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Measuring Frailty in HIV-infected Individuals. Identification of Frail Patients is the First Step to Amelioration and Reversal of Frailty
Published on: July 24, 2013
Brief Report: Interpersonal and Intrapersonal Factors as Parallel Independent Mediators in the Association Between
Victoria C Seghatol-Eslami1, Heather E Dark, James L Raper
1Departments of *Psychology;†Medicine, University of Alabama at Birmingham, Birmingham, AL; and‡Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, AL.
Introduction:
People living with HIV (PLWH) need to adhere to antiretroviral therapy (ART) to achieve optimal health. One reason for ART nonadherence is HIV-related stigma.
Objectives:
We aimed to examine whether HIV treatment self-efficacy (an intrapersonal mechanism) mediates the stigma-adherence association. We also examined whether self-efficacy and the concern about being seen while taking HIV medication (an interpersonal mechanism) are parallel mediators independent of each other.
Methods:
A total of 180 people living with HIV self-reported internalized HIV stigma, ART adherence, HIV treatment self-efficacy, and concerns about being seen while taking HIV medication. We calculated bias-corrected 95% confidence intervals for indirect effects using bootstrapping to conduct mediation analyses.
Results:
Adherence self-efficacy mediated the relationship between internalized stigma and ART adherence. Additionally, self-efficacy and concern about being seen while taking HIV medication uniquely mediated and explained almost all the stigma-adherence association in independent paths (parallel mediation).
Conclusion:
These results can inform intervention strategies to promote ART adherence.
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