Du Bois Steve N, McKirnan David J
Department of Psychology, The University of Illinois at Chicago, Chicago, IL, USA.
AIDS Care. 2012;24(11):1425-31. doi: 10.1080/09540121.2011.650676. Epub 2012 Jan 31.
HIV is best managed by adhering to both medication and HIV care appointment schedules. Nonetheless, many HIV-positive men who have sex with men (MSM) report low levels of adherence to both. To explain this, we tested a cognitive escape model whereby drug and alcohol use mediate the effects of depression on HIV medication and appointment adherence. We used longitudinal data (n=856) from a behavioral intervention promoting increased treatment adherence among HIV-positive MSM. All model variables predicted appointment adherence, and our mediation hypotheses were supported. Conversely, although depression related to medication adherence, substance use did not mediate this relationship, as predicted. Self-reported appointment, but not medication, adherence related to changes in viral load over time. Therefore, cognitive escape characterizes appointment, but not medication, adherence within this sample. Future behavioral interventions for this population should target HIV appointment adherence, given its relationship to important clinical, psychological, and behavioral outcomes.
通过坚持药物治疗和艾滋病护理预约时间表，能最好地控制艾滋病病毒（HIV）。尽管如此，许多男男性行为者（MSM）艾滋病病毒呈阳性者报告称，他们在这两方面的坚持程度都很低。为了解释这一现象，我们测试了一种认知逃避模型，即药物和酒精使用介导了抑郁症对艾滋病药物治疗和预约坚持的影响。我们使用了来自一项行为干预的纵向数据（n = 856），该干预旨在提高艾滋病病毒呈阳性的男男性行为者的治疗依从性。所有模型变量都预测了预约坚持情况，我们的中介假设得到了支持。相反，尽管抑郁症与药物治疗依从性有关，但正如预测的那样，物质使用并未介导这种关系。自我报告的预约坚持情况（而非药物治疗坚持情况）与病毒载量随时间的变化有关。因此，在这个样本中，认知逃避是预约坚持（而非药物治疗坚持）的特征。鉴于艾滋病预约坚持与重要的临床、心理和行为结果之间的关系，针对该人群的未来行为干预应针对艾滋病预约坚持情况。
Zotero 插件