Huang Bishan, Younger Alitasha, Gallant Mary P, O'Grady Thomas J
School of Public Health, University at Albany, State University of New York, Rensselaer, NY, USA.
New York State Department of Health, AIDS Institute, Albany, NY, USA.
AIDS Behav. 2025 Mar;29(3):870-883. doi: 10.1007/s10461-024-04571-0. Epub 2024 Dec 18.
Previous research suggests that depression impacts HIV outcomes, including viral suppression. This meta-analysis quantifies the association between depression and HIV viral suppression. A systematic literature search was conducted in PubMed, Web of Science, EBSCO, and OVID to identify studies published through 2012 to 2022. The software Rayyan was used to evaluate eligibility of studies, and the 2020 Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines were used for abstracting data. A random effects meta-analysis was performed using Review Manager 5.4.1. Of the 1911 articles screened, 16 studies were included covering 80,103 participants. The results showed individuals without depression were more likely to achieve HIV viral suppression or undetectable viral load compared to individuals with depression (OR 1.30; 95%CI 1.15, 1.48; I = 76%). Subgroup analysis indicated this effect was significant among the general population of people living with HIV (n = 75,353; OR 1.32; 95%CI 1.12, 1.55; I = 85%) and cisgender women living with HIV (n = 4553; OR 1.28; 95%CI 1.09, 1.50; I = 16%), but not among cisgender men living with HIV (most identified as men who have sex with men) (n = 197; OR 2.13; 95%CI 0.43, 10.61; I = 83%). This meta-analysis shows a significant positive association between the absence of depression and achieving HIV viral suppression overall and among the subgroup of cisgender women. Public health interventions for people living with HIV should include strategies to identify and address the depressive symptoms that impact adherence to treatment, increase the risk of psycho-behavioral co-morbidities, and exacerbate social or structural factors impeding viral suppression.
先前的研究表明，抑郁症会影响艾滋病病毒的治疗结果，包括病毒抑制。这项荟萃分析对抑郁症与艾滋病病毒病毒抑制之间的关联进行了量化。在PubMed、科学网、EBSCO和OVID中进行了系统的文献检索，以识别2012年至2022年发表的研究。使用Rayyan软件评估研究的合格性，并使用2020年系统评价和荟萃分析的首选报告项目指南提取数据。使用Review Manager 5.4.1进行随机效应荟萃分析。在筛选的1911篇文章中，纳入了16项研究，涵盖80103名参与者。结果显示，与患有抑郁症的个体相比，未患抑郁症的个体更有可能实现艾滋病病毒的病毒抑制或病毒载量检测不到（比值比1.30；95%置信区间1.15，1.48；I² = 76%）。亚组分析表明，这种效应在感染艾滋病病毒的普通人群（n = 75353；比值比1.32；95%置信区间1.12，1.55；I² = 85%）和感染艾滋病病毒的顺性别女性（n = 4553；比值比1.28；95%置信区间1.09，1.50；I² = 16%）中显著，但在感染艾滋病病毒的顺性别男性（大多数被认定为男男性行为者）（n = 197；比值比2.13；95%置信区间0.43，10.61；I² = 83%）中不显著。这项荟萃分析表明，没有抑郁症与总体上以及在顺性别女性亚组中实现艾滋病病毒病毒抑制之间存在显著的正相关。针对感染艾滋病病毒者的公共卫生干预措施应包括识别和解决影响治疗依从性、增加心理行为共病风险以及加剧阻碍病毒抑制的社会或结构因素的抑郁症状的策略。
