Review question in PEO format.

Mental health problems, particularly depression and anxiety, are common in women and young girls living with HIV/ AIDS particularly in low- and middle-income (LMICs) countries where women’s vulnerability to psychiatric symptoms is heightened due to the prevalent intersectional stressors such as stigma and intimate partner violence. However, no synthesized evidence exists on the mental health burden of females living with HIV/AIDS (FLWHA) in Africa. This systematic review aimed to synthesize the current evidence on the mental health burden among FLWHA in sub-Saharan Africa. A systematic literature review of articles published from 2013–2023 was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA). Five electronic databases; PubMed, MEDLINE with full text, Scopus, Academic Search Complete, and Health Source: Nursing Academic Edition were searched for articles published in English. Nineteen articles (15 quantitative, 3 qualitative, and 1 case study) from over 7 African countries met the inclusion criteria. The majority of the studies’ quality was determined to be moderate. The prevalence of depression ranged from 5.9 to 61% and anxiety from 28.9 to 61%. Mental health burden was a logical outcome of HIV diagnosis. Predictors of mental health outcomes in the context of HIV/AIDS were identified as intimate partner violence (IPV), stigma, childhood traumas, sexual abuse, poverty, unemployment, and social isolation. Social support and resilience were identified as protective factors against mental illness in FLWHA. Mental illness had a deleterious effect on viral suppression rates among FLWHA, resulting in delayed initiation of antiretroviral therapy treatment and increased mortality but had no impact on immune reconstitution in the face of ART adherence. Given the high prevalence rates of depression and anxiety and their relationship with HIV progression, it is crucial that mental health care services are integrated into routine HIV care.

感染艾滋病毒/艾滋病的女性与年轻女孩，尤其是在低收入和中等收入国家（Low- and Middle-Income Countries, LMICs），常面临心理健康问题，其中以抑郁与焦虑最为普遍。由于污名化、亲密伴侣暴力等普遍存在的交叉性应激因素，女性罹患精神症状的风险显著升高。然而，目前尚无针对非洲感染艾滋病毒/艾滋病的女性（Females Living with HIV/AIDS, FLWHA）心理健康负担的综合研究证据。本系统综述旨在整合撒哈拉以南非洲地区该群体的心理健康负担相关现有研究证据。本研究遵循系统综述与元分析首选报告条目（Preferred Reporting Items for Systematic Reviews and Meta-Analyses, PRISMA）指南，对2013至2023年发表的文献开展系统综述。共检索PubMed、MEDLINE（全文版）、Scopus、Academic Search Complete以及Health Source: Nursing Academic Edition共5个电子数据库，筛选以英语发表的相关文献。最终有来自7个以上非洲国家的19篇文献符合纳入标准，其中15篇为定量研究、3篇为定性研究、1篇为案例研究，绝大多数纳入研究的方法学质量被评定为中等。研究显示，抑郁症状的患病率介于5.9%至61%之间，焦虑症状患病率则介于28.9%至61%之间。心理健康负担是艾滋病毒诊断后的合理结局之一。本研究识别出艾滋病毒/艾滋病背景下精神健康结局的预测因素包括亲密伴侣暴力（Intimate Partner Violence, IPV）、污名化、童年创伤、性虐待、贫困、失业与社会孤立；社会支持与心理韧性则被认定为该群体抵御精神疾病的保护因素。精神疾病会对感染艾滋病毒/艾滋病女性的病毒抑制率产生不利影响，导致抗逆转录病毒治疗（Antiretroviral Therapy, ART）启动延迟及死亡率升高，但在抗逆转录病毒治疗依从性良好的情况下，对免疫重建无显著影响。鉴于抑郁与焦虑症状的高患病率及其与艾滋病毒疾病进展的关联，将精神健康护理服务整合入常规艾滋病毒护理体系中具有重要意义。