Stigma Reduction Among African American Women With HIV: UNITY Health Study

Rao, Deepa; Kemp, Christopher G.; Huh, David; Nevin, Paul E.; Turan, Janet M.; Cohn, Susan E.; Simoni, Jane M.; Andrasik, Michele P.; Molina, Yamilé; Mugavero, Michael J.; French, Audrey L.

doi:10.1097/qai.0000000000001673

Cited by 31 publications

(34 citation statements)

References 29 publications

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“…We conducted a secondary analysis of longitudinal data from participants in the Unity Health Study (Rao, Kemp, et al, 2018), a randomized controlled trial that tested the effectiveness of a peer-led HIV-related stigma reduction intervention among 239 AA WLWH. Of those, 237 had at least one HIV medical care appointment scheduled during the study period and were included in our secondary analysis.…”

Section: Methodsmentioning

confidence: 99%

“…The Unity Health Study was approved by the institutional review boards at each of the participating study sites, and each study participant provided written informed consent prior to participating in study activities. Comprehensive details of the Unity Health Study are reported in Rao, Kemp, et al (2018).…”

Section: Methodsmentioning

confidence: 99%

“…Covariates.-Covariates were chosen a priori based on their potential as confounders of the association between HIV-related stigma and engagement in care (Haley et al, 2014) and included: clinic type (private, university-based, public hospital-affiliated, public universitybased), age in years, marital status (never been married, married or living with partner, separated/divorced/widowed), number of children (0, 1 to 3, 4 or more), education level (< high school, high school degree or equivalent, some college/AA/technical degree, college degree or higher), occupation (employed, homemaker, student, other), number of years since HIV diagnosis, and treatment group (treatment vs. control). Finally, we chose to include social support in our analysis as our research team recently found an association between increased social support and decreased HIV-related stigma over time among AA women enrolled in the Unity Health Study (Rao, Kemp, et al, 2018).…”

Section: Methodsmentioning

confidence: 99%

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

McCoy¹,

Lipira²,

Kemp³

et al. 2020

J Assoc Nurses AIDS Care

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Engagement in HIV care reduces HIV-related health disparities that persist across racial/ethnic and gender lines, yet African American (AA) women face multiple challenges to remaining engaged in care, including HIV-related stigma. We analyzed longitudinal data from 239 participants in the Unity Health Study to estimate associations between HIV-related stigma and engagement in care among AA women linked to HIV care. In adjusted Poisson regression analyses, engagement in care was not associated with HIV-related stigma, but was associated with older age (IRR = 1.01, 95% CI = [1.00, 1.01], p = .01), higher levels of education (IRR = 1.18, 95% CI = [1.02, 1.35], p = .03), and higher levels of social support (IRR = 1.05, 95% CI = [1.01-1.09], p = 0.04). Our findings suggest the need for targeted interventions to enhance engagement in care and to incorporate social support into health promotion programming for AA women living with HIV.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

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

McCoy¹,

Lipira²,

Kemp³

et al. 2020

J Assoc Nurses AIDS Care

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View full text Add to dashboard Cite

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“…This study is a secondary analysis of baseline data from the Unity Study, a multisite randomized controlled trial evaluating the longterm effectiveness of an HIV-related stigmareduction intervention for African-American women living with HIV. 56 From 2013 to 2015, African-American women living with HIV were recruited from three clinical sites that provide HIV care: Northwestern University Infectious Diseases HIV clinic (NU) and the Ruth M. Rothstein CORE Center (CORE) in Chicago, Ilinois and the University of Alabama, Birmingham 1917 HIV Clinic (UAB) in Birmingham, Alabama.…”

Section: Data Sourcementioning

confidence: 99%

Religiosity, Social Support, and Ethnic Identity: Exploring “Resilience Resources” for African-American Women Experiencing HIV-Related Stigma

Lipira

Williams

Nevin

et al. 2019

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Introduction: African-American women living with HIV report substantial HIV-related stigma and depression. Resilience resources are strength-based resources that may moderate the effects of HIV-related stigma on poor psychosocial outcomes such as depression. Objective: To evaluate whether religiosity, social support and ethnic identity moderate the effects of HIV-related stigma on depression among African-American women living with HIV. Methods: We used baseline data (5/2013-10/2015) from a randomized controlled trial testing the efficacy of an HIV-related stigma reduction intervention among African-American women living with HIV in Chicago, IL and Birmingham, AL who were >18 years old and currently receiving HIV services. To assess whether religiosity (7-item Religious Beliefs and Behaviors survey, RBB), social support (select subscales from the Medical Outcomes Study Social Support Survey, MOS-SSS), and ethnic identity (Commitment subscale from the Multigroup Ethnic Identity Measure, MEIM-R) modified the relationship between HIV-related stigma (Stigma Scale for Chronic Illness, SSCI) and depression (8-item Patient Health Questionnaire, PHQ-8), we conducted three separate moderation analyses using linear regression with interactions between HIV-related stigma and each moderator of interest, adjusted for study site, age, time since diagnosis, and education. Results: Among 226 African-American women living with HIV, greater levels of HIV-related stigma were associated with greater depression in all three models (p < 0.05). Only religiosity modified this association (p = 0.04), with a weaker association among women reporting higher levels of religiosity. Conclusions: The protective effects of religiosity may be leveraged in interventions for African-American women living with HIV struggling with HIV-related stigma.

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“…While some clinic-based strategies such as early initiation of ART have improved retention in care (Brown et al., 2016 ), other clinic-based strategies such as peer support or innovative counselling programmes have lacked anti-stigma or health outcome benefits, respectively (Rao et al., 2018 ; Uusküla et al., 2018 ). Some HIV-infected persons who take ART face barriers to care and require accompaniment in the community for various reasons, ranging from a weak health system, stigma, social ostracisation, alcohol abuse, as well as competing demands on time and money in the context of widespread abject poverty (Fatti, Meintjes, Shea, Eley, & Grimwood, 2012 ; Munyaneza et al., 2018 ; Pokhrel, Gaulee Pokhrel, Neupane, & Sharma, 2018 ; Vogt et al., 2017 ).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of a community-based ART programme after tapering home visits in rural Sierra Leone: a 24-month retrospective study

Kelly

Frankfurter²,

Lurton

et al. 2018

SAHARA-J: Journal of Social Aspects of HIV/AIDS

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Evaluations of community-based antiretroviral therapy (ART) programmes have demonstrated positive outcomes, but little is known about the impact of tapering community-based ART. The objective of this study was to assess 24-month HIV retention outcomes of a community-based ART programme and its tapered visit frequency in Koidu City, Sierra Leone. This retrospective, quasi-experimental study compared outcomes of 52 HIV-infected persons initiated on community-based ART against 91 HIV-infected persons receiving the standard of care from November 2009 to February 2013. The community-based ART pilot programme was designed to strengthen the standard of care through a comprehensive, patient-centred case management strategy. The strategy included medical, educational, psychological, social, and economic support. Starting in October 2011, the frequency of home visits was tapered from twice daily every day per week to once daily three days per week. Outcomes were retention in care at 12 and 24 months and adherence to ART over a three-month time period. Participants who received community-based ART had significantly higher retention than those receiving standard of care. At 12 months, retention rates for community-based ART and standard of care were 61.5% and 31.9%, respectively (p < .01). At 24 months, retention rates for community-based ART and standard of care were 73.1% and 44.0%, respectively (p < .01). Significant differences in levels of adherence were observed when comparing community-based ART against persons receiving standard of care (p < .05). No differences in adherence levels were observed between groups of people receiving various frequencies of home visits. Our pilot programme in Koidu City provides new evidence that community-based ART has the potential to improve retention and adherence outcomes for HIV-infected persons, regardless of the frequency of home visits. Overcoming the barriers to HIV care requires a comprehensive, patient-centred approach that may include clinic-based and community-based interventions.

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Stigma Reduction Among African American Women With HIV: UNITY Health Study

Abstract: Although UNITY did not significantly reduce HIV-related stigma in this population, our findings suggest that social support may be key to HIV-related stigma reduction.

Cited by 31 publications

References 29 publications

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

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

Religiosity, Social Support, and Ethnic Identity: Exploring “Resilience Resources” for African-American Women Experiencing HIV-Related Stigma

Evaluation of a community-based ART programme after tapering home visits in rural Sierra Leone: a 24-month retrospective study

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