Stigma and mental health challenges among adolescents living with HIV in selected adolescent-specific antiretroviral therapy clinics in Zomba District, Malawi.
Stigma and mental health challenges among adolescents living with HIV in selected adolescent-specific antiretroviral therapy clinics in Zomba District, Malawi.
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DOI：
10.1186/s12887-022-03292-4
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发表时间：
2022-05-06
期刊：
影响因子：
2.4
通讯作者：
Gaynes, Bradley N.
中科院分区：
文献类型：
--
作者：
Kip, Esther C.;Udedi, Michael;Kulisewa, Kazione;Go, Vivian F.;Gaynes, Bradley N.
到2020年，全球有180万10至19岁的青少年感染艾滋病毒；其中约150万人生活在撒哈拉以南非洲。这些携带艾滋病毒(ALHIV)的青少年经历精神健康问题的风险比没有感染的青少年更高；在马拉维，18.9%的人患有抑郁障碍。ALHIV可能面临许多心理社会挑战，但马拉维的ALHIV对这些应激源的看法知之甚少。了解ALHIV的心理社会挑战是确保良好的精神卫生保健的关键一步。这项研究的目的是评估在马拉维Zomba参加青少年特定ART项目的ALHIV面临的心理社会挑战。在2019年4月至5月期间，我们对12-18岁(n = 80)的ALHIV进行了有目的的抽样，参加了一系列八个焦点小组，这些小组来自四个青少年俱乐部，与一个专门针对青少年的艺术项目有关。对数据进行归纳和演绎分析，以确定与ALHIV心理社会经历有关的主题。这项研究得出的两个主题包括：1)社区和家庭中的耻辱和歧视；2)不坚持药物治疗。与艾滋病毒相关的污名与增加的心理痛苦、身体和情感/言语虐待、低社会支持、孤立和被拒绝的感觉有关，以及危险的健康行为，如藏匿药物和不遵守抗逆转录病毒治疗。歧视性行为表现为在学校为他们提供单独的餐具和虐待。此外，由于担心艾滋病毒传播，一些父母不允许他们的孩子与参与者一起玩耍。耻辱和歧视是被忽视的艾滋病毒治疗和护理的潜在障碍。如果艾滋病毒服务要有效地满足ALHIV者的需求，就需要心理健康干预来预防和管理抑郁症，并提高对抗逆转录病毒疗法的遵守程度。这些发现突显了开发与文化相关的心理干预措施的迫切需要，旨在帮助ALHIV应对这些不同的挑战。
Of the 1.8 million adolescents between the ages of 10 and 19 living with HIV globally in 2020; approximately 1.5 million of these live in sub-Saharan Africa. These adolescents living with HIV (ALHIV) are at higher risk of experiencing mental health problems than those without; in Malawi, 18.9% have a depressive disorder. ALHIV can face numerous psychosocial challenges, but little is known about how ALHIV in Malawi perceive these stressors. Understanding psychosocial challenges of ALHIV is a key step in ensuring good mental health care. The aim of this study was to assess the psychosocial challenges faced by ALHIV attending adolescent-specific ART program in Zomba, Malawi. Between April and May 2019, we engaged a purposive sample of ALHIV ages 12–18 (n = 80) in a series of eight focus groups drawing from four Teen Clubs linked to an adolescent-specific ART program. Data were analyzed inductively and deductively to identify themes related to ALHIV psychosocial experiences. Two themes that emerged from the study include: 1) stigma and discrimination within communities and families; 2) non-adherence to medications. HIV-related stigma was associated with increased psychological distress; physical and emotional/verbal abuse; low social support, isolation, and a feeling of rejection; and risky health behaviors such as medication hiding and non-adherence to ART. Discriminatory actions were manifested in a form of being given separate utensils for their meals and mistreatment at school. Furthermore, some parents did not allow their children to play with the participants out of fear that HIV transmission. Stigma and discrimination are overlooked potential barriers to HIV treatment and care. If HIV services are to effectively meet ALHIVs' needs, mental health interventions are needed to prevent and manage depression and improve adherence to ART. These findings highlight the crucial need to develop culturally relevant mental interventions aimed at helping ALHIV to cope with these diverse challenges.
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影响因子：
3.7
作者：
Akatukwasa C;Getahun M;El Ayadi AM;Namanya J;Maeri I;Itiakorit H;Owino L;Sanyu N;Kabami J;Ssemmondo E;Sang N;Kwarisiima D;Petersen ML;Charlebois ED;Chamie G;Clark TD;Cohen CR;Kamya MR;Bukusi EA;Havlir DV;Camlin CS
通讯作者：
Camlin CS
影响因子：
6
作者：
Laurenzi, Christina A.;Skeen, Sarah;Ross, David A.
通讯作者：
Ross, David A.
影响因子：
1.3
作者：
Earnshaw VA;Quinn DM;Park CL
通讯作者：
Park CL
DOI：
10.3390/ijerph18105424
发表时间：
2021-05-19
影响因子：
--
作者：
Fauk NK;Hawke K;Mwanri L;Ward PR
通讯作者：
Ward PR
影响因子：
4.5
作者：
Dow, Dorothy E.;Mmbaga, Blandina T.;O'Donnell, Karen E.
通讯作者：
O'Donnell, Karen E.