Medical mistrust of health systems as a moderator of resilience and self-reported HIV care engagement in Black and Latinx young adults living with HIV.

IF 3.2 2区心理学 Q1 ETHNIC STUDIES

Cultural Diversity & Ethnic Minority Psychology Pub Date : 2025-01-01 Epub Date: 2023-08-17 DOI:10.1037/cdp0000615

John Andrew Sauceda, Chadwick K Campbell, Samuel O Ndukwe, Karine Dubé, Parya Saberi

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引用次数: 0

Abstract

Objective: To study resilience and its association with HIV care engagement in a sample of young adult Black and Latinx people living with HIV (PLWH) in the United States and to test if a systems-level barrier, medical mistrust, would moderate the resilience-engagement association.

Method: Between April and August 2021, we recruited participants through social media and dating apps (N = 212) and verified age and HIV status through a review process of digital text-messaged and emailed photos. Participants completed a one-time online survey consisting of the Connor-Davidson Resilience Scale, The Index of Engagement in HIV Care, and the Medical Mistrust Index. We ran a regression-based moderation analysis using the Johnson-Neyman Technique to estimate regions of significance.

Results: The sample (N = 212) was 80.5% Black and 19.5% Latinx with a mean age of 25.8 years (SD = 2.84). Higher resilience scores were associated with higher HIV care engagement scores (b = 0.72, p = .003), and medical mistrust moderated this relationship as evidenced by a mistrust by resilience interaction (b = -0.16, p = .01). Our regions of statistical significance showed that as mistrust increased, the size of the resilience-engagement association decreased.

Conclusion: Resilience may be a protective factor associated with greater participation and sense of connection to HIV care, but is diminished by mistrust of the medical system at large. This suggest that systems-level changes, in addition to individual-level interventions, are needed to address medical mistrust to fully harness the resilience of young PLWH. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

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对医疗系统的不信任是黑人和拉美裔年轻成人艾滋病感染者复原力和自我报告的艾滋病护理参与度的调节因素。

目的研究美国年轻的成年黑人和拉美裔艾滋病病毒感染者（PLWH）的抗逆力及其与艾滋病护理参与度之间的关系，并检验系统层面的障碍--医疗不信任--是否会缓和抗逆力与参与度之间的关系：2021 年 4 月至 8 月间，我们通过社交媒体和约会应用程序招募参与者（N = 212），并通过数字短信和电子邮件照片审查程序核实年龄和 HIV 感染状况。参与者完成一次性在线调查，调查内容包括康纳-戴维森复原力量表、艾滋病护理参与指数和医疗不信任指数。我们使用约翰逊-奈曼技术（Johnson-Neyman Technique）进行了回归调节分析，以估计显著性区域：样本（N = 212）中 80.5% 为黑人，19.5% 为拉丁裔，平均年龄为 25.8 岁（SD = 2.84）。较高的抗逆力得分与较高的艾滋病护理参与度得分相关（b = 0.72，p = .003），医疗不信任调节了这种关系，不信任与抗逆力的交互作用（b = -0.16，p = .01）证明了这一点。我们的统计显著性区域显示，随着不信任度的增加，抗逆力与参与度之间的关系也在减弱：抗逆力可能是一种保护性因素，与更大程度地参与艾滋病护理和增强与艾滋病护理的联系感相关，但会因对整个医疗系统的不信任而减弱。这表明，除了个人层面的干预措施外，还需要系统层面的变革来解决医疗不信任问题，以充分利用年轻艾滋病感染者的复原力。(PsycInfo Database Record (c) 2023 APA, 版权所有）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cultural Diversity & Ethnic Minority Psychology Multiple-

CiteScore

5.90

自引率

6.10%

发文量

101

期刊介绍： Cultural Diversity & Ethnic Minority Psychology seeks to publish theoretical, conceptual, research, and case study articles that promote the development of knowledge and understanding, application of psychological principles, and scholarly analysis of social–political forces affecting racial and ethnic minorities.