Valverde Eduardo, Rodriguez Allan, White Becky, Guo Ying, Waldrop-Valverde Drenna
Division of Global HIV and TB, Centers for Disease Control and Prevention, Georgia.
Division of Infectious Diseases, University of Miami Miller School of Medicine, USA.
J HIV AIDS. 2018 Oct;4(3). doi: 10.16966/2380-5536.159. Epub 2018 Oct 4.
Internalized HIV stigma plays a detrimental role in terms of linkage to HIV care and adherence to antiretroviral treatment. Yet, little is known regarding the association of internalized HIV stigma with retention in HIV care. We conducted an analysis of interview and medical record abstraction data collected from 188 HIV positive men and women receiving HIV care in Miami, Florida. Demographic characteristics, HIV risk behaviors and care related factors were used to explore the association of internalized HIV stigma with retention in care in a Poisson regression analysis. The relationship of internalized HIV stigma and retention in care was moderated by the patient's level of engagement with an HIV care provider (p=0.004) in that higher levels of provider engagement were significantly associated with higher retention in care rates among patients with moderate levels of internalized HIV stigma. Additionally, retention in care rates were lower for females than for males and for 18-44 year olds than for individuals 44 years and older. Our findings indicate that higher levels of patient-provider engagement may reduce the impact that internalized HIV stigma has on retention in HIV care for some patients. Interventions with HIV care providers or patients to enhance patient-provider engagement may be beneficial.
内化的艾滋病耻辱感在与艾滋病护理的联系以及对抗逆转录病毒治疗的依从性方面起着有害作用。然而,关于内化的艾滋病耻辱感与艾滋病护理留存率之间的关联却知之甚少。我们对从佛罗里达州迈阿密接受艾滋病护理的188名艾滋病毒呈阳性的男性和女性收集的访谈及病历摘要数据进行了分析。在泊松回归分析中,使用人口统计学特征、艾滋病毒风险行为和护理相关因素来探讨内化的艾滋病耻辱感与护理留存率之间的关联。内化的艾滋病耻辱感与护理留存率之间的关系受到患者与艾滋病护理提供者的参与程度的调节(p = 0.004),即对于内化的艾滋病耻辱感处于中等水平的患者,较高的提供者参与程度与较高的护理留存率显著相关。此外,女性的护理留存率低于男性,18 - 44岁人群的护理留存率低于44岁及以上人群。我们的研究结果表明,较高水平的患者 - 提供者参与度可能会降低内化的艾滋病耻辱感对某些患者艾滋病护理留存率的影响。对艾滋病护理提供者或患者进行干预以提高患者 - 提供者参与度可能会有益。