Quality of life, psychosocial health, and antiretroviral therapy among HIV-positive women in Zimbabwe.

Quality of life, psychosocial health, and antiretroviral therapy among HIV-positive women in Zimbabwe.
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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。

DOI:
10.1080/09540120902923055
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发表时间:
2009-12
期刊:
影响因子:
1.7
通讯作者:
Katzenstein D
Katzenstein D
中科院分区:
医学4区
文献类型:
--
作者:
Patel R;Kassaye S;Gore-Felton C;Wyshak G;Kadzirange G;Woelk G;Katzenstein D

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关于抗逆转录病毒疗法(ART)对撒哈拉以南非洲妇女的心理社会影响,人们知之甚少。因此,我们在津巴布韦进行了一项横断面研究,以评估抗逆转录病毒疗法对艾滋病毒阳性妇女健康相关生活质量的影响,使用的是医疗结果研究-艾滋病毒生活质量(QOL)问卷。此外,我们评估了社会人口统计学、生殖和性健康、艾滋病毒相关病史、披露、社会污名、自尊和抑郁。对200名艾滋病毒阳性妇女进行了结构化访谈,并按治疗分为三组:(1)第1组(n=31)不符合临床或实验室标准开始治疗;(2)第2组(n=73)有资格开始治疗但正在等待开始治疗;(3)第3组(n=96)接受抗逆转录病毒治疗的中位数为13个月。这些女性具有相似的社会人口学特征,但在临床特征上存在显著差异。在过去的一周和一年中,接受抗逆转录病毒治疗的女性报告的艾滋病相关症状较少,与未接受抗逆转录病毒治疗的女性相比,目前的CD4计数较高,基线CD4计数较低。在大多数生活质量领域,接受抗逆转录病毒治疗的女性报告的平均得分高于不接受抗逆转录病毒治疗的女性(p<0.01)。此外,接受抗逆转录病毒治疗的女性报告的抑郁程度低于未接受抗逆转录病毒治疗的女性(p<0.001)。出乎意料的是,在没有接受抗逆转录病毒治疗的两组女性中,她们的生活质量或抑郁得分没有显著差异。因此,津巴布韦艾滋病毒携带者的总体生活质量更好,抗逆转录病毒治疗的抑郁程度更低。总之,我们的发现表明,在资源匮乏的社区进行抗逆转录病毒治疗可以提高总体生活质量和心理社会功能,这对公共卫生具有广泛的影响。
Little is known about the psychosocial impact of antiretroviral therapy (ART) among women in sub-Saharan Africa. Therefore, we conducted a cross-sectional study in Zimbabwe to assess the impact of ART on HIV-positive women’s health-related quality of life, using the Medical Outcomes Study-HIV Quality of Life (QOL) questionnaire. Additionally, we assessed socio-demographics, reproductive and sexual health, HIV-related history, disclosure, social stigma, self-esteem, and depression. Structured interviews were conducted with 200 HIV-positive women and categorized into three groups by treatment: (1) Group 1 (n = 31) did not meet clinical or laboratory criteria to begin treatment; (2) Group 2 (n = 73) was eligible to begin treatment but awaiting initiation of treatment; and (3) Group 3 (n = 96) was on ART for a median of 13 months. The women had similar sociodemographic characteristics but varied significantly in clinical characteristics. Women on ART reported fewer AIDS-related symptoms in the last week and year and had higher current and lower baseline CD4 counts compared to women not on ART. On most QOL domains women on ART reported higher mean scores as compared to women not on ART ( p<0.01). Additionally, women on ART reported less depression compared to women not on ART ( p<0.001). Between the two groups of women not on ART, unexpectedly, there were no significant differences in their scores for QOL or depression. Thus, Zimbabwean women living with HIV experience better overall QOL and lower depression on ART. Altogether, our findings suggest that ART delivery in resource-poor communities can enhance overall QOL as well as psychosocial functioning, which has wide-ranging public health implications.
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