Department of Psychology, University of Miami, Coral Gables, FL, USA.
AIDS Behav. 2024 Apr;28(4):1276-1290. doi: 10.1007/s10461-023-04157-2. Epub 2023 Aug 29.
To better understand factors that may contribute to HIV outcomes experienced by Black women living with HIV (BWLWH), the present study examined the relationships among gendered racial microaggressions (GRM; subtle daily insults due to racism and sexism), self-silencing, substance use, antiretroviral therapy (ART) medication adherence, and viral suppression using structural equation modeling and path analysis. Self-silencing and substance use were examined as potential mediators. Participants were 119 BWLWH residing in South Florida. Results of this study showed that GRM was directly and positively associated with self-silencing and indirectly and negatively associated with medication adherence via self-silencing. GRM was directly related to higher alcohol use disorder severity. Self-silencing was directly and negatively associated with medication adherence. Medication adherence was directly and negatively related to viral suppression. The model fit the data well. Identifying the negative consequences of GRM in conjunction with self-silencing and substance use may help inform prevention and intervention strategies to improve mental health and HIV-related outcomes among BWLWH.
为了更好地理解导致感染艾滋病毒的黑人女性（BWLWH）经历的艾滋病毒结果的因素，本研究使用结构方程建模和路径分析，考察了性别种族微侵犯（GRM；由于种族主义和性别歧视而导致的微妙的日常侮辱）、自我沉默、物质使用、抗逆转录病毒疗法（ART）药物依从性和病毒抑制之间的关系。自我沉默和物质使用被视为潜在的中介因素。参与者是居住在佛罗里达州南部的 119 名 BWLWH。本研究结果表明，GRM 与自我沉默呈直接正相关，与药物依从性呈间接负相关，而这种负相关是通过自我沉默产生的。GRM 与更高的酒精使用障碍严重程度直接相关。自我沉默与药物依从性直接负相关。药物依从性与病毒抑制直接负相关。该模型很好地拟合了数据。确定 GRM 与自我沉默和物质使用相结合的负面影响，可能有助于制定预防和干预策略，改善 BWLWH 的心理健康和艾滋病毒相关结果。
