Positive affect promotes engagement in care after HIV diagnosis.
Positive affect promotes engagement in care after HIV diagnosis.
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DOI：
10.1037/hea0000011
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发表时间：
2014-07
期刊：
影响因子：
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通讯作者：
Moskowitz JT
中科院分区：
文献类型：
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作者：
Carrico AW;Moskowitz JT
压力和应对理论修正版提出，积极情感具有适应性功能，其有益效果在压力时期得到加强。本研究探讨了积极的影响和参与护理在18个月后，艾滋病毒血清阳性诊断的前瞻性关系。应对、HIV和情感访谈（CHAI）队列研究招募了153名最近接受HIV血清阳性诊断的个体。使用逻辑和线性回归，基线积极影响被检查为与艾滋病毒护理、抗逆转录病毒治疗（ART）持续性（即，开始抗逆转录病毒治疗并在随后的随访评估期间继续使用），以及随访期间的平均log10 HIV病毒载量。在控制了受教育程度、辅助性T细胞（CD4+）计数、HIV病毒载量和消极情绪后，较高的基线积极情绪独立预测了诊断后3个月与HIV护理联系的几率增加（调整后OR [AOR]= 1.10; 95% CI = 1.01 - 1.21）和18个月随访期间ART持续性（AOR = 1.08; 95% CI = 1.01 - 1.16）。积极影响与随访期间平均HIV病毒载量较低无直接相关性。然而，一个标准差高的积极影响通过更大的ART持续性几率间接预测了6.7%的HIV病毒载量降低（β间接=-0.18，p <0.05）。更大的积极影响预测链接到艾滋病毒护理和抗逆转录病毒治疗的持久性。反过来，抗逆转录病毒疗法的持续性与较低的艾滋病毒载量有关。需要进行临床研究，以检查旨在增强积极影响的干预措施是否可以提高艾滋病毒治疗的有效性。
Revised Stress and Coping Theory proposes that positive affect serves adaptive functions and its beneficial effects are heightened during stressful periods. This study examined the prospective relationship between positive affect and engagement in care during the 18 months following a HIV seropositive diagnosis. The Coping, HIV, and Affect Interview (CHAI) cohort study enrolled 153 individuals who had recently received a HIV seropositive diagnosis. Using logistic and linear regression, baseline positive affect was examined as a predictor of linkage to HIV care, anti-retroviral therapy (ART) persistence (i.e., starting ART and remaining on it during subsequent follow-up assessments), and mean log10 HIV viral load over follow-up. After controlling for education, T-helper (CD4+) count, HIV viral load, and negative affect, higher baseline positive affect independently predicted increased odds of linkage to HIV care at 3 months post-diagnosis (adjusted OR [AOR] = 1.10; 95% CI = 1.01 – 1.21) and ART persistence over the 18-month follow-up period (AOR = 1.08; 95% CI = 1.01 – 1.16). Positive affect was not directly associated with lower mean HIV viral load over follow-up. However, one standard deviation higher positive affect indirectly predicted 6.7% lower HIV viral load via greater odds of ART persistence (βindirect = −0.18, p < .05). Greater positive affect predicts linkage to HIV care and ART persistence. ART persistence, in turn, is associated with lower HIV viral load. Clinical research is needed to examine if interventions designed to enhance positive affect can boost the effectiveness of HIV treatment as prevention.