The Role of HIV Stigma in ART Adherence and Quality of Life Among Rural Women Living with HIV in India

Heylen, Elsa; Mazur, Amanda; Steward, Wayne T.; Carpenter, Catherine L.; Yadav, Kartik; Sinha, Sanjeev; Nyamathi, Adey

doi:10.1007/s10461-018-2157-7

Cited by 41 publications

(23 citation statements)

References 66 publications

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“…The results of the study indicate that participants were more ready to share their status, get more social supports and also reduce stigma. Stigma has been reported to affect adherence, in a study carried out in India, It was found out that internalized stigma affected adherence among rural women [18]. This is consistent with our finding were stigma hindered participants adherence and interventions to solve this stigma would improve adherence.…”

Section: Discussionsupporting

confidence: 91%

Influence of intensified adherence counselling on viral load suppression of people receiving antiretroviral therapy at a health centre IV in southwestern Uganda: a qualitative study

et al. 2021

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Background The prevalence of Human Immunodeficiency Virus (HIV) among adults and children in Uganda is 6.2% and 0.5% respectively. The prevalence of viral load suppression in Uganda among all adults and children living with HIV is 59.6% and 39.3% respectively. High viral load compromises on the quality of life of an individual, and as well increases on the risk of transmission of the virus to the unborn for pregnant mothers and to the spouse. The UNAID 90-90-90 campaign recommends that 90% know their status, 90% get treatment and 90% have viral suppression. Non-adherence to Antiretroviral Therapy (ART) is one of the causes of the high viral load. The world health organization recommends Intensified Adherence Counselling (IAC) be given to all individuals with a high viral load. The perceptions, attitudes and practices of people receiving IAC is important in understanding how best IAC should be implemented. Methods A qualitative study was done among 30 purposively selected individuals/guardians of children receiving ART and IAC at Kyabugimbi Health Center Four [HC IV (mini-hospital headed by a medical doctor)]. Data collected from Focus Group Discussion as audio-recordings in local language (Runyankole) was transcribed and later translated into English. Translated transcripts were analyzed manually using thematic content analysis. Results The major themes identified include: adherence to ART; change of attitude towards ART after IAC, IAC expectation and outcomes, IAC and stigma, and improving social support through IAC for PLWHIV. Conclusion Participating in IAC to be informative and led to change in their perceptions of HIV and better understanding the reasons for adherence to ART. IAC influenced the change in attitude and behavior thus seeking social support and mitigate stigma, which lead to a better ART adherence. However, there is need to improve on the way it is delivered both in structural setting and break down and packaging of information.

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Section: Discussionsupporting

confidence: 91%

Influence of intensified adherence counselling on viral load suppression of people receiving antiretroviral therapy at a health centre IV in southwestern Uganda: a qualitative study

et al. 2021

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“…36 In addition, our finding that lifetime number of sexual partners was not associated with abnormal cytology suggests that cervical cancer risk in this population of women may be driven by sexual risk behaviors among male partners, independent of their own sexual history. 37 In India and other developing nations, there is a significant amount of evidence for the association between men who migrate for employment and increased sexual risk behaviors [38][39][40][41] and HIV risks for female partners. 41,42 Mobile migrant workers, such as truck drivers, may act as the potential bridge population and transmit infection from high-risk groups to their partners residing home who would have been at low risk for infection.…”

Section: Discussionmentioning

confidence: 99%

Cervical cancer awareness and presence of abnormal cytology among HIV-infected women on antiretroviral therapy in rural Andhra Pradesh, India

et al. 2019

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Cervical cancer is a leading cause of death among women in low- and middle-income countries, and women living with HIV are at high risk for cervical cancer. The objective of this study was to estimate the prevalence and correlates of cervical cancer and pre-cancer lesions and to examine cervical cancer knowledge among women living with HIV receiving antiretroviral therapy in rural Andhra Pradesh, India. We conducted cytology-based screening and administered a standardized questionnaire among 598 HIV-infected women. We found 5 (0.8%), 39 (6.5%), 29 (4.9%), and 4 (0.7%) had atypical squamous cells of undetermined significance (ASCUS), low-grade squamous intraepithelial lesion (LSIL), high-grade squamous intraepithelial lesion (HSIL), and squamous cervical carcinoma (SCC), respectively. In multivariable logistic regression analysis, ASCUS/LSIL was independently associated with age >16 years old at first sexual encounter and smokeless tobacco use. We found no factors associated with HSIL/SCC. In total, 101 women (16.9%) had heard of cervical cancer and 28 (27.7%) of them correctly identified HIV infection as a risk factor. In light of the high prevalence of pre-cancer lesions and low level of cervical cancer knowledge in our study population, focused interventions are needed to improve cervical cancer literacy and prevention among rural women living with HIV.

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“…HIV-related stigma is common among PLWH and associated with poor HRQoL [14][15][16]. HIV-related stigma can take many forms including anticipatory stigma, internalized stigma, and enacted stigma.…”

Section: Introductionmentioning

confidence: 99%

Gender, HIV-Related Stigma, and Health-Related Quality of Life Among Adults Enrolling in HIV Care in Tanzania

et al. 2019

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HIV-related stigma has been associated with worse health-related quality of life (HRQoL) among people living with HIV (PLWH). Little is known about how different types of HIV-related stigma (i.e., anticipatory, internalized, or enacted HIVrelated stigma) influence HRQoL and whether these relationships differ by gender. The sample included 912 PLWH aged 18 years or older enrolling in HIV care at four health facilities in Tanzania. HRQoL was assessed with the life satisfaction and overall function subscales of the HIV/AIDS-Targeted Quality of Life (HAT-QoL) instrument. Sex-stratified multivariable logistic regression modeled the association of anticipatory, internalized, and enacted HIV-related stigma on poor HRQoL. Across all participants, the mean life satisfaction score was 63.4 (IQR: 43.8, 81.3) and the mean overall function score was 72.0 (IQR: 58.3, 91.7). Mean HRQoL scores were significantly higher for women compared to men for overall function (5.1 points higher) and life satisfaction (4.3 points higher). Fourteen percent of respondents reported recent enacted HIV-related stigma and 13% reported recent medium or high levels of internalized stigma. In multivariable models, high internalized and high anticipatory stigma were significantly associated with higher odds of poor life satisfaction and poor overall function in both men and women. Psychosocial interventions to prevent or reduce the impact of internalized and anticipatory stigma may improve HRQoL among persons in HIV care. Future research should longitudinally examine mechanisms between HIV-related stigma, poor HRQoL, and HIV care outcomes.

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The Role of HIV Stigma in ART Adherence and Quality of Life Among Rural Women Living with HIV in India

Cited by 41 publications

References 66 publications

Influence of intensified adherence counselling on viral load suppression of people receiving antiretroviral therapy at a health centre IV in southwestern Uganda: a qualitative study

Influence of intensified adherence counselling on viral load suppression of people receiving antiretroviral therapy at a health centre IV in southwestern Uganda: a qualitative study

Cervical cancer awareness and presence of abnormal cytology among HIV-infected women on antiretroviral therapy in rural Andhra Pradesh, India

Gender, HIV-Related Stigma, and Health-Related Quality of Life Among Adults Enrolling in HIV Care in Tanzania

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