Department of Health Promotion & Disease Prevention, Robert Stempel College of Public Health & Social Work, Florida International University, 3000 N.E. 151 Street - ACI #260, Miami, FL 33181, USA.
AIDS Behav. 2013 May;17(4):1221-30. doi: 10.1007/s10461-012-0400-1.
Haiti has the highest number of individuals living with HIV in the Caribbean. Due to Haiti's resource-poor environment and inadequate mental health and substance abuse services, adherence to antiretroviral therapy (ART) may be especially difficult. This study examined associations among demographics, maladaptive coping, partner conflict, alcohol problems, depression, and negative attitudes about medications and their impact on adherence among 194 HIV-positive Haitians. In a mediated directional structural equation model, depression and negative attitudes about ART directly predicted poorer adherence. Greater partner conflict, maladaptive coping and alcohol problems predicted more depression. Maladaptive coping predicted a negative attitude about ART. Alcohol problems predicted partner conflict and maladaptive coping. Significant indirect effects on adherence mediated through both depression and negative attitudes about ART include negative effects of female gender, alcohol problems and maladaptive coping. Results highlight the importance of integrated care for depression, alcohol use and other psychosocial problems to increase ART adherence.
海地拥有加勒比地区数量最多的艾滋病毒感染者。由于海地资源匮乏，心理健康和药物滥用服务不足，因此坚持接受抗逆转录病毒疗法（ART）可能特别困难。这项研究调查了 194 名艾滋病毒阳性海地人在人口统计学，适应不良的应对方式，伴侣冲突，酒精问题，抑郁和对药物的负面态度方面的差异及其对依从性的影响。在中介定向结构方程模型中，抑郁和对 ART 的负面态度直接预测了较差的依从性。更大的伴侣冲突，适应不良的应对方式和酒精问题会导致更多的抑郁。适应不良的应对方式预示着对 ART 的负面态度。酒精问题预示着伴侣冲突和适应不良的应对方式。通过抑郁和对 ART 的负面态度对依从性产生的间接影响，包括女性，酒精问题和适应不良的应对方式的负面影响。研究结果强调了针对抑郁，酒精使用和其他心理社会问题进行综合护理的重要性，以提高对 ART 的依从性。
