Mental health outcomes of a pilot 2-arm randomized controlled trial of a HIV-prevention program for South African adolescent girls and young women and their female caregivers.
Mental health outcomes of a pilot 2-arm randomized controlled trial of a HIV-prevention program for South African adolescent girls and young women and their female caregivers.
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DOI：
10.1186/s12889-021-12010-1
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发表时间：
2021-11-30
影响因子：
4.5
通讯作者：
Bekker LG
中科院分区：
文献类型：
--
作者：
Donenberg G;Merrill KG;Atujuna M;Emerson E;Bray B;Bekker LG
南非少女和青年妇女报告了严重的精神痛苦以及性健康和生殖健康问题。精神健康问题和创伤症状始终与性和生殖健康行为有关。尽管她们有交集，但很少有干预措施能同时解决这些问题，或者让女性照顾者（FC）作为合作者。本研究介绍了经验支持的文化适应性家庭艾滋病毒预防项目“知情、积极、意识和负责任的青少年和成年人-南非”（IMARA-SA）的试点测试结果，该项目涉及AGYW焦虑、抑郁和创伤。60名来自开普敦以外的15 - 19岁AGYW（平均年龄= 17.1岁）及其FC随机分配到IMARA-SA或健康促进控制计划。AGYW在基线和随访时（6-10个月后）使用GAD-7报告焦虑，使用PHQ-9报告抑郁，使用PC-PTSD-5报告创伤。两种干预措施均由讲科萨语的南非黑人妇女进行，分组时间为2天，持续约10小时。我们对焦虑使用零膨胀负二项回归，对抑郁使用多项逻辑回归，对创伤使用逻辑回归来检验干预效果。在基线时，各组人口统计学特征没有差异，但随机分配到IMARA-SA组的AGYW抑郁评分高于对照组（p = 0.04）， PTSD筛查阳性比例更高（p = 0.07）。对照基线心理健康评分，接受IMARA-SA治疗的AGYW与对照组相比，随访时焦虑症状明显减少（计数模型调整发生率比= 0.54,95% CI = 0.29-0.99, p = 0.05），与无症状相比，至少报告一种抑郁症状的可能性更小（相对风险比= 0.22,95% CI = 0.05, 0.95, p = 0.04），与无症状相比，报告PTSD症状的可能性更小。但这种差异在统计上并不显著。精神健康与危险的性行为有关，减少情绪困扰可以减轻对不良性健康和生殖健康结果的暴露。这项初步研究对IMARA-SA对心理健康的影响产生了有希望的发现，证明了在更大的随机试验中重复的合理性。ClinicalTrials.gov编号NCT04758390，接受日期为2021年2月17日。
South African adolescent girls and young women (AGYW) report significant mental distress and sexual and reproductive health concerns. Mental health problems and trauma symptoms are consistently associated with sexual and reproductive health behavior. Despite their intersection, few interventions address them simultaneously or engage female caregivers (FC) as collaborators. This study presents findings from a pilot test of an empirically supported culturally adapted family-based HIV-prevention program, Informed Motivated Aware and Responsible Adolescents and Adults- South Africa (IMARA-SA), on AGYW anxiety, depression, and trauma. Sixty 15–19-year-old AGYW (mean age = 17.1 years) and their FC from outside Cape Town were randomized to IMARA-SA or a health promotion control program. AGYW reported their anxiety using the GAD-7, depression using the PHQ-9, and trauma using the PC-PTSD-5 at baseline and follow-up (6–10 months post). Both interventions were delivered by Xhosa-speaking Black South African women in groups over 2 days for approximately 10 h. We examined intervention effects using zero-inflated negative binomial regression for anxiety, multinomial logistic regression for depression, and logistic regression for trauma. At baseline, groups did not differ in demographic characteristics but AGYW randomized to IMARA-SA had higher depression scores than controls (p = 0.04) and a greater proportion screened positive for PTSD (p = .07). Controlling for baseline mental health scores, AGYW who received IMARA-SA compared to controls had significantly fewer anxiety symptoms at follow-up (adjusted incidence rate ratio for count model = 0.54, 95% CI = 0.29–0.99, p = 0.05), were less likely to report at least one depressive symptom relative to no symptoms (relative risk ratio = 0.22, 95% CI = 0.05, 0.95, p = 0.04), and were less likely to report symptoms of PTSD relative to no symptoms, but this difference was not statistically significant. Mental health is implicated in risky sexual behavior, and reducing emotional distress can mitigate exposure to poor sexual and reproductive health outcomes. This pilot study yielded promising findings for the mental health impact of IMARA-SA, justifying replication in a larger randomized trial. ClinicalTrials.gov Number NCT04758390, accepted 17/02/2021.
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影响因子：
3.3
作者：
Harder, Valerie S.;Mutiso, Victoria N.;Ndetei, David M.
通讯作者：
Ndetei, David M.
DOI：
10.7196/samj.2018.v108i3.12904
发表时间：
2018-03-01
期刊：
SAMJ: South African Medical Journal
影响因子：
--
作者：
Jacob, N;Coetzee, D
通讯作者：
Coetzee, D
影响因子：
3.8
作者：
James, Shamagonam;Reddy, Sasiragha Priscilla;Naidoo, Pamela
通讯作者：
Naidoo, Pamela
影响因子：
1.1
作者：
Barhafumwa, Bernard;Dietrich, Janan;Miller, Cari L.
通讯作者：
Miller, Cari L.
影响因子：
6.6
作者：
Barthel, Dana;Barkmann, Claus;Bindt, Carola
通讯作者：
Bindt, Carola