Shah Krupa, McMahon James M, Trabold Nicole, Aidala Angela A, Chen Michael, Pouget Enrique R, Simmons Janie, Klostermann Keith
a Department of Medicine , Highland Hospital , Rochester , NY , USA.
b School of Nursing , University of Rochester Medical Center , Rochester , NY , USA.
AIDS Care. 2015;27(9):1079-86. doi: 10.1080/09540121.2015.1026308. Epub 2015 Mar 27.
Little is known about the psychosocial factors that might impact the functioning ability of heterosexual men living with HIV. We examined positive and negative coping, social support, and HIV stigma as predictors of physical and global functioning in a cross-sectional sample of 317 HIV-infected adult heterosexual male patients recruited from clinical and social service agencies in New York City. Study participants were primarily minority and low income. Sixty-four percent were African-American, 55% were single, and 90% were 40 years of age or older. The majority had long-term HIV (LTHIV), with an average duration of 15 years since diagnosis. After controlling for participant characteristics, structural equation modeling analyses revealed that positive coping and social support had a significant positive direct effect on global functioning, while stigma had a significant negative direct effect on global functioning. The physical functioning model revealed that negative coping and HIV stigma had significant negative direct effects, whereas social support had a significant positive indirect effect. Age and duration of HIV diagnosis were not associated with physical and global functioning. In conclusion, we found that heterosexual men living with LTHIV who have ineffective coping, less social support, and greater stigma have reduced functioning ability. Study findings have implications for developing interventions aimed at increasing and retaining functioning ability with the end goal of improving successful aging in this population.
对于可能影响感染艾滋病毒的异性恋男性功能能力的社会心理因素，我们知之甚少。我们在一个横断面样本中，考察了积极应对与消极应对、社会支持以及艾滋病毒污名化情况，将其作为317名从纽约市临床和社会服务机构招募的感染艾滋病毒的成年异性恋男性患者身体功能和整体功能的预测因素。研究参与者主要是少数族裔且收入较低。64%为非裔美国人，55%为单身，90%年龄在40岁及以上。大多数人患有长期艾滋病毒感染（LTHIV），自确诊以来平均病程为15年。在控制了参与者特征后，结构方程模型分析显示，积极应对和社会支持对整体功能有显著的正向直接影响，而污名化对整体功能有显著的负向直接影响。身体功能模型显示，消极应对和艾滋病毒污名化有显著的负向直接影响，而社会支持有显著的正向间接影响。年龄和艾滋病毒诊断病程与身体功能和整体功能无关。总之，我们发现，患有长期艾滋病毒感染的异性恋男性，若应对方式无效、社会支持较少且污名化程度较高，则其功能能力会下降。研究结果对于制定旨在提高和保持功能能力的干预措施具有启示意义，最终目标是改善该人群的成功老龄化状况。
