Discrimination and adherence in a cross-sectional study of Latino sexual minority men with HIV: Coping with discrimination as a mediator and coping self-efficacy as a moderator.

Autor: Barreras JL; School of Social Work, California State University Long Beach, 1250 Bellflower Boulevard, Long Beach, CA, 90840, USA. Joanna.Barreras@csulb.edu.; Bienestar Human Services, Inc, 5326 East Beverly Blvd, Los Angeles, CA, 90022, USA. Joanna.Barreras@csulb.edu., Bogart LM; RAND Corporation, 1776 Main Street, Santa Monica, CA, 90407, USA., MacCarthy S; Department of Health Behavior, University of Alabama, 1665 University Boulevard, Birmingham, AL, 35294, USA., Klein DJ; RAND Corporation, 1776 Main Street, Santa Monica, CA, 90407, USA., Pantalone DW; Department of Psychology, University of Massachusetts Boston, 100 Morrissey Boulevard, Boston, MA, 02125, USA.; The Fenway Institute, Fenway Health, 1340 Boylston Street, Boston, MA, 02215, USA.
Jazyk: angličtina
Zdroj: Journal of behavioral medicine [J Behav Med] 2023 Dec; Vol. 46 (6), pp. 1057-1067. Date of Electronic Publication: 2023 Jul 01.
DOI: 10.1007/s10865-023-00426-6
Abstrakt: Discrimination is associated with antiretroviral therapy non-adherence and reduced well-being among people with HIV. We examined the potential for coping to mediate the associations between intersectional discrimination and non-adherence and coping self-efficacy (confidence in one's ability to cope with discrimination) as a moderator that may buffer the negative effects of discrimination on non-adherence in a cross-sectional convenience sample of 82 Latino sexual minority men with HIV. In bivariate linear regressions, discrimination targeting Latino ethnic origin, undocumented residency status, and sexual orientation were each significantly associated with lower self-reported antiretroviral therapy non-adherence (percentage of prescribed doses taken in the last month) and greater use of disengagement coping (denial, substance use, venting, self-blame, behavioral disengagement). Associations between discrimination targeting Latino ethnicity and non-adherence, and discrimination targeting undocumented residency status and non-adherence, were each mediated by disengagement coping responses. Moderation analyses highlighted significant discrimination by coping self-efficacy interaction effects-both coping self-efficacy for problem solving and stopping unpleasant emotions/thoughts each moderated the associations between Latino discrimination and adherence, between undocumented residency status discrimination and adherence, and between HIV discrimination and adherence. Coping self-efficacy for getting social support moderated the association between undocumented residency status discrimination and adherence. Further, the interaction coefficients across models indicated that the negative effects of discrimination on adherence were attenuated at higher levels of coping self-efficacy. Findings highlight the need for structural interventions that reduce-and ultimately eliminate-discrimination, and interventions that address the harmful effects of discrimination and adherence improvement interventions to enhance coping skills among people faced with intersectional discrimination.
(© 2023. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.)
Databáze: MEDLINE
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