Fred Hutchinson Cancer Research Center, Seattle, USA.
Department of Global Health, University of Washington, Seattle, USA.
AIDS Behav. 2019 Mar;23(3):661-674. doi: 10.1007/s10461-018-2348-2.
Experiencing HIV-related stigma has important impacts on the mental health of people living with HIV, which has implications for treatment adherence, disease progression, and health outcomes. The impacts of stigma are particularly important to consider among sexual and gender minorities, who often face a disproportionate burden of HIV. To address the implications of stigma in these key populations, we leveraged a longitudinal study conducted among Peruvian sexual and gender minorities to compare the relative effects of multiple mediators affecting the relationship between experienced HIV-related stigma and psychological distress: internalized HIV-related stigma, adaptive coping, and maladaptive coping. HIV-related stigma, coping, and distress were measured, respectively, at 24 weeks, 36 weeks, and 48 weeks post-diagnosis for 145 participants from the Sabes Study. HIV-related maladaptive coping largely mediated the relationship between experienced HIV-related stigma and distress. Our findings suggest interventions targeting maladaptive coping may alleviate the mental health consequences of experiencing HIV-related stigma.
经历与 HIV 相关的污名对 HIV 感染者的心理健康有重要影响,这对治疗依从性、疾病进展和健康结果都有影响。污名的影响在性少数群体和性别少数群体中尤为重要,他们往往面临不成比例的 HIV 负担。为了解决这些关键人群中污名的影响,我们利用在秘鲁性少数群体和性别少数群体中进行的一项纵向研究,比较了影响经历与 HIV 相关的污名和心理困扰之间关系的多种中介因素的相对影响:与 HIV 相关的内化污名、适应性应对和适应性应对。在 Sabes 研究中,对 145 名参与者在诊断后 24 周、36 周和 48 周分别测量了与 HIV 相关的污名、应对和困扰。与 HIV 相关的适应不良应对在很大程度上介导了经历与 HIV 相关的污名与困扰之间的关系。我们的研究结果表明,针对适应不良应对的干预措施可能减轻经历与 HIV 相关的污名的心理健康后果。