Miller Robin Lin, Lee Kyung-Sook, Chiaramonte Danielle, Santiago-Rivera Olga J, Acevedo-Polakovich Ignacio, Boyer Cherrie B, Ellen Jonathan M
Michigan State University.
UCSF.
Vulnerable Child Youth Stud. 2018;13(2):142-157. doi: 10.1080/17450128.2017.1371818. Epub 2017 Sep 4.
We assessed the relationships among HIV-related social and behavioral outcomes resulting from an adolescent-focused HIV structural change initiative in eight urban sites operating Connect to Protect (C2P) coalitions. Over a 4-year period, annual cross-sectional panels of adolescents (N = 2,248) completed an audio-computer-assisted interview, providing data on satisfaction with their communities as adolescent-supportive environments, internalized HIV stigma, lifetime HIV-testing, lifetime sexual risk-taking, and number of sexual partners in the prior year. We used structural equation modeling to estimate hypothesized links between time since coalition mobilization to our social and behavioral outcomes. Over the 4 years, adolescents perceived their communities to become more supportive (p < .05). Positive perceptions of community support were associated with lower lifetime HIV sexual risk (p < .05). The effect of time on risk behavior was mediated by perceptions of community support. Stigma was unchanged over time. Stigma had damaging effects on risk behavior, effects which were also mediated by perceptions of community support. Special efforts are needed to address the deleterious effect of HIV stigma on high-risk urban adolescents.
我们评估了在八个开展“连接以保护”（C2P）联盟的城市地区，一项以青少年为重点的艾滋病病毒结构变革倡议所产生的与艾滋病病毒相关的社会和行为结果之间的关系。在四年时间里，青少年年度横断面样本（N = 2248）完成了一次音频计算机辅助访谈，提供了有关他们对作为青少年支持性环境的社区的满意度、内化的艾滋病病毒耻辱感、终身艾滋病病毒检测、终身性风险行为以及上一年性伴侣数量的数据。我们使用结构方程模型来估计从联盟动员开始的时间与我们的社会和行为结果之间的假设联系。在这四年中，青少年认为他们的社区变得更具支持性（p < 0.05）。对社区支持的积极看法与较低的终身艾滋病病毒性风险相关（p < 0.05）。时间对风险行为的影响是通过对社区支持的看法来介导的。耻辱感随时间没有变化。耻辱感对风险行为有破坏性影响，这种影响也通过对社区支持的看法来介导。需要做出特别努力来解决艾滋病病毒耻辱感对城市高危青少年的有害影响。
