Molina Yamilé, Ulrich Angela, Greer Anna C, Primbas Angela, Wandell Grace, Sanchez Hugo, Bain Carolyn, Konda Kelika A, Clark Jesse L, De la Grecca Robert, Villarán Manuel V, Pasalar Siavash, Lama Javier R, Duerr Ann C
a Community Health Sciences, Center for Research on Women and Gender , University of Illinois at Chicago , Chicago , IL , USA.
b Cancer Center, Center for Research on Women and Gender , University of Illinois at Chicago , Chicago , IL , USA.
AIDS Care. 2019 Jul;31(7):848-856. doi: 10.1080/09540121.2018.1563282. Epub 2019 Jan 7.
A substantial body of literature has characterized how psychosocial factors, including HIV-related stigma and coping, are associated with HIV testing and HIV care utilization post-diagnosis. Less is known about if certain psychosocial characteristics pre-diagnosis may also predict linkage to care among individuals who receive an HIV-positive diagnosis. We examined if pre-diagnosis awareness/perception about HIV-related stigma and dispositional coping styles predicted linkage to HIV care within three months post-diagnosis with a secondary analysis of 604 patients from a randomized controlled trial (Sabes Study). Awareness/perception about HIV-related stigma, dispositional maladaptive and adaptive coping were measured before patients underwent an HIV test. Linkage to care was measured as receipt of care within three months of receiving the diagnosis. After adjusting for covariates, individuals who reported greater dispositional maladaptive coping pre-diagnosis had lower odds of linking to care, OR = 0.82, 95%CI [0.67, 1.00], p = .05. There was also a non-significant inverse association between dispositional adaptive coping pre-diagnosis and linkage to care. These preliminary data suggest the need for further longitudinal research and highlight the potential utility of pre-diagnosis psychosocial assessment and tailored counseling when providing positive HIV diagnosis results.
大量文献描述了包括与艾滋病毒相关的耻辱感和应对方式在内的社会心理因素如何与艾滋病毒检测以及确诊后的艾滋病毒治疗利用情况相关联。对于确诊前的某些社会心理特征是否也能预测艾滋病毒检测呈阳性的个体与治疗的联系,我们所知较少。我们通过对一项随机对照试验(萨贝斯研究)中的604名患者进行二次分析,研究了确诊前对与艾滋病毒相关耻辱感的认知/感知以及性格应对方式是否能预测确诊后三个月内与艾滋病毒治疗的联系。在患者进行艾滋病毒检测之前,测量其对与艾滋病毒相关耻辱感的认知/感知、性格上的适应不良和适应应对方式。与治疗的联系以确诊后三个月内接受治疗来衡量。在对协变量进行调整后,报告确诊前性格上适应不良应对方式较多的个体与治疗建立联系的几率较低,比值比(OR)=0.82,95%置信区间[0.67, 1.00],p=0.05。确诊前性格上的适应应对方式与治疗联系之间也存在非显著的负相关。这些初步数据表明需要进一步开展纵向研究,并突出了在提供艾滋病毒阳性诊断结果时进行确诊前社会心理评估和针对性咨询的潜在效用。