clinical questionnaire; an adapted World Health Organization (WHO) Alcohol, Smoking and Substance Involvement Screening Test; WHO ACEs International Questionnaire, and Patient Health Questionnaire.
The most common ACEs were having one or no parent, parental separation or divorce ( = 131, 66.8%), exposure to collective ( = 57, 29.1%) and community violence ( = 55, 28.1%), with 40.3% ( = 79) experiencing ≥ 3 ACEs. The most commonly used substances were alcohol ( = 34, 17.3%), tobacco ( = 33, 16.8%), and cannabis ( =13, 6.6%). The prevalence of depressive symptoms was 19.4% ( = 38). Linear regression analyses indicated greater alcohol (adj β = 2.84, < 0.01), tobacco (adj β = 3.64, < 0.01) and cannabis use risk scores (adj β = 2.39, < 0.01) were associated with ≥ 3 ACEs. Logistic regression indicated depressive risk (adjusted odds ratio [OR] = 9.39, 95% confidence interval [CI] 4.78-23.51) was associated with ≥ 3 ACEs.
A high prevalence of ACEs, substance use and depressive symptoms exists among PLWHIV, along with an association between cumulative ACEs and both substance use and depressive symptoms.
Enhanced screening and management services are recommended to address this triple burden in PLWHIV.
儿童期不良经历（ACEs）、物质使用、抑郁症状以及人类免疫缺陷病毒（HIV）感染者（PLWHIV）的HIV相关结局尚未在一项研究中得到全面调查。
本研究旨在调查2019年冠状病毒病（COVID-19）大流行期间接受HIV治疗的PLWHIV中ACEs、物质使用、抑郁症状及HIV相关结局的患病率和相关性。
南非地区医院的HIV诊所。
共有196名PLWHIV完成了一份社会人口学和临床问卷；一份改编后的世界卫生组织（WHO）酒精、吸烟及物质使用筛查测试；WHO儿童期不良经历国际问卷以及患者健康问卷。
最常见的ACEs是父母一方或双方缺失、父母分居或离婚（n = 131，66.8%），遭受集体暴力（n = 57，29.1%）和社区暴力（n = 55，28.1%），40.3%（n = 79）的人经历了≥3次ACEs。最常用的物质是酒精（n = 34，17.3%）、烟草（n = 33，16.8%）和大麻（n = 13，6.6%）。抑郁症状的患病率为19.4%（n = 38）。线性回归分析表明，更多的酒精（调整后β = 2.84，P < 0.01）、烟草（调整后β = 3.64，P < 0.01）和大麻使用风险评分（调整后β = 2.39，P < 0.01）与≥3次ACEs相关。逻辑回归表明，抑郁风险（调整后的优势比[OR] = 9.39，95%置信区间[CI] 4.78 - 23.51）与≥3次ACEs相关。
PLWHIV中ACEs、物质使用和抑郁症状的患病率较高，累积的ACEs与物质使用和抑郁症状之间存在关联。
建议加强筛查和管理服务，以应对PLWHIV的这三重负担。
