Mental health challenges among adolescents living with HIV.
Mental health challenges among adolescents living with HIV.
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DOI：
10.7448/ias.20.4.21497
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发表时间：
2017-05-16
影响因子：
6
通讯作者：
Lee, Sonia
中科院分区：
文献类型：
--
作者：
Vreeman, Rachel C;McCoy, Brittany M;Lee, Sonia
导言：对于感染艾滋病毒的青少年来说，心理健康是一个关键的、被忽视的全球健康挑战。随着世界加强对青少年的艾滋病毒预防和治疗，感染艾滋病毒的青少年中普遍存在的心理和行为健康问题可能得不到很好的理解或解决。这篇叙述性综述的目的是评估目前与青少年艾滋病毒感染者面临的精神健康挑战有关的文献，包括获得精神健康服务的机会，从儿科向成人护理服务过渡过程中精神健康挑战的作用和责任，以及精神健康干预的影响。方法：对纳入综述的每个主题，使用Medline和PubMed进行个人搜索，并扫描相关文章的书目。对感染艾滋病毒的青少年进行搜索的主题包括抑郁和焦虑、从儿科到成人艾滋病毒护理的过渡及其对遵从性和精神健康的影响、与艾滋病毒有关的心理健康服务和干预措施以及精神健康问题的衡量。结果和讨论：艾滋病毒感染青少年的心理和行为健康挑战在感染艾滋病毒的青少年中普遍存在，包括在他们大多数人生活的资源有限的环境中，这些挑战影响到艾滋病毒预防和治疗的方方面面。在衡量艾滋病毒携带者青少年心理健康挑战的影响，评估干预措施以最好地维持或改善这一人群的心理健康，或创建具有促进心理健康的人员或资源的医疗系统方面，所做的工作太少。结论：所有感染艾滋病毒的青少年在青春期应积极解决心理健康问题。此外，护理系统需要更加重视如何将精神健康支助纳入艾滋病毒护理管理，特别是在从儿童到青春期再到成年期的整个生命周期中。在资源有限的情况下，缺乏对精神卫生需求的研究和支持，这是一个巨大的负担，迫切需要具有成本效益的解决办法。
INTRODUCTION: Mental health is a critical and neglected global health challenge for adolescents infected with HIV. The prevalence of mental and behavioural health issues among HIV-infected adolescents may not be well understood or addressed as the world scales up HIV prevention and treatment for adolescents. The objective of this narrative review is to assess the current literature related to mental health challenges faced by adolescents living with HIV, including access to mental health services, the role of mental health challenges during transition from paediatric to adult care services and responsibilities, and the impact of mental health interventions.METHODS: For each of the topics included in this review, individual searches were run using Medline and PubMed, accompanied by scans of bibliographies of relevant articles. The topics on which searches were conducted for HIV-infected adolescents include depression and anxiety, transition from paediatric to adult HIV care and its impact on adherence and mental health, HIV-related, mental health services and interventions, and the measurement of mental health problems. Articles were included if the focus was consistent with one of the identified topics, involved HIV-infected adolescents, and was published in English.RESULTS AND DISCUSSION: Mental and behavioural health challenges are prevalent in HIV-infected adolescents, including in resource-limited settings where most of them live, and they impact all aspects of HIV prevention and treatment. Too little has been done to measure the impact of mental health challenges for adolescents living with HIV, to evaluate interventions to best sustain or improve the mental health of this population, or to create healthcare systems with personnel or resources to promote mental health.CONCLUSIONS: Mental health issues should be addressed proactively during adolescence for all HIV-infected youth. In addition, care systems need to pay greater attention to how mental health support is integrated into the care management for HIV, particularly throughout lifespan changes from childhood to adolescence to adulthood. The lack of research and support for mental health needs in resource-limited settings presents an enormous burden for which cost-effective solutions are urgently needed.