Depressive Symptoms, Disclosure, HIV-Related Stigma, and Coping Following HIV Testing Among Outpatients in Uganda: A Daily Process Analysis.
Depressive Symptoms, Disclosure, HIV-Related Stigma, and Coping Following HIV Testing Among Outpatients in Uganda: A Daily Process Analysis.
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DOI：
10.1007/s10461-017-1953-9
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发表时间：
2018-05
影响因子：
4.4
通讯作者：
Wanyenze RK
中科院分区：
文献类型：
--
作者：
Kiene SM;Dove M;Wanyenze RK
随着终止艾滋病毒流行的努力加快，重点是向未确诊的艾滋病毒感染者提供帮助。新诊断的个体面临许多社会心理挑战，但我们对诊断后几周内的抑郁症状知之甚少，也不知道披露、应对和其他因素如何影响短期和长期抑郁症状。有目的抽样的乌干达门诊患者在艾滋病毒检测前立即完成了结构化访谈，在收到检测结果后的28天内每天完成一次访谈，并在检测后的3个月和6个月进行了访谈。样本共包括244名参与者：20名基线时HIV检测呈阳性，每日提供342个数据点，224名基线时HIV检测呈阴性，每日提供4388个数据点。我们使用线性混合效应模型来检验28天每日访谈期间抑郁症状评分的变化，以及抑郁症状评分和随时间变化的预测因子。混合模型的结果显示，虽然那些被诊断患有艾滋病毒的人在诊断后最初表现出高度抑郁症状，但他们的症状显著减轻，平均在诊断后约15天降至可能抑郁的临界值以下。在艾滋病毒检测呈阴性的人群中，平均而言，他们的抑郁症状低于可能抑郁的临界值，并且没有随着时间的推移而改变。在被诊断为艾滋病毒感染者中，在特定的一天向伴侣透露信息，与当天更高的抑郁症状有关。然而，那些在诊断后28天内向伴侣透露病情的人在28天结束时的抑郁评分明显低于那些没有透露病情的人，在诊断后3个月和6个月的抑郁评分也低于那些没有透露病情的人。在某一天，与艾滋病毒相关的耻辱得分越高，当天的抑郁症状就越严重，而在某一天积极应对，当天的抑郁症状就越低。随着时间的推移，积极应对也加速了抑郁症状的减轻。这些数据强调了及时向伴侣披露的重要性，并表明在诊断后定期进行抑郁症筛查和提供精神卫生服务可以改善艾滋病毒护理参与和治疗结果。
As efforts to end the HIV epidemic accelerate there is emphasis on reaching those living with undiagnosed HIV infection. Newly diagnosed individuals face a number of psychosocial challenges, yet we know little about depressive symptoms in the weeks immediately following diagnosis and how disclosure, coping, and other factors may affect short and longer-term depressive symptoms. Purposively sampled Ugandan outpatients completed structured interviews immediately prior to testing for HIV, daily for 28 days after receiving their test results, and at 3 and 6 months post-test. The sample included a total of 244 participants: 20 who tested HIV positive at baseline, and who provided 342 daily data points, and 224 who tested HIV negative at baseline and provided 4,388 daily data points. We used linear mixed effects modeling to examine changes in depression symptom scores over the 28 day daily interview period and predictors of depressive symptom scores and changes over time. Results from the mixed modeling revealed that while those diagnosed with HIV showed initially high depressive symptoms following diagnosis, their symptoms decreased significantly and on average fell below the cutoff for possible depression approximately 15 days after diagnosis. Among those who tested HIV-negative, on average their depressive symptoms were below the cutoff for possible depression and did not change over time. Among those diagnosed with HIV, disclosure, especially to a partner, on a particular day was associated with higher depressive symptoms that day. However, those who disclosed to their partner during the 28 days after diagnosis had significantly lower depression scores by the end of the 28 days as well as lower depression scores 3 and 6 months after diagnosis than did those who did not disclose. Scoring higher on HIV-related stigma on a particular day was associated with higher depressive symptoms that day and engaging in positive coping on a particular day was associated with lower depressive symptoms that day. Positive coping also accelerated the decrease in depressive symptoms over time. These data under score the importance of timely disclosure to partner sand suggest that regular depression screening after diagnosis and provision of mental health services could improve HIV care engagement and treatment outcomes.
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影响因子：
3.6
作者：
Kalichman, SC;Simbayi, LC
通讯作者：
Simbayi, LC
DOI：
10.1002/bs.3830190102
发表时间：
1974-01-01
期刊：
BEHAVIORAL SCIENCE
影响因子：
--
作者：
DEROGATIS, LR;LIPMAN, RS;COVI, L
通讯作者：
COVI, L
影响因子：
4.2
作者：
FLEISHMAN, JA;FOGEL, B
通讯作者：
FOGEL, B
影响因子：
12.7
作者：
Cook, JA;Grey, D;Hessol, NA
通讯作者：
Hessol, NA
DOI：
10.1080/09540121.2011.630360
发表时间：
2012-01-01
影响因子：
1.7
作者：
Fagan, Jennifer L.;Beer, Linda;Bertolli, Jeanne
通讯作者：
Bertolli, Jeanne