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探讨生物心理社会因素对坦桑尼亚感染艾滋病毒青少年中与艾滋病毒相关的抑郁和认知功能之间关系的调节作用:一项分析性横断面研究方案

Examining the moderating effects of biopsychosocial factors on the relationship between HIV-related depression and cognitive function among adolescents living with HIV in Tanzania: A protocol for an analytical cross-sectional study.

作者信息

Kitoki Siku, Seif Saada Ali, Masika Golden Mwakibo

机构信息

Department of Clinical Nursing, School of Nursing and Public Health, University of Dodoma, Dodoma, Tanzania.

Department of Public Health and Community Nursing, School of Nursing and Public Health, University of Dodoma, Dodoma, Tanzania.

出版信息

PLoS One. 2025 Jan 6;20(1):e0313223. doi: 10.1371/journal.pone.0313223. eCollection 2025.

Abstract

BACKGROUND

Adolescents living with HIV face unique challenges, including mental health issues such as depression and cognitive dysfunction. Despite this significant burden, there is a lack of evidence focusing on this population. This study therefore aims to examine the moderating effects of biopsychosocial factors on the bi-directional relationship between HIV-related depression and cognitive function among adolescents living with HIV in the Mbeya region, Tanzania.

METHODS

The analytical cross-sectional study will be conducted in public healthcare facilities in the Mbeya region, involving 207 adolescents living with HIV who will be selected using a systematic random sampling technique. Depression will be assessed using a standardized PHQ-9 tool, while cognitive functioning will be evaluated using a validated Montreal Cognitive Assessment Tool Version 8.3. A biopsychosocial model will be used to guide this study. Descriptive statistics will be used to describe the frequency distribution of the study variables, a chi-square test will be used to describe the relationship between the variables and a binary logistic regression model will be used to predict the moderating effects of biopsychosocial factors on the relationship between HIV-related depression and cognitive function. The odds ratio and a 95% confidence interval will be reported, and the p-value of 0.05 will be considered statistical significance. This study is expected to be conducted for three months. The high prevalence of mental health issues among HIV-positive adolescents, the detrimental effect of HIV on cognitive development, and the lack of studies focused on this population raised the need to conduct this study.

DISCUSSION

The findings of this study will inform the development of a comprehensive integrated care model that addresses both the mental and cognitive aspects of living with HIV during adolescence. Moreover, the identification of factors associated with depression and cognitive performance will help healthcare providers in identifying at-risk adolescents and proper management of the conditions. This study's results will also help reveal areas that need in-depth exploration that will lead to a better understanding of the responsible factors.

摘要

背景

感染艾滋病毒的青少年面临着独特的挑战,包括抑郁症和认知功能障碍等心理健康问题。尽管负担如此沉重,但针对这一人群的研究证据却很匮乏。因此,本研究旨在探讨生物心理社会因素对坦桑尼亚姆贝亚地区感染艾滋病毒青少年中与艾滋病毒相关的抑郁症和认知功能之间双向关系的调节作用。

方法

这项分析性横断面研究将在姆贝亚地区的公共医疗设施中进行,纳入207名感染艾滋病毒的青少年,他们将采用系统随机抽样技术选取。抑郁症将使用标准化的PHQ - 9工具进行评估,而认知功能将使用经过验证的蒙特利尔认知评估工具第8.3版进行评估。将采用生物心理社会模型来指导本研究。描述性统计将用于描述研究变量的频率分布,卡方检验将用于描述变量之间的关系,二元逻辑回归模型将用于预测生物心理社会因素对与艾滋病毒相关的抑郁症和认知功能之间关系的调节作用。将报告比值比和95%置信区间,p值小于0.05将被视为具有统计学意义。本研究预计进行三个月。艾滋病毒阳性青少年中心理健康问题的高患病率、艾滋病毒对认知发展的有害影响以及缺乏针对这一人群的研究,促使开展本研究。

讨论

本研究的结果将为制定一个全面的综合护理模式提供依据,该模式可解决青少年感染艾滋病毒后的心理和认知问题。此外,确定与抑郁症和认知表现相关的因素将有助于医疗服务提供者识别有风险的青少年并对病情进行妥善管理。本研究的结果还将有助于揭示需要深入探索的领域,从而更好地理解相关因素。

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