Interrelationships among HIV-associated neurocognitive dysfunction, avoidant coping, cognitively-oriented coping, and psychological distress were examined using structural equation modeling in an ethnically diverse sample of 209 adults predominantly in the mid-range of illness. Global neurocognitive deficits, assessed with the HIV-dementia scale, were associated with higher levels of avoidant coping, lower levels of cognitive coping, and a higher avoidant/cognitive coping ratio, which were each in turn associated with higher psychological distress measured by a latent factor comprising symptoms of depression, anxiety, and HIV-related distressing thoughts. There were significant indirect effects through avoidant coping and a higher avoidant/cognitive coping ratio. Results suggest the presence of HIV-associated neurocognitive deficits may interfere with the utilization of cognitive-based coping strategies and increase reliance on more maladaptive strategies, which in turn may translate to elevated reports of psychological distress. Findings may help inform interventions aimed at reducing avoidant coping and psychological distress, two factors associated with accelerated HIV disease progression.

在 209 名主要处于疾病中期的成年人的种族多样化样本中，使用结构方程模型研究了 HIV 相关神经认知功能障碍、回避应对、认知导向应对和心理困扰之间的相互关系。用 HIV-痴呆量表评估的整体神经认知缺陷与较高水平的回避应对、较低水平的认知应对和较高的回避/认知应对比率相关，而这又分别与较高的心理压力相关，这些心理压力通过潜在的因素包括抑郁症、焦虑症和与 HIV 相关的痛苦想法。通过回避应对和更高的回避/认知应对比率有显着的间接影响。结果表明，与 HIV 相关的神经认知缺陷的存在可能会干扰基于认知的应对策略的使用，并增加对更多适应不良策略的依赖，这反过来可能会转化为心理困扰报告的增加。研究结果可能有助于为旨在减少回避应对和心理困扰的干预措施提供信息，这两个因素与加速 HIV 疾病进展有关。