Meyers-Pantele Stephanie A, Helm Jonathan L, Miller-Perusse Michael, Ma Junye, Horvath Keith J
Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, La Jolla, California, USA.
Department of Psychology, San Diego State University, San Diego, California, USA.
AIDS Res Treat. 2025 Aug 12;2025:8199608. doi: 10.1155/arat/8199608. eCollection 2025.
While racial disparities in HIV antiretroviral treatment (ART) adherence and viral suppression among sexual minority men (SMM) with HIV persist, resilience may serve as an important protective factor. There is, however, a dearth of research exploring the longitudinal associations between resilience and ART adherence among this group. As such, the current study examined prospective associations, including the between- and within-person effects, between resilience and ART adherence among racially diverse SMM with HIV. Data were drawn from (TWM), a randomized controlled trial of an mHealth intervention targeting ART adherence among SMM. Generalized estimating equations (GEEs) models examined longitudinal associations, including between- and within-person effects, between resilience scores and self-reported 30-day ART adherence, dichotomized as optimal (≥ 90% of doses) versus suboptimal (< 90% of doses) across the 17-month study timeframe, while controlling for covariates. Among 401 SMM with HIV that completed the TWM baseline assessment ( = 39.1 years, Standard Deviation = 10.8), 59.9% self-identified as Black/African American. In GEE models, resilience scores were prospectively associated with optimal 30-day ART adherence ( = 0.06, = 0.38, < 0.001), at the between-person level, above the effects of covariates. In moderation analyses, resilience scores were associated with optimal ART adherence among Black/African American SMM but not among those identifying as White or another race. These results suggest bolstering resilience may be an important strategy for future interventions aiming to improve ART adherence over time for racially and ethnically diverse SMM with HIV.
虽然感染艾滋病毒的性少数男性(SMM)在抗逆转录病毒治疗(ART)依从性和病毒抑制方面的种族差异依然存在,但心理韧性可能是一个重要的保护因素。然而,目前缺乏关于该群体心理韧性与ART依从性之间纵向关联的研究。因此,本研究考察了感染艾滋病毒的不同种族SMM中,心理韧性与ART依从性之间的前瞻性关联,包括个体间和个体内效应。数据来自一项针对SMM的ART依从性的移动健康干预随机对照试验(TWM)。广义估计方程(GEE)模型考察了在17个月的研究时间范围内,心理韧性得分与自我报告的30天ART依从性之间的纵向关联,包括个体间和个体内效应,将其分为最佳(≥90%的剂量)与次优(<90%的剂量),同时控制协变量。在401名完成TWM基线评估的感染艾滋病毒的SMM中(年龄=39.1岁,标准差=10.8),59.9%自我认定为黑人/非裔美国人。在GEE模型中,在个体间水平上,心理韧性得分与最佳30天ART依从性前瞻性相关(β=0.06,SE=0.38,p<0.001),高于协变量的影响。在调节分析中,心理韧性得分与黑人/非裔美国SMM中的最佳ART依从性相关,但与自我认定为白人或其他种族的SMM无关。这些结果表明,增强心理韧性可能是未来干预措施的一项重要策略,旨在随着时间的推移提高感染艾滋病毒的不同种族和族裔SMM的ART依从性。
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