Bogart Laura M, Wagner Glenn J, Green Harold D, Mutchler Matt G, Klein David J, McDavitt Bryce
Division of General Pediatrics, Department of Medicine, Boston Children's Hospital, Boston, MA, USA.
Department of Pediatrics, Harvard Medical School, Boston, MA, USA.
Ann Behav Med. 2015 Dec;49(6):865-72. doi: 10.1007/s12160-015-9724-1.
Stigma may contribute to HIV-related disparities among HIV-positive Black Americans.
We examined whether social network characteristics moderate stigma's effects.
At baseline and 6 months post-baseline, 147 HIV-positive Black Americans on antiretroviral treatment completed egocentric social network assessments, from which we derived a structural social support capacity measure (i.e., ability to leverage support from the network, represented by the average interaction frequency between the participant and each alter). Stigma was operationalized with an indicator of whether any social network member had expressed stigmatizing attributions of blame or responsibility about HIV. Daily medication adherence was monitored electronically.
In a multivariate regression, baseline stigma was significantly related to decreased adherence over time. The association between stigma and non-adherence was attenuated among participants who increased the frequency of their interactions with alters over time.
Well-connected social networks have the potential to buffer the effects of stigma.
耻辱感可能导致美国黑人艾滋病病毒感染者中与艾滋病相关的差异。
我们研究了社交网络特征是否会调节耻辱感的影响。
在基线期和基线期后6个月,147名接受抗逆转录病毒治疗的美国黑人艾滋病病毒感染者完成了自我中心社交网络评估,我们从中得出了一种结构性社会支持能力指标(即从网络中获取支持的能力,以参与者与每个他人之间的平均互动频率表示)。耻辱感通过一个指标来衡量,即是否有任何社交网络成员表达了对艾滋病病毒感染者的指责或责任的耻辱性归因。通过电子方式监测每日药物依从性。
在多变量回归分析中,基线期的耻辱感与随着时间推移依从性降低显著相关。随着时间推移与他人互动频率增加的参与者中,耻辱感与不依从之间的关联减弱。
联系紧密的社交网络有可能缓冲耻辱感的影响。