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性别种族微侵犯、自我沉默、物质使用与 HIV 结局：一项针对感染 HIV 的黑人女性的结构方程建模研究。

Gendered Racial Microaggressions, Self-silencing, Substance Use, and HIV Outcomes Among Black Women Living with HIV: A Structural Equation Modeling Approach.

机构信息

Department of Psychology, University of Miami, Coral Gables, FL, USA.

出版信息

AIDS Behav. 2024 Apr;28(4):1276-1290. doi: 10.1007/s10461-023-04157-2. Epub 2023 Aug 29.

DOI:10.1007/s10461-023-04157-2
PMID:37642823
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11505459/
Abstract

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.

摘要

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。

相似文献

[1]
Gendered Racial Microaggressions, Self-silencing, Substance Use, and HIV Outcomes Among Black Women Living with HIV: A Structural Equation Modeling Approach.

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[2]
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[3]
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[4]
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[5]
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[6]
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[7]
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[8]
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[10]
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引用本文的文献

[1]
A commentary on forging a path for CHANGE: culturally focused HIV training for the next generation in pursuit of equity.

Crit Public Health. 2024

[2]
Using network analysis to elucidate the relationships among support systems, trauma and depressive symptoms, self-silencing, and risk of HIV viral non-suppression among black women living with HIV.

J Behav Med. 2025-4

[3]
A Pilot Randomized Control Trial of the Striving Towards EmPowerment and Medication Adherence (STEP-AD) Intervention for Black Women Living with HIV.

AIDS Behav. 2024-10

本文引用的文献

[1]
Structural equation model of intersectional microaggressions, discrimination, resilience, and mental health among black women with hiv.

Health Psychol. 2023-5

[2]
Structural equation modeling of microaggressions, religious and racism-related coping, medication adherence, and viral load among Black women living with HIV.

J Behav Med. 2023-10

[3]
Gendered racial microaggressions and emerging adult Black women's social and general anxiety: Distress intolerance and stress as mediators.

J Clin Psychol. 2023-4

[4]
Moderating effects of social support on the relationship between substance use disorders and HIV viral load and medication adherence among Black women living with HIV in the United States.

AIDS Care. 2022-10

[5]
Daily Microaggressions and Related Distress among Black Women Living with HIV during the Onset of the COVID-19 Pandemic and Black Lives Matter Protests.

AIDS Behav. 2021-12

[6]
Gendered Racial Microaggressions and Self-Silencing Associated with Suicidality Among Black Women Living with HIV.

J Racial Ethn Health Disparities. 2022-6

[7]
The Costs of Silencing the Self and Divided Self in the Context of Physical Abuse, Racial/Ethnic Identity, and Medication Adherence in Women Living with HIV.

Sex Roles. 2020-6

[8]
Psychiatric Disorders and Substance Use Among African American Women in HIV Care.

AIDS Behav. 2020-11

[9]
Gendered Racial Microaggressions Associated with Depression Diagnosis among Black Women Living with HIV.

J Urban Health. 2020-6

[10]
Patterns of alcohol use and associated characteristics and HIV-related outcomes among a sample of African-American women living with HIV.

Drug Alcohol Depend. 2019-11-20

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