Mental, Neurological, and Substance Use Disorders in People Living With HIV/AIDS in Low- and Middle-Income Countries
Mental, Neurological, and Substance Use Disorders in People Living With HIV/AIDS in Low- and Middle-Income Countries
复制标题
DOI：
10.1097/qai.0000000000000258
复制
发表时间：
2014-09-01
影响因子：
3.6
通讯作者：
Abas, Melanie
中科院分区：
文献类型：
--
作者：
Chibanda, Dixon;Benjamin, Laura;Abas, Melanie
抑郁症、酒精使用障碍（AUD）和神经认知障碍是低收入和中等收入国家（LMIC）艾滋病毒感染者中最常见的3种精神、神经和物质使用障碍。重要的是，它们对日常功能和艾滋病毒结果产生影响。许多低收入国家已经验证了在一般人群中筛查和诊断抑郁症和AUD的工具，这些工具可用于艾滋病毒感染者。在抗逆转录病毒治疗时代，目前对艾滋病毒相关神经认知障碍的筛查和诊断方法是次优的，需要进一步研究。在我们看来，两个研究重点是最关键的。一个是开发一种综合筛查方法，用于抑郁症、AUD和神经认知障碍，可供LMIC的非专家使用。其次，需要研究针对抑郁症和AUD的干预措施，这些干预措施也针对行为改变，因为这些可能会影响抗逆转录病毒治疗的依从性并改善精神症状。需要进一步支持个人和机构一级的辅导和研究金计划，以建设能力，并为中低收入国家的艾滋病毒和精神、神经和药物使用障碍研究提供平台。
Depression, alcohol use disorders (AUD), and neurocognitive disorders are the 3 most prevalent mental, neurological, and substance use disorders in people living with HIV infection in low-and middle-income countries (LMICs). Importantly, they have an impact on everyday functions and on HIV outcomes. Many LMICs have validated tools to screen for and diagnose depression and AUD in the general population that can be used among people living with HIV infection. Current screening and diagnostic methods for HIV-associated neurocognitive disorders in the era of antiretroviral therapy are suboptimal and require further research. In our view, 2 research priorities are most critical. One is the development of an integrated screening approach for depression, AUD, and neurocognitive disorders that can be used by nonspecialists in LMICs. Second, research is needed on interventions for depression and AUD that also target behavior change, as these could impact on adherence to antiretroviral therapy and improve mental symptoms. Mentorship and fellowship schemes at an individual and institutional level need to be further supported to build capacity and provide platforms for research on HIV and mental, neurological, and substance use disorders in LMICs.