Quinn Katherine, Voisin Dexter R, Bouris Alida, Jaffe Kate, Kuhns Lisa, Eavou Rebecca, Schneider John
Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, 2071 N. Summit, Milwaukee, WI, 53202, USA.
School of Social Service Administration, University of Chicago, Chicago, IL, USA.
AIDS Behav. 2017 Jan;21(1):207-216. doi: 10.1007/s10461-016-1439-1.
This study is among the first to examine the association between multiple domains of HIV-related stigma and health-related correlates including viral load and medication adherence among young Black men who have sex with men (N = 92). Individual logistic regressions were done to examine the hypothesized relationships between HIV-related stigma and various health and psychosocial outcomes. In addition to examining total stigma, we also examined four domains of HIV stigma. Findings revealed the various domains of stigma had differential effects on health-related outcomes. Individuals who reported higher levels of total stigma and personalized stigma were less likely to be virally suppressed (OR 0.96, 95 % CI 0.91-1.00 and OR 0.50, 95 % CI 0.25-1.02, respectively). Concerns about public attitudes toward HIV were positively related to medication adherence (OR 2.18, 95 % CI 1.20-3.94) and psychological distress (OR 5.02, 95 % CI 1.54-16.34). The various domains of HIV stigma differentially affected health and psychosocial outcomes, and our findings suggest that some forms of HIV stigma may significantly affect viral load and medication adherence among this population. Stigma-informed approaches to care and treatment are needed, along with incorporated psychological and social supports.
本研究是首批考察与艾滋病相关耻辱感的多个领域与健康相关因素之间关联的研究之一,这些因素包括病毒载量以及男男性行为黑人青年(N = 92)的药物依从性。进行了个体逻辑回归分析,以检验与艾滋病相关耻辱感和各种健康及心理社会结果之间的假设关系。除了考察总体耻辱感外,我们还考察了艾滋病耻辱感的四个领域。研究结果显示,耻辱感的各个领域对与健康相关的结果有不同影响。报告总体耻辱感和个性化耻辱感水平较高的个体病毒得到抑制的可能性较小(分别为OR 0.96,95% CI 0.91 - 1.00和OR 0.50,95% CI 0.25 - 1.02)。对公众对艾滋病态度的担忧与药物依从性呈正相关(OR 2.18,95% CI 1.20 - 3.94)以及与心理困扰呈正相关(OR 5.02,95% CI 1.54 - 16.34)。艾滋病耻辱感的各个领域对健康和心理社会结果有不同影响,我们的研究结果表明,某些形式的艾滋病耻辱感可能会显著影响该人群的病毒载量和药物依从性。需要采用基于耻辱感认知的护理和治疗方法,并纳入心理和社会支持。