ACRIA, Center on HIV and Aging, New York.
Department of Gerontology, University of Massachusetts, Boston.
Gerontologist. 2017 Apr 1;57(2):219-228. doi: 10.1093/geront/gnv128.
The National Institutes of Health calls for research that explores what it means to age optimally with HIV/AIDS as half of the U.S. people with HIV are aged 50 or older. This study applied the stress process model to examine the association between HIV stigma and psychological well-being and mediating resources (i.e., spirituality and complementary and integrative health [CIH]) approaches) in older adults with HIV.
Using data from the Research on Older Adults with HIV (ROAH) study, structural equation modeling was used to estimate these relationships within a latent variable model. Namely, a direct negative association between HIV stigma and psychological well-being was hypothesized that would be mediated by spirituality and/or CIH use.
The analyses showed that the model fits the data well [χ2 (137, N = 914) = 561.44, p = .000; comparative fit index = .964; root mean square error of approximation = .058, 95% confidence interval = .053 to .063]. All observed variables significantly loaded on their latent factor, and all paths were significant. Results indicated that spirituality and CIH use significantly mediated the negative association between HIV stigma and psychological well-being.
Findings highlight the importance of spiritual and CIH interventions for older adults with HIV/AIDS. Practice recommendations are provided at the micro- and mesolevel.
美国国立卫生研究院呼吁开展研究，探索在半数美国艾滋病毒感染者年龄在 50 岁及以上的情况下，如何实现最佳老龄化与艾滋病毒/艾滋病共存。本研究应用压力过程模型，检验艾滋病毒污名与心理健康之间的关联，以及艾滋病毒感染者老年人群体中的中介资源（即精神信仰和补充与整合健康[CIH]方法）。
利用来自艾滋病毒老年研究（ROAH）的研究数据，采用结构方程模型，在潜在变量模型中估计这些关系。假设艾滋病毒污名与心理健康之间存在直接的负相关关系，而精神信仰和/或 CIH 使用会起到中介作用。
分析表明，该模型很好地拟合了数据[χ2（137，N=914）=561.44，p=.000；比较拟合指数=0.964；均方根误差=0.058，95%置信区间为 0.053 至 0.063]。所有观察变量均显著加载到其潜在因子上，且所有路径均具有统计学意义。结果表明，精神信仰和 CIH 使用显著中介了艾滋病毒污名与心理健康之间的负相关关系。
研究结果强调了针对艾滋病毒/艾滋病老年感染者开展精神信仰和 CIH 干预的重要性。本文还提供了微观和中观层面的实践建议。
