HIV-Related Stress and Life Chaos Mediate the Association Between Poverty and Medication Adherence Among People Living with HIV/AIDS

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• 作者：Seth C. Kalichman ; Moira O. Kalichman
• 关键词：HIV/AIDS treatment ; Medication adherence ; Poverty ; Stress
• 刊名：Journal of Clinical Psychology in Medical Settings
• 出版年：2016
• 出版时间：December 2016
• 年：2016
• 卷：23
• 期：4
• 页码：420-430
• 全文大小：
• 刊物类别：Behavioral Science
• 刊物主题：Medicine/Public Health, general; Health Psychology; General Practice / Family Medicine;
• 出版者：Springer US
• ISSN：1573-3572
• 卷排序：23

文摘

HIV treatment depends on high-levels of antiretroviral therapy (ART) adherence, which is severely impeded by poverty. Men and women living with HIV infection (N = 92) completed computerized interviews of demographic and health characteristics, poverty markers, stressful life events, and life chaos, as well as unannounced pill counts to determine prospective medication adherence and medical record chart abstractions for HIV viral load. Poverty markers were associated with both stressors and chaos, and the direct effects of all three factors predicted ART non-adherence. The multiple mediation model showed that accounting for stressors and chaos resulted in a non-significant association between poverty markers and ART adherence. The indirect effect of poverty markers on adherence through life chaos was significant, whereas the indirect effect of poverty markers on adherence through stressors was not significant. Factors that render HIV-related stress and create chaos offer intervention targets that are more amenable to change than poverty itself.