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回避应对在新诊断出 HIV 的男男性行为者的 HIV 披露自我效能感与抑郁症状之间起中介作用。

Avoidant Coping Mediates the Relationship Between Self-Efficacy for HIV Disclosure and Depression Symptoms Among Men Who Have Sex with Men Newly Diagnosed with HIV.

机构信息

Department of Psychology and Neuroscience, Duke University, 417 Chapel Drive, Box 90086, Durham, NC, 27708-0086, USA.

Duke Global Health Institute, Duke University, Durham, NC, USA.

出版信息

AIDS Behav. 2018 Oct;22(10):3130-3140. doi: 10.1007/s10461-018-2036-2.

Abstract

HIV diagnosis presents a critical opportunity to reduce secondary transmission, improve engagement in care, and enhance overall well-being. To develop relevant interventions, research is needed on the psychosocial experiences of newly diagnosed individuals. This study examined avoidant coping, self-efficacy for HIV disclosure decisions, and depression among 92 newly diagnosed men who have sex with men who reported recent sexual risk behavior. It was hypothesized that avoidant coping would mediate the relationship between self-efficacy and depression. Cross-sectional surveys were collected from participants 3 months after HIV diagnosis. To test for mediation, multiple linear regressions were conducted while controlling for HIV disclosure to sexual partners. Self-efficacy for HIV disclosure decisions showed a negative linear relationship to depression symptoms, and 99% of this relationship was mediated by avoidant coping. The index of mediation of self-efficacy on depression indicated a small-to-medium effect. Higher self-efficacy was related to less avoidant coping, and less avoidant coping was related to decreased depression symptoms, all else held constant. These findings highlight the role of avoidant coping in explaining the relationship between self-efficacy for HIV disclosure decisions and depression.

摘要

HIV 诊断为减少二次传播、提高治疗参与度和改善整体健康状况提供了一个关键机会。为了制定相关干预措施,需要对新诊断个体的社会心理体验进行研究。本研究调查了 92 名新诊断的男男性行为者(MSM)在报告近期性行为风险后采取回避应对、HIV 披露决策自我效能感和抑郁情况。研究假设回避应对会在自我效能感和抑郁之间起中介作用。在 HIV 诊断后 3 个月收集参与者的横断面调查。为了检验中介作用,在控制向性伴侣披露 HIV 的情况下进行了多元线性回归。HIV 披露决策的自我效能感与抑郁症状呈负线性关系,并且该关系的 99%是由回避应对介导的。自我效能感对抑郁的中介指标表明存在小到中等效应。自我效能感越高,回避应对越少,而回避应对越少,抑郁症状越低,其他因素保持不变。这些发现强调了回避应对在解释 HIV 披露决策的自我效能感与抑郁之间关系中的作用。

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