吸毒,精神痛苦,和其他社会心理因素威胁到对感染艾滋病毒的青年(YLWH)的艾滋病毒护理。我们旨在确定YLWH中的共病心理社会模式,并研究这些模式如何影响HIV结局。使用来自HIV治疗依从性干预的208名YLWH的基线数据,我们对9项社会心理指标的二分法反应进行了潜在的类别分析(制定了HIV污名;临床抑郁和焦虑;酒精,大麻,和非法药物滥用;食品和住房不安全;法律历史)。我们使用多项逻辑回归来评估潜在的类别人口统计学关联,并使用自动Bolck-Croon-Hagenaars方法来按类别评估HIV结果。参与者的平均年龄为21岁;三分之二被确定为顺式男性,60%是非西班牙裔黑人,一半被认定为同性恋。出现了三个类别:“多药物-社会经济综合症”(n=29;13.9%),“困境-社会经济综合症”(n=35,17.1%),和“无辛迪加”(n=142,69.0%)。年纪更大,失业的非学生在“多药物-社会经济联盟”类中的比例过高。在“多药物-社会经济联盟”类别(81.4%)中,与“无联盟”类别(32.8%)和“困境-社会经济联盟”类别(31.0%)相比,错过/没有艾滋病毒护理的任命明显更高。“多药物-社会经济综合症”类别中的HIV治疗依从性明显高于“无综合症”类别(59.4%),而不是“痛苦-社会经济综合症”类别(70.8%)。缺乏HIV病毒载量抑制在“多药物-社会经济综合症”类别中(29.7%)相对于“无综合症”类别(16.2%)和“痛苦-社会经济综合症”类别(15.4%)。使用多种药物,社会经济上脆弱的YLWH面临着不良HIV结果的风险,保证将量身定制的方案纳入现有的艾滋病毒护理系统。
Drug use, mental distress, and other psychosocial factors threaten HIV care for youth living with HIV (YLWH). We aimed to identify
syndemic psychosocial patterns among YLWH and examine how such patterns shape HIV outcomes. Using baseline data from 208 YLWH enrolled in an HIV treatment adherence intervention, we performed latent class analysis on dichotomized responses to 9 psychosocial indicators (enacted HIV stigma; clinical depression and anxiety; alcohol, marijuana, and illicit drug misuse; food and housing insecurity; legal history). We used multinomial logistic regression to assess latent class-demographic associations and the automatic Bolck-Croon-Hagenaars method to assess HIV outcomes by class. Mean age of participants was 21 years; two thirds identified as cis male, 60% were non-Hispanic Black, and half identified as gay. Three classes emerged: \"Polydrug-Socioeconomic Syndemic\" (n = 29; 13.9%), \"Distress-Socioeconomic
Syndemic\" (n = 35, 17.1%), and \"
Syndemic-free\" (n = 142, 69.0%). Older, unemployed non-students were overrepresented in the \"Polydrug-Socioeconomic Syndemic\" class. Missed/no HIV care appointments was significantly higher in the \"Polydrug-Socioeconomic Syndemic\" class (81.4%) relative to the \"
Syndemic-free\" (32.8%) and \"Distress-Socioeconomic
Syndemic\" (31.0%) classes. HIV treatment nonadherence was significantly higher in the \"Polydrug-Socioeconomic Syndemic\" class (88.5%) relative to the \"
Syndemic-free\" class (59.4%) but not the \"Distress-Socioeconomic
Syndemic\" class (70.8%). Lack of HIV viral load suppression was non-significantly higher in the \"Polydrug-Socioeconomic Syndemic\" class (29.7%) relative to the \"
Syndemic-free\" (16.2%) and \"Distress-Socioeconomic
Syndemic\" (15.4%) classes. Polydrug-using, socioeconomically vulnerable YLWH are at risk for adverse HIV outcomes, warranting tailored programming integrated into extant systems of HIV care.