Childhood Sexual Trauma, Substance Use, and Antiretroviral Therapy Adherence Among Older Adults Living With HIV: A Mediational Analysis.

IF 2.2 3区医学 Q2 GERONTOLOGY

Journal of Applied Gerontology Pub Date : 2025-02-01 Epub Date: 2024-09-24 DOI:10.1177/07334648241271903

Monique J Brown, Josie Zhang, Prince Nii Ossah Addo, Amandeep Kaur, Daniel Amoatika, Elizabeth Crouch, Steven A Cohen

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引用次数: 0

Abstract

Childhood sexual abuse (CSA) is linked to substance use and lower antiretroviral therapy (ART) adherence. However, studies examining the mediational role of substance use between CSA and ART adherence are lacking. Therefore, the aim of this study was to determine the potential mediational role of substance use between CSA and ART adherence among older adults living with HIV (OALH) (n = 91). Mediation analyses assessed the direct and indirect relationships between CSA, substance use, and ART adherence. Statistically significant differences existed in substance use by gender (male vs. female: 12.3 vs. 9.97) and ART adherence by race (Black vs. White: 98.2% vs. 99.6%) and employment. CSA was associated with ART adherence (β = -3.27, p < .001) and substance use (β = 2.14, p = .035), but substance use was not associated with ART adherence, and did not mediate the pathway between CSA and ART adherence in the adjusted model. Trauma-informed interventions may lower substance use among OALH with CSA.

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童年性创伤、药物使用和老年艾滋病毒感染者坚持抗逆转录病毒疗法的情况：中介分析

童年性虐待（CSA）与药物使用和较低的抗逆转录病毒疗法（ART）依从性有关。然而，目前还缺乏研究来探讨 CSA 与抗逆转录病毒疗法依从性之间的药物使用中介作用。因此，本研究旨在确定 CSA 与抗逆转录病毒疗法依从性之间的潜在中介作用。中介分析评估了 CSA、药物使用和坚持抗逆转录病毒疗法之间的直接和间接关系。不同性别（男性与女性：12.3 与 9.97）的药物使用情况以及不同种族（黑人与白人：98.2% 与 99.6%）和就业情况的抗逆转录病毒疗法依从性存在统计学意义上的差异。CSA 与抗逆转录病毒疗法的坚持率（β = -3.27，p < .001）和药物使用率（β = 2.14，p = .035）相关，但药物使用率与抗逆转录病毒疗法的坚持率无关，而且在调整模型中也不调解 CSA 与抗逆转录病毒疗法坚持率之间的关系。创伤知情干预可降低有 CSA 的 OALH 的药物使用率。

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

Journal of Applied Gerontology GERONTOLOGY-

CiteScore

5.10

自引率

13.30%

发文量

202

期刊介绍： The Journal of Applied Gerontology (JAG) is the official journal of the Southern Gerontological Society. It features articles that focus on research applications intended to improve the quality of life of older persons or to enhance our understanding of age-related issues that will eventually lead to such outcomes. We construe application broadly and encourage contributions across a range of applications toward those foci, including interventions, methodology, policy, and theory. Manuscripts from all disciplines represented in gerontology are welcome. Because the circulation and intended audience of JAG is global, contributions from international authors are encouraged.