关于 HIV 的阴谋论信念与感染 HIV 的非裔美国男性抗逆转录病毒治疗不依从有关。
Conspiracy beliefs about HIV are related to antiretroviral treatment nonadherence among african american men with HIV.
机构信息
Children's Hospital Boston/Harvard Medical School, Department of Medicine, Division of General Pediatrics, Boston, MA 02215, USA.
出版信息
J Acquir Immune Defic Syndr. 2010 Apr;53(5):648-55. doi: 10.1097/QAI.0b013e3181c57dbc.
BACKGROUND
Medical mistrust is prevalent among African Americans and may influence health care behaviors such as treatment adherence. We examined whether a specific form of medical mistrust-HIV conspiracy beliefs (eg, HIV is genocide against African Americans)-was associated with antiretroviral treatment nonadherence among African American men with HIV.
METHODS
On baseline surveys, 214 African American men with HIV reported their agreement with 9 conspiracy beliefs, sociodemographic characteristics, depression symptoms, substance use, disease characteristics, medical mistrust, and health care barriers. Antiretroviral medication adherence was monitored electronically for one month postbaseline among 177 men in the baseline sample.
RESULTS
Confirmatory factor analysis revealed 2 distinct conspiracy belief subscales: genocidal beliefs (eg, HIV is manmade) and treatment-related beliefs (eg, people who take antiretroviral treatments are human guinea pigs for the government). Both subscales were related to nonadherence in bivariate tests. In a multivariate logistic regression, only treatment-related conspiracies were associated with a lower likelihood of optimal adherence at one-month follow-up (odds ratio = 0.60, 95% confidence interval = 0.37 to 0.96, P < 0.05).
CONCLUSIONS
HIV conspiracy beliefs, especially those related to treatment mistrust, can contribute to health disparities by discouraging appropriate treatment behavior. Adherence-promoting interventions targeting African Americans should openly address such beliefs.
背景
医疗不信任在非裔美国人中很普遍，可能会影响他们的医疗行为，例如治疗依从性。我们研究了一种特定形式的医疗不信任——HIV 阴谋论信念（例如，HIV 是对非裔美国人的种族灭绝）是否与感染 HIV 的非裔美国男性的抗逆转录病毒治疗不依从有关。
方法
在基线调查中，214 名感染 HIV 的非裔美国男性报告了他们对 9 种阴谋论信念的认同程度，包括社会人口特征、抑郁症状、物质使用、疾病特征、医疗不信任和医疗保健障碍。在基线样本中，有 177 名男性在基线后一个月内通过电子方式监测了抗逆转录病毒药物的依从性。
结果
验证性因子分析显示出 2 个不同的阴谋论信念子量表：灭绝种族信念（例如，HIV 是人为制造的）和与治疗相关的信念（例如，服用抗逆转录病毒治疗的人是政府的人类豚鼠）。在单变量测试中，这两个子量表都与不依从有关。在多变量逻辑回归中，只有与治疗相关的阴谋论与一个月随访时不太可能达到最佳依从性相关（比值比=0.60，95%置信区间=0.37 至 0.96，P<0.05）。
结论
HIV 阴谋论信念，特别是与治疗不信任相关的信念，可能会通过阻碍适当的治疗行为导致健康差距。针对非裔美国人的依从性促进干预措施应该公开解决这些信念。
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