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赞比亚感染艾滋病毒的年轻人中,感知到的、内化的和表现出的艾滋病毒耻辱感与药物依从性、依从性障碍及心理健康之间的关联

The Association of Perceived, Internalized, and Enacted HIV Stigma With Medication Adherence, Barriers to Adherence, and Mental Health Among Young People Living With HIV in Zambia.

作者信息

Masa Rainier, Zimba Mathias, Tamta Mohit, Zimba Gilbert, Zulu Graham

机构信息

School of Social Work, University of North Carolina, Chapel Hill, NC.

Global Social Development Innovations, University of North Carolina, at Chapel Hill, NC.

出版信息

Stigma Health. 2022 Nov;7(4):443-453. doi: 10.1037/sah0000404. Epub 2022 Aug 4.


DOI:10.1037/sah0000404
PMID:36408093
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9673916/
Abstract

Few studies have examined the independent effects of different manifestations of HIV stigma experiences on health outcomes among youth living with HIV in low- and middle-income countries. We examined the association of internalized, enacted, and perceived HIV stigmas with medication adherence, self-esteem, depression, and barriers to adherence. Young people living with HIV aged 18-21 years ( = 120) were purposively sampled from two health facilities in Eastern Province, Zambia, and completed self-report measures. Results indicated heterogeneous associations. Internalized HIV stigma was positively associated with depression and negatively associated with adherence, adherence motivation, behavioral adherence skills, and self-esteem. Perceived stigma was negatively associated with self-esteem. No significant association was observed between enacted stigma and health outcomes. The complexity of HIV stigma requires a precise explication of the associations among different HIV stigma experiences and outcomes, which can inform the development of stigma reduction interventions targeting one or more stigma experiences.

摘要

很少有研究考察在低收入和中等收入国家中,感染艾滋病毒的青少年所经历的不同形式的艾滋病毒污名化对健康结果的独立影响。我们研究了内化污名、遭受的污名和感知到的艾滋病毒污名与药物依从性、自尊、抑郁以及依从性障碍之间的关联。从赞比亚东部省的两个医疗机构中,有目的地抽取了18至21岁的120名感染艾滋病毒的年轻人,并让他们完成了自我报告测量。结果显示出不同的关联。内化的艾滋病毒污名与抑郁呈正相关,与依从性、依从动机、行为依从技能和自尊呈负相关。感知到的污名与自尊呈负相关。在遭受的污名与健康结果之间未观察到显著关联。艾滋病毒污名的复杂性需要对不同的艾滋病毒污名经历与结果之间的关联进行精确阐释,这可为针对一种或多种污名经历的减少污名干预措施的制定提供信息。

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The Association of Perceived, Internalized, and Enacted HIV Stigma With Medication Adherence, Barriers to Adherence, and Mental Health Among Young People Living With HIV in Zambia.

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[8]
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[10]
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本文引用的文献

[1]
Intersections of financial agency, gender dynamics, and HIV risk: A qualitative study with adolescent girls and young women in Zambia.

Glob Public Health. 2022-8

[2]
Defining the optimal cut-point of self-reported ART adherence to achieve viral suppression in the era of contemporary HIV therapy: a cross-sectional study.

AIDS Res Ther. 2021-6-26

[3]
Dimensions of HIV-related stigma in rural communities in Kenya and Uganda at the start of a large HIV 'test and treat' trial.

PLoS One. 2021

[4]
The Association between HIV-Stigma and Depressive Symptoms among People Living with HIV/AIDS: A Systematic Review of Studies Conducted in South Africa.

J Affect Disord. 2021-5-15

[5]
An Adaptable Framework for Factors Contributing to Medication Adherence: Results from a Systematic Review of 102 Conceptual Frameworks.

J Gen Intern Med. 2021-9

[6]
Self-Esteem Assessment among Adolescents Living with HIV and Seeking Healthcare at Komfo Anokye Teaching Hospital-Kumasi, Ghana.

J Int Assoc Provid AIDS Care. 2020

[7]
Pathways to Depression and Poor Quality of Life Among Adolescents in Western Kenya: Role of Anticipated HIV Stigma, HIV Risk Perception, and Sexual Behaviors.

AIDS Behav. 2021-5

[8]
Multiple forms of discrimination and internalized stigma compromise retention in HIV care among adolescents: findings from a South African cohort.

J Int AIDS Soc. 2020-5

[9]
Towards an AIDS free generation: Is stigma still an issue in Zambia? Results from a legal environment assessment of the HIV/AIDS/TB program of the Churches Health Association of Zambia.

J Public Health Afr. 2020-3-19

[10]
Project YES! Youth Engaging for Success: A randomized controlled trial assessing the impact of a clinic-based peer mentoring program on viral suppression, adherence and internalized stigma among HIV-positive youth (15-24 years) in Ndola, Zambia.

PLoS One. 2020-4-2

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