Jack Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, USA.
Sol Price School of Public Policy, University of Southern California, Los Angeles, CA, USA.
AIDS Care. 2024 Aug;36(8):1111-1118. doi: 10.1080/09540121.2024.2331221. Epub 2024 Apr 22.
This study examined the relationship between exposure to community violence and HIV care engagement among 107 Black gay or bisexual men living with HIV in Chicago. Measures assessed the importance of demographic covariates (age, annual income, health insurance status, and years living with HIV), community violence exposures, mental health, social support, in explaining variations in missed doses of antiretroviral therapy (ART) medication and missed HIV care appointments. Results showed that participants who reported higher rates of exposure to community violence were two times more likely to have missed ART doses and HIV care appointments. Participants who reported depression scores were two times more likely to have greater non-ART adherence Finally, older participants were more likely to report fewer missed ART doses. More research is needed to clarify the mechanisms between age or depression and ART adherence given community violence exposure. Health care providers should screen for depression when attempting to promote better ART adherence and keeping HIV care appointments for Black gay and bisexual men living with HIV. Younger Black gay and bisexual men living with HIV may be more vulnerable than older men for missed ART doses and may require additional screening and follow-up.
本研究调查了 107 名居住在芝加哥的感染艾滋病毒的黑人男同性恋或双性恋者接触社区暴力与艾滋病毒护理参与之间的关系。研究采用了多种措施来评估人口统计学协变量(年龄、年收入、健康保险状况和感染艾滋病毒的年限)、社区暴力暴露、心理健康、社会支持对解释抗逆转录病毒疗法(ART)药物漏服剂量和错过艾滋病毒护理预约的差异的重要性。结果表明,报告接触社区暴力率较高的参与者漏服 ART 剂量和错过艾滋病毒护理预约的可能性是其他人的两倍。报告抑郁得分较高的参与者,其非 ART 治疗的依从性更差的可能性是其他人的两倍。此外,年龄较大的参与者报告的 ART 剂量漏服次数较少。鉴于社区暴力的暴露,需要进一步研究来阐明年龄或抑郁与 ART 依从性之间的机制。医疗保健提供者在试图促进更好的 ART 依从性和保持艾滋病毒护理预约时,应该筛查抑郁。感染艾滋病毒的年轻黑人男同性恋或双性恋者可能比年长的男性更容易漏服 ART 剂量,可能需要额外的筛查和随访。