Individuals living with HIV report disproportionately high levels of trauma exposure and PTSD symptoms, both which have been associated with suboptimal ART adherence. Often conflated, the question arises as to which construct is driving subsequent HIV self-care behavior. Given the HIV disparities among Black and Hispanic/Latinx individuals, and that Miami is a geographic region with a high racial/ethnic minority make up and a unique socioeconomic environment, it is important to explore factors related to HIV outcomes in Miami to mitigate its uncontrolled epidemic. This study aimed to examine the association of trauma exposure, PTSD symptoms, and relevant additional key factors with adherence to ART among a sample of majority Black and Hispanic/Latinx individuals who are economically marginalized receiving public HIV care in Miami, FL (N = 1237) via a cross-sectional survey. Sequential linear regression was used to examine the study aim in four blocks: (1) trauma, (2) PTSD symptoms, and key covariates of ART adherence including (3) depression and substance use (potential psychological covariates), and (4) indicators of socioeconomic status (potential structural covariates). In the first block, trauma exposure was associated with worse adherence. However, in the second block, the association with trauma dropped and PTSD was significantly associated with worse adherence. Of note, for those experiencing high levels of trauma exposure, adherence was negatively impacted regardless of PTSD. When other key factors associated with adherence were entered in the third and fourth blocks, neither trauma exposure nor PTSD were uniquely significant. In this final model, depression, substance use, and unstable housing were uniquely associated with worse adherence. Trauma-informed models of HIV care that holistically address co-occurring factors are warranted to cater to communities with HIV health disparities and keep them from falling off the HIV care continuum.

HIV 感染者报告的创伤暴露和 PTSD 症状异常高，这两者都与 ART 依从性不佳有关。经常混淆的问题是，哪种结构推动了随后的 HIV 自我护理行为。鉴于黑人和西班牙裔/拉丁裔个体之间的艾滋病毒差异，以及迈阿密是一个具有高种族/少数族裔组成和独特的社会经济环境的地理区域，探索与迈阿密艾滋病毒结果相关的因素以减轻其不受控制的影响非常重要流行性。本研究旨在检查在佛罗里达州迈阿密接受公共 HIV 护理的经济边缘化的大多数黑人和西班牙裔/拉丁裔个体样本中，创伤暴露、PTSD 症状和相关的其他关键因素与坚持抗逆转录病毒疗法的关系。ñ = 1237) 通过横断面调查。顺序线性回归用于检查四个部分的研究目标：(1) 创伤，(2) PTSD 症状，以及 ART 依从性的关键协变量，包括 (3) 抑郁和物质使用（潜在的心理协变量），以及 (4) 指标社会经济地位（潜在的结构协变量）。在第一个区块中，创伤暴露与较差的依从性相关。然而，在第二个区块中，与创伤的关联下降，PTSD 与较差的依从性显着相关。值得注意的是，对于那些经历高水平创伤暴露的人来说，无论创伤后应激障碍如何，依从性都会受到负面影响。当与依从性相关的其他关键因素被输入到第三和第四块时，创伤暴露和 PTSD 都不是唯一显着的。在这个最终模型中，抑郁症，物质使用和不稳定的住房与较差的依从性有关。有必要从整体上解决共同发生的因素的创伤知情 HIV 护理模型，以迎合存在 HIV 健康差异的社区，并防止他们脱离 HIV 护理连续体。