AIDS Behav. 2014 Jul;18(7):1237-46. doi: 10.1007/s10461-013-0621-y.
Critical consciousness, the awareness of social oppression, is important to investigate as a buffer against HIV disease progression in HIV-infected African American women in the context of experiences with discrimination. Critical consciousness comprises several dimensions, including social group identification, discontent with distribution of social power, rejection of social system legitimacy, and a collective action orientation. The current study investigated self-reported critical consciousness as a moderator of perceived gender and racial discrimination on HIV viral load and CD4+ cell count in 67 African American HIV-infected women. Higher critical consciousness was found to be related to higher likelihood of having CD4+ counts over 350 and lower likelihood of detectable viral load when perceived racial discrimination was high, as revealed by multiple logistic regressions that controlled for highly active antiretroviral therapy (HAART) adherence. Multiple linear regressions showed that at higher levels of perceived gender and racial discrimination, women endorsing high critical consciousness had a larger positive difference between nadir CD4+ (lowest pre-HAART) and current CD4+ count than women endorsing low critical consciousness. These findings suggest that raising awareness of social oppression to promote joining with others to enact social change may be an important intervention strategy to improve HIV outcomes in African American HIV-infected women who report experiencing high levels of gender and racial discrimination.
批判意识，即对社会压迫的认识，对于研究在经历歧视的情况下，感染艾滋病毒的非裔美国女性如何抵御艾滋病毒疾病进展具有重要意义。批判意识包含几个方面，包括社会群体认同、对社会权力分配的不满、对社会制度合法性的拒绝以及集体行动取向。本研究调查了自我报告的批判意识作为一个调节变量，以调查在 67 名感染艾滋病毒的非裔美国女性中，感知到的性别和种族歧视对艾滋病毒病毒载量和 CD4+细胞计数的影响。多项逻辑回归显示，当感知到的种族歧视程度较高时，较高的批判意识与 CD4+计数超过 350 的可能性较高和检测不到病毒载量的可能性较低有关，这些回归控制了高效抗逆转录病毒治疗（HAART）的依从性。多元线性回归显示，在感知到的性别和种族歧视程度较高的情况下，认同高批判意识的女性，其当前 CD4+计数与最低 HAART 前 CD4+计数之间的差值大于认同低批判意识的女性。这些发现表明，提高对社会压迫的认识，以促进与他人一起采取行动来改变社会，可能是改善报告经历高度性别和种族歧视的感染艾滋病毒的非裔美国女性艾滋病毒结果的一个重要干预策略。
