Exploring HIV-Related Stigma as a Determinant of Engagement in HIV Care by African American Women

McCoy, Katryna; Lipira, Lauren; Kemp, Christopher G.; Nevin, Paul E.; Huh, David; Turan, Janet M.; Mugavero, Michael J.; Cohn, Susan E.; Bahk, Mieoak; Simoni, Jane M.; Andrasik, Michele P.; Rao, Deepa

doi:10.1097/jnc.0000000000000140

Cited by 9 publications

(10 citation statements)

References 35 publications

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“…Our study did not find an association between HIV related stigma and retention in HIV care. This is similar to what was found in other studies [ 36 – 38 ]. However, there are studies which showed that HIV related stigma was associated with retention in HIV care [ 39 – 45 ].…”

Section: Discussionsupporting

confidence: 93%

“…The difference in our findings could also be due to our strict definition of retention as some studies that found an association between HIV related stigma and retention in care have defined poor retention as going 12 months since the last documented clinic visit [ 43 ]. Some authors have also suggested that HIV related stigma may hinder initial linkage to care but play a lesser role on retention of patients in care [ 36 ]. This may explain the lack of association between HIV related stigma and retention in care for those already linked to care.…”

Section: Discussionmentioning

confidence: 99%

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Retention in HIV care and associated factors among youths aged 15–24 years in rural southwestern Uganda

et al. 2021

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Background Retention in HIV care contributes to antiretroviral therapy adherence, which is a key factor for improved treatment outcomes and prevention of drug resistance. However, HIV treatment among the youths is characterized by loss to follow up, poor adherence to ART, risk of treatment failure and high mortality rates compared to young children and adults. There is limited information about factors associated with retention of youths in HIV care in rural settings in Uganda. We aimed to determine retention in HIV care and associated factors among youths aged 15–24 years in rural southwestern Uganda. Methods A cross-sectional study was conducted among youths aged 15–24 years who were receiving care at the HIV clinic at Kabuyanda HC IV who had been in care for at least 1 year before the study. We used an interviewer-administered questionnaire to collect socio-demographic information. Participant chart abstraction was used to collect information on HIV clinic attendance. We collected information on HIV related stigma using the 40-item Berger Stigma Scale. Chi-square test and multivariable logistic regression analysis were used to determine the factors associated with retention in HIV care with a significance level of < 0.05. Retention in HIV care was, defined as having sought care at least once per quarter in the 12 months prior to the study. Results We enrolled 102 participants with a mean age of 20.95 (SD ± 3.07) years. Two thirds (65.7%) of the youths had been retained in HIV care in the previous 12 months. In adjusted analyses, being male, married and had perinatally acquired HIV were independently associated with retention in HIV care. The association between HIV related stigma and retention in HIV care was not statistically significant. Conclusion Retaining adolescents and young adults in HIV care in rural southwestern Uganda is still much lower than the WHO target of 90%. Being male, having perinatally acquired HIV and married or in a relationship are associated with retention in HIV care. Interventions targeting adolescents and young adults living with HIV are necessary to improve retention in HIV care to the WHO target of 90%.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Retention in HIV care and associated factors among youths aged 15–24 years in rural southwestern Uganda

et al. 2021

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“…Stigma has been widely assessed and examined in studies on various health and psychiatric conditions: human immunodeficiency virus (HIV), hepatitis C virus (HCV), obesity, major depressive disorder, generalized anxiety disorder, bipolar disorder, alcohol and substance use, and type 2 diabetes mellitus (T2DM) [64][65][66][67][68][69][70][71][72][73]. Respective studies have demonstrated that stigma is commonly experienced by people with specific health and psychiatric conditions, and that stigma is negatively associated with multiple outcomes: suboptimal health or help-seeking behaviors, low engagement in health care, low treatmentseeking behaviors, and low testing or diagnostic uptake.…”

Section: Stigmamentioning

confidence: 99%

Stigma and Endometriosis: A Brief Overview and Recommendations to Improve Psychosocial Well-Being and Diagnostic Delay

Sims

Gupta

Missmer

et al. 2021

IJERPH

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Endometriosis is a chronic gynecological disease that affects approximately 1 in 10 women of reproductive age. Symptoms of severe pelvic pain, infertility, fatigue, and abnormal menstruation can cause significant negative effects on an individual’s physical and mental health, including interactions with their family, friends, and health care providers. Stigma associated with endometriosis has been under-studied and is rarely discussed in current literature. Herein, this paper aims to provide a brief overview of published literature to explore and establish the plausibility of stigma as a driver of suboptimal psychosocial well-being and diagnostic delay among individuals living with endometriosis. We present the clinical characteristics and physical and mental health consequences associated with endometriosis, highlight several theoretical constructs of stigma, and review the limited studies documenting women’s lived experiences of endometriosis-related stigma. To mitigate harmful effects of this phenomenon, we recommend increasing efforts to assess the prevalence of and to characterize endometriosis-related stigma, implementing awareness campaigns, and developing interventions that combat the multidimensional negative effects of stigma on timely care, treatment, and quality of life for individuals living with endometriosis.

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“…Clinical trial tests of anti-HIV stigma approaches include a faith-based intervention for Black churches [ 77 – 79 ], a group-level intervention for Black women [ 80 ], and a community-level intervention for young Black men [ 81 , 82 ]. Whereas Rao and colleagues [ 80 ] did not find group differences in stigma reduction, follow-up analyses reveal important impact of HIV stigma on viral load [ 83 ] and engagement in HIV care [ 84 ], and the mediating role of depression and ART non-adherence [ 58 ].…”

Section: Nih Icos With Hiv-related Stigma Research Approaches and Activitiesmentioning

confidence: 99%

HIV-Related Stigma Research as a Priority at the National Institutes of Health

et al. 2021

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The National Institutes of Health (NIH) recognizes that, despite HIV scientific advances, stigma and discrimination continue to be critical barriers to the uptake of evidence-based HIV interventions. Achieving the Ending the HIV Epidemic: A Plan for America (EHE) goals will require eliminating HIV-related stigma. NIH has a significant history of supporting HIV stigma research across its Institutes, Centers, and Offices (ICOs) as a research priority. This article provides an overview of NIH HIV stigma research efforts. Each ICO articulates how their mission shapes their interest in HIV stigma research and provides a summary of ICO-relevant scientific findings. Research gaps and/or future opportunities are identified throughout, with key research themes and approaches noted. Taken together, the collective actions on the part of the NIH, in tandem with a whole of government and whole of society approach, will contribute to achieving EHE’s milestones.

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Exploring HIV-Related Stigma as a Determinant of Engagement in HIV Care by African American Women

Cited by 9 publications

References 35 publications

Retention in HIV care and associated factors among youths aged 15–24 years in rural southwestern Uganda

Retention in HIV care and associated factors among youths aged 15–24 years in rural southwestern Uganda

Stigma and Endometriosis: A Brief Overview and Recommendations to Improve Psychosocial Well-Being and Diagnostic Delay

HIV-Related Stigma Research as a Priority at the National Institutes of Health

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