Examining stigma, social support, and gender differences in unsuppressed HIV viral load among participants in HPTN 065
Examining stigma, social support, and gender differences in unsuppressed HIV viral load among participants in HPTN 065
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DOI：
10.1007/s10865-020-00186-7
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发表时间：
2020-11-08
影响因子：
3.1
通讯作者：
Tolley, Elizabeth E.
中科院分区：
文献类型：
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作者：
Maragh-Bass, Allysha C.;Gamble, Theresa;Tolley, Elizabeth E.
艾滋病毒护理连续体的成功导航对于维持病毒抑制是必要的。我们探讨了HPTN 065阳性预防（P4P）组分中病毒未抑制的性别分层相关性。感兴趣的结果是已经感染HIV的个体中未抑制的病毒载量（> 40拷贝/mL）。相关因素包括药物依从性因素、社会支持和耻辱感。Logistic回归模型按性别分层（N = 673）。男性特异性相关的病毒未抑制包括异性伴侣，年龄较大和艾滋病毒披露耻辱。女性特有的相关因素包括自诊断以来的时间，以及个人层面的药物依从性障碍。当更多的人知道他们的艾滋病毒状况时，妇女被病毒抑制的可能性增加一倍以上;在男子中没有发现这种联系。此外，较高水平的社会支持与女性的病毒抑制无关。干预措施应考虑采取针对性别的办法，争取社会支持，消除艾滋病毒带来的耻辱感，促进坚持服药，并随后抑制病毒。
Successful navigation of the HIV care continuum is necessary to maintain viral suppression. We explored gender-stratified correlates of being virally unsuppressed in the Prevention for Positives (P4P) component of HPTN 065. The outcome of interest was unsuppressed viral load (> 40 copies/mL) among individuals already living with HIV. Correlates included medication adherence factors, social support and stigma. Logistic regression models were stratified by gender (N = 673). Men-specific correlates of being virally unsuppressed included opposite-sex partners, older age and HIV disclosure stigma. Women-specific correlates included time since diagnosis, and personal-level barriers to medication adherence. When more individuals knew about their HIV status, women had over twice the likelihood of being virally unsuppressed; no such association was seen among men. Additionally, higher levels of social support were not associated with viral suppression among women. Interventions should consider gender-specific approaches to engaging social support in de-stigmatization of HIV and promotion of medication adherence and subsequent viral suppression.