Sauceda John Andrew, Campbell Chadwick K, Ndukwe Samuel O, Dubé Karine, Saberi Parya
Department of Medicine, Center for AIDS Prevention Studies, University of California, San Francisco.
Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego.
Cultur Divers Ethnic Minor Psychol. 2025 Jan;31(1):118-123. doi: 10.1037/cdp0000615. Epub 2023 Aug 17.
To study resilience and its association with HIV care engagement in a sample of young adult Black and Latinx people living with HIV (PLWH) in the United States and to test if a systems-level barrier, medical mistrust, would moderate the resilience-engagement association.
Between April and August 2021, we recruited participants through social media and dating apps ( = 212) and verified age and HIV status through a review process of digital text-messaged and emailed photos. Participants completed a one-time online survey consisting of the Connor-Davidson Resilience Scale, The Index of Engagement in HIV Care, and the Medical Mistrust Index. We ran a regression-based moderation analysis using the Johnson-Neyman Technique to estimate regions of significance.
The sample ( = 212) was 80.5% Black and 19.5% Latinx with a mean age of 25.8 years ( = 2.84). Higher resilience scores were associated with higher HIV care engagement scores ( = 0.72, = .003), and medical mistrust moderated this relationship as evidenced by a mistrust by resilience interaction ( = -0.16, = .01). Our regions of statistical significance showed that as mistrust increased, the size of the resilience-engagement association decreased.
Resilience may be a protective factor associated with greater participation and sense of connection to HIV care, but is diminished by mistrust of the medical system at large. This suggest that systems-level changes, in addition to individual-level interventions, are needed to address medical mistrust to fully harness the resilience of young PLWH. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
在美国年轻的成年黑人及拉丁裔艾滋病毒感染者（PLWH）样本中研究心理韧性及其与艾滋病毒护理参与度的关联，并检验医疗不信任这一系统层面的障碍是否会调节心理韧性与护理参与度之间的关联。
在2021年4月至8月期间，我们通过社交媒体和约会应用程序招募参与者（n = 212），并通过对数字短信和电子邮件照片的审核过程核实年龄和艾滋病毒感染状况。参与者完成了一项一次性在线调查，该调查包括康纳 - 戴维森心理韧性量表、艾滋病毒护理参与指数和医疗不信任指数。我们使用约翰逊 - 内曼技术进行基于回归的调节分析，以估计显著区域。
样本（n = 212）中80.5%为黑人，19.5%为拉丁裔，平均年龄为25.8岁（标准差 = 2.84）。较高的心理韧性得分与较高的艾滋病毒护理参与度得分相关（β = 0.72，p = .003），并且医疗不信任调节了这种关系，心理韧性与不信任的交互作用证明了这一点（β = -0.16，p = .01）。我们的统计显著区域表明，随着不信任程度的增加，心理韧性与护理参与度之间关联的大小会减小。
心理韧性可能是一个保护因素，与更多地参与艾滋病毒护理以及与之的联系感相关，但会因对整个医疗系统的不信任而减弱。这表明，除了个人层面的干预措施外，还需要进行系统层面的变革来解决医疗不信任问题，以充分发挥年轻PLWH的心理韧性。（PsycInfo数据库记录（c）2025美国心理学会，保留所有权利）
