Long-Term Effect of Group Support Psychotherapy on Depression and HIV Treatment Outcomes: Secondary Analysis of a Cluster Randomized Trial in Uganda.
Long-Term Effect of Group Support Psychotherapy on Depression and HIV Treatment Outcomes: Secondary Analysis of a Cluster Randomized Trial in Uganda.
复制标题
DOI：
10.1097/psy.0000000000001128
复制
发表时间：
2022-10-01
影响因子：
3.3
通讯作者：
Mills, Edward J.
中科院分区：
文献类型：
--
作者：
Nakimuli-Mpungu, Etheldreda;Smith, Colin M.;Wamala, Kizito;Okello, James;Birungi, Josephine;Etukoit, Micheal;Mojtabai, Ramin;Nachega, Jean B.;Harari, Ofir;Musisi, Seggane;Mills, Edward J.
关键词：
depressiongroup support psychotherapyHIVAIDSantiretroviral therapy adherenceviral suppressionUgandaAE = adverse eventsANS = autonomic nervous systemART = antiretroviral therapyGSEM = generalized multilevel structural equation modelingGHE = group HIV educationGSP = group support psychotherapyHIV = human immunodeficiency virusLHW = lay health workerPLWH = people living with HIV
比较团体支持心理治疗（GSP）与团体HIV教育（GHE）对治疗后24个月抑郁和HIV治疗结果的影响。我们进一步旨在探讨抑郁症和抗逆转录病毒治疗（ART）依从性在GSP和病毒载量抑制之间的关系中的中介作用。三个地区的30家艾滋病诊所被随机分配为抑郁症患者提供GSP或GHE治疗。在治疗后基线、6个月、12个月、18个月和24个月评估抑郁和最佳抗逆转录病毒治疗依从性（≥95%）。从基线、治疗后12个月和24个月的医学图表中提取病毒载量。采用多水平混合效应回归模型和广义结构方程模型估计24个月的结局和中介效应。参与者（N=1140）来自提供GSP （N= 578[51%]）或GHE （N= 562[49%]）的HIV诊所。在治疗后24个月，GSP患者比GHE患者更少符合抑郁标准[1%对25%；校正优势比(aOR) = 0.002, 95% CI 0.0002 - 0.018]。GSP参与者比GHE参与者报告最佳ART依从性（≥95%）的比例更高[96%对88%；aOR =20.88, 95% CI 5.78- 75.33]和改善的病毒抑制[96%对88%；aOR =3.38, 95% CI 1.02- 11.02]。GSP通过在12个月时连续减少抑郁和改善ART依从性的间接作用可能部分解释了GSP在24个月时比GHE组更高的病毒抑制率。在艾滋病毒持续流行的环境中，采用团体支持心理治疗的抑郁症治疗可能是获得最佳艾滋病毒治疗结果的关键。
To determine the effect of group support psychotherapy (GSP) compared to group HIV education (GHE) on depression and HIV treatment outcomes 24 months after treatment. We further aimed to investigate the mediating role of depression and anti-retroviral therapy (ART) adherence in the relationship between GSP and viral load suppression. Thirty HIV clinics across three districts were randomly assigned to deliver either GSP or GHE for depression. Depression and optimal (≥95%) ART adherence was assessed at baseline, 6, 12, 18, and 24 months post-treatment. Viral load was drawn from the medical chartsat baseline, 12 and 24 months post-treatment. Multilevel mixed effects regression models and generalised structural equation modelling were used to estimate 24 months outcomes and mediation effects. Participants (N=1140) were enrolled from HIV clinics offering either GSP (n=578 [51%]) or GHE (n=562 [49%]). Fewer GSP than GHE participants met criteria for depression at 24 months post treatment [1% versus 25%; adjusted odds ratio (aOR) =0·002, 95% CI 0·0002-0·018]. More GSP than GHE participants reported optimal (≥95%) ART adherence [96% versus 88%; aOR =20.88, 95% CI 5.78- 75.33] and improved viral suppression [96% versus 88%; aOR =3.38, 95% CI 1.02- 11.02]. The indirect effects of GSP through sequential reduction in depression and improvement in ART adherence at 12 months may partially explain the higher viral suppression rates at 24 months in GSP than GHE groups. In settings where the HIV epidemic persists, depression treatment with group support psychotherapy may be critical for optimal HIV treatment outcomes.
影响因子：
1.7
作者：
Nakimuli-Mpungu E;Musisi S;Wamala K;Okello J;Ndyanabangi S;Mojtabai R;Nachega J;Harari O;Mills E
通讯作者：
Mills E
津巴布韦的HIV阳性女性的生活质量，社会心理健康和抗逆转录病毒疗法。
影响因子：
1.7
作者：
Patel R;Kassaye S;Gore-Felton C;Wyshak G;Kadzirange G;Woelk G;Katzenstein D
通讯作者：
Katzenstein D