Gender Roles and Mental Health in Women With and at Risk for HIV

Brody, Leslie R.; Stokes, Lynissa R.; Dale, Sannisha K.; Kelso, Gwendolyn A.; Cruise, Ruth C.; Weber, Kathleen M.; Burke-Miller, Jane K.; Cohen, Mardge H.

doi:10.1177/0361684314525579

Cited by 31 publications

(38 citation statements)

References 93 publications

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“…Data suggest that men and women are impacted differently by sexual risk in the context of heterosexual sex (Brody et al, 2014; Katz & Gerberding, 1998; Royce, Sena, Cates, & Cohen, 1997) and often this risk includes the combination of substance use and sexual behavior (Mimiaga et al, 2013; Raj, Saitz, Cheng, Winter, & Samet, 2007). This relationship cuts across substances to include alcohol (Avins et al, 1994; Raj et al, 2007; Shillington, Cottler, Compton, & Spitznagel, 1995; Shuper, Joharchi, Irving, & Rehm, 2009), cocaine (Edlin et al, 1994; Khan et al, 2013; McElrath, 2005; Mimiaga et al, 2013; Molitor, Truax, Ruiz, & Sun, 1998; Raj et al, 2007), methamphetamine (Corsi & Booth, 2008), and opioids (Centers for Disease Control and Prevention, 2006; Chitwood, Comerford, & Sanchez, 2003; Kelly & Parsons, 2013; Mackesy-Amiti, Boodram, Williams, Ouellet, & Broz, 2013).…”

Section: Introductionmentioning

confidence: 99%

Sociodemographic and Substance Use Disorder Determinants of HIV Sexual Risk Behavior in Men and Women in Outpatient Drug Treatment in the NIDA National Drug Abuse Treatment Clinical Trials Network

Kidd

Tross

Pavlicová

et al. 2017

Substance Use & Misuse

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BACKGROUND Sexual risk behavior is now the primary vector of HIV transmission among substance users in the United States with gender as a crucial moderator of risk behavior. OBJECTIVES The purpose of this study was to examine gender differences in factors (age, race/ethnicity, education) that predict main-partner unprotected sexual occasions (USO) using the unique platform of two parallel NIDA National Drug Abuse Treatment Clinical Trials Network gender-specific safer sex intervention trials. METHODS Baseline assessments of male (N=430) and female (N=377) participants included demographic characteristics; past 3-month sexual activity; and a diagnostic assessment for alcohol, cocaine/stimulant, and opioid use disorders. Using mixed effects generalized linear modeling of the main outcome USO, two-way interactions of gender with age, race/ethnicity, and education were evaluated and adjusted by alcohol, cocaine/stimulant, or opioid use disorder. RESULTS When adjusted for alcohol use disorder, the interaction of education and gender was significant. For men, a high school or greater education was significantly associated with more USO compared to men with less than high school. For women, greater than high school education was significantly associated with less USO compared to women with a high school education. None of the other interactions were significant when adjusted for cocaine/stimulant or opioid use disorder. CONCLUSIONS/IMPORTANCE This study demonstrates gender differences in the relationship of education, alcohol use disorder, and main-partner USO in individuals in substance abuse treatment. This underscores the importance of considering demographic and substance use factors in HIV sexual risk behavior and in crafting prevention messages for this population.

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Section: Introductionmentioning

confidence: 99%

Sociodemographic and Substance Use Disorder Determinants of HIV Sexual Risk Behavior in Men and Women in Outpatient Drug Treatment in the NIDA National Drug Abuse Treatment Clinical Trials Network

Kidd

Tross

Pavlicová

et al. 2017

Substance Use & Misuse

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“…(11) HIV seropositive women present higher average scores for depressive symptoms and lower quality of life than non-infected women. (12) The objective of this study was to analyze the quality of life of HIV seropositive women.…”

Section: Introductionmentioning

confidence: 99%

Qualidade de vida de mulheres portadoras do HIV

et al. 2015

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Objective: Analyze the quality of life of HIV seropositive women. Methods: Cross-sectional study including 40 women selected through non-probabilistic sampling. The questionnaire WHOQOL-HIV bref was the research instrument employed, considering the six domains of the instrument and socio-demographic and clinical aspects. Data analysis was performed using the KolmogorovSmirnov test to analyze the normality of sampling average distributions, and the Mann-Whitney and KruskalWallis tests to analyze the difference between averages or medians of the scores for quality of life. The Spearman coefficient was used for potential correlations. Results: According to the questionnaire, the Spirituality domain (average=59.5) reported the highest score, while the Environment domain (average=52.1) scored lowest. The average age was 41 years old; 97.5% declared themselves to be heterosexual; and 80.0% used antiretroviral treatment. Conclusion: Spirituality was the best-performing domain, followed by the Physical domain. The lowest average scores were observed for the Environment and Social Relations domains. ResumoObjetivo: Analisar a qualidade de vida de mulheres portadoras do HIV. Métodos: Estudo transversal que incluiu 40 mulheres selecionadas por amostra não-probabilística. O instrumento de pesquisa foi o questionário WHOQOL-HIV bref, considerando-se os seis domínios do instrumento e os aspectos sociodemográficos e clínicos. Para análise dos dados foi realizado o teste de Kolmogorov-Smirnov para a normalidade das distribuições de médias amostrais e os testes Mann-Whitney e Kruskal-Wallis para analisar a diferença entre as médias ou medianas dos escores de qualidade de vida. O coeficiente de Spearman foi utilizado para possíveis correlações. Resultados: Segundo o questionário, o domínio Espiritualidade (média = 59,5) apresentou maior escore e o domínio Meio Ambiente (média = 52,1) o menor escore obtido. A média da idade foi de 41 anos, 97,5% declararam ser heterossexuais, 80,0% utilizavam tratamento antirretroviral. Conclusão: A espiritualidade foi o domínio com melhor desempenho, seguido do domínio Físico. Os menores escores médios foram observados nos domínios Meio Ambiente e Relações Sociais.

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“…5,6 In contrast, affiliation often predicts positive health outcomes. 6 We hypothesized that better antiretroviral medication adherence (ART) and HIV biomarkers (viral load and CD4 count) would relate to lower self-silencing and unmitigated communion and to higher affiliation in women with HIV.…”

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confidence: 99%

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confidence: 99%

“…3,4 High self-silencing and unmitigated communion are reported more by women with HIV compared to uninfected women 5 and predict high depression, lower quality of life, and worse health care behaviors in diverse samples. 5,6 In contrast, affiliation often predicts positive health outcomes. 6 We hypothesized that better antiretroviral medication adherence (ART) and HIV biomarkers (viral load and CD4 count) would relate to lower self-silencing and unmitigated communion and to higher affiliation in women with HIV.…”

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confidence: 99%

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Gender Role Behaviors of High Affiliation and Low Self-Silencing Predict Better Adherence to Antiretroviral Therapy in Women with HIV

Brody

Stokes

Kelso

et al. 2014

AIDS Patient Care and STDs

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Socially prescribed gender-role behaviors for women include communion or affiliation (behaviors and characteristics that foster positive interpersonal relationships, such as empathy and warmth); self-silencing (concealing feelings to avoid conflict, loss, and protect self-esteem); and unmitigated communion (prioritizing care for others over self-care).1,2 Socialization experiences influence the extent to which individual women adopt gender-role behaviors, which may reflect strategies to cope with patriarchal systems that limit women's choices and punish self-advocacy.3,4 High self-silencing and unmitigated communion are reported more by women with HIV compared to uninfected women 5 and predict high depression, lower quality of life, and worse health care behaviors in diverse samples. 5,6 In contrast, affiliation often predicts positive health outcomes. 6 We hypothesized that better antiretroviral medication adherence (ART) and HIV biomarkers (viral load and CD4 count) would relate to lower self-silencing and unmitigated communion and to higher affiliation in women with HIV. We also hypothesized that self-silencing and unmitigated communion would moderate the relationships between affiliation and health outcomes, such that higher self-silencing and unmitigated communion would minimize the health benefits of affiliation.Participants were from the Chicago site of the Women's Interagency HIV Study (WIHS), a longitudinal cohort study of women with and at risk for HIV enrolled during three waves (1 = 1994-1995; 2 = 2001; 3 = 2010-2011). Study visits are conducted semiannually, and include a structured interview, physical and gynecologic examinations, and specimen collections, as previously described.7,8 The current study included a convenience sample of 100 HIV + women (n = 44, wave 1, and n = 56, wave 2), who were recruited at a regularly scheduled WIHS visit during 2008-2012 that coincided with data collection for the current study.Gender roles were assessed with three self-report measures demonstrating good validity and reliability with similar samples, including: (1) Silencing the Self Scale, 1 a 31-item measure with four subscales (Care as Self Sacrifice, Divided Self, Externalized Self-Perception, and Self-Silencing); (2) Personal Attributes Questionnaire-F Scale, 9 an eight-item scale measuring affiliation; and (3) Revised Unmitigated Communion Scale, 2 a nine-item scale measuring concern for others rather than the self. Sample items for scales are described in Table 1. Each measure was divided into two categories using median splits (0 = below median and 1 = scores including and above median) in order to facilitate interpretation of the analysis, comparing women who report high versus low gender roles in relation to HIV outcomes. The Silencing the Self Scale (total and subscale scores) and the Unmitigated Communion Scale were reverse scored before median split groups were created to model the effect of healthier behaviors.To measure ART adherence, participants estimated the percentage of time they took their m...

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Gender Roles and Mental Health in Women With and at Risk for HIV

Cited by 31 publications

References 93 publications

Sociodemographic and Substance Use Disorder Determinants of HIV Sexual Risk Behavior in Men and Women in Outpatient Drug Treatment in the NIDA National Drug Abuse Treatment Clinical Trials Network

Sociodemographic and Substance Use Disorder Determinants of HIV Sexual Risk Behavior in Men and Women in Outpatient Drug Treatment in the NIDA National Drug Abuse Treatment Clinical Trials Network

Qualidade de vida de mulheres portadoras do HIV

Gender Role Behaviors of High Affiliation and Low Self-Silencing Predict Better Adherence to Antiretroviral Therapy in Women with HIV

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