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与 iENGAGE 新入 HIV 护理队列患者的 HIV 披露状况相关的因素。

Factors Associated with HIV Disclosure Status Among iENGAGE Cohort of New to HIV Care Patients.

机构信息

Department of Pathology, University of Alabama at Birmingham, Birmingham, Alabama.

Department of Epidemiology, and University of Alabama at Birmingham, Birmingham, Alabama.

出版信息

AIDS Patient Care STDS. 2020 May;34(5):213-227. doi: 10.1089/apc.2019.0271.

Abstract

HIV disclosure is an important behavior with implications for HIV treatment and prevention but understudied among new to HIV care patients who face unique challenges adjusting to a new diagnosis. This study evaluated the factors associated with HIV disclosure status and patterns of HIV disclosure among new to HIV care patients. A cross-sectional study was conducted evaluating the iENGAGE (integrating ENGagement and Adherence Goals upon Entry) cohort. Participants were enrolled in this randomized behavioral trial between December 2013 and June 2016. The primary and secondary outcomes included HIV disclosure status (Yes/No) and patterns of disclosure (Broad, Selective and Nondisclosure), respectively. Logistic and Multinomial Logistic Regression were used to evaluate the association of participant factors with HIV disclosure and patterns of HIV disclosure, respectively. Of 371 participants, the average age was 37 ± 12 years, 79.3% were males, and 62.3% were African Americans. A majority of participants (78.4%) disclosed their HIV status at baseline, 63.1% were broad disclosers and 15.2% were selective disclosers. In multivariable regression, black race, emotional support, and unmet needs predicted any HIV and broad disclosure, whereas males, emotional support, active coping, and acceptance were associated with selective disclosure. Interventions to promote early disclosure should focus on coping strategies and unmet needs, particularly among black and male people living with HIV initiating care.

摘要

HIV 披露是一种重要的行为,对 HIV 的治疗和预防有影响,但在新接受 HIV 护理的患者中研究不足,他们在适应新诊断时面临独特的挑战。本研究评估了与新接受 HIV 护理的患者 HIV 披露状况和披露模式相关的因素。进行了一项横断面研究,评估了 iENGAGE(整合 ENGagement 和 Adherence Goals upon Entry)队列。参与者于 2013 年 12 月至 2016 年 6 月期间参加了这项随机行为试验。主要和次要结局分别包括 HIV 披露状况(是/否)和披露模式(广泛、选择性和不披露)。Logistic 和多变量 Logistic 回归分别用于评估参与者因素与 HIV 披露和 HIV 披露模式的关联。在 371 名参与者中,平均年龄为 37±12 岁,79.3%为男性,62.3%为非裔美国人。大多数参与者(78.4%)在基线时披露了他们的 HIV 状况,63.1%是广泛披露者,15.2%是选择性披露者。在多变量回归中,黑种人、情感支持和未满足的需求预测了任何 HIV 和广泛披露,而男性、情感支持、积极应对和接受与选择性披露相关。促进早期披露的干预措施应侧重于应对策略和未满足的需求,特别是在开始接受护理的黑人和男性 HIV 感染者中。

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