抑郁症状及相关因素分析：在德西镇公立卫生机构就诊的 HIV 阳性患者的横断面研究。
Depressive symptoms and associated factors among HIV positive patients attending public health facilities of Dessie town: A cross-sectional study.
机构信息
Department of Reproductive and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessi, Ethiopia.
Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessi, Ethiopia.
出版信息
PLoS One. 2021 Aug 5;16(8):e0255824. doi: 10.1371/journal.pone.0255824. eCollection 2021.
BACKGROUND
Depressive symptoms are the most common psychiatric complication of Human Immunodeficiency Virus (HIV) infection. They are associated with poor drug adherence, treatment failure, and increase the risk for suicide. There was limited evidence of depressive symptoms among HIV-positive patients in the study area. So, this study aimed to determine the prevalence of depressive symptoms and associated factors among HIV-positive patients attending public health facilities of Dessie town, North-central Ethiopia, 2019.
METHOD
A cross-sectional study was conducted on 380 HIV-positive patients attending ART clinics in Dessie town, North-central Ethiopia, 2019. Samples were selected using systematic random sampling and the data were collected by using structured, pretested, and interviewer-administered questionnaires. Patient Health Questionnaire (PHQ-9) at a cut-off point of 5 was used to assess depressive symptoms. The data were entered by Epi data version 3.1 and analyzed by SPSS version 25. A binary logistic regression model was used to identify factors associated with depressive symptoms. The Adjusted Odds Ratio (AOR) along with a 95% Confidence Interval (CI) was estimated to measure the association. The level of significance was declared at a p-value of less than 0.05.
RESULT
The prevalence of depressive symptoms among HIV positive patients was 15.5% (95% CI: (12.4%, 19.2%)). Age 40-49 years compared to 30-39 years (AOR = 2.96, 95% CI: (1.01, 8.68)), age ≥50 years compared to 30-39 years (AOR = 3.81, 95% CI: (1.05, 13.8)), having perceived stigma (AOR = 10.2, 95%CI: (4.26, 24.4)) taking medication other than Antiretroviral Therapy (ART) (AOR = 2.58, 95% CI: (1.25, 5.33)) and history of opportunistic infections (AOR = 5.17, 95% CI: (1.31, 20.4)) were factors associated with depressive symptoms.
CONCLUSION
The prevalence of depressive symptoms was low compared to previous studies. Age, perceived stigma, taking medication other than ART, and history of opportunistic infections were factors associated with depressive symptoms. Health education and counseling programs should be strengthened and target older patients, patients who took medications other than ART, patients who experienced perceived stigma and patients with a history of history opportunistic infections.
背景
抑郁症状是人类免疫缺陷病毒（HIV）感染最常见的精神并发症。它们与药物依从性差、治疗失败有关，并增加自杀风险。在研究区域，HIV 阳性患者的抑郁症状证据有限。因此，本研究旨在确定 2019 年埃塞俄比亚中北部德西镇公立卫生机构接受抗逆转录病毒治疗（ART）的 HIV 阳性患者中抑郁症状的流行率及其相关因素。
方法
2019 年，在埃塞俄比亚中北部德西镇的 ART 诊所对 380 名 HIV 阳性患者进行了横断面研究。采用系统随机抽样选择样本，通过结构化、预测试和访谈者管理的问卷收集数据。使用 5 分截断值的患者健康问卷（PHQ-9）评估抑郁症状。数据由 EpiData 版本 3.1 录入，由 SPSS 版本 25 进行分析。采用二项逻辑回归模型确定与抑郁症状相关的因素。使用调整后的比值比（AOR）及其 95%置信区间（CI）来衡量关联。显著性水平定义为 p 值小于 0.05。
结果
HIV 阳性患者抑郁症状的患病率为 15.5%（95%CI：（12.4%，19.2%））。40-49 岁年龄组与 30-39 岁年龄组相比（AOR=2.96，95%CI：（1.01，8.68）），年龄≥50 岁与 30-39 岁年龄组相比（AOR=3.81，95%CI：（1.05，13.8）），感知耻辱感（AOR=10.2，95%CI：（4.26，24.4）），服用抗逆转录病毒治疗（ART）以外的药物（AOR=2.58，95%CI：（1.25，5.33））和机会性感染史（AOR=5.17，95%CI：（1.31，20.4））与抑郁症状相关。
结论
与之前的研究相比，抑郁症状的流行率较低。年龄、感知耻辱感、服用 ART 以外的药物以及机会性感染史是与抑郁症状相关的因素。应加强健康教育和咨询计划，并针对老年患者、服用 ART 以外药物的患者、经历感知耻辱感的患者和有机会性感染史的患者。
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