Exploring direction of causation between social support and clinical outcome for HIV-positive adults in the context of highly active antiretroviral therapy
Exploring direction of causation between social support and clinical outcome for HIV-positive adults in the context of highly active antiretroviral therapy
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DOI：
10.1080/09540120412331305179
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发表时间：
2005-01-01
影响因子：
1.7
通讯作者：
Burgoyne, RW
中科院分区：
文献类型：
--
作者：
Burgoyne, RW
社会支持及其与病毒学结果的关联进行了评估，在4年的时间内，34例成人门诊艾滋病毒感染者/艾滋病患者，并一直在高活性抗逆转录病毒治疗（HAART）。临床变量和社会支持的感知可用性分三波测量（T1，1997; T2，1999; T3，2001）。交叉滞后逻辑回归分析，以评估社会支持和临床状态之间的潜在因果关系的方向“检测不到”的病毒载量。社会支持评分总体上适度下降，对于最终“可检测”病毒载量的亚组（n = 11; 32%），具有临床（效应量，0.82）和统计学显著性（p = 0.000）的下降更明显。证据表明因果方向性，其中横截面社会支持和/或社会支持随时间的改善预测病毒学结果，更好的社会支持与病毒载量抑制到“不可检测”水平的可能性更大相关，68%（n = 23）的样本实现了这一结果。相反，横断面病毒学状态反映了免疫学结果，但不能预测随后的社会支持评分或社会支持评分的变化。持续服用HAART的HIV阳性成年人，如果他们认为可以获得人际、信息和情感支持，似乎会获得更好的临床获益，这一发现强调了社会支持对这一人群治疗结果的重要性。
Social support and its associations with virological outcome were assessed over a 4-year period for 34 adult outpatients living with HIV/AIDS and consistently on highly active antiretroviral therapy ( HAART). Clinical variables and perceived availability of social support were measured in three waves (T1, 1997; T2, 1999; T3, 2001). Cross-lagged logistic regression analyses were employed to evaluate the direction of potential causal pathways between social support and clinical status in terms of 'undetectable' viral load. Social support ratings declined moderately overall, with a more pronounced reduction that was of clinical ( effect size, 0.82) and statistical significance ( p = 0.000) for the subgroup ( n = 11; 32%) with final 'detectable' viral load. Evidence suggested causal directionality in which cross-sectional social support and/or improvements in social support over time predicted virological outcome, with better social support associated with greater likelihood of viral load suppression to 'undetectable' level, an outcome achieved for 68% ( n = 23) of the sample. In contrast, cross-sectional virological status reflected immunological outcomes but did not predict subsequent ratings of social support or changes in social support ratings. HIV-positive adults consistently taking HAART appeared to experience better clinical benefit if they perceived interpersonal, informational and emotional support to be available, a finding that underscores the importance of social support in relation to treatment outcome for this population.