Experiences of HIV-related discrimination and consequences for internalised stigma, depression and alcohol use
Experiences of HIV-related discrimination and consequences for internalised stigma, depression and alcohol use
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DOI：
10.1080/08870446.2019.1572143
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发表时间：
2019-07-03
影响因子：
3.3
通讯作者：
Katner, Harold P.
中科院分区：
文献类型：
--
作者：
Crockett, Kaylee B.;Kalichman, Seth C.;Katner, Harold P.
目的：艾滋病污名化损害了艾滋病病毒感染者（PLWH）的健康和福祉。关于污名机制的概念性工作表明，污名或歧视的经历会增加内化的污名。然而，并非所有艾滋病毒携带者都能将他们所经历的艾滋病毒歧视内化。我们的目的是调查与HIV相关的歧视事件相关的压力对内化的HIV污名的作用，以及对抑郁症状和酒精使用严重程度的下游影响。设计：199名参与者从美国东南部的一家HIV诊所招募。主要研究措施：艾滋病毒相关的歧视进行了评估，使用项目改编自措施颁布艾滋病毒的耻辱和歧视。参与者对与每个歧视项目相关的感知压力进行评分。内化艾滋病毒的耻辱进行了评估，使用艾滋病毒耻辱机制量表的内化耻辱分量表。抑郁症状的评估与流行病学研究中心抑郁指数。酒精使用的严重程度进行了评估与酒精使用障碍识别测试。结果如下：在系列调解模型，艾滋病毒相关的歧视是间接相关的抑郁症状和酒精使用的严重程度，通过其与压力和内在的艾滋病毒的耻辱。结论：了解艾滋病毒感染者将艾滋病毒污名化并导致不良健康结果的机制可以产生临床干预焦点。
Objective: HIV stigma undermines health and well-being of people living with HIV (PLWH). Conceptual work on stigma mechanisms suggests that experiences of stigma or discrimination increase internalised stigma. However, not all PLWH may internalise the HIV discrimination they experience. We aimed to investigate the role of stress associated with events of HIV-related discrimination on internalised HIV stigma, as well as the downstream effects on depressive symptoms and alcohol use severity. Design: 199 participants were recruited from an HIV clinic in the southeastern United States. Main study measures: HIV-related discrimination was assessed using items adapted from measures of enacted HIV stigma and discrimination. Participants rated perceived stress associated with each discrimination item. Internalised HIV stigma was assessed using the internalised stigma subscale of the HIV Stigma Mechanisms Scale. Depressive symptoms were assessed with the Centre for Epidemiological Studies-Depression Index. Alcohol use severity was assessed with the Alcohol Use Disorders Identification Test. Results: In serial mediation models, HIV-related discrimination was indirectly associated with both depressive symptoms and alcohol use severity through its associations with stress and internalised HIV stigma. Conclusions: Understanding the mechanisms through which PLWH internalise HIV stigma and lead to poor health outcomes can yield clinical foci for intervention.