Medical mistrust among social network members may contribute to antiretroviral treatment nonadherence in African Americans living with HIV
Medical mistrust among social network members may contribute to antiretroviral treatment nonadherence in African Americans living with HIV
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DOI：
10.1016/j.socscimed.2016.03.028
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发表时间：
2016-09-01
影响因子：
5.4
通讯作者：
Hilliard, Charles L.
中科院分区：
文献类型：
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作者：
Bogart, Laura M.;Wagner, Glenn J.;Hilliard, Charles L.
理由：与其他种族/族裔群体相比，感染艾滋病毒的非洲裔美国人坚持抗逆转录病毒治疗（ART）的可能性较小。医学上的不信任被认为是造成这种差异的一个因素。目的：我们研究了（1）暴露于艾滋病毒阴谋信念，一种特殊类型的艾滋病毒相关的不信任（关于艾滋病毒的起源和治疗）在社交网络与艾滋病毒感染的非裔美国人之间的抗逆转录病毒治疗不依从性是否相关;和（2）个人的特点，谁讨论艾滋病毒相关的不信任在社交网络的非裔美国人感染艾滋病毒。研究方法：在基线和基线后6个月和12个月，175名接受抗逆转录病毒治疗的非洲裔美国人艾滋病毒感染者完成了以自我为中心的社交网络评估，我们从中评估了他们个人网络的结构和组成（他们周围的社会环境）。与艾滋病毒相关的不信任与是否有任何社会网络成员向参与者表达艾滋病毒阴谋信念的指标一起操作。电子监测每日药物依从性。结果如下：在基线时，63%的参与者同意至少一个阴谋信念，55%的人报告说听到至少一个社交网络成员（“alter”）表达阴谋信念。在多变量线性重复测量回归中，网络中类似他人（年龄，性别，HIV状态，性取向和种族/民族）的阴谋信念表达与ART不依从性相关（即，服用处方剂量的百分比）。在多变量逻辑回归中，阴谋信念的表达更有可能在HIV阳性的社交网络成员中，他们知道参与者的血清状态，并且参与者经常与他们互动，而在关系更好的社交网络成员中不太可能。结论：网络中与艾滋病相关的不信任在由类似的HIV阳性者表达时可能最有影响力。(C)2016爱思唯尔有限公司版权所有
Rationale: African Americans living with HIV are less likely to adhere to antiretroviral treatment (ART) compared to other racial/ethnic groups. Medical mistrust is thought to be a factor in this disparity. Objective: We examined (1) whether exposure to HIV conspiracy beliefs, a specific type of HIV-related mistrust (about the origins and treatment of HIV) in social networks is associated with ART nonadherence among African Americans living with HIV; and (2) the characteristics of individuals who discuss HIV-related mistrust in the social networks of African Americans living with HIV. Methods: At baseline and 6- and 12-months post-baseline, 175 African Americans living with HIV on ART completed egocentric social network assessments, from which we assessed the structure and composition of their personal networks (the social context immediately surrounding them). HIV related mistrust was operationalized with an indicator of whether any social network member had expressed HIV conspiracy beliefs to the participant. Daily medication adherence was monitored electronically. Results: At baseline, 63% of participants agreed with at least one conspiracy belief, and 55% reported hearing at least one social network member ("alter") express conspiracy beliefs. In a multivariate linear repeated measures regression, expression of conspiracy beliefs by similar others in the network (in terms of age, gender, HIV status, sexual orientation, and race/ethnicity) was associated with ART nonadherence (i.e., percentage of prescribed doses taken). In a multivariate logistic regression, expression of conspiracy beliefs was more likely among social network members who were HIV-positive, who knew the participants' serostatus, and with whom participants interacted frequently, and less likely among more well-connected social network members. Conclusion: HIV related mistrust in the network may be most influential when expressed by similar others who may be HIV-positive themselves. (C) 2016 Elsevier Ltd. All rights reserved.