Mental Health Pathways From Interpersonal Violence to Health-Related Outcomes in HIV-Positive Sexual Minority Men
Mental Health Pathways From Interpersonal Violence to Health-Related Outcomes in HIV-Positive Sexual Minority Men
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DOI：
10.1037/a0019307
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发表时间：
2010-06-01
影响因子：
5.9
通讯作者：
Simoni, Jane M.
中科院分区：
文献类型：
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作者：
Pantalone, David W.;Hessler, Danielle M.;Simoni, Jane M.
目的：我们研究了人际暴力（IPV）和健康相关的结果之间的心理健康途径，在艾滋病毒阳性的性少数男性从事医疗保健。方法：HIV阳性男同性恋和双性恋男性（N = 178）从2个公共HIV初级保健诊所，在城市环境中治疗门诊病人招募这项横断面研究。参与者（M年龄= 44.1岁，36%非白人）填写了一份计算机辅助调查，并从他们的电子病历中提取了与健康相关的数据。我们使用结构方程模型来测试成人虐待和伴侣暴力的潜在因素之间的关联（每个因素包括身体，性和心理虐待的指标）和测量变量：病毒载量，健康相关的生活质量（HRQOL），艾滋病毒药物依从性和急诊室（ER）访问。中介进行了测试的潜在结构的心理健康问题，包括抑郁症，焦虑，创伤后应激障碍，和自杀意念。结果如下：最终模型显示可接受的拟合，x（2）（123）= 157.05，p = 0.02，CFI = 0.95，TLI = 0.94，RMSEA = 0.04，SRMR = 0.06，解释了病毒载量（13%）、HRQOL（41%）、依从性（7%）和ER访视（9%）方差的显著部分，以及潜在变量心理健康问题（24%）。只有1个直接联系出现：成人虐待和急诊室访问之间的正相关。结论：研究结果表明，IPV和心理健康问题在艾滋病毒/艾滋病感染者的健康中发挥着重要作用。艾滋病护理提供者应评估所有患者的IPV病史和心理健康问题，并参考基于证据的心理社会治疗，包括关注健康行为。
Objective: We examined mental health pathways between interpersonal violence (IPV) and healthrelated outcomes in HIV-positive sexual minority men engaged with medical care. Method: HIV-positive gay and bisexual men (N = 178) were recruited for this cross-sectional study from 2 public HIV primary care clinics that treated outpatients in an urban setting. Participants (M age = 44.1 years, 36% non-White) filled out a computer-assisted survey and had health-related data extracted from their electronic medical records. We used structural equation modeling to test associations among the latent factors of adult abuse and partner violence (each comprising indicators of physical, sexual, and psychological abuse) and the measured variables: viral load, health-related quality of life (HRQOL), HIV medication adherence, and emergency room (ER) visits. Mediation was tested for the latent construct mental health problems, comprising depression, anxiety, symptomatology of posttraumatic stress disorder, and suicidal ideation. Results: The final model demonstrated acceptable fit, x(2)(123) = 157.05, p =.02, CFI =.95, TLI =.94, RMSEA =.04, SRMR =.06, accounting for significant portions of the variance in viral load (13%), HRQOL (41%), adherence (7%), and ER visits (9%), as well as the latent variable mental health problems (24%). Only 1 direct link emerged: a positive association between adult abuse and ER visits. Conclusions: Findings indicate a significant role of IPV and mental health problems in the health of people living with HIV/AIDS. HIV care providers should assess for IPV history and mental health problems in all patients and refer for evidence-based psychosocial treatments that include a focus on health behaviors.