一项关于HIV感染者中HIV污名与睡眠质量关联的有调节的系列中介分析:一项横断面研究。

A moderated serial mediation analysis of the association between HIV stigma and sleep quality in people living with HIV: a cross-sectional study.

作者信息

Jiang Taiyi, Jianhua Hou, Wei Jiaqi, Mu Tingting, Zhu Guanlin, Wang Xiuwen, Qu Diyang, Wu Hao, Zhang Tong, Su Bin

机构信息

Beijing Key Laboratory for HIV/AIDS Research, Sino-French Joint Laboratory for Research on Humoral Immune Response to HIV Infection, Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China.

Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong Special Administrative Region, China.

出版信息

Transl Behav Med. 2023 Jan 20;13(1):25-33. doi: 10.1093/tbm/ibac017.

Abstract

With the wide use of antiretroviral therapy in people living with HIV (PLWH), the mortality and morbidity rates among this community are dramatically decreasing. However, sleep disorder is still one of the prominent health issues among PLWH, and it lowers their quality of life. Although we already know the potential biological pathway that links poor sleep quality among PLWH, the potential contribution of the psychosocial pathway (e.g., stigma) is far from understood. In this study, we aimed to explore the potential serial mediating effects (HIV stigma-loneliness-depression-sleep quality) and potential moderating effects of perceived social support. We recruited a consecutive sample of 139 participants from voluntary counseling testing (VCT) clinics of Beijing Youan Hospital and participant referrals. Then, we used serial mediation models and moderated serial mediation models to fit our data. We found significant serial mediation effects between three types of HIV stigma (enacted, anticipated, and internalized) and sleep quality via depression and loneliness. Perceived social support also significantly moderated this serial mediation between enacted stigma, internalized stigma, and sleep quality. Our results highlight the potential role of perceived social support in moderating the negative effects of enacted and internalized stigma on sleep quality and identify potential psychosocial pathways.

摘要

随着抗逆转录病毒疗法在艾滋病毒感染者(PLWH)中的广泛应用,该群体的死亡率和发病率正在大幅下降。然而,睡眠障碍仍然是艾滋病毒感染者中突出的健康问题之一,它降低了他们的生活质量。尽管我们已经了解了与艾滋病毒感染者睡眠质量差相关的潜在生物学途径,但心理社会途径(如耻辱感)的潜在作用仍远未被理解。在本研究中,我们旨在探讨潜在的系列中介效应(艾滋病毒耻辱感-孤独感-抑郁-睡眠质量)以及感知社会支持的潜在调节作用。我们从北京佑安医院的自愿咨询检测(VCT)诊所和参与者推荐中连续招募了139名参与者作为样本。然后,我们使用系列中介模型和调节系列中介模型来拟合我们的数据。我们发现三种类型的艾滋病毒耻辱感(表现出的、预期的和内化的)与睡眠质量之间通过抑郁和孤独感存在显著的系列中介效应。感知社会支持也显著调节了表现出的耻辱感、内化的耻辱感与睡眠质量之间的这种系列中介作用。我们的研究结果突出了感知社会支持在调节表现出的和内化的耻辱感对睡眠质量负面影响方面的潜在作用,并确定了潜在的心理社会途径。

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