中老年HIV/AIDS歧视感知对抗病毒治疗依从性的作用及社会支持的修饰效应分析.

Objective To explore the impact of perceived HIV-related discrimination on antiretroviral therapy (ART) adherence among middle-aged and elderly individuals living with HIV/AIDS and the modifying effect of social support, so as to provide guidance for improving ART treatment success rates. Methods By using cluster random sampling method, a questionnaire survey was conducted among middle-aged and elderly HIV/AIDS patients in the city of Mianyang. The survey assessed their sociodemographic characteristics, social support, perceived discrimination, and treatment adherence. Logistic regression models were used to analyze the relationship between these factors and ART adherence. Results The study included 401 middle-aged and elderly HIV/AIDS patients receiving ART. Good adherence was observed in 69.82% of participants, while 30.18% had poor adherence. Univariate analysis revealed that patients with effective viral suppression (viral load ≤20) demonstrated better adherence compared to treatment failure patients (viral load >20). Adherence was also higher among those following single or dual antiretroviral drug regimens. Logistic regression results indicated that fear of disclosure (OR=1.116, 95% CI: 1.023–1.217), public discrimination (OR=1.105, 95% CI: 1.008–1.211), and internal shame (OR=1.119, 95% CI: 1.022–1.225) significantly influenced treatment adherence. Stratified analysis further revealed that fear of disclosure (OR=1.159, 95% CI: 1.034–1.299), public discrimination (OR=1.128, 95% CI: 1.004–1.267), and internal shame (OR=1.150, 95% CI: 1.021–1.297) were associated with adherence. Conclusion Enhancing social support, particularly at the individual and family levels, is crucial to mitigate the impact of fear of disclosure, public discrimination, internal shame, and treatment regimens on HIV/AIDS treatment adherence. Public education and support programs should aim to reduce discrimination, strengthen viral load monitoring, and adjust personalized treatment plans promptly. [ABSTRACT FROM AUTHOR]