Gomez Elliott M, Mustafa Andrea, Beltran-Najera Ilex, Ridgely Natalie R, Thompson Jennifer L, Medina Luis D, Woods Steven Paul
Department of Psychology, University of Houston, Houston, Texas, USA.
Clin Neuropsychol. 2025 Apr;39(3):658-679. doi: 10.1080/13854046.2024.2319902. Epub 2024 Feb 27.
Gay and bisexual men (GBM) account for the highest rates of incident infection with HIV in the U.S., and experience social, systemic barriers to accessing and engaging in healthcare services. Interacting with healthcare providers can be a complex process for some GBM with HIV disease. The current study examined the contributions of cognition and health literacy to perceived interactions with healthcare providers among GBM with HIV disease. The sample included 100 adults with HIV disease (ages 24-75) who identified as GBM. All participants completed the Dealing with Health Professionals subscale of the Beliefs Related to Medication Adherence survey, as well as the Cogstate neuropsychological battery, self-report measures of cognitive symptoms, and well-validated measures of health literacy. Worse performance-based cognition and subjective cognitive symptoms were both associated with perceived difficulties dealing with healthcare providers, but these associations were fully mediated by lower health literacy. Health literacy may play a role in the association between poorer cognitive functioning and difficulties navigating healthcare interactions among GBM with HIV disease. Further studies are needed to determine whether cognitive approaches to enhancing the access, understanding, and use of health information in GBM with HIV disease improves healthcare interactions and outcomes.
男同性恋者和双性恋男性（GBM）在美国的HIV新发感染率最高，并且在获得和参与医疗服务方面面临社会和系统性障碍。对于一些患有HIV疾病的GBM来说，与医疗服务提供者互动可能是一个复杂的过程。当前的研究调查了认知和健康素养对患有HIV疾病的GBM与医疗服务提供者之间感知互动的影响。样本包括100名患有HIV疾病的成年人（年龄在24至75岁之间），他们自认为是GBM。所有参与者都完成了与药物依从性相关信念调查中的“与医疗专业人员打交道”分量表，以及Cogstate神经心理测试组、认知症状的自我报告测量和经过充分验证的健康素养测量。基于表现的认知较差和主观认知症状都与在与医疗服务提供者打交道时感知到的困难相关，但这些关联完全由较低的健康素养介导。健康素养可能在患有HIV疾病的GBM中较差的认知功能与在医疗互动中遇到困难之间的关联中起作用。需要进一步研究以确定，采用认知方法来增强患有HIV疾病的GBM对健康信息的获取、理解和使用，是否能改善医疗互动及结果。
