Center for Population Sciences and Health Equity College of Social Work, Florida State University, FL.
Institute for Sexual and Gender Minority Health and Wellbeing, Center for Population Sciences and Health Equity, Northwestern University, Florida State University, FL.
J Acquir Immune Defic Syndr. 2023 Jan 1;92(1):59-66. doi: 10.1097/QAI.0000000000003099.
To elucidate how and in what ways cumulative violence affects health-related quality of life (HRQoL) among a clinical cohort of virally stable people living with HIV.
We used data from the University of North Carolina Center for AIDS Research HIV clinical cohort. Our analysis was limited to participants with an undetectable viral load (<200) and those who completed the Clinical, Sociodemographic, and Behavioral Survey between 2008 and 2017 ( n = 284).
A path analysis was used to test our primary hypothesis that the effect of cumulative violence on HRQoL would be mediated through symptoms of post-traumatic stress disorder (PTSD), depressive symptoms, and HIV symptom distress.
The impact of cumulative violence on HRQoL was fully mediated by symptoms of PTSD, depressive symptoms, and HIV symptom distress. Greater exposure to violence was associated with higher odds of PTSD symptoms ( P <0.001), increased depressive symptoms ( P <0.001), and increased HIV symptom distress ( P < 0.01). HIV symptom distress displayed the largest association with HRQoL ( P < 0.001), followed by depressive symptoms ( P = 0.001) and PTSD symptoms ( P < 0.001). These factors explained approximately 51% of the variance in HRQoL ( R2 = 0.51, P < 0.001).
Our findings indicate that addressing physical and mental health symptoms rooted in violent victimization should be a point of focus in efforts to improve HRQoL among people living with HIV who are virally stable.
阐明在感染艾滋病毒的临床稳定人群中，累积暴力是如何以及以何种方式影响与健康相关的生活质量（HRQoL）。
我们使用了北卡罗来纳大学艾滋病研究中心艾滋病毒临床队列的数据。我们的分析仅限于病毒载量不可检测（<200）且在 2008 年至 2017 年间完成临床、社会人口统计学和行为调查的参与者（n=284）。
路径分析用于检验我们的主要假设，即累积暴力对 HRQoL 的影响将通过创伤后应激障碍（PTSD）、抑郁症状和 HIV 症状困扰的症状来介导。
累积暴力对 HRQoL 的影响完全通过 PTSD 症状、抑郁症状和 HIV 症状困扰来介导。更多的暴力暴露与 PTSD 症状（P<0.001）、抑郁症状增加（P<0.001）和 HIV 症状困扰增加（P<0.01）的几率增加相关。HIV 症状困扰与 HRQoL 的关联最大（P<0.001），其次是抑郁症状（P=0.001）和 PTSD 症状（P<0.001）。这些因素解释了 HRQoL 约 51%的方差（R2=0.51，P<0.001）。
我们的研究结果表明，解决与暴力受害有关的身心症状应该是提高病毒稳定的艾滋病毒感染者 HRQoL 的重点。
