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HIV 污名与新诊断出 HIV 的男同性恋、双性恋和其他男男性行为者之间基于性取向的医疗不信任之间的社会支持的中介作用。

The mediating role of social support between HIV stigma and sexual orientation-based medical mistrust among newly HIV-diagnosed gay, bisexual, and other men who have sex with men.

机构信息

Center for AIDS Prevention Studies, Department of Medicine, University of California, San Francisco, CA, USA.

Department of Emergency Medicine, University of Colorado, Aurora, CO, USA.

出版信息

AIDS Care. 2023 May;35(5):696-704. doi: 10.1080/09540121.2022.2119472. Epub 2022 Oct 7.

Abstract

HIV-related stigma and medical mistrust are significant challenges to addressing HIV inequities among gay, bisexual, and other men who have sex with men (MSM). HIV-related stigma is associated with high levels of medical mistrust, but there is limited knowledge regarding the mechanisms that link these variables. We examined the potential mediating roles of social support and coping in the relationship between perceived HIV stigma and sexual orientation based-medical mistrust among newly HIV-diagnosed MSM. We hypothesized that HIV-related stigma would be associated with mistrust and that social support, and coping would mediate this relationship. Data were obtained from 202 newly HIV-diagnosed (<1 year) MSM receiving care at community HIV clinics in New York. A path model indicated that HIV stigma was directly related to greater sexual orientation based medical mistrust, and that this relationship was mediated by social support. However, coping did not mediate the relationship between HIV stigma and mistrust. Efforts to increase social support and decrease stigma are critical for strengthening relationships between MSM and HIV care networks. Future research should assess the feasibility of designing and implementing interventions focused on increasing social network support and improving trust in the medical community among newly HIV-diagnosed MSM.

摘要

HIV 相关的耻辱感和对医疗的不信任是解决男同性恋、双性恋和其他与男性发生性关系的男性(MSM)中 HIV 不平等问题的重大挑战。HIV 相关的耻辱感与高度的医疗不信任有关,但对于将这些变量联系起来的机制知之甚少。我们研究了在新诊断为 HIV 的 MSM 中,感知到的 HIV 耻辱感与基于性取向的医疗不信任之间,社会支持和应对方式在其中的潜在中介作用。我们假设 HIV 相关的耻辱感与不信任有关,而社会支持和应对方式则会调节这种关系。数据来自于纽约社区 HIV 诊所接受治疗的 202 名新诊断为 HIV 的(<1 年)MSM。路径模型表明,HIV 耻辱感与更大的基于性取向的医疗不信任直接相关,而这种关系是由社会支持介导的。然而,应对方式并不能调节 HIV 耻辱感和不信任之间的关系。增加社会支持和减少耻辱感的努力对于加强 MSM 与 HIV 护理网络之间的关系至关重要。未来的研究应该评估设计和实施干预措施的可行性,这些干预措施侧重于增加新诊断为 HIV 的 MSM 的社交网络支持,并提高他们对医疗社区的信任。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0242/10079779/28f9e46c38d5/nihms-1835177-f0001.jpg

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