Longitudinal Relationships Between Antiretroviral Treatment Adherence and Discrimination Due to HIV-Serostatus, Race, and Sexual Orientation Among African–American Men with HIV

Bogart, Laura M.; Wagner, Glenn; Galván, Frank H.; Klein, David J.

doi:10.1007/s12160-010-9200-x

Cited by 134 publications

(129 citation statements)

References 49 publications

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“…Stigma manifested at the individual level among targets can impair treatment adherence. A study at the intersection of race, HIV, and sexual orientation suggests that perceived stigma due to race plays a significant role in antiretroviral adherence: In a multivariate model including the effects of perceived stigma due to race, HIV, and sexual orientation, only perceived stigma due to race was a significant predictor of adherence (Bogart, Wagner, Galvan, & Klein, 2010). People living with HIV who have internalized stigma are also more likely to report suboptimal adherence (Sayles et al, 2009).…”

Section: Treatmentmentioning

confidence: 99%

Stigma and racial/ethnic HIV disparities: Moving toward resilience.

Earnshaw¹,

Bogart²,

Dovidio³

et al. 2015

Stigma and Health

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108

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Prior research suggests that stigma plays a role in racial/ethnic health disparities. However, there is limited understanding about the mechanisms by which stigma contributes to HIV-related disparities in risk, incidence and screening, treatment, and survival and what can be done to reduce the impact of stigma on these disparities. We introduce the Stigma and HIV Disparities Model to describe how societal stigma related to race and ethnicity is associated with racial/ethnic HIV disparities via its manifestations at the structural level (e.g., residential segregation) as well as the individual level among perceivers (e.g., discrimination) and targets (e.g., internalized stigma). We then review evidence of these associations. Because racial/ethnic minorities at risk of and living with HIV often possess multiple stigmas (e.g., HIV-positive, substance use), we adopt an intersectionality framework and conceptualize interdependence among co-occurring stigmas. We further propose a resilience agenda and suggest that intervening on modifiable strength-based moderators of the association between societal stigma and disparities can reduce disparities. Strengthening economic and community empowerment and trust at the structural level, creating common ingroup identities and promoting contact with people living with HIV among perceivers at the individual level, and enhancing social support and adaptive coping among targets at the individual level can improve resilience to societal stigma and ultimately reduce racial/ethnic HIV disparities.

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Section: Treatmentmentioning

confidence: 99%

Stigma and racial/ethnic HIV disparities: Moving toward resilience.

Earnshaw¹,

Bogart²,

Dovidio³

et al. 2015

Stigma and Health

Self Cite

108

View full text Add to dashboard Cite

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“…acial differences in clinical responses to HIV therapy have been a consistent finding of both clinical trials and cohort studies, with African-Americans having a greater risk for virologic failure compared to other races (1)(2)(3)(4)(5)(6). For example, in AIDS Clinical Trials Group (ACTG) study A5202, a comparative trial of efavirenz-and atazanavir/ritonavir-based initial treatment regimens, African-American participants had a significantly shorter time to virologic failure compared to white participants (7).…”

mentioning

confidence: 82%

Raltegravir Pharmacokinetics in Treatment-Naive Patients Is Not Influenced by Race: Results from the Raltegravir Early Therapy in African-Americans Living with HIV (REAL) Study

Wohl

Dumond

Blevins

et al. 2013

Antimicrob Agents Chemother

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Racial differences in antiretroviral treatment responses remain incompletely explained and may be a consequence of differential pharmacokinetics (PK) associated with race. Raltegravir, an inhibitor of HIV-1 integrase, is commonly used in the treatment of HIV-infected patients, many of whom are African-American. However, there are few data regarding the PK of raltegravir in African-Americans. HIV-infected men and women, self-described as African-American and naive to antiretroviral therapy were treated with raltegravir (RAL) at 400 mg twice a day, plus a fixed dose of tenofovir-emtricitabine (TDF/FTC) at 300 mg/200 mg once daily. Intensive PK sampling was conducted over 24 h at week 4. Drug concentrations at two trough values of 12 and 24 h after dosing (C 12 and C 24 ), area under the concentration-curve values (AUC), maximum drug concentration (C max ), and the time at which this concentration occurred (T max ) in plasma were estimated with noncompartmental pharmacokinetic methods and compared to data from a subset of white subjects randomized to the RAL twice a day (plus TDF/FTC) arm of the QDMRK study, a phase III study of the safety and efficacy of once daily versus twice daily RAL in treatment naive patients. A total of 38 African-American participants were enrolled (90% male) into the REAL cohort with the following median baseline characteristics: age of 36 years, body mass index (BMI) of 23 kg/m 2 , and a CD4 cell count of 339/ml. Plasma HIV RNA levels were below 200 copies/ml in 95% of participants at week 4. The characteristics of the 16 white QDMRK study participants were similar, although fewer (69%) were male, the median age was higher (45 years), and BMI was lower (19 kg/m 2 ). There was considerable interindividual variability in RAL concentrations in both cohorts. Median C 12 in REAL was 91 ng/ml (range, 10 to 1,386) and in QDMRK participants was 128 ng/ml (range, 15 to 1,074). The C max median concentration was 1,042 ng/ml (range, 196 to 10,092) for REAL and 1,360 ng/ml (range, 218 to 9,701) for QDMRK. There were no significant differences in any RAL PK parameter between these cohorts of African-American and white individuals. Based on plasma PK, and with similar adherence rates, the performance of RAL among HIV-infected African-Americans should be no different than that of infected patients who are white.

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“…Responses choices were yes/no. This measure was adapted from a prior measure developed for use with MSM (Bogart, Wagner, & Galvan, 2010) and was internally consistent in this sample (a = .70).…”

Section: Discrimination Experiencesmentioning

confidence: 99%

Use of the Internet to Meet Sexual Partners, Sexual Risk Behavior, and Mental Health in Transgender Adults

et al. 2014

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The purpose of this study was to examine the use of the internet to meet sexual partners among transgender individuals and examine correlates of this use, including sexual risk behavior, discrimination experiences, and mental health. A sample of 166 transgender adults (112 male-to-female transgender women and 54 female-to-male transgender men) were recruited in community venues and anonymously completed measures assessing these variables. Most participants (64.5 %) were HIV-negative, 25.2 % were HIV-positive, and 10.3 % did not know their HIV status. Overall, 33.7 % of participants reported having met a sexual partner over the internet, which did not differ significantly between transgender women and men. Among these individuals, transgender women reported significantly more lifetime internet sexual partners (median = 3) than transgender men (median = 1). Use of the internet to meet sexual partners was associated with lower self-esteem but not with depression, anxiety, somatic distress or discrimination experiences. Among transgender women, use of the internet to meet sexual partners was associated with each of the 11 sexual risk behaviors examined, including having multiple partners, sex under the influence of drugs, number of unprotected anal or vaginal sex acts, and history of commercial sex work. The use of the internet to meet partners was not associated with sexual risk behavior among transgender men (0/11 variables assessed). Although the internet is a common mode of meeting sexual partners among some transgender adults, it may also be a potential venue for prevention interventions targeting transgender individuals at particularly high risk for HIV acquisition.

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Longitudinal Relationships Between Antiretroviral Treatment Adherence and Discrimination Due to HIV-Serostatus, Race, and Sexual Orientation Among African–American Men with HIV

Cited by 134 publications

References 49 publications

Stigma and racial/ethnic HIV disparities: Moving toward resilience.

Stigma and racial/ethnic HIV disparities: Moving toward resilience.

Raltegravir Pharmacokinetics in Treatment-Naive Patients Is Not Influenced by Race: Results from the Raltegravir Early Therapy in African-Americans Living with HIV (REAL) Study

Use of the Internet to Meet Sexual Partners, Sexual Risk Behavior, and Mental Health in Transgender Adults

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