Background

People living with HIV/AIDS (PLWHA) are at increased risk of stigma and mental illness, and this appears to be a particular issue in South Africa, which is home to 19% of the world's HIV-positive population. This paper aims to systematically review the literature investigating the relationship between HIV-stigma and depressive symptoms among PLWHA in South Africa.

Methods

A keyword search of four bibliographic databases (CINAHL, Ovid MEDLINE, PsycINFO, and Web of Science) and two grey literature websites was conducted. The quality of eligible studies was assessed using established criteria.

Results

Fourteen quantitative studies were included in the review. PLWHA in South Africa experience high levels of HIV-stigma and depressive symptoms. All forms of stigma were found to be associated with depressive symptoms amongst PLWHA. Prospective findings were mixed, with one study finding that stigma did not predict depressive symptoms over 36 months, and another that depressive symptoms predicted stigma 12 months later, suggesting a potentially bidirectional relationship. Females and young adults may be particularly vulnerable to HIV-stigma and its negative psychological effects. Some support was found for the moderating role of social support in the relationship between stigma and depressive symptoms across different sub-populations.

Limitations

Few studies conducted prospective analyses or tested mediation/moderation.

Conclusions

Despite limitations, this study highlights the importance of understanding the mechanisms underlying HIV-stigma across different sub-populations in South Africa. This may lead to more effective and context-specific interventions to combat adverse mental health outcomes.

中文翻译：

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艾滋病毒耻辱感与艾滋病毒/艾滋病患者之间的抑郁症状之间的关联：在南非进行的研究的系统综述

背景

艾滋病毒/艾滋病感染者（PLWHA）遭受耻辱和精神疾病的风险增加，这在南非似乎是一个特殊问题，南非是全球19％的HIV阳性人口的家园。本文旨在系统地回顾研究南非艾滋病毒感染者中艾滋病毒柱头与抑郁症状之间关系的文献。

方法

对四个书目数据库（CINAHL，Ovid MEDLINE，PsycINFO和Web of Science）和两个灰色文献网站进行了关键字搜索。使用既定标准评估合格研究的质量。

结果

该评价包括十四项定量研究。南非的PLWHA感染艾滋病毒并带有较高的污名和抑郁症状。发现所有形式的污名与PLWHA中的抑郁症状有关。前瞻性研究结果参差不齐，一项研究发现柱头症在36个月内没有预示抑郁症状，而另一项研究结果显示抑郁症症状在12个月后预示了柱头症状，这表明存在潜在的双向关系。女性和年轻人可能特别容易受到艾滋病毒耻辱及其负面心理影响。人们发现，社会支持在不同亚人群的耻辱感和抑郁症状之间的关系中起着调节作用。

局限性

很少有研究进行前瞻性分析或检验中介/调节作用。

结论

尽管有局限性，但这项研究强调了了解南非不同亚人群的艾滋病毒耻辱机制的重要性。这可能会导致更有效和针对具体情况的干预措施，以对抗不良的心理健康结果。