College of Nursing, University of Colorado Anschutz Medical Campus, 13120 E 19th Ave, C288, Aurora, CO, 80045, USA.
School of Nursing, Columbia University, New York, NY, 10032, USA.
AIDS Behav. 2020 Sep;24(9):2656-2665. doi: 10.1007/s10461-020-02823-3.
Little is known about how engagement with healthcare providers mediates the relationship between psychosocial factors (anxiety, depression, stigma) and medication adherence among persons living with HIV (PLWH). Moreover, little research has investigated potential biological sex differences in this relationship. We conducted a secondary analysis of data collected from four projects (N = 281) focused on improving health outcomes in PLWH. Males displayed (a) negative association between depression and engagement with healthcare providers (β = - 0.02, z = - 3.20, p = 0.001) and (b) positive association between engagement with healthcare providers and medication adherence (β = 0.55, OR = 1.73, z = 2.62, p = 0.009). Females showed no association between any of these factors. Anxiety and stigma were not significantly associated with medication adherence. Path analysis modeling for males had a very good fit (CFI = 1, TLI = 1, RMSEA = 0); none of the regression coefficients was significant for females. The significant relationship between depression and medication adherence among males was fully mediated by engagement with healthcare providers. Findings suggest that adherence interventions for PLWH should be tailored by biological sex.
目前对于医疗服务提供者的参与如何调节艾滋病毒感染者（PLWH）的心理社会因素（焦虑、抑郁、耻辱感）与药物依从性之间的关系知之甚少。此外，很少有研究调查这种关系中潜在的生物学性别差异。我们对四个专注于改善 PLWH 健康结果的项目（N=281）收集的数据进行了二次分析。男性表现出（a）抑郁与与医疗服务提供者的参与之间的负相关（β=-0.02，z=-3.20，p=0.001）和（b）与医疗服务提供者的参与和药物依从性之间的正相关（β=0.55，OR=1.73，z=2.62，p=0.009）。女性在这些因素之间没有任何关联。焦虑和耻辱感与药物依从性没有显著关联。男性的路径分析模型拟合度非常好（CFI=1，TLI=1，RMSEA=0）；女性的回归系数均不显著。男性抑郁与药物依从性之间的显著关系完全由与医疗服务提供者的参与来介导。研究结果表明，针对 PLWH 的依从性干预措施应根据生物学性别进行调整。
