医学不信任作为感知歧视与 HIV 阳性拉丁裔男性抗逆转录病毒治疗依从性之间关联的主要中介因素。
Medical mistrust as a key mediator in the association between perceived discrimination and adherence to antiretroviral therapy among HIV-positive Latino men.
机构信息
Bienestar Human Services, Inc., 5326 East Beverly Blvd., Los Angeles, CA, 90022, USA.
RAND Corporation, 1776 Main Street, Santa Monica, CA, 90407, USA.
出版信息
J Behav Med. 2017 Oct;40(5):784-793. doi: 10.1007/s10865-017-9843-1. Epub 2017 Mar 23.
Abstract
Discrimination has been found to have deleterious effects on physical health. The goal of the present study was to examine the association between perceived discrimination and adherence to antiretroviral therapy (ART) among HIV-positive Latino men and the extent to which medical mistrust serves as a mediator of that association. A series of linear and logistic regression models was used to test for mediation for three types of perceived discrimination (related to being Latino, being perceived as gay and being HIV-positive). Medical mistrust was found to be significantly associated with perceived discrimination based on Latino ethnicity and HIV serostatus. Medical mistrust was found to mediate the associations between two types of perceived discrimination (related to being Latino and being HIV-positive) and ART adherence. Given these findings, interventions should be developed that increase the skills of HIV-positive Latino men to address both perceived discrimination and medical mistrust.
摘要
歧视已被发现对身体健康有不良影响。本研究的目的是检验感知歧视与 HIV 阳性拉丁裔男性接受抗逆转录病毒治疗（ART）之间的关系，以及医疗不信任在多大程度上充当这种关系的中介。使用一系列线性和逻辑回归模型来检验三种感知歧视（与拉丁裔、被视为同性恋和 HIV 阳性有关）的中介作用。医疗不信任与基于拉丁裔种族和 HIV 阳性的感知歧视显著相关。医疗不信任中介了两种感知歧视（与拉丁裔和 HIV 阳性有关）与 ART 依从性之间的关联。鉴于这些发现，应该制定干预措施，提高 HIV 阳性拉丁裔男性解决感知歧视和医疗不信任的技能。
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