Mechanism of Change in Cognitive Behavioral Therapy for Body Image and Self-Care on ART Adherence Among Sexual Minority Men Living with HIV.
Mechanism of Change in Cognitive Behavioral Therapy for Body Image and Self-Care on ART Adherence Among Sexual Minority Men Living with HIV.
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DOI：
10.1007/s10461-018-2143-0
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发表时间：
2018-08
影响因子：
4.4
通讯作者：
Blashill AJ
中科院分区：
文献类型：
--
作者：
Lamb KM;Nogg KA;Safren SA;Blashill AJ
身体形象障碍是感染艾滋病毒的性少数男性中常见的问题，并与抗逆转录病毒治疗（ART）依从性差有关。最近，一种新的综合干预（身体形象和自我保健认知行为疗法；CBT-BISC）被开发出来并进行了试点测试，以同时改善这一人群的身体形象和ART依从性。虽然CBT-BISC在改善ART依从性方面已显示出初步疗效，但其改变机制尚不清楚。利用两组随机对照试验（N = 44名艾滋病毒感染者）的数据，将CBT-BISC与常规强化治疗（ETAU）条件进行比较，通过潜在差异评分评估顺序过程中介作用，并将身体形象干扰的变化作为治疗条件与ART依从性变化之间的机制。被分配到CBT-BISC组的参与者报告了干预后身体形象障碍的统计学显著减少，这随后预测了干预后到长期随访期间ART依从性的变化（b = 20.01, SE = 9.11, t = 2.19, p = 0.028）。CBT-BISC积极影响ART依从性的一个途径是通过减少身体形象干扰。身体形象障碍可能是预测感染艾滋病毒的性少数男性坚持抗逆转录病毒治疗的一种机制。
Body image disturbance is a common problem reported among sexual minority men living with HIV, and is associated with poor antiretroviral therapy (ART) adherence. Recently, a novel integrated intervention (cognitive behavioral therapy for body image and self-care; CBT-BISC) was developed and pilot tested to simultaneously improve body image and ART adherence in this population. Although CBT-BISC has demonstrated preliminary efficacy in improving ART adherence, the mechanisms of change are unknown. Utilizing data from a two-armed randomized controlled trial (N = 44 sexual minority men living with HIV), comparing CBT-BISC to an enhanced treatment as usual (ETAU) condition, sequential process mediation via latent difference scores was assessed, with changes in body image disturbance entered as the mechanism between treatment condition and changes in ART adherence. Participants assigned to CBT-BISC reported statistically significant reductions in body image disturbance post-intervention, which subsequently predicted changes in ART adherence from post-intervention to long term follow-up (b = 20.01, SE = 9.11, t = 2.19, p = 0.028). One pathway in which CBT-BISC positively impacts ART adherence is through reductions in body image disturbance. Body image disturbance represents one, of likely several, mechanism that prospectively predicts ART adherence among sexual minority men living with HIV.
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DOI：
10.1080/10705519909540118
发表时间：
1999-01-01
影响因子：
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作者：
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影响因子：
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