Recent Stressful Life Events, Lifetime Traumatic Events, Missed Visits, and Antiretroviral Adherence Among Black Women With HIV in the Southeastern United States: A Cross-sectional Study

Abstract

Lifetime traumatic events are prevalent among people with HIV and consistently associated with deleterious HIV outcomes. Yet, little is known about the impact of recent stressful events on health outcomes among Black women with HIV (WWH). This cross-sectional study assessed the prevalence of recent stressful events and lifetime traumatic events and their association with HIV outcomes in Black WWH (n = 200) in the Southeastern United States. We evaluated the association between stressful events and HIV outcomes using chi-square tests and unadjusted and adjusted logistic regression analyses. In the unadjusted analyses, missed visits were associated with higher odds of recent stressful events (odds ratio [OR] 1.10, 95% confidence interval [CI] 1.04–1.16) and lifetime traumatic events (OR 1.15, 95% CI 1.05–1.26). In the adjusted analysis, exposure to recent stressful events was independently associated with missed visits (adjusted OR 1.08, 95% CI 1.01–1.15). Interventions addressing recent stressful events are warranted.

Psychological grit moderates the relation between lifetime stressor exposure and functional outcomes among HIV‐seropositive and HIV‐seronegative adults

“…The results of this study are also related to previous research on Black women living with HIV (WLWH), where experiencing recent stress and lifetime traumatic events has many negative outcomes, such as missing HIV care appointments (Chapman Lambert, Wright, et al., 2022). Positive factors (i.e., social support and resilience) have been found to mediate the association between different dimensions of stigma (e.g., enacted stigma in the community) and patient activation (the patient's overall ability to manage a chronic condition) in Black WLWH, where these positive factors appear to buffer against the negative effects of stigma (Chapman Lambert, Fazeli, et al., 2022).…”

“…Positive factors (i.e., social support and resilience) have been found to mediate the association between different dimensions of stigma (e.g., enacted stigma in the community) and patient activation (the patient's overall ability to manage a chronic condition) in Black WLWH, where these positive factors appear to buffer against the negative effects of stigma (Chapman Lambert, Fazeli, et al., 2022). Given that HIV‐seropositive individuals experience stressors unique to their HIV‐status (Chapman Lambert, Wright, et al., 2022; López‐Matos et al., 2021), the difference in the stressor exposure and functional impairment association at low levels of grit between HIV status groups in our study may be related to the stigma the HIV‐seropositive group experiences. Although lifetime and chronic stressor exposure did not predict functional impairment in the HIV‐seropositive group at any level of grit, it may be that the development of functional impairment is tied specifically to stressors related to stigma, which future studies should examine.…”

“…Given that HIV-seropositive individuals experience stressors unique to their HIV-status (Chapman Lambert, Wright, et al, 2022;López-Matos et al, 2021), the difference in the stressor exposure and functional impairment association at low levels of grit between HIV status groups in our study may be related to the stigma the HIVseropositive group experiences. Although lifetime and chronic stressor exposure did not predict functional impairment in the HIV-seropositive group at any level of grit, it may be that the development of functional impairment is tied specifically to stressors related to stigma, which future studies should examine.…”

“…Rhodes et al (2016) conducted a similar study finding that adolescent grit scores predicted better cognitive ability in older adults. Given that HIV-seropositive individuals experience many stressors specific to their HIV-status (e.g., stigma; Chapman Lambert, Wright, et al, 2022;López-Matos et al, 2021), future studies should examine the impact of these HIV-related stressors in relation to grit and functional impairment.…”