HIV-Related Stigma and Viral Suppression Among African-American Women: Exploring the Mediating Roles of Depression and ART Nonadherence.
HIV-Related Stigma and Viral Suppression Among African-American Women: Exploring the Mediating Roles of Depression and ART Nonadherence.
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DOI：
10.1007/s10461-018-2301-4
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发表时间：
2019-08
影响因子：
4.4
通讯作者：
Rao D
中科院分区：
文献类型：
--
作者：
Lipira L;Williams EC;Huh D;Kemp CG;Nevin PE;Greene P;Unger JM;Heagerty P;French AL;Cohn SE;Turan JM;Mugavero MJ;Simoni JM;Andrasik MP;Rao D
我们使用了来自感染艾滋病毒的非裔美国女性的样本的基线数据，这些女性被招募参加在芝加哥和伯明翰进行的减少耻辱干预(2013-2015)，以1)评估艾滋病毒相关耻辱和病毒抑制之间的关系，以及2)评估抑郁和不坚持抗逆转录病毒治疗(ART)作为媒介的作用。如果女性在接受抗逆转录病毒治疗，在研究开始后8周内收集了病毒载量数据，并有完整的协变量数据，那么她们的数据就包括在这项二级分析中。我们使用Logistic回归来估计HIV相关污名(14项慢性病污名量表)对病毒抑制(<；200拷贝/毫升)的总影响，并使用系列中介分析来估计抑郁症状(8项患者健康问卷)和ART不依从性(错过剂量的天数)所介导的间接影响。在符合研究纳入标准的100名女性中，95%的人报告了不同程度的艾滋病毒相关耻辱。在调整后的模型中，HIV相关污名水平越高，被病毒抑制的几率越低(AOR=0.93，95%CI=[0.89，0.98])。在中介分析中，抑郁和ART不坚持的间接影响不显著。研究结果表明，与艾滋病毒相关的污名在感染艾滋病毒的非裔美国女性中很常见，那些遭受更高程度污名的人不太可能受到病毒抑制。然而，机制仍不清楚。
We used baseline data from a sample of African-American women living with HIV who were recruited to participate in a stigma-reduction intervention in Chicago and Birmingham (2013–2015) to 1) evaluate the relationship between HIV-related stigma and viral suppression, and 2) assess the role of depression and nonadherence to antiretroviral therapy (ART) as mediators. Data from women were included in this secondary analysis if they were on ART, had viral load data collected within 8-weeks of study entry and had complete covariate data. We used logistic regression to estimate the total effect of HIV-related stigma (14-item Stigma Scale for Chronic Illness) on viral suppression (< 200 copies/mL), and serial mediation analysis to estimate indirect effects mediated by depressive symptoms (8-item Patient Health Questionnaire) and ART nonadherence (number of days with missed doses). Among 100 women who met study inclusion criteria, 95% reported some level of HIV-related stigma. In adjusted models, higher levels of HIV-related stigma were associated with lower odds of being virally suppressed (AOR = 0.93, 95% CI = [0.89, 0.98]). In mediation analysis, indirect effects through depression and ART nonadherence were not significant. Findings suggest that HIV-related stigma is common among African-American women living with HIV, and those who experience higher levels of stigma are less likely to be virally suppressed. However, the mechanisms remain unclear.
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影响因子：
4.4
作者：
Blake Helms C;Turan JM;Atkins G;Kempf MC;Clay OJ;Raper JL;Mugavero MJ;Turan B
通讯作者：
Turan B
影响因子：
1.6
作者：
Clark, HJ;Lindner, G;Austin, BJ
通讯作者：
Austin, BJ
影响因子：
39.2
作者：
Bryson, Chris L.;Au, David H.;Bradley, Katharine A.
通讯作者：
Bradley, Katharine A.
影响因子：
4.4
作者：
Baugher, Amy R.;Beer, Linda;Shouse, R. Luke
通讯作者：
Shouse, R. Luke
影响因子：
3.8
作者：
Gross, R;Bilker, WB;Strom, BL
通讯作者：
Strom, BL