Time to get it right: investing in the mental wellbeing of people living with HIV.
Time to get it right: investing in the mental wellbeing of people living with HIV.
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是时候采取正确措施了：投资于艾滋病毒感染者的心理健康。
DOI：
10.1097/qad.0000000000003554
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Gaynes,BradleyN
中科院分区：
文献类型：
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作者：
Pence,BrianW;Gaynes,BradleyN
21年前，约翰霍普金斯大学艾滋病精神病学服务中心主任格伦·特赖斯曼（Glenn Treisman）来到查佩尔山的北卡罗来纳州大学，为一个入门级的艾滋病调查课程做了一个关于心理健康和艾滋病的讲座。你认为艾滋病是一种被忽视、被污名化和毁灭性的疾病吗？（根据第一作者的回忆）他向数百名本科生、预科生和至少一名一年级流行病学博士生的演讲厅提问。让我告诉你艾滋病毒感染者的精神疾病。没有人知道这件事，没有人研究它，它正在杀死我的病人，这21年来发生了什么变化？我们现在有一个深厚而强大的文献基础，令人信服地证明了Treisman博士和许多其他人已经知道的事情：特别是抑郁症，以及其他心理健康问题，在艾滋病毒感染者中非常普遍，比一般人群要多得多[1-3];抑郁症和其他心理健康问题始终与药物依从性差，失去护理，疾病进展和早期死亡率[4-6];治疗抑郁症和其他心理健康问题可以逆转这些负面影响并改善结局[7-9]。我们知道，将心理健康咨询与围绕药物依从性和艾滋病毒护理的技能建设相结合的综合治疗方法特别有效[9-11]。现在，感谢令人信服的，复杂的，和优雅的分析，
Twenty-one years ago, Glenn Treisman, director of the AIDS Psychiatry service at Johns Hopkins and the moving force behind one of the oldest and what continues to be one of the preeminent integrated HIV/mental health clinics in the country, came to the University of North Carolina at Chapel Hill to give a lecture about mental health and HIV to a broad entrylevel HIV survey course. You think HIV is a neglected, stigmatized, and devastating disease?(according to the memory of the first author) he asked the lecture hall of hundreds of undergrads, premeds and at least one firstyear epidemiology doctoral student. Let me tell you about mental illness among people with HIV. No one knows about this, no one is researching it, and it is killing my patients.What has changed in these 21 years? We now have a deep and robust literature base convincingly demonstrating what Dr Treisman and many others already knew: depression in particular, and other mental health concerns generally, are overwhelmingly common among people with HIV, much more so than in the general population [1–3]; depression and other mental health concerns are consistently and strongly associated with worse medication adherence, falling out of care, disease progression, and early mortality in this population [4–6]; and treating depression and other mental health concerns reverses these negative effects and improves outcomes [7–9]. We know that combined treatment approaches that integrate mental health counseling with skill-building around medication adherence and HIV care are particularly impactful [9–11]. And now, thanks to the compelling, intricate, and elegant analysis by