The Effects of Perceived Stress and Cortisol Concentration on Antiretroviral Adherence When Mediated by Psychological Fl
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ORIGINAL PAPER
The Effects of Perceived Stress and Cortisol Concentration on Antiretroviral Adherence When Mediated by Psychological Flexibility Among Southern Black Men Living with HIV Robert L. Cooper1 · Lauren L. Brown2,3 · Mohammad Tabatabai1 · David W. Haas1,3 · Bryan E. Shepherd3 · Hector F. Myers3 · Ryan D. Edgerton1 · Castro Bonny1 · Julia A. Watson1 · Vladimir Berthaud1
© Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract This pilot study investigates the correlation between psychological stress and antiretroviral therapy (ART) adherence and plasma HIV RNA (viral load) as mediated by psychological flexibility among Black men in the south. Data were collected from 48 HIV-positive, low income Black men. Results indicate a strong positive correlation between perceived stress and psychological inflexibility (adjusted for age and income r s = 0.67; p 0.05 for each); hair cortisol concentration was positively associated with the disclosure subscale of our HIV stigma scale (rs = 0.30; p = 0.04), but not with any of the other HIV stigma measures. Psychological inflexibility
The hypothesized model shown in Fig. 1 was constructed based on previously reported correlations between stress and adherence in the literature [9], as well as the correlational analyses described above. After explatory analysis found no correlation between hair cortisol and any other variables we excluded from the final model. Figure 2 is the adapted version of the conceptional model, that includes the findings in the model. The resultant correlational model involves stress, as measured by the PSS, psychological inflexibility measured with the AAQ, the visual analogue scale of ART adherence, and log10-transformed HIV RNA viral load; all analyses also adjust for the potential confounding variables of age and income (log10-transformed). The correlation between perceived stress and psychological inflexibility was strong (adjusted r s = 0.67; p
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