Interpersonal Mechanisms Contributing to the Association Between HIV-Related Internalized Stigma and Medication Adherence.
Interpersonal Mechanisms Contributing to the Association Between HIV-Related Internalized Stigma and Medication Adherence.
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DOI：
10.1007/s10461-016-1320-2
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发表时间：
2017-01
影响因子：
4.4
通讯作者：
Turan B
中科院分区：
文献类型：
--
作者：
Blake Helms C;Turan JM;Atkins G;Kempf MC;Clay OJ;Raper JL;Mugavero MJ;Turan B
以前的研究表明，艾滋病毒感染者（PLWH）有时会内化社区中存在的与艾滋病毒有关的耻辱感，并因其艾滋病毒状况而产生自卑感和羞耻感，这可能对治疗依从性产生负面影响。PLWH的人际关系的关注，他们的艾滋病毒状况可能会影响他们现有的关系的安全可能有助于解释如何内化的耻辱影响依从行为。在2013年3月至2015年1月在阿拉巴马州伯明翰进行的一项横断面研究中，从门诊艾滋病诊所招募的180名PLWH完成了先前验证的内化耻辱，依恋风格和服用艾滋病药物时被看到的担忧措施。参与者还自我报告了他们的艾滋病毒药物依从性。更高水平的艾滋病毒相关的内化耻辱，依恋相关的焦虑（即，害怕被关系伙伴抛弃），以及担心在服用艾滋病毒药物时被其他人看到，都与药物依从性较差有关。艾滋病毒相关的内化污名对药物依从性的影响是由依恋相关的焦虑和服用艾滋病毒药物时被他人看到的担忧介导的。鉴于药物依从性对于PLWH实现长期积极的健康结果至关重要，了解影响药物依从性的人际因素至关重要。旨在提高艾滋病毒治疗依从性的干预措施应解决人际因素以及个人因素。
Previous research suggests that persons living with HIV (PLWH) sometimes internalize HIV-related stigma existing in the community and experience feelings of inferiority and shame due to their HIV status, which can have negative consequences for treatment adherence. PLWH’s interpersonal concerns about how their HIV status may affect the security of their existing relationships may help explain how internalized stigma affects adherence behaviors. In a cross-sectional study conducted between March 2013 and January 2015 in Birmingham, AL, 180 PLWH recruited from an outpatient HIV clinic completed previously validated measures of internalized stigma, attachment styles, and concern about being seen while taking HIV medication. Participants also self-reported their HIV medication adherence. Higher levels of HIV-related internalized stigma, attachment-related anxiety (i.e., fear of abandonment by relationship partners), and concerns about being seen by others while taking HIV medication were all associated with worse medication adherence. The effect of HIV-related internalized stigma on medication adherence was mediated by attachment-related anxiety and by concerns about being seen by others while taking HIV medication. Given that medication adherence is vitally important for PLWH to achieve long-term positive health outcomes, understanding interpersonal factors affecting medication adherence is crucial. Interventions aimed at improving HIV treatment adherence should address interpersonal factors as well as intrapersonal factors.