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HIV 护理患者中社会支持不足的影响及其相关性。

Impact and correlates of sub-optimal social support among patients in HIV care.

机构信息

Medicine, University of Washington, Seattle, WA, USA.

Internal Medicine, Wake Forest Baptist Health, Winston-Salem, NC, USA.

出版信息

AIDS Care. 2021 Sep;33(9):1178-1188. doi: 10.1080/09540121.2020.1853660. Epub 2021 Jan 14.

Abstract

Social support (SS) predicts health outcomes among patients living with HIV. We administered a brief, validated measure of SS, the Multifactoral Assessment of Perceived Social Support, within a patient-reported outcomes assessment of health domains in HIV care at 4 U.S. clinics in English and Spanish ( = 708). In univariate analysis, low SS was associated with poorer engagement in care, antiretroviral adherence, and health-related quality of life; current methamphetamine/crystal use, depression, anxiety, and HIV stigma (all  < 0.001); any use of either methamphetamines/crystal, illicit opioids, or cocaine/crack ( = 0.001), current marijuana use ( = 0.012), nicotine use ( = 0.005), and concern for sexually transmitted infection exposure ( = 0.001). High SS was associated with undetectable viral load ( = 0.031). Multivariate analyses found low SS independently associated with depression (risk ratio (RR) 3.72, 95% CI 2.93-4.72), lower adherence (RR 0.76, 95% CI 0.64-0.89), poor engagement in care (RR 2.05, 95% CI 1.44-2.96), and having more symptoms (RR 2.29, 95% CI 1.92-2.75). Medium SS was independently associated with depression (RR 2.59, 95% CI 2.00-3.36), poor engagement in care (RR 1.62, 95% CI 1.15-2.29) and having more symptoms (RR 1.75, 95% CI 1.44-2.13). SS assessment may help identify patients at risk for these outcomes.

摘要

社会支持(SS)可预测 HIV 感染者的健康结果。我们在美国 4 家诊所的 HIV 护理患者报告的健康评估中,以英语和西班牙语实施了一种简短的、经过验证的 SS 测量方法,即多因素感知社会支持评估(Multifactoral Assessment of Perceived Social Support),共纳入 708 名患者。在单变量分析中,低 SS 与较差的治疗依从性、抗逆转录病毒治疗依从性和健康相关生活质量相关;当前使用冰毒/冰毒、抑郁、焦虑和 HIV 耻辱感(均 < 0.001);任何一种冰毒/冰毒、非法阿片类药物或可卡因/快克的使用( = 0.001)、当前大麻使用( = 0.012)、尼古丁使用( = 0.005)和对性传播感染风险的关注( = 0.001)相关。高 SS 与不可检测的病毒载量相关( = 0.031)。多变量分析发现,低 SS 与抑郁(风险比(RR)3.72,95%置信区间(CI)2.93-4.72)、较低的治疗依从性(RR 0.76,95% CI 0.64-0.89)、较差的治疗参与(RR 2.05,95% CI 1.44-2.96)和更多症状(RR 2.29,95% CI 1.92-2.75)独立相关。中等 SS 与抑郁(RR 2.59,95% CI 2.00-3.36)、较差的治疗参与(RR 1.62,95% CI 1.15-2.29)和更多症状(RR 1.75,95% CI 1.44-2.13)独立相关。SS 评估可能有助于识别存在这些结果风险的患者。

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