Zhang Liying, Li Xiaoming, Qiao Shan, Zhou Yuejiao, Shen Zhiyong, Tang Zhenzhu, Shah Iqbal, Stanton Bonita
a Pediatric Prevention Research Center, The Carman and Ann Adams Department of Pediatrics , Wayne State University School of Medicine , 4707 St Antoine Street, Hutzel Building, Suite W534, Detroit , MI 48201-2196 , USA.
b Guangxi Center for Disease Control and Prevention , Nanning , China.
AIDS Care. 2015;27(10):1317-25. doi: 10.1080/09540121.2015.1054338. Epub 2015 Aug 14.
Despite the vigorous global efforts to reduce stigma, HIV-related stigma continues to undermine the health status of people living with HIV (PLHIV). Internalized HIV stigma may cause stress adversely affecting the health of PLHIV. Resilience is the process of an effective coping and positive adaption in the face of adversities. To date, limited data are available on the mediating role of resilience in the relationship of internalized HIV stigma and health status among PLHIV in China. A cross-sectional survey was conducted among 2987 PLHIV in Guangxi Autonomous Region (Guangxi) in China. A mediation analysis was employed and Sobel test was used to test the mediation effect of individual resilience. Of the 2987 PLHIV, 62.8% were men. The mean age of the sample was 42.5 years (SD = 12.8). Over 57.7% of PLHIV reported their overall health status being poor. About 72% of PLHIV reported experiencing internalized HIV stigma. Internalized HIV stigma had a negative direct effect on self-rated health status (p < .001). Individual resilience resources mediated the relationship between internalized HIV stigma and self-rated health status (p < .001). Sobel test confirmed the mediation effect of resilience (z = -8.359, SE = 0.003, p < .001). Resilience as a protective factor might buffer the effect of internalized HIV stigma on health status. Multilevel interventions are needed to foster resilience of PLHIV in order to mitigate the negative impact of HIV stigma and to improve the overall health status of PLHIV.
尽管全球为减少耻辱感做出了积极努力,但与艾滋病毒相关的耻辱感仍在损害艾滋病毒感染者(PLHIV)的健康状况。内化的艾滋病毒耻辱感可能会导致压力,对艾滋病毒感染者的健康产生不利影响。复原力是面对逆境时有效应对和积极适应的过程。迄今为止,关于复原力在中国艾滋病毒感染者内化的艾滋病毒耻辱感与健康状况关系中的中介作用的数据有限。在中国广西壮族自治区对2987名艾滋病毒感染者进行了一项横断面调查。采用中介分析,并使用Sobel检验来检验个体复原力的中介效应。在2987名艾滋病毒感染者中,62.8%为男性。样本的平均年龄为42.5岁(标准差=12.8)。超过57.7%的艾滋病毒感染者报告其总体健康状况较差。约72%的艾滋病毒感染者报告经历过内化的艾滋病毒耻辱感。内化的艾滋病毒耻辱感对自我评定的健康状况有负面直接影响(p<0.001)。个体复原力资源介导了内化的艾滋病毒耻辱感与自我评定的健康状况之间的关系(p<0.001)。Sobel检验证实了复原力的中介效应(z=-8.359,标准误=0.003,p<0.001)。复原力作为一种保护因素可能会缓冲内化的艾滋病毒耻辱感对健康状况的影响。需要采取多层次干预措施来培养艾滋病毒感染者的复原力,以减轻艾滋病毒耻辱感的负面影响,并改善艾滋病毒感染者的总体健康状况。