Division of Prevention Science, Department of Medicine, Center for AIDS Prevention Studies, University of California, 550 16th Street, 3rd Floor, 0886, San Francisco, CA, 94158-2549, USA.
Department of Psychology, Georgia State University, Atlanta, GA, USA.
AIDS Behav. 2018 Mar;22(3):774-790. doi: 10.1007/s10461-016-1601-9.
The primary romantic relationship plays a fundamental role in health maintenance, but little is known about its role in HIV care engagement among young Black men who have sex with men (MSM) living with HIV. We examined how HIV care engagement outcomes (i.e., having a primary healthcare provider, receiving HIV treatment, taking antiretroviral medication, and medication adherence) vary by partnership status (single vs. concordant-positive vs. discordant) in a sample of young Black MSM living with HIV. Results showed mixed findings. Partnership status was significantly associated with HIV care engagement, even after adjusting for individual, social, and structural factors. While partnered men were consistently more likely than their single counterparts to have a regular healthcare provider, to receive recent treatment, and to have ever taken antiretroviral medication, they were less likely to report currently receiving antiretroviral therapy. Moreover, men with a discordant partner reported better adherence compared to men with a concordant or no partner. The association between partnership status and HIV care engagement outcomes was not consistent across the stages of the HIV Care Continuum, highlighting the complexity in how and why young Black men living with HIV engage in HIV healthcare. Given the social context of HIV disease management, more research is needed to explicate underlying mechanisms involved in HIV care and treatment that differ by relational factors for young Black MSM living with HIV.
主要的浪漫关系对维持健康起着至关重要的作用,但对于与艾滋病毒共存的黑人男男性行为者 (MSM) 来说,其在艾滋病毒护理参与中的作用知之甚少。我们研究了在与艾滋病毒共存的年轻黑人 MSM 样本中,艾滋病毒护理参与结果(即有主要医疗保健提供者、接受艾滋病毒治疗、服用抗逆转录病毒药物和药物依从性)如何因伴侣关系状况(单身与双阳性与双阴性)而异。结果显示出混合的发现。即使在调整了个体、社会和结构因素后,伴侣关系状况也与艾滋病毒护理参与显著相关。虽然有伴侣的男性比单身男性更有可能有定期的医疗保健提供者、接受最近的治疗和曾经服用过抗逆转录病毒药物,但他们更不可能报告目前正在接受抗逆转录病毒治疗。此外,与有伴侣的男性相比,与无伴侣或伴侣不匹配的男性报告的药物依从性更好。伴侣关系状况与艾滋病毒护理参与结果之间的关联在艾滋病毒护理连续体的各个阶段并不一致,突出了在与艾滋病毒共存的年轻黑人男性中,艾滋病毒护理参与的方式和原因的复杂性。鉴于艾滋病毒疾病管理的社会背景,需要更多的研究来阐明与年轻黑人 MSM 艾滋病毒护理和治疗不同的关系因素有关的潜在机制。