背景: 愛滋感染者因面臨病程變化及疾病相關的壓力，易誘發憂鬱症狀的發生。然而，憂鬱的情緒不易由病人的外觀察覺出，醫護人員若未能及早發現其憂鬱症狀，不僅影響其生活品質，減少對藥物的遵從性，進而使疾病病程惡化。
目的: 本研究旨在探討HIV感染者之疾病病程、壓力知覺感受、社會歧視與其憂鬱症狀之關係，及預測影響重度憂鬱症狀發生的危險因子。
方法: 研究對象來自南部某醫學中心160位固定於門診追蹤治療之HIV感染者，以結構式問卷包括:貝克憂鬱量表、壓力知覺量表、自覺社會支持的多面向量表、社會衝擊量表及病歷回顧方式搜集資料。以多元迴歸分析CD4數目、壓力知覺感受、社會歧視對憂鬱症狀之關係及邏輯式迴歸預測重度憂鬱症狀發生的危險因素。
結果: 感染者其憂鬱症狀盛行率約42.5％，重度憂鬱症狀盛行率約15.6％；感染者之CD4數目減少其憂鬱症狀強度愈高，自覺承受壓力愈大及自覺社會歧視愈嚴重其憂鬱症狀強度愈高，CD4數目、壓力知覺感受、社會歧視對憂鬱症狀之解釋力約46％；而預測感染者出現重度憂鬱症狀的主要因素為壓力知覺感受(OR:1.24, 95% CI:1.10-1.39)與社會歧視(OR:1.47, 95% CI:1.09-1.97)。
結論: 降低感染者其自覺壓力、社會歧視可作為預防HIV感染者重度憂鬱症狀之介入性措施的參考。

Background: People living with HIV who was faced with HIV disease progression and HIV related stress that may trigger off depressive symptom. However, depressive symptoms are difficult to detect. The depressive symptoms of patients with HIV might affect their quality of life, decrease adherence to antiretroviral therapy, and further exacerbate disease progression.
Objective: The study purposes were to examine the relationships among HIV disease progress, perceived stress, social stigma, and depressive symptoms and to investigate the predictors of depressive and major depressive symptoms among patients with HIV.
Method: Study subjects were recruited from infectious disease outpatient clinics in a university hospital in southern Taiwan. Data was collected including chart reviews and four self-administered questionnaires: Beck Depression Inventory, Perceived Stress Scale, Multidimensional Scale of Perceived Social Support, and Social Impact Scale.
Results: The prevalence rate of depressive symptoms and major depressive symptoms among patients with HIV were 42.5% and 15.6%, respectively. Multiple regression analysis indicated that CD4 cell counts, perceived stress, and social stigma were associated with depressive symptoms, accounting for 46% of the variance in depressive symptoms. The independent predictors associated with increased odds of major depressive symptoms were perceived stress (OR:1.24, 95% CI:1.10-1.39) and social stigma (OR:1.47, 95% CI:1.09-1.97).
Conclusion: People living with HIV were prone to major depressive symptoms which were affected by perceived stress and social stigma. Perceived stress and social stigma could provide reference for further intervention to prevent major depressive symptoms among people living with HIV.

行政院衛生署疾病管制局 (2009，3月31日)‧愛滋虛擬博物館‧國內疫情報導‧2009年4月18日取自http://www.cdc.gov.tw/public/Attachment/9488505271.xls
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