Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA.
Department of Psychology, College of Arts and Sciences, University of Miami, Miami, Florida, USA.
AIDS Patient Care STDS. 2022 Sep;36(9):364-374. doi: 10.1089/apc.2022.0053. Epub 2022 Aug 30.
Black women living with HIV (BWLWH) face adversities, including discrimination (race, HIV, and gender related) and trauma. This study examines which latent profiles of resilience (R) and adversity (A) are most prevalent and their relationships to mental health among 119 BWLWH [age = 44.1 (standard deviation = 10.9)]. Questionnaires measured resilience (post-traumatic growth, trait/coping resilience, religious coping, social support), adversity (discrimination, trauma, microaggressions), and mental health [post-traumatic stress disorder (PTSD) symptoms, post-traumatic cognitions (PTC), and depressive symptoms]. Four salient profiles emerged through latent profile analysis and mental health differences were evaluated. Profile 1 (19.8%) reported lowest scores on 4 resilience measures, lowest traumas, and second lowest on discrimination (low resilience/low adversity-LR/LA). Profile 2 (13.8%) had second lowest on 3 resilience measures but second highest social support, highest/second highest on traumas and discrimination and microaggressions (low resilience/high adversity-LR/HA). Profile 3 (59.5%) exhibited higher scores on resilience and lowest scores on 3 of 4 adversity measures (high resilience/low adversity-HR/LA). Profile 4 (6.9%) reported high on 3 resilience measures, but third lowest on social support, and second highest/highest traumas, discrimination, and microaggressions (high resilience/high adversity-HR/HA). For PTC, the HR/LA group had significantly lower scores compared with the LR/LA and LR/HA groups; and LR/HA had higher PTC scores than the HR/HA group. PTSD scores were significantly lower for HR/LA than all profiles. Depression scores were significantly higher for LR/LA and LR/HA groups than HR/LA. Findings indicate that lower adversity alongside higher resilience leads to better mental health. Policies must address intersectional discrimination and prevent trauma impacting BWLWH; interventions are needed to improve social support and healing. Clinical Trial Registration number NCT02764853.
感染艾滋病毒的黑人女性（BWLWH）面临着各种逆境，包括歧视（种族、艾滋病毒和性别相关）和创伤。本研究调查了哪些弹性（R）和逆境（A）的潜在特征最普遍，以及它们与 119 名 BWLWH 的心理健康之间的关系[年龄=44.1（标准差=10.9）]。问卷调查了弹性（创伤后成长、特质/应对弹性、宗教应对、社会支持）、逆境（歧视、创伤、微侵犯）和心理健康[创伤后应激障碍（PTSD）症状、创伤后认知（PTC）和抑郁症状]。通过潜在特征分析得出了四个显著特征，并评估了心理健康差异。特征 1（19.8%）在 4 项弹性测量中得分最低，创伤最少，歧视得分第二低（低弹性/低逆境-LR/LA）。特征 2（13.8%）在 3 项弹性测量中得分第二低，但社会支持第二高，创伤和歧视以及微侵犯得分最高/第二高（低弹性/高逆境-LR/HA）。特征 3（59.5%）在弹性方面得分较高，在 4 项逆境测量中有 3 项得分最低（高弹性/低逆境-HR/LA）。特征 4（6.9%）在 3 项弹性测量中得分较高，但社会支持第三低，创伤、歧视和微侵犯第二高/最高（高弹性/高逆境-HR/HA）。对于 PTC，HR/LA 组的得分明显低于 LR/LA 和 LR/HA 组；而 LR/HA 组的 PTC 得分高于 HR/HA 组。PTSD 评分 HR/LA 组明显低于所有特征。抑郁评分 LR/LA 和 LR/HA 组明显高于 HR/LA 组。研究结果表明，较低的逆境和较高的弹性会导致更好的心理健康。政策必须解决交叉歧视问题，防止创伤影响 BWLWH；需要干预措施来改善社会支持和治疗。临床试验注册号 NCT02764853。
