Psychological Distress Increases 30-Fold Among People with HIV in the First Year on ART in Nigeria—a Call for Integrated Mental Health Services
International Journal of Behavioral Medicine(2022)
摘要
Background Few studies have longitudinally assessed psychological distress among people with HIV (PWH) initiating ART in resource-limited settings. Method Baseline, 6-month, and 12-month psychological distress were measured in a Nigerian cohort newly initiating therapy; the relationship between baseline factors and psychological distress at 12 months was assessed; and the association between psychological distress at 12 months and care retention or immunologic failure was determined. Results Among 563 patients, median age was 38 years (IQR: 33–46 years), 62% were female, and 51% were married. Psychological distress increased from 3% at baseline to 34% at 12 months. Age (aOR 1.28, 95% CI 1.06–1.56), female sex (aOR 2.89, 95% CI 1.93–4.33), lack of disclosure (aOR 4.32, 95% CI 2.48–7.51), and time on ART (6 months [aOR 6.91, 95% CI 3.14–15.18] and 12 months [aOR 32.63, 95% CI 16.54–64.36]) were associated with psychological distress while being married (OR 0.42, 95% CI 0.30–0.61) was associated with reduced odds. Tweve-month psychological distress was associated with increased risk of immunologic failure (aOR 2.22, 95% CI 1.31–3.82). Conclusion The risk of psychological distress increased 30-fold in the first year on therapy in PWH in Nigeria.
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关键词
Mental health,Psychological distress,Immunologic failure,ART initiation
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