Mental Health, ART Adherence, and Viral Suppression Among Adolescents and Adults Living with HIV in South Africa: A Cohort Study

被引：33

作者：

Haas, Andreas D. ^{[1
]}

Lienhard, Raphael ^{[1
]}

Didden, Christiane ^{[1
,2
]}

Cornell, Morna ^{[3
]}

Folb, Naomi ^{[4
]}

Boshomane, Tebatso M. G. ^{[5
,6
]}

Salazar-Vizcaya, Luisa ^{[7
]}

Ruffieux, Yann ^{[1
]}

Nyakato, Patience ^{[3
]}

Wettstein, Anja E. ^{[1
,8
]}

Tlali, Mpho ^{[3
]}

Davies, Mary-Ann ^{[3
]}

von Groote, Per ^{[1
]}

Wainberg, Milton ^{[9
]}

Egger, Matthias ^{[1
,3
,10
]}

Maartens, Gary ^{[11
]}

Joska, John A. ^{[12
,13
]}

机构：

[1] Univ Bern, Inst Social & Prevent Med, Mittelstr 43, CH-3012 Bern, Switzerland

[2] Ludwig Maximilians Univ Munchen, Dept Sociol, Munich, Germany

[3] Univ Cape Town, Sch Publ Hlth, Ctr Infect Dis Epidemiol & Res, Cape Town, South Africa

[4] Medscheme, Cape Town, South Africa

[5] Univ Pretoria, Dept Nucl Med, Pretoria, South Africa

[6] Steve Biko Acad Hosp, Pretoria, South Africa

[7] Univ Bern, Bern Univ Hosp, Dept Infect Dis, Bern, Switzerland

[8] Univ Bern, Grad Sch Hlth Sci, Bern, Switzerland

[9] Columbia Univ, New York State Psychiat Inst, Dept Psychiat, New York, NY USA

[10] Univ Bristol, Bristol Med Sch, Populat Hlth Sci, Bristol, England

[11] Univ Cape Town, Dept Med, Div Clin Pharmacol, Cape Town, South Africa

[12] Univ Cape Town, Neurosci Inst, HIV Mental Hlth Res Unit, Cape Town, South Africa

[13] Univ Cape Town, Fac Hlth Sci, Dept Psychiat & Mental Hlth, Div Neuropsychiat, Cape Town, South Africa

来源：

AIDS AND BEHAVIOR | 2023年 / 27卷 / 06期

基金：

瑞士国家科学基金会; 美国国家卫生研究院;

关键词：

Mental disorders; HIV; Antiretroviral therapy; Adherence; Viral suppression; South Africa; ANTIRETROVIRAL THERAPY; INCOME COUNTRIES; PRIMARY-CARE; YOUNG-WOMEN; DISORDERS; DEPRESSION; INTERVENTION; PREVENTION; SYMPTOMS; SERVICES;

D O I：

10.1007/s10461-022-03916-x

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

We followed adolescents and adults living with HIV aged older than 15 years who enrolled in a South African private-sector HIV programme to examine adherence and viral non-suppression (viral load > 400 copies/mL) of participants with (20,743, 38%) and without (33,635, 62%) mental health diagnoses. Mental health diagnoses were associated with unfavourable adherence patterns. The risk of viral non-suppression was higher among patients with organic mental disorders [adjusted risk ratio (aRR) 1.55, 95% confidence interval (CI) 1.22-1.96], substance use disorders (aRR 1.53, 95% CI 1.19-1.97), serious mental disorders (aRR 1.30, 95% CI 1.09-1.54), and depression (aRR 1.19, 95% CI 1.10-1.28) when compared with patients without mental health diagnoses. The risk of viral non-suppression was also higher among males, adolescents (15-19 years), and young adults (20-24 years). Our study highlights the need for psychosocial interventions to improve HIV treatment outcomes-particularly of adolescents and young adults-and supports strengthening mental health services in HIV treatment programmes.

引用

页码：1849 / 1861

页数：13

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