Differential relationships of stress and HIV disclosure by gender: a person centered longitudinal study.
Differential relationships of stress and HIV disclosure by gender: a person centered longitudinal study.
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DOI：
10.1186/s12889-021-10291-0
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发表时间：
2021-02-02
影响因子：
4.5
通讯作者：
Zhou Y
中科院分区：
文献类型：
--
作者：
Zeng C;Qiao S;Li X;Yang X;Shen Z;Zhou Y
现有的文献大多将艾滋病暴露视为一个静态事件，并采用横断面设计研究其与压力的关系。目前尚不清楚艾滋病毒披露水平（定义为披露目标的数量）的动态变化以及压力如何影响这些变化。本研究采用以人为中心的纵向方法探讨了不同的披露水平，研究了压力是否可以预测这些披露水平，并调查了这种关系是否因艾滋病毒感染者（PLWH）的性别而异。数据来源于2016年11月至2018年1月在中国广西进行的前瞻性队列研究。纳入444例PLWH。在基线、6个月和12个月随访时，对参与者的感知压力、社会人口学特征和艾滋病毒披露目标数量进行评估。基于披露目标数的变化，使用增长混合模型来表征披露水平。在调整协变量后，使用多项逻辑回归预测基线压力下的披露水平。研究结果表明，压力与性别之间存在交互作用，调整后的优势比（AOR）及其95%可信区间显示了压力与性别之间的关联强度。因此，分别有355名（81.2%）、28名（6.4%）和64名（12.4%）艾滋病毒携带者被归类为低、高和高披露水平。基线应激水平与性别的交互作用在区分1级和3级时有显著性差异（AOR = 0.85 [0.74 ~ 0.99]），而在1级和2级之间无显著性差异（AOR = 0.96 [0.81 ~ 1.15]）。与女性相比，具有较高基线压力的男性PLWH随着时间的推移具有一致的高披露水平的概率较低。已婚/同居的艾滋病病毒携带者被归类为高水平暴露的概率低于低水平暴露的概率（AOR = 0.43 [0.19 ~ 0.94]）。压力与HIV暴露水平的关系存在性别差异。为了促进艾滋病毒的披露，应采用针对性别的干预措施，以帮助艾滋病毒感染者科普压力。在线版本包含补充材料，可通过10.1186/s12889-021-10291-0获得。
Existing literature mostly consider HIV disclosure as a static event and investigate its relationship with stress using a cross-sectional design. It is unclear about the dynamic changes of HIV disclosure levels (defined as the number of disclosure targets) and how stress may influence these changes. This study explored different disclosure levels using a person-centered longitudinal approach, examined whether stress could predict these disclosure levels, and investigated if this relationship differed by gender among people living with HIV (PLWH). Data were derived from a prospective cohort study conducted from November 2016 to January 2018 in Guangxi, China. Four hundred forty-four PLWH were included. Participants were assessed on perceived stress, sociodemographic characteristics, and number of HIV disclosure targets at baseline, 6-month, and 12-month follow-ups. Growth mixture modeling was used to characterize disclosure levels based on the changes of disclosure target number. Multinomial logistic regression was used to predict disclosure levels with baseline stress after adjusting for covariates. The interaction effect of stress by gender was examined. Adjusted odds ratio (AOR) with its 95% confidence interval were reported to show the strength of association. Three levels of disclosure were characterized as “Low levels of disclosure” (Level One), “Increased levels of disclosure” (Level Two), and “High levels of disclosure” (Level Three). Accordingly, 355 (81.2%), 28 (6.4%), and 64 (12.4%) of PLWH were categorized respectively under low, increased, and high levels of disclosure. The interaction of baseline stress by gender was significant in differentiating Level One from Three (AOR = 0.85 [0.74 ~ 0.99]) while it was not significant between Level One and Two (AOR = 0.96 [0.81 ~ 1.15]). Compared to female, male PLWH with higher baseline stress had lower probability to have consistent high disclosure levels over time. PLWH who were married/cohabited had lower probability of being classified into consistent high levels of disclosure than low level (AOR = 0.43 [0.19 ~ 0.94]). There was gender difference in the relationship between stress and levels of HIV disclosure. To promote HIV disclosure, gender tailored interventions should be employed to help PLWH cope with stress. The online version contains supplementary material available at 10.1186/s12889-021-10291-0.
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影响因子：
5
作者：
COHEN, S;KAMARCK, T;MERMELSTEIN, R
通讯作者：
MERMELSTEIN, R
影响因子：
1.7
作者：
Ding Y;Li L;Ji G
通讯作者：
Ji G
影响因子：
4.4
作者：
Mi, Tianyue;Li, Xiaoming;Zhou, Yuejiao
通讯作者：
Zhou, Yuejiao
影响因子：
4.4
作者：
Hart, TA;Wolitski, RJ;Gómez, CA
通讯作者：
Gómez, CA
影响因子：
4.2
作者：
Kalichman, SC;Nachimson, D
通讯作者：
Nachimson, D