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艾滋病毒感染者预期的耻辱感与药物依从性：药物支持和抗逆转录病毒疗法自我效能感的作用机制

Anticipated stigma and medication adherence among people living with HIV: the mechanistic roles of medication support and ART self-efficacy.

作者信息

Zeng Chengbo, Li Xiaoming, Qiao Shan, Yang Xueying, Shen Zhiyong, Zhou Yuejiao

机构信息

South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.

Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.

出版信息

AIDS Care. 2020 Aug;32(8):1014-1022. doi: 10.1080/09540121.2020.1728213. Epub 2020 Apr 26.

DOI:10.1080/09540121.2020.1728213
PMID:32336130
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7368809/
Abstract

This study aimed to examine the relationship between anticipated stigma and medication adherence as well as the mechanistic roles of medication support and ART self-efficacy. Data were derived from the baseline assessment of a prospective cohort study in Guangxi, China. A total of 1198 PLWH were recruited and assessed on their sociodemographic characteristics, medication adherence, anticipated stigma, medication support, and ART self-efficacy. Path analysis was used to examine the direct effect from anticipated stigma to medication adherence and indirect effects through medication support and ART self-efficacy. Path model revealed that the indirect effect from anticipated stigma to medication adherence was statistically significant while the direct effect was not significant. Anticipated stigma could influence medication adherence through ART self-efficacy but not through medication support. The serial mediating effect of medication support and ART self-efficacy on the relationship between anticipated stigma and medication adherence was significant. Anticipated stigma affects medication adherence among PLWH through its adverse impact on medication support and ART self-efficacy. Tailored interventions promoting medication support and ART self-efficacy may alleviate the negative influence of anticipated stigma on medication adherence among PLWH. Additionally, policy efforts aiming to reduce stigma against PLWH and increasing medication support are warranted to improve medication adherence among PLWH.

摘要

本研究旨在探讨预期污名与服药依从性之间的关系，以及药物支持和抗逆转录病毒治疗自我效能感的作用机制。数据来源于中国广西一项前瞻性队列研究的基线评估。共招募了1198名艾滋病毒感染者，并对他们的社会人口学特征、服药依从性、预期污名、药物支持和抗逆转录病毒治疗自我效能感进行了评估。采用路径分析来检验预期污名对服药依从性的直接效应，以及通过药物支持和抗逆转录病毒治疗自我效能感的间接效应。路径模型显示，预期污名对服药依从性的间接效应具有统计学意义，而直接效应不显著。预期污名可通过抗逆转录病毒治疗自我效能感影响服药依从性，但不能通过药物支持。药物支持和抗逆转录病毒治疗自我效能感在预期污名与服药依从性之间的系列中介效应显著。预期污名通过对药物支持和抗逆转录病毒治疗自我效能感的不利影响，影响艾滋病毒感染者的服药依从性。针对性地促进药物支持和抗逆转录病毒治疗自我效能感的干预措施，可能会减轻预期污名对艾滋病毒感染者服药依从性的负面影响。此外，有必要通过政策努力减少对艾滋病毒感染者的污名，并增加药物支持，以提高艾滋病毒感染者的服药依从性。

相似文献

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[2]
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[3]
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[4]
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[5]
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[6]
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[8]
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引用本文的文献

[1]
Self-perceived stigma in people living with HIV in Spain: a mixed-methods study.

Infez Med. 2025-6-1

[2]
Correlates of internalized stigma and antiretroviral therapy adherence among people living with HIV in the Volta region of Ghana.

BMC Public Health. 2025-1-27

[3]
Associations of stigma, loneliness, and treatment self-regulation with HIV medication adherence among individuals with substance use disorder using a mobile health application.

Front Public Health. 2024

[4]
Adaptation and validation of the Adherence Barriers Questionnaire for HIV Patients on Antiretroviral Therapy (ABQ-HIV) for the Brazilian context.

Cad Saude Publica. 2024

[5]
Adherence to antiretroviral therapy among cisgender gay, bisexual and other men who have sex with men in Brazil: Evaluating the role of HIV-related stigma dimensions.

PLoS One. 2024-8-8

[6]
Stigma and fear of getting sick in the care of people living with HIV: an exploratory systematic review.

Infez Med. 2024-6-1

[7]
What may encourage or deter health services utilization by people living with or at the risk of HIV/AIDS in special health centers? Qualitative evidence from a stigmatized community.

BMC Public Health. 2024-4-8

[8]
Relationship between self-efficacy and adherence to antiretroviral therapy in HIV/AIDS patients: An analytical cross-sectional study in southern Iran.

Health Sci Rep. 2024-2-8

[9]
How Does Anticipated HIV Stigma Affect Medication Adherence? A Longitudinal Path Analysis Model.

AIDS Behav. 2024-5

[10]
Adaptation and validation of a TB stigma scale for adolescents in Lima, Peru.

Int J Tuberc Lung Dis. 2023-10-1

本文引用的文献

[1]
HIV-Related Stigma, Motivation to Adhere to Antiretroviral Therapy, and Medication Adherence Among HIV-Positive Methadone-Maintained Patients.

J Acquir Immune Defic Syndr. 2019-2-1

[2]
A structural equation model of perceived and internalized stigma, depression, and suicidal status among people living with HIV/AIDS.

BMC Public Health. 2018-1-15

[3]
Is patient empowerment the key to promote adherence? A systematic review of the relationship between self-efficacy, health locus of control and medication adherence.

PLoS One. 2017-10-17

[4]
Influence of Side Effects on ART Adherence Among PLWH in China: The Moderator Role of ART-Related Knowledge.

AIDS Behav. 2018-3

[5]
A Note on Testing Mediated Effects in Structural Equation Models: Reconciling Past and Current Research on the Performance of the Test of Joint Significance.

Educ Psychol Meas. 2016-12

[6]
How Does Stigma Affect People Living with HIV? The Mediating Roles of Internalized and Anticipated HIV Stigma in the Effects of Perceived Community Stigma on Health and Psychosocial Outcomes.

AIDS Behav. 2017-1

[7]
Social support and moment-to-moment changes in treatment self-efficacy in men living with HIV: Psychosocial moderators and clinical outcomes.

Health Psychol. 2016-10

[8]
Side effects, adherence self-efficacy, and adherence to antiretroviral treatment: a mediation analysis in a Chinese sample.

AIDS Care. 2016-7

[9]
Self-report measures of medication adherence behavior: recommendations on optimal use.

Transl Behav Med. 2015-12

[10]
Task shifting of HIV/AIDS case management to Community Health Service Centers in urban China: a qualitative policy analysis.

BMC Health Serv Res. 2015-7-2

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