Physician-Patient Interaction Quality Mediates the Association Between HIV-Related Stigma and HIV-Prevention Behaviors Among Sexual Minority Men in Zambia.

Autor: Aggarwal A; Department of Health Promotion, Education and Behavior, University of South Carolina, Columbia, USA., Zhang R; Department of Health Promotion, Education and Behavior, University of South Carolina, Columbia, USA., Qiao S; Department of Health Promotion, Education and Behavior, University of South Carolina, Columbia, USA. shanqiao@mailbox.sc.edu., Wang B; Population and Quantitative Health Sciences, University of Massachusetts, Boston, USA., Lwatula C; Department of Psychology, University of Zambia, Lusaka, Zambia., Menon A; Department of Psychology, University of Zambia, Lusaka, Zambia., Ostermann J; Department of Health Service Policy and Management, University of South Carolina, Columbia, USA., Li X; Department of Health Promotion, Education and Behavior, University of South Carolina, Columbia, USA., Harper G; Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, USA.
Jazyk: angličtina
Zdroj: AIDS and behavior [AIDS Behav] 2024 May; Vol. 28 (5), pp. 1559-1569. Date of Electronic Publication: 2023 Oct 24.
DOI: 10.1007/s10461-023-04171-4
Abstrakt: HIV-related stigma is a major challenge to HIV prevention for sexual minority men (SMM) in Zambia, but little is known about the underlying mechanisms. This study aimed to investigate whether physician-patient interaction quality mediates the relationship between HIV-related stigma and HIV-prevention behaviors among SMM. Data were collected using a cross-sectional survey from 194 SMM (aged: mean = 24.08, SD = 4.27) across four districts in Zambia between February and November 2021. Participants were asked about their demographic characteristics, HIV-related stigma, SMM-related stigma, physician-patient interaction quality, HIV-testing intention, and use of pre-exposure prophylaxis (PrEP). Path analysis was used to test the mediation effect of physician-patient interaction quality in the associations of HIV-related stigma/SMM-related stigma with HIV-testing intention and current PrEP use. Higher self-reported physician-patient interaction quality was negatively associated with HIV-related stigma (β = - 0.444, z = - 2.223, p < 0.05), and positively associated with HIV-testing intention (β = 0.039, z = 5.121, p < 0.001) and current PrEP use (β = 0.008, z = 2.723, p < 0.01). HIV-related stigma among SMM had a significant and negative indirect effect on HIV-testing intention (β = - 0.017, z = - 2.006, p < 0.05), and current PrEP use (β = - 0.004, z = - 2.009, p < 0.05) through physician-patient interaction quality. Contrary to our expectations, SMM-related stigma did not have a significant and negative indirect effect on HIV prevention behaviors through physician-patient interaction quality. Health interventions need to improve physician-patient interaction quality by offering healthcare provider training, targeting HIV-related stigma in healthcare settings, and devising inclusive healthcare policies to promote HIV prevention efforts.
(© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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