1 Department of Psychology, Boston University , Boston, Massachusetts.
AIDS Patient Care STDS. 2014 Mar;28(3):136-43. doi: 10.1089/apc.2013.0329. Epub 2014 Feb 25.
Abuse is highly prevalent among HIV+ women, leading to behaviors, including lower adherence to highly active antiretroviral therapy (HAART) that result in poor health outcomes. Resilience (functioning competently despite adversity) may buffer the negative effects of abuse. This study investigated how resilience interacted with abuse history in relation to HAART adherence, HIV viral load (VL), and CD4+ cell count among a convenience sample of 138 HIV+ women from the Ruth M. Rothstein CORE Center/Cook County Health and Hospital Systems site of the Women's Interagency HIV Study (WIHS). Resilience was measured by the 10-item Connor-Davidson Resilience Scale (CD-RISC). HAART adherence (≥95% vs. <95% self reported usage of prescribed medication) and current or prior sexual, physical, or emotional/domestic abuse, were reported during structured interviews. HIV viral load (≥20 vs. <20 copies/mL) and CD4+ count (200 vs. <200 cells/mm) were measured with blood specimens. Multiple logistic regressions, controlling for age, race, income, enrollment wave, substance use, and depressive symptoms, indicated that each unit increase in resilience was significantly associated with an increase in the odds of having ≥95% HAART adherence and a decrease in the odds of having a detectable viral load. Resilience-Abuse interactions showed that only among HIV+ women with sexual abuse or multiple abuses did resilience significantly relate to an increase in the odds of ≥95% HAART adherence. Interventions to improve coping strategies that promote resilience among HIV+ women may be beneficial for achieving higher HAART adherence and viral suppression.
虐待在 HIV+ 女性中非常普遍,导致包括对高效抗逆转录病毒疗法(HAART)的依从性降低在内的行为,从而导致健康状况不佳。韧性(在逆境中仍能正常运作)可能会缓冲虐待的负面影响。本研究调查了韧性如何与滥用史相互作用,以了解其与 HAART 依从性、HIV 病毒载量(VL)和 CD4+细胞计数之间的关系,该研究是在 Ruth M. Rothstein CORE 中心/库克县卫生和医院系统的妇女机构间 HIV 研究(WIHS)便利样本中的 138 名 HIV+ 女性中进行的。韧性通过 10 项 Connor-Davidson 韧性量表(CD-RISC)进行衡量。在结构访谈中报告了 HAART 依从性(≥95%与<95%自我报告的规定药物使用)和当前或以前的性、身体或情感/家庭虐待。使用血液样本测量 HIV 病毒载量(≥20 与<20 拷贝/ml)和 CD4+计数(200 与<200 个细胞/mm)。在控制年龄、种族、收入、入组波、物质使用和抑郁症状后,多变量逻辑回归表明,韧性每增加一个单位,HAART 依从性≥95%的几率就会显著增加,病毒载量可检测的几率就会显著降低。韧性-滥用相互作用表明,只有在经历过性虐待或多种虐待的 HIV+女性中,韧性才与 HAART 依从性≥95%的几率增加显著相关。改善应对策略以提高 HIV+ 女性韧性的干预措施可能有助于提高 HAART 依从性和病毒抑制。
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