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穆拉戈国际艾滋病服务中心诊所中感染艾滋病毒的老年人中可能存在的焦虑症患病率及相关因素:一项横断面研究。

Prevalence and factors associated with probable anxiety disorders among elderly persons living with HIV at Mulago ISS clinic: A cross-sectional study.

作者信息

Muyunga Anthony, Ojiambo Kevin Ouma, Nakigudde Janet, Mugerwa Jovan, Owori Benard, Naturinda Kevin, Mikka Brian, Babirye Janet Peace, Nalule Namutale R, Kintu Isaac Samuel, Kigozi Enos, Birungi Caroline

机构信息

Clinical Epidemiology Unit, Department of Internal Medicine, School of Medicine College of Health Sciences, Makerere University, Kampala, Uganda.

Reach Out Mbuya Community Health Initiative, Kampala, Uganda.

出版信息

PLoS One. 2025 Aug 1;20(8):e0329111. doi: 10.1371/journal.pone.0329111. eCollection 2025.

Abstract

INTRODUCTION

Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) is a major public health concern globally. Due to advancements in Anti-Retroviral Treatment (ART) therapy, more people with HIV are living longer with about 1.4 million infected people in Uganda. Anxiety disorders are often unrecognized and undetected in older persons living with HIV (PLWH) yet they impair an elderly person's physical health and decrease the ability to perform daily activities.

OBJECTIVE

To determine the prevalence and factors associated with probable anxiety disorders among elderly PLWH at Mulago Immune Suppression Syndrome (ISS) clinic.

METHODS

A cross-sectional study was conducted at Mulago ISS clinic among 273 systematically selected participants living with HIV/AIDS on antiretroviral therapy for at least 6 months between April and May 2024. Interviews were conducted using the Generalized Anxiety Disorder 7-item (GAD-7) screening tool to help identify individuals who may be at risk for anxiety disorders and structured questionnaires for socio-demographics, and psychological factors. Drug and clinical factors data were extracted from records, entered into Epidata, and later to STATA version 17 for analysis. Prevalence was reported as a percentage and modified Poisson regression analysis was used to determine the factors associated with anxiety disorders.

RESULTS

We enrolled 273 participants with a median age (Interquartile range) was 56 (52, 61.5) years. 54.9% were females, 56.8% didn't have a partner and 53.8% were employed. The prevalence of probable anxiety disorders was 16.8% (95% CI 12.5-21.6). Employment status (aPR- 2.113, 95% CI 1.252-3.567), family history of mental health disorder (aPR-2.041, 95% CI 1.228-3.394), stigma (aPR-2.564, 95% CI 1.544-4.257) and family support (aPR-2.169, 95% CI 1.272-3.699) were significantly associated with having probable anxiety disorders.

CONCLUSION

One in every six elderly persons living with HIV may have a probable anxiety disorder. Being unemployed, having a family history of mental health disorders, having stigma and having inadequate family support were significantly associated with having a probable anxiety disorder. Healthcare workers should provide comprehensive anxiety screening and patient-centered care for elderly persons with HIV. At the same time, the government develops financial empowerment strategies and supports mental health through family groups, and public campaigns to reduce HIV stigma and educate families on effective support.

摘要

引言

人类免疫缺陷病毒/获得性免疫缺陷综合征(HIV/AIDS)是全球主要的公共卫生问题。由于抗逆转录病毒治疗(ART)的进步,乌干达约有140万艾滋病毒感染者的寿命得以延长。焦虑症在老年艾滋病毒感染者(PLWH)中常常未被识别和检测到,但它们会损害老年人的身体健康并降低其进行日常活动的能力。

目的

确定穆拉戈免疫抑制综合征(ISS)诊所老年PLWH中可能存在的焦虑症的患病率及相关因素。

方法

于2024年4月至5月在穆拉戈ISS诊所对273名系统选取的接受抗逆转录病毒治疗至少6个月的艾滋病毒/艾滋病感染者进行了一项横断面研究。使用广泛性焦虑障碍7项(GAD-7)筛查工具进行访谈,以帮助识别可能有焦虑症风险的个体,并使用结构化问卷收集社会人口统计学和心理因素信息。从记录中提取药物和临床因素数据,录入Epidata,随后导入STATA 17版本进行分析。患病率以百分比表示,并使用修正泊松回归分析来确定与焦虑症相关的因素。

结果

我们纳入了273名参与者,年龄中位数(四分位间距)为56(52,61.5)岁。54.9%为女性,56.8%没有伴侣,53.8%有工作。可能存在焦虑症的患病率为16.8%(95%置信区间12.5 - 21.6)。就业状况(调整后患病率比 - 2.113,95%置信区间1.252 - 3.567)、心理健康障碍家族史(调整后患病率比 - 2.041,95%置信区间1.228 - 3.394)、耻辱感(调整后患病率比 - 2.564,95%置信区间1.544 - 4.257)和家庭支持(调整后患病率比 - 2.169,95%置信区间1.272 - 3.699)与可能存在焦虑症显著相关。

结论

每六名老年艾滋病毒感染者中可能就有一人患有焦虑症。失业、有心理健康障碍家族史、有耻辱感以及家庭支持不足与可能患有焦虑症显著相关。医护人员应为老年艾滋病毒感染者提供全面的焦虑筛查和以患者为中心的护理。同时,政府应制定经济赋权策略,并通过家庭团体和公共宣传活动支持心理健康,以减少对艾滋病毒的耻辱感并教育家庭提供有效支持。

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