Burke Aoife, Davoren Martin P, Arensman Ella, Harrington Janas
School of Public Health, College of Medicine and Health, University College Cork, Cork, Ireland.
Cork City Council, City Hall, Anglesea Street, Cork, Ireland.
BMC Public Health. 2025 Feb 20;25(1):707. doi: 10.1186/s12889-025-21906-1.
The effectiveness of antiretroviral therapy means that human immunodeficiency virus (HIV) can now be defined as a manageable chronic illness. It is the facilitation of psychosocial care that has increasingly become a priority, as people living with HIV (PLWH) are disproportionately impacted by psychosocial stressors compared to the general population. The aim of this study was to identify barriers and facilitators to psychosocial care for PLWH in Ireland.
A mixed methods study design was used, employing a national survey of PLWH (n = 54) via Qualtrics and semi-structured interviews with healthcare professionals that provide clinical support to PLWH across Ireland (n = 11). Content analysis was used to analyse the interviews.
More than half (59.3%) of survey respondents agreed that living with HIV currently impacts their mental health, with nearly two thirds (64.8%) agreeing that they have experienced stigma as a result of living with HIV. Less than half (40.7%) were comfortable disclosing their status to family, and less than a third (27.8%) to friends. Stigma was identified by healthcare professionals as a barrier to psychosocial care, along with a number of system-level barriers, provider-level or practical barriers, and individual barriers. The value of multidisciplinary care teams and reliance on community support was emphasised, and potential for further integration of support services was highlighted.
Community-based organisations contribute significantly to the facilitation of psychosocial support for PLWH in Ireland, and greater integration of community services could promote a more holistic, patient-centred approach to meeting the diverse needs of this growing cohort. PLWH benefit from multidisciplinary care teams, and the facilitation of safe and effective peer support should be encouraged to afford opportunities to disclose and receive social support. HIV-related stigma remains a barrier to psychosocial care, highlighting the need for stigma reduction interventions.
抗逆转录病毒疗法的有效性意味着人类免疫缺陷病毒（HIV）现在可被定义为一种可控制的慢性疾病。随着与感染HIV者（PLWH）相比，普通人群受到心理社会压力源的影响较小，心理社会护理的推动日益成为优先事项。本研究的目的是确定爱尔兰PLWH心理社会护理的障碍和促进因素。
采用混合方法研究设计，通过Qualtrics对PLWH进行全国性调查（n = 54），并对为爱尔兰各地PLWH提供临床支持的医疗保健专业人员进行半结构化访谈（n = 11）。采用内容分析法对访谈进行分析。
超过一半（59.3%）的调查受访者同意感染HIV目前影响他们的心理健康，近三分之二（64.8%）的受访者同意他们因感染HIV而遭受耻辱。不到一半（40.7%）的人愿意向家人透露自己的感染状况，不到三分之一（27.8%）的人愿意向朋友透露。医疗保健专业人员将耻辱视为心理社会护理的障碍，同时还有一些系统层面的障碍、提供者层面或实际障碍以及个人障碍。强调了多学科护理团队的价值以及对社区支持的依赖，并突出了支持服务进一步整合的潜力。
基于社区的组织对促进爱尔兰PLWH的心理社会支持做出了重大贡献，社区服务的更大整合可以促进采用更全面、以患者为中心的方法来满足这一不断增长群体的多样化需求。PLWH受益于多学科护理团队，应鼓励提供安全有效的同伴支持，以便有机会披露并获得社会支持。与HIV相关的耻辱仍然是心理社会护理的障碍，凸显了减少耻辱干预措施的必要性。
