Burmen Barbara, Kurtzman Gregory, Olashore Anthony A, Baghirova-Busang Leyla, Poku Ohemaa, Morakanyane Phenyo, Tshume Ontibile, Phoi Onkemetse, Matshaba Mogomotsi, Lowenthal Elizabeth D, Morales Knashawn H, Brooks Merrian J
Botswana-UPenn Partnership, Gaborone, Botswana, United States.
Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, United States.
Int J MCH AIDS. 2025 May 9;14:e007. doi: 10.25259/IJMA_45_2024. eCollection 2025.
Human Immunodeficiency Virus (HIV) care programs in resource-limited settings reserve counseling and referral for individuals with identified mental illness for those with HIV virological treatment failure (VTF). Adolescence is a period that may increase the likelihood of internalizing psychiatric disorders (IPDs). We assessed the relationship between HIV VTF and symptoms of IPDs among adolescents and young adults (AYA) living with HIV in Gaborone, Botswana.
A cross-sectional study was conducted in Botswana from December 2018 to December 2019 among AYA living with HIV aged 12-24 years. Logistic regression analysis was used to examine relationships between age, sex, and HIV VTF (≥400 copies/mL) and clinically relevant IPD symptoms, namely, depression (Patient Health Questionnaire-9 score of ≥10) and anxiety (Generalized Anxiety Disorder-7 score of ≥10).
Of 553 participants, most were aged 16-19 years (53%) with an equal sex distribution; the minority had VTF using HIV viral load (VL) cutoff levels of ≥400 copies/mL (11%). Close to one-sixth (15%) had clinical depression symptoms; participants aged 16-19 years and 20-24 years were more likely to have clinically relevant depression symptoms when compared to participants who were aged 12-15 years (odds ratio [OR] 3.160, 95% confidence interval [CI] 1.094-9.123 and OR 4.748, 95% CI 1.624-13.877, = 0.0117, for participants aged 15- 19 years and 20-24 years, respectively). Participants with clinically relevant anxiety symptoms (11%) or both clinically relevant anxiety and depression symptoms (8%) did not differ from those without these symptoms by age, gender, or VTF status. Similar results were observed using HIV VL cutoff levels of <1000 copies/mL.
HIV VTF may be a poor proxy for mental well-being among AYAs receiving HIV. Universal screening should be considered for AYA receiving care for HIV.
资源有限环境下的人类免疫缺陷病毒（HIV）护理项目将咨询和转诊服务保留给那些HIV病毒学治疗失败（VTF）且被确诊患有精神疾病的个体。青春期是内化性精神障碍（IPD）患病可能性增加的时期。我们评估了博茨瓦纳哈博罗内感染HIV的青少年和青年（AYA）中HIV VTF与IPD症状之间的关系。
2018年12月至2019年12月在博茨瓦纳对12至24岁感染HIV的AYA进行了一项横断面研究。采用逻辑回归分析来检验年龄、性别和HIV VTF（≥400拷贝/毫升）与具有临床意义的IPD症状之间的关系，即抑郁（患者健康问卷-9得分≥10）和焦虑（广泛性焦虑障碍-7得分≥10）。
在553名参与者中，大多数年龄在16至19岁（53%），性别分布均衡；少数人HIV病毒载量（VL）临界值≥400拷贝/毫升时出现VTF（11%）。近六分之一（15%）有临床抑郁症状；与12至15岁的参与者相比，16至19岁和20至24岁的参与者更有可能出现具有临床意义的抑郁症状（优势比[OR]分别为3.160，95%置信区间[CI]为1.094至9.123；OR为4.748，95%CI为1.624至13.877，15至19岁和20至24岁参与者的P值均为0.0117）。具有临床意义的焦虑症状（11%）或同时具有临床意义的焦虑和抑郁症状（8%）的参与者在年龄、性别或VTF状态方面与没有这些症状的参与者没有差异。使用HIV VL临界值<1000拷贝/毫升时观察到类似结果。
在接受HIV治疗的AYA中，HIV VTF可能不是心理健康的良好指标。对于接受HIV护理的AYA，应考虑进行普遍筛查。
