Mehnert Linn, Siem Birte, Stürmer Stefan, Rohmann Anette
a Department of Psychology , FernUniversität in Hagen , Hagen , Germany.
AIDS Care. 2018 Apr;30(4):461-465. doi: 10.1080/09540121.2017.1381329. Epub 2017 Sep 29.
This study investigates the effect of similarity of health status between counselors and clients on the acceptance of counseling services among women living with HIV (WLWH). We hypothesized that WLWH should be more willing to seek counseling from an HIV-positive counselor as opposed to one living free of HIV or with another stigmatized disease like Hepatitis C, because a counselor with HIV should be perceived as more empathetic and credible. Moreover, the positive effect of similarity on acceptance should be particularly pronounced among WLWH who perceive high levels of HIV-related stigmatization and low levels of social support. Participants were 89 WLWH in Germany. In an online scenario experiment, we varied the similarity of health status between participants and a fictitious female counselor by presenting participants with one of three counselor profiles: The profile either stated that she was living with HIV but not Hepatitis C, with Hepatitis C but not HIV, or with neither HIV nor Hepatitis C. We then measured participants' perceptions of the counselor's similarity, empathy, and credibility, and their willingness to accept counseling with her. Results from an ANOVA with planned contrasts supported our assumption that participants presented with an HIV-positive counselor perceived her to be more similar to themselves and were more willing to accept the counseling than participants exposed to a HIV-negative counselor (either with or without Hepatitis C), for all relevant contrasts, ηs ≥ .08. Regression analyses corroborated that this effect was mediated by the counselor's perceived empathy and credibility, total indirect effect = .36, 95%CI [0.22, 0.53]. Moreover, moderated regression analyses revealed that the similarity effect on acceptance was particularly strong when participants experienced high levels of stigmatization and low levels of social support, for both interaction terms, ΔRs≥ .04, F(1, 85)s ≥ 5.03, ps ≤ .028.
本研究调查了咨询师与客户健康状况的相似性对感染艾滋病毒女性（WLWH）接受咨询服务的影响。我们假设，与未感染艾滋病毒或感染丙型肝炎等其他污名化疾病的咨询师相比，感染艾滋病毒的WLWH应该更愿意向感染艾滋病毒的咨询师寻求咨询，因为感染艾滋病毒的咨询师应该被认为更有同理心和可信度。此外，对于那些感受到高水平艾滋病毒相关污名化和低水平社会支持的WLWH来说，相似性对接受度的积极影响应该尤为明显。参与者为德国的89名WLWH。在一项在线情景实验中，我们通过向参与者展示三种咨询师简介之一，来改变参与者与虚拟女性咨询师之间健康状况的相似性：简介中要么表明她感染了艾滋病毒但未感染丙型肝炎，感染了丙型肝炎但未感染艾滋病毒，要么既未感染艾滋病毒也未感染丙型肝炎。然后，我们测量了参与者对咨询师的相似性、同理心和可信度的看法，以及他们接受她咨询的意愿。方差分析和计划对比的结果支持了我们的假设，即对于所有相关对比，ηs≥0.08，与接触艾滋病毒阴性咨询师（无论是否感染丙型肝炎）的参与者相比，接触感染艾滋病毒咨询师的参与者认为她与自己更相似，并且更愿意接受咨询。回归分析证实，这种影响是由咨询师被感知到的同理心和可信度介导的，总间接效应=0.36，95%CI[0.22，0.53]。此外，调节回归分析表明，当参与者经历高水平的污名化和低水平的社会支持时，相似性对接受度的影响尤为强烈，对于两个交互项，ΔRs≥0.04，F(1, 85)s≥5.03，ps≤0.028。
