艾滋病毒污名与心理健康症状、生活满意度和生活质量之间的关联，在感染艾滋病毒的黑人性少数群体男性中。
The associations between HIV stigma and mental health symptoms, life satisfaction, and quality of life among Black sexual minority men with HIV.
机构信息
Department of Social Welfare, UCLA Luskin School of Public Affairs, University of California Los Angeles, 3250-Public Affairs Building, Los Angeles, CA, 90095-1656, USA.
The Williams Institute, School of Law, University of California Los Angeles, Los Angeles, CA, USA.
出版信息
Qual Life Res. 2023 Jun;32(6):1693-1702. doi: 10.1007/s11136-023-03342-z. Epub 2023 Jan 17.
PURPOSE
With the advancement of antiretroviral therapy (ART), HIV/AIDS has become a manageable illness, similar to other chronic conditions. This study examined the associations between HIV stigma and patient-reported outcomes including mental health symptoms, life satisfaction, and quality of life among Black sexual minority men with HIV.
METHODS
We analyzed baseline data from a randomized comparison trial of a mobile app intervention aimed to address the social work and legal needs of Black sexual minority men with HIV in Los Angeles County. We used validated scales including the Berger HIV stigma scale, the Patient Health Questionnaire-9 & the General Anxiety Disorder-7, the Satisfaction with Life Scale, and the Ladder Scale to assess HIV stigma, depressive symptoms, anxiety, life satisfaction, and quality of life, and we conducted multivariable linear regression to examine their associations.
RESULTS
Participants experienced HIV stigma especially about disclosure concerns (e.g., 81.9% participants indicated "I am very careful who I tell that I have HIV") and public attitudes (52.3% believed "Most people with HIV are rejected when others find out"). In the multivariable models, higher overall stigma scores were associated with higher likelihood of experiencing depression (adjusted b = 0.235, p < 0.001) and anxiety (adjusted b = 0.188, p = 0.002), and lower life satisfaction (adjusted b = - 0.236, p < 0.001) and quality of life (adjusted b = - 0.053, p = 0.013), adjusting for clinical characteristics including ART initiation, viral load suppression, and medication adherence. In addition, being attacked or harassed in the past year were significantly associated with lower life satisfaction and quality of life (adjusted b = - 3.028, p = 0.046; adjusted b = - 1.438, p = 0.002).
CONCLUSION
Our findings highlight the need for focused HIV stigma reduction interventions to promote the overall well-being of Black sexual minority men with HIV. Strategies to promote the patient-reported outcomes may benefit from trauma-informed approaches.
目的
随着抗逆转录病毒疗法（ART）的进步，艾滋病毒/艾滋病已成为一种可控制的疾病，类似于其他慢性疾病。本研究调查了艾滋病毒耻辱感与患者报告的结果之间的关联，这些结果包括艾滋病毒阳性的黑人男同性恋者的心理健康症状、生活满意度和生活质量。
方法
我们分析了一项针对洛杉矶县艾滋病毒阳性黑人男同性恋者的社会和法律需求的移动应用干预随机比较试验的基线数据。我们使用了经过验证的量表，包括 Berger HIV 耻辱量表、患者健康问卷-9 和广泛性焦虑症-7、生活满意度量表和 Ladder 量表，评估 HIV 耻辱感、抑郁症状、焦虑、生活满意度和生活质量，并进行多变量线性回归分析以检查它们之间的关联。
结果
参与者经历了 HIV 耻辱感，特别是关于披露问题的耻辱感（例如，81.9%的参与者表示“我非常小心告诉别人我有 HIV”）和公众态度（52.3%的人认为“当其他人发现时，大多数艾滋病毒感染者会被拒绝”）。在多变量模型中，较高的总体耻辱感得分与更高的抑郁（调整后的 b=0.235，p<0.001）和焦虑（调整后的 b=0.188，p=0.002）发生率相关，以及较低的生活满意度（调整后的 b=-0.236，p<0.001）和生活质量（调整后的 b=-0.053，p=0.013）相关，调整了包括开始接受抗逆转录病毒治疗、病毒载量抑制和药物依从性在内的临床特征。此外，过去一年中受到攻击或骚扰与较低的生活满意度和生活质量显著相关（调整后的 b=-3.028，p=0.046；调整后的 b=-1.438，p=0.002）。
结论
我们的研究结果强调需要有针对性的艾滋病毒耻辱感降低干预措施，以促进艾滋病毒阳性的黑人男同性恋者的整体健康。促进患者报告结果的策略可能受益于以创伤为中心的方法。
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