Department of Psychology, College of Arts and Sciences, University of Alabama at Birmingham, Birmingham, AL.
J Acquir Immune Defic Syndr. 2018 May 1;78(1):9-15. doi: 10.1097/QAI.0000000000001636.
People living with HIV (PLWH) have higher levels of tobacco use compared with the general population, increasing their risk of morbidity and mortality. PLWH also face potential chronic stressors related to the stigma and discrimination associated with HIV and other characteristics (eg, race and sexual orientation). These experiences may be associated with harmful health behaviors, such as tobacco use. The purpose of the current study is to explore the psychosocial context of tobacco use in PLWH, examining avoidance coping as a mediator in the relationship between multiple forms of discrimination and tobacco use.
Participants included 202 PLWH recruited from an HIV primary care clinic in Birmingham, AL, between 2013 and 2015.
Participants responded to parallel items assessing experiences of discrimination related to HIV status, race, and sexual orientation, as well as items assessing avoidance coping. Data on current tobacco use were obtained from participants' clinic records. Mediation models for each form of discrimination (HIV, race and sexual orientation) adjusting for demographic variables and the other forms of discrimination were evaluated.
The indirect effect of HIV-related discrimination on likelihood of tobacco use through avoidance coping was significant, suggesting that avoidance coping mediates the association between HIV-related discrimination and tobacco use. However, the indirect effects of the other forms of discrimination were not significant.
Given the disparity in tobacco use in PLWH, behavioral scientists and interventionists should consider including content specific to coping with experiences of discrimination in tobacco prevention and cessation programs for PLWH.
与普通人群相比，感染艾滋病毒的人（PLWH）的烟草使用水平更高，增加了他们发病和死亡的风险。PLWH 还面临与艾滋病毒和其他特征（如种族和性取向）相关的耻辱和歧视相关的潜在慢性压力源。这些经历可能与有害的健康行为有关，如吸烟。本研究的目的是探讨 PLWH 中烟草使用的心理社会背景，研究回避应对作为多种形式歧视与烟草使用之间关系的中介。
参与者包括 2013 年至 2015 年间从阿拉巴马州伯明翰的 HIV 初级保健诊所招募的 202 名 PLWH。
参与者对与 HIV 状况、种族和性取向相关的歧视经历的平行项目做出回应，以及回避应对的项目。目前吸烟的数据是从参与者的临床记录中获得的。评估了调整人口统计学变量和其他形式歧视的每种歧视形式（HIV、种族和性取向）的中介模型。
HIV 相关歧视通过回避应对对烟草使用可能性的间接影响是显著的，这表明回避应对中介了 HIV 相关歧视与烟草使用之间的关系。然而，其他形式歧视的间接影响并不显著。
鉴于 PLWH 中吸烟的差异，行为科学家和干预者应考虑在针对 PLWH 的烟草预防和戒烟计划中纳入针对应对歧视经历的内容。
