Health Care-Specific Enacted HIV-Related Stigma's Association with Antiretroviral Therapy Adherence and Viral Suppression Among People Living with HIV in Florida

Algarin, Angel B.; Sheehan, Diana M.; Varas-Díaz, Nelson; Fennie, Kristopher; Zhou, Zehong; Spencer, Emma; Cook, Robert L.; Morano, Jamie P.; Ibáñez, Gladys

doi:10.1089/apc.2020.0031

Cited by 28 publications

(19 citation statements)

References 43 publications

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“…Our findings are also consistent with what has been reported in the state of Florida, regarding significant correlations between HIV-related stigma (by healthcare workers) and ARV adherence (34), and HIV-related stigma and depression (35), although this is specific to a population of majority non-Hispanic Black men and women with HIV. Outside of the US, the relationship between HIV-related stigma and adherence has also been established among marginalized populations in the Dominican Republic, including men and women of Haitian descent (36).…”

Section: Quantitative Findingssupporting

confidence: 92%

Pills, PrEP, and Pals: Adherence, Stigma, Resilience, Faith and the Need to Connect Among Minority Women With HIV/AIDS in a US HIV Epicenter

Duthely

Sanchez‐Covarrubias

Brown

et al. 2021

Front. Public Health

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Background: Ending HIV/AIDS in the United States requires tailored interventions. This study is part of a larger investigation to design mCARES, a mobile technology-based, adherence intervention for ethnic minority women with HIV (MWH).Objective: To understand barriers and facilitators of care adherence (treatment and appointment) for ethnic MWH; examine the relationship between these factors across three ethnic groups; and, explore the role of mobile technologies in care adherence.Methods: Cross-sectional, mixed-methods data were collected from a cohort of African-American, Hispanic-American and Haitian-American participants. Qualitative data were collected through a focus group (n = 8) to assess barriers and facilitators to care adherence. Quantitative data (n = 48) surveyed women on depressive symptomology (PHQ-9), HIV-related stigma (HSS) and resiliency (CD-RISC25). We examined the relationships between these factors and adherence to treatment and care and across groups.Findings: Qualitative analyses revealed that barriers to treatment and appointment adherence were caregiver-related stressors (25%) and structural issues (25%); routinization (30%) and religion/spirituality (30%) promoted adherence to treatment and care. Caregiver role was both a hindrance (25%) and promoter (20%) of adherence to treatment and appointments. Quantitatively, HIV-related stigma differed by ethnic group; Haitian-Americans endorsed the highest levels while African-Americans endorsed the lowest. Depression correlated to stigma (R = 0.534; p < 0.001) and resiliency (R = −0.486; p < 0.001). Across ethnic groups, higher depressive symptomology and stigma were related to viral non-suppression (p < 0.05)—a treatment adherence marker; higher resiliency was related to viral suppression. Among Hispanic-Americans, viral non-suppression was related to depression (p < 0.05), and among African-Americans, viral suppression was related to increased resiliency (p < 0.04).Conclusion: Multiple interrelated barriers to adherence were identified. These findings on ethnic group-specific differences underscore the importance of implementing culturally-competent interventions. While privacy and confidentiality were of concern, participants suggested additional intervention features and endorsed the use of mCARES as a strategy to improve adherence to treatment and appointments.

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Section: Quantitative Findingssupporting

confidence: 92%

Pills, PrEP, and Pals: Adherence, Stigma, Resilience, Faith and the Need to Connect Among Minority Women With HIV/AIDS in a US HIV Epicenter

Duthely

Sanchez‐Covarrubias

Brown

et al. 2021

Front. Public Health

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“…Various layers of stigma are explored, including enacted (experienced) stigma and perceived public (anticipated) stigma. Enacted stigma refers to actual negative actions taken against someone due to their infection status [ 11 ]. Perceived public stigma refers to the perception of being stigmatized and the anticipation of being discriminated against [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

A systematic review and meta-analysis on the prevalence of stigma in infectious diseases, including COVID-19: a call to action

et al. 2021

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Infectious diseases, including COVID-19, are crucial public health issues and may lead to considerable fear among the general public and stigmatization of, and discrimination against, specific populations. This meta-analysis aimed to estimate the pooled prevalence of stigma in infectious disease epidemics. We systematically searched PubMed, PsycINFO, Embase, MEDLINE, Web of Science, and Cochrane databases since inception to June 08, 2021, and reported the prevalence of stigma towards people with infectious diseases including SARS, H1N1, MERS, Zika, Ebola, and COVID-19. A total of 50 eligible articles were included that contributed 51 estimates of prevalence in 92722 participants. The overall pooled prevalence of stigma across all populations was 34% [95% CI: 28−40%], including enacted stigma (36% [95% CI: 28−44%]) and perceived stigma (31% [95% CI: 22−40%]). The prevalence of stigma in patients, community population, and health care workers, was 38% [95% CI: 12− 65%], 36% [95% CI: 28−45%], and 30% [95% CI: 20−40%], respectively. The prevalence of stigma in participants from low- and middle-income countries was 37% [95% CI: 29−45%], which is higher than that from high-income countries (27% [95% CI: 18−36%]) though this difference was not statistically significant. A similar trend of prevalence of stigma was also observed in individuals with lower education (47% [95% CI: 23−71%]) compared to higher education level (33% [95% CI: 23−4%]). These findings indicate that stigma is a significant public health concern, and effective and comprehensive interventions are needed to counteract the damaging effects of the infodemics during infectious disease epidemics, including COVID-19, and reduce infectious disease-related stigma.

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“…1 HIV stigma deters uptake of HIV testing, HIV sero-status disclosure, retention in care, and adherence to antiretroviral therapies. 2,3 In the Arab world, social norms associated with sexuality in general and sexual behaviors of marginalized groups contribute to HIV stigma and possibly compromise the reliability of data on the HIV epidemic. 4 For example, in Egypt, the General Penalties Laws and laws regulating inappropriate social conduct criminalize commercial sex workers, intravenous drug uses, and men having sex with men.…”

Section: Introductionmentioning

confidence: 99%

“…6 Furthermore, stigmatization leads to deterioration of PLHIV physical and mental health and overall quality of life. 2,7,8 Eliminating discrimination against PLHIV in health care settings is considered a key component in the protection of human rights of PLHIV and achieving the sustainable development goals relevant to HIV. 9,10 Health care providers (HCPs) are ethically obligated to not discriminate against PLHIV.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Cross-Cultural Adaptation and Psychometric Assessment of an Arabic Version of the Health Care Provider HIV/AIDS Stigma Scale

Aziz

Badahdah

Mohammed

2021

J Int Assoc Provid AIDS Care

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HIV stigma among health care providers in the Arab world is understudied due to a lack of valid and reliable measures. Data from 352 Egyptian physicians was used to validate an Arabic version of the Health Care Provider HIV/AIDS Stigma Scale (HPASS). Exploratory factor analysis ( n = 1 9 4) suggested a 3 -factor structure. Confirmatory factor analysis ( n = 1 5 8) validated the three-factor solution with 18 items, which explained 5 3 .3 6% of the variance. All items loaded on their designated constructs, which ranged from 0 .58 to 0 .82 (prejudice) to 0 .58 to 0 .66 (stereotypes) and 0 .52 to 0 .91 (discrimination). The prejudice, stereotypes, and discrimination subscales consisted of seven, five, and six items, respectively. The internal consistency (α = 0 .9 0) and the test-retest reliability demonstrated ( r = 0 .9 5) were excellent. The cultural adaptation of the Arabic version of HPASS suggests that it is a suitable scale for assessing HIV stigma among Arab health care providers.

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Health Care-Specific Enacted HIV-Related Stigma's Association with Antiretroviral Therapy Adherence and Viral Suppression Among People Living with HIV in Florida

Cited by 28 publications

References 43 publications

Pills, PrEP, and Pals: Adherence, Stigma, Resilience, Faith and the Need to Connect Among Minority Women With HIV/AIDS in a US HIV Epicenter

Pills, PrEP, and Pals: Adherence, Stigma, Resilience, Faith and the Need to Connect Among Minority Women With HIV/AIDS in a US HIV Epicenter

A systematic review and meta-analysis on the prevalence of stigma in infectious diseases, including COVID-19: a call to action

Cross-Cultural Adaptation and Psychometric Assessment of an Arabic Version of the Health Care Provider HIV/AIDS Stigma Scale

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