Efficacy on the rocks: how hazardous drinking contextualizes the path from internalized heterosexism to antiretroviral adherence via adherence self-efficacy.
Stephen D Ramos, Wilson Vincent, Daniel E Siconolfi, Keith J Horvath, Chadwick K Campbell, Susan M Kegeles, Erik D Storholm
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引用次数: 0
Abstract
Background: Young Black sexual minority men living with HIV (YBSMM+) in the US South face a confluence of structural and psychosocial barriers that impact antiretroviral therapy (ART) adherence. Internalized heterosexism and hazardous drinking have emerged as significant yet understudied factors influencing adherence self-efficacy, a known determinant of sustained ART adherence.
Purpose: This study examined the relationships among internalized heterosexism, adherence self-efficacy, and ART adherence in a sample of YBSMM+, with a particular focus on the moderating role of hazardous drinking.
Methods: Utilizing cross-sectional survey data from a community-based sample of YBSMM+ in the US South, we conducted moderated mediation analyses to assess the direct and indirect effects of internalized heterosexism on ART adherence via adherence self-efficacy, as well as whether hazardous drinking moderates the direct effect of internalized heterosexism on adherence self-efficacy.
Results: Findings indicated that higher levels of internalized heterosexism were associated with lower adherence self-efficacy, which in turn predicted lower ART adherence. Adherence self-efficacy significantly mediated the relationship between internalized heterosexism and ART adherence, replicating prior research. Moreover, participants who reported hazardous drinking evidenced a stronger inverse association between internalized heterosexism and adherence self-efficacy than those who did not report hazardous drinking.
Conclusions: The results underscore the complex interplay among internalized heterosexism, adherence self-efficacy, and hazardous drinking in shaping ART adherence among YBSMM+. Interventions targeting adherence self-efficacy and addressing hazardous drinking, while also directly addressing internalized stigma, may help buffer the harmful effects of these factors and support improved HIV health outcomes in this population.
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