A Structural Equation Model of Factors Contributing to Quality of Life Among African and Caribbean Women Living with HIV in Ontario, Canada
A Structural Equation Model of Factors Contributing to Quality of Life Among African and Caribbean Women Living with HIV in Ontario, Canada
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DOI：
10.1089/aid.2016.0013
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发表时间：
2017-03-01
影响因子：
1.5
通讯作者：
Loutfy, Mona R.
中科院分区：
文献类型：
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作者：
Logie, Carmen H.;Ahmed, Uzma;Loutfy, Mona R.
加拿大的非洲和加勒比黑人（ACB）妇女受到新的艾滋病毒感染的影响不成比例。ACB妇女的艾滋病毒脆弱性是由污名化和歧视环境造成的。艾滋病毒相关的污名损害了艾滋病毒感染者（WLWH）的生活质量（QOL），但很少有研究调查种族歧视和艾滋病毒相关的污名对生活质量的伴随影响。我们使用安大略省ACB WLWH的横断面调查数据（n=173）来检验hiv相关污名、种族歧视、抑郁、社会支持和生活质量之间途径的概念模型。我们使用极大似然估计进行结构方程建模来检验模型。在独立模型中，hiv相关的耻辱感与较低的生活质量相关，抑郁在hiv相关的耻辱感与生活质量之间起到部分中介作用。在同步模型中，hiv相关的耻辱感对抑郁、社会支持有显著的直接影响，对生活质量有显著的间接影响。加入社会支持作为中介后，hiv相关污名对生活质量的直接影响不再显著，提示存在中介作用。种族歧视对hiv相关的污名、抑郁和社会支持有显著的直接影响，对生活质量有显著的间接影响。生活质量与较高的社会支持和较低的抑郁评分相关。模型拟合数据较好：(2)=203.266，自由度（DF）： 112, p
African and Caribbean Black (ACB) women in Canada are disproportionately impacted by new HIV infections. ACB women's HIV vulnerability is shaped by contexts of stigma and discrimination. HIV-related stigma compromises quality of life (QOL) among women living with HIV (WLWH), yet scant research has examined concomitant effects of racial discrimination and HIV-related stigma on QOL. We used data from a cross-sectional survey with ACB WLWH in Ontario (n=173) to test a conceptual model of pathways between HIV-related stigma, racial discrimination, depression, social support, and QOL. We conducted structural equation modeling using maximum likelihood estimation to test the model. In independent models, HIV-related stigma was associated with lower QOL, and depression partially mediated the association between HIV-related stigma and QOL. In the simultaneous model, HIV-related stigma had significant direct effects on depression, social support, and an indirect effect on QOL. When social support was added as a mediator, the direct effect between HIV-related stigma and QOL was no longer significant, suggesting mediation. Racial discrimination had significant direct effects on HIV-related stigma, depression, and social support and an indirect effect on QOL. QOL was associated with higher social support and lower depression scores. The model fit the data well: (2)=203.266, degrees of freedom (DF): 112, p