Socio-cognitive facilitators of ART-adherence among predominantly black sexual and gender minoritized persons living with HIV in Atlanta, Georgia: a latent profile analysis.
John Mark Wiginton, Lisa A Eaton, Valeria A Earnshaw, Ryan J Watson, Seth C Kalichman
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引用次数: 0
Abstract
The Integrated Change Model describes several social and cognitive factors (e.g., health attitudes, social support, self-efficacy) that can affect medication adherence. Guided by this model, we sought to identify profiles of socio-cognitive facilitators of ART (antiretroviral therapy) adherence among diversely minoritized persons living with HIV enrolled in a behavioral intervention trial in Atlanta, Georgia (N = 477). To do this, we performed latent profile analysis on baseline responses to scales assessing 6 indicators of interest: HIV-care self-efficacy, social support, TasP (treatment-as-prevention) beliefs, trust in healthcare providers, perceived need for ART, and trust in ART. We regressed emergent profiles on internalized, enacted, and microaggressive HIV stigma and compared prospective 30-day ART adherence and several cross-sectional HIV outcomes across profiles. Mean age was 29 years; 83% of participants were non-Hispanic Black, 53% were gay/homosexual-identifying, and 12% were gender expansive. Three profiles emerged: "Constrained/Capable" (6%), featuring high self-efficacy but low-moderate provider trust, social support, TasP beliefs, ART trust, and ART need; "Conflicted" (13%), featuring high TasP beliefs, provider trust, and ART need but moderate self-efficacy, ART trust, and social support; and "Motivated" (81%), featuring high levels of all indicators. Greater internalized, enacted, and microaggressive stigma were positively associated with "Conflicted" relative to "Motivated" profile membership. ART-nonadherence, unsuppressed viral load, and viral load unawareness were more likely for the "Conflicted" relative to the "Motivated" profile. Personalized HIV care tailored to such profiles may improve ART adherence and related outcomes for minoritized persons living with HIV.
期刊介绍:
The Journal of Behavioral Medicine is a broadly conceived interdisciplinary publication devoted to furthering understanding of physical health and illness through the knowledge, methods, and techniques of behavioral science. A significant function of the journal is the application of this knowledge to prevention, treatment, and rehabilitation and to the promotion of health at the individual, community, and population levels.The content of the journal spans all areas of basic and applied behavioral medicine research, conducted in and informed by all related disciplines including but not limited to: psychology, medicine, the public health sciences, sociology, anthropology, health economics, nursing, and biostatistics. Topics welcomed include but are not limited to: prevention of disease and health promotion; the effects of psychological stress on physical and psychological functioning; sociocultural influences on health and illness; adherence to medical regimens; the study of health related behaviors including tobacco use, substance use, sexual behavior, physical activity, and obesity; health services research; and behavioral factors in the prevention and treatment of somatic disorders. Reports of interdisciplinary approaches to research are particularly welcomed.