Depression, Substance Abuse and Other Contextual Predictors of Adherence to Antiretroviral Therapy (ART) Among Haitians
Depression, Substance Abuse and Other Contextual Predictors of Adherence to Antiretroviral Therapy (ART) Among Haitians
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DOI：
10.1007/s10461-012-0400-1
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发表时间：
2013-05-01
影响因子：
4.4
通讯作者：
Pape, Jean W.
中科院分区：
文献类型：
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作者：
Malow, Robert;Devieux, Jessy G.;Pape, Jean W.
海地是加勒比地区艾滋病毒感染者人数最多的国家。由于海地资源匮乏的环境以及心理健康和药物滥用服务不足，坚持抗逆转录病毒治疗（ART）可能特别困难。这项研究调查了 194 名 HIV 阳性海地人的人口统计特征、适应不良的应对方式、伴侣冲突、酗酒问题、抑郁症和对药物的消极态度之间的关联及其对依从性的影响。在介导的方向结构方程模型中，抑郁和对 ART 的消极态度直接预测依从性较差。更大的伴侣冲突、适应不良的应对方式和酗酒问题预示着更多的抑郁症。适应不良的应对方式预示着人们对 ART 持消极态度。酒精问题预示着伴侣冲突和适应不良的应对方式。通过抑郁和对 ART 的消极态度介导的对依从性的显着间接影响包括女性性别、酗酒问题和适应不良的应对方式的负面影响。结果强调了对抑郁症、酗酒和其他心理社会问题进行综合护理对于提高 ART 依从性的重要性。
Haiti has the highest number of individuals living with HIV in the Caribbean. Due to Haiti's resource-poor environment and inadequate mental health and substance abuse services, adherence to antiretroviral therapy (ART) may be especially difficult. This study examined associations among demographics, maladaptive coping, partner conflict, alcohol problems, depression, and negative attitudes about medications and their impact on adherence among 194 HIV-positive Haitians. In a mediated directional structural equation model, depression and negative attitudes about ART directly predicted poorer adherence. Greater partner conflict, maladaptive coping and alcohol problems predicted more depression. Maladaptive coping predicted a negative attitude about ART. Alcohol problems predicted partner conflict and maladaptive coping. Significant indirect effects on adherence mediated through both depression and negative attitudes about ART include negative effects of female gender, alcohol problems and maladaptive coping. Results highlight the importance of integrated care for depression, alcohol use and other psychosocial problems to increase ART adherence.