Are psychological consequences of stigma enduring or transitory? A longitudinal study of HIV stigma and distress among Asians and Pacific Islanders living with HIV illness
Are psychological consequences of stigma enduring or transitory? A longitudinal study of HIV stigma and distress among Asians and Pacific Islanders living with HIV illness
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DOI：
10.1089/apc.2006.20.712
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发表时间：
2006-10-01
影响因子：
4.9
通讯作者：
DeAlmeida, Chrystianne
中科院分区：
文献类型：
--
作者：
Kang, Ezer;Rapkin, Bruce D.;DeAlmeida, Chrystianne
横断面研究结果清楚地揭示了美国艾滋病毒/艾滋病感染者的疾病耻辱与心理结果之间的关系。然而，尚无研究探讨疾病耻辱对感染艾滋病毒/艾滋病的亚洲人和太平洋岛民的心理健康可能产生的长期影响，由于根深蒂固的社会文化规范，这一群体特别容易受到艾滋病毒耻辱的影响。这项为期两年的纵向研究以 2002 年至 2004 年间纽约市 44 名艾滋病毒血清阳性的亚洲人和太平洋岛民为样本，考察了五种艾滋病毒耻辱因素（社会排斥、消极自我价值、感知人际不安全感、财务不安全感、随意披露）与心理困扰维度变化（自尊、绝望、恐惧、思维混乱、悲伤、焦虑）之间的关系。在基线和两年随访中，与记录的参与者相比，人际不安全感和自尊水平较低。分层多元回归分析的结果表明，在控制基线自尊和随访时的身体症状的情况下，基线社会拒绝和感知的人际不安全感与两年随访时自尊的变化显着相关。基线财务不安全感和酌情披露之间的相互作用与两年随访时的恐惧显着相关。研究结果强调了减少耻辱干预措施的重要性：(1) 认识到基于性取向、性别和移民身份的多重耻辱； (2) 解决导致美国亚裔和太平洋岛民长期遭受艾滋病毒耻辱的个人和结构性限制。
Cross-sectional findings have shed considerable light on the relationships between illness stigma and psychological outcomes among persons living with HIV/AIDS in the United States. However, no studies have examined the possible long-term consequences of illness stigma on mental health among Asians and Pacific Islanders living with HIV/AIDS, a group particularly vulnerable to HIV stigma due to ingrained sociocultural norms. This 2-year longitudinal study examined the relationship between five HIV-stigma factors (social rejection, negative self-worth, perceived interpersonal insecurity, financial insecurity, discretionary disclosure) and changes in psychological distress dimensions (self-esteem, hopelessness, dread, confused thinking, sadness, anxiety) among a convenience sample of 44 HIV-seropositive Asians and Pacific Islanders in New York City from 2002 to 2004. Undocumented Asians independently endorsed higher levels of perceived interpersonal insecurity and lower levels of self-esteem than documented participants at both baseline and 2-year follow-up. Results from hierarchical multiple regression analyses indicated that baseline social rejection and perceived interpersonal insecurity were significantly associated with changes in self-esteem at 2-year follow-up, controlling for baseline self-esteem and physical symptoms at follow-up. An interaction effect between baseline financial insecurity and discretionary disclosure was significantly associated with dread at 2-year follow-up. Findings highlight the importance of stigma reduction interventions that: (1) recognize multiple layers of stigma based sexual orientation, gender, and immigration status; and (2) address both individual and structural constraints that perpetuate HIV-stigma among Asians and Pacific Islanders in the United States.