Mitzel Luke D, Foley Jacklyn D, Sweeney Shannon M, Park Aesoon, Vanable Peter A
Department of Psychology, Syracuse University.
Behav Med. 2021 Jan-Mar;47(1):40-50. doi: 10.1080/08964289.2019.1629386. Epub 2019 Jul 10.
HIV-related stigma and beliefs about medication necessity and concerns have separately demonstrated significant associations with antiretroviral adherence in people with HIV. However, no work has examined both of these associations in the same model. Based on the necessity-concerns framework, this study examined four alternative models of relationships among HIV-related stigma, medication beliefs, and adherence. Cross-sectional analyses were used to test the four alternative models to best depict associations among HIV-related stigma, medication beliefs, and medication adherence. Models tested included two indirect effects models, an interaction model, and a simple predictors model with no interaction or indirect effects. The outcome variable was HIV medication adherence, and model fit was determined by variance accounted for, Akaike information criterion (AIC), and Bayesian information criterion (BIC) values. An interaction model between internalized stigma and medication concerns accounted for the most variance in adherence. There was also a significant indirect effect of internalized stigma on adherence via medication concerns. Medication concerns are a promising target for interventions focusing on increasing adherence among people with HIV.
与艾滋病病毒相关的耻辱感以及对药物必要性和担忧的观念，已分别证明与艾滋病病毒感染者的抗逆转录病毒治疗依从性存在显著关联。然而，尚无研究在同一模型中考察这两种关联。基于必要性-担忧框架，本研究考察了与艾滋病病毒相关的耻辱感、用药观念和依从性之间关系的四种替代模型。采用横断面分析来检验这四种替代模型，以最佳描述与艾滋病病毒相关的耻辱感、用药观念和药物治疗依从性之间的关联。所检验的模型包括两个间接效应模型、一个交互作用模型和一个无交互作用或间接效应的简单预测模型。结果变量为艾滋病病毒药物治疗依从性，模型拟合度由方差解释率、赤池信息准则（AIC）和贝叶斯信息准则（BIC）值确定。内化耻辱感与用药担忧之间的交互作用模型在依从性方面解释的方差最多。内化耻辱感通过用药担忧对依从性也有显著的间接效应。用药担忧是旨在提高艾滋病病毒感染者依从性的干预措施的一个有前景的目标。
