Conspiracy beliefs about HIV are related to antiretroviral treatment nonadherence among african american men with HIV.
Conspiracy beliefs about HIV are related to antiretroviral treatment nonadherence among african american men with HIV.
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DOI：
10.1097/qai.0b013e3181c57dbc
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发表时间：
2010-04
期刊：
影响因子：
--
通讯作者：
Banks D
中科院分区：
文献类型：
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作者：
Bogart LM;Wagner G;Galvan FH;Banks D
医疗不信任在非裔美国人中很普遍，可能会影响医疗保健行为，如治疗依从性。我们研究了一种特殊形式的医疗不信任-艾滋病毒阴谋信念（例如，艾滋病毒是对非洲裔美国人的种族灭绝）-与非洲裔美国人艾滋病毒感染者不依从抗逆转录病毒治疗有关。在基线调查中，214名非洲裔美国男性艾滋病毒感染者报告了他们与9种阴谋信念，社会人口特征，抑郁症状，物质使用，疾病特征，医疗不信任和医疗障碍的协议。在基线样本中的177名男性中，抗逆转录病毒药物治疗依从性在基线后一个月进行电子监测。实证因素分析揭示了两个不同的阴谋信念分量表：种族灭绝信念（例如，艾滋病毒是人造的）和治疗相关的信念（例如，接受抗逆转录病毒治疗的人是政府的试验品）。在双变量检验中，两个分量表均与不依从性相关。在多变量logistic回归中，只有治疗相关的共谋与1个月随访时最佳依从性的可能性较低相关（比值比= 0.60，95%置信区间= 0.37至0.96，p < 0.05）。艾滋病毒阴谋信念，特别是那些与治疗不信任有关的信念，可以通过阻止适当的治疗行为而导致健康差异。针对非裔美国人的促进依从性的干预措施应该公开地解决这些信念。
Medical mistrust is prevalent among African Americans and may influence health care behaviors such as treatment adherence. We examined whether a specific form of medical mistrust – HIV conspiracy beliefs (e.g., HIV is genocide against African Americans) – was associated with antiretroviral treatment nonadherence among African American men with HIV. On baseline surveys, 214 African American men with HIV reported their agreement with 9 conspiracy beliefs, socio-demographic characteristics, depression symptoms, substance use, disease characteristics, medical mistrust, and health care barriers. Antiretroviral medication adherence was monitored electronically for one-month post-baseline among 177 men in the baseline sample. Confirmatory factor analysis revealed two distinct conspiracy belief subscales: genocidal beliefs (e.g., HIV is manmade) and treatment-related beliefs (e.g., people who take antiretroviral treatments are human guinea pigs for the government). Both subscales were related to nonadherence in bivariate tests. In a multivariate logistic regression, only treatment-related conspiracies were associated with a lower likelihood of optimal adherence at one-month follow-up (Odds ratio = 0.60, 95% confidence interval = 0.37 to 0.96, p < 0.05). HIV conspiracy beliefs, especially those related to treatment mistrust, can contribute to health disparities by discouraging appropriate treatment behavior. Adherence-promoting interventions targeting African Americans should openly address such beliefs.