The impact of multiple-behavior HIV interventions as a function of regional disadvantages: An analysis of syndemics.

IF 4.5 1区 心理学 Q1 PSYCHOLOGY, CLINICAL
Journal of consulting and clinical psychology Pub Date : 2023-10-01 Epub Date: 2023-07-06 DOI:10.1037/ccp0000827
Man-Pui Sally Chan, Sicong Liu, Benjamin White, Angela Zhang, Yubo Zhou, Melody Leung, Wenhao Dai, Xi Liu, Marta Durantini, Qijia Ye, Lidia Palmese, Devlin O'Keefe, Dolores Albarracín
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引用次数: 0

Abstract

Objective: Disadvantaged populations, including inhabitants of developing countries as well as racial/ethnic and sexual minorities in the United States, are disproportionally burdened by human immunodeficiency virus (HIV) infection, delayed HIV diagnosis, and unfavorable HIV-treatment outcomes. HIV interventions targeting single behaviors (e.g., testing) in these populations have shown to be efficacious at producing behavioral and clinical change but have been unable to eliminate the social health disparities associated with syndemics (i.e., a set of connected risks, interacting synergistically, and contributing to excess burden of disease in a population).

Method: This meta-analysis of 331 reports (clusters; number of effect sizes [k] = 1,364) assessed whether multiple-behavior interventions that target clusters of syndemic risks are more efficacious for those in disadvantaged regions and social groups.

Results: Across the board, multiple-behavior interventions were more efficacious than single-behavior ones as well as passive control groups among samples from countries with lower log gross domestic product (GDP), lower Human Development Index (HDI), and lower Healthcare Access and Quality (HAQ) Index.

Conclusions: Within the United States, the efficacy of multiple-behavior interventions was similar across different levels of representation of racial/ethnic and sexual minorities. The analyses used robust variance estimation with small-sample corrections to assess the differential effects of multiple-behavior interventions and Egger Sandwich test with the multilevel meta-analysis approach to detect selection biases. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

多种行为HIV干预措施对地区劣势的影响:综合征分析。
目标:弱势群体,包括发展中国家的居民以及美国的种族/族裔和性少数群体,因人类免疫缺陷病毒(HIV)感染、HIV诊断延迟和不利的HIV治疗结果而承受着不成比例的负担。针对这些人群的单一行为(如检测)的HIV干预措施已被证明在产生行为和临床变化方面是有效的,但无法消除与综合征相关的社会健康差异(即一组相互关联的风险,协同作用,并导致人群疾病负担过重)331份报告(集群;效应大小数[k]=1364)评估了针对综合征风险集群的多种行为干预措施是否对弱势地区和社会群体更有效。结果:在来自国内生产总值对数(GDP)较低、人类发展指数(HDI)较低和医疗保健可及性和质量指数(HAQ)较低的国家的样本中,综合而言,多重行为干预比单一行为干预以及被动对照组更有效。结论:在美国,在不同种族/民族和性少数群体的代表性水平上,多种行为干预的效果相似。分析使用了小样本校正的稳健方差估计来评估多种行为干预的差异效应,并使用多水平荟萃分析方法的Egger Sandwich检验来检测选择偏差。(PsycInfo数据库记录(c)2023 APA,保留所有权利)。
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来源期刊
CiteScore
9.00
自引率
3.40%
发文量
94
期刊介绍: The Journal of Consulting and Clinical Psychology® (JCCP) publishes original contributions on the following topics: the development, validity, and use of techniques of diagnosis and treatment of disordered behaviorstudies of a variety of populations that have clinical interest, including but not limited to medical patients, ethnic minorities, persons with serious mental illness, and community samplesstudies that have a cross-cultural or demographic focus and are of interest for treating behavior disordersstudies of personality and of its assessment and development where these have a clear bearing on problems of clinical dysfunction and treatmentstudies of gender, ethnicity, or sexual orientation that have a clear bearing on diagnosis, assessment, and treatmentstudies of psychosocial aspects of health behaviors. Studies that focus on populations that fall anywhere within the lifespan are considered. JCCP welcomes submissions on treatment and prevention in all areas of clinical and clinical–health psychology and especially on topics that appeal to a broad clinical–scientist and practitioner audience. JCCP encourages the submission of theory–based interventions, studies that investigate mechanisms of change, and studies of the effectiveness of treatments in real-world settings. JCCP recommends that authors of clinical trials pre-register their studies with an appropriate clinical trial registry (e.g., ClinicalTrials.gov, ClinicalTrialsRegister.eu) though both registered and unregistered trials will continue to be considered at this time.
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