目的构建基于现实主义整合的人类免疫缺陷病毒（human immunodeficiency virus，HIV）/获得性免疫缺陷综合征（acquired immunodeficiency syndrome，AIDS）患者社会支持干预概念框架，明确不同情境下社会支持干预的机制以及激活路径，为制订个性化干预提供理论依据。方法按照现实主义方法学RAMESES标准(realist and Meta-narrative evidence syntheses:evolving standards)，进行现实主义整合，共包括5个关键过程，系统检索PubMed、Web of Science、Cochrane library、CINAHL、万方、维普、中国知网等数据库，检索时限为2020年1月至2025年7月，根据纳入和排除标准筛选文献，2名研究者独立依据相关性和严谨性进行质量评价并提取干预要素，分析“情境-机制-结局”配置，构建社会支持干预机制链，结合利益相关者反馈进行理论优化。结果共纳入15项研究，归纳出同伴共情与同伴榜样、认知重构与社交激活、技术赋能与安全空间构建、系统整合这四类典型社会支持干预机制配置。干预效果依赖机制激活条件，情境评估是优化干预成效的关键。结论 HIV/AIDS患者社会支持干预应根据情境精准激活核心机制，形成适应性干预路径，以提升干预效果。

Objective To develop a conceptual framework for social support intervention in HIV/AIDS patients based on realist synthesis,and clarify the activation pathways of intervention mechanisms in different contexts,in order to provide a theoretical basis for developing personalized intervention.MethodsAccording to the realist and Meta-narrative evidence syntheses:evolving standards(RAMESES) standards for realist methodology, a synthesis comprising 5 key steps was conducted. A systematic search was performed in databases including PubMed, Web of Science, Cochrane Library, CINAHL, Wanfang, VIP, and CNKI from January 2020 to July 2025, where literatures were screened based on inclusion and exclusion criteria. 2 researchers independently assessed the quality of the studies and extracted intervention components according to relevance and rigor, analyzed the “context-mechanism-outcome” configurations, constructed a chain of mechanisms for social support intervention, and refined the theory by incorporating feedback from stakeholders.Results A total of 15 studies were included,with 4 typical social support intervention mechanism configurations summarized: peer empathy and peer modeling,cognitive restructuring and social activation,technology empowerment and safe space construction,and system integration.Intervention effects depend on the conditions for mechanism activation,and context assessment is key to optimizing intervention outcomes.Conclusions Social support intervention for HIV/AIDS patients should precisely activate core mechanisms according to contexts and form adaptive intervention pathways to enhance effectiveness.

R473.51

复旦大学复星护理科研基金（FNF202401）