| Autor: |
Algarin AB; Department of Epidemiology, Florida International University, Miami, Florida, USA., Sheehan DM; Department of Epidemiology, Florida International University, Miami, Florida, USA.; Center for Research on US Latino HIV/AIDS and Drug Abuse (CRUSADA), and Florida International University, Miami, Florida, USA.; FIU Research Center in Minority Institutions (FIU-RCMI), Florida International University, Miami, Florida, USA., Varas-Diaz N; Department of Global & Sociocultural Studies, Florida International University, Miami, Florida, USA., Fennie KP; Division of Natural Sciences, New College of Florida, Sarasota, Florida, USA., Zhou Z; Department of Epidemiology, University of Florida, Gainesville, Florida, USA., Spencer EC; Florida Department of Health, Tallahassee, Florida, USA., Cook RL; Department of Epidemiology, University of Florida, Gainesville, Florida, USA., Morano JP; Division of Infectious Diseases and International Medicine, University of South Florida, Tampa, Florida, USA., Ibanez GE; Department of Epidemiology, Florida International University, Miami, Florida, USA. |
| Abstrakt: |
Among people living with HIV (PLWH) in Florida, <2/3 are virally suppressed (viral load <200 copies/mL). Previous theoretical frameworks have pointed to HIV-related stigma as an important factor for viral suppression; an important outcome related to the HIV continuum of care. This study aims to analyze the association between enacted HIV-related stigma and antiretroviral therapy (ART) adherence and viral suppression among a sample of PLWH in Florida. The overall sample ( n = 932) was male (66.0%), majority greater than 45 years of age (63.5%), black (58.1%), and non-Hispanic (79.7%). Adjusted odds ratios (AOR) and 95% confidence intervals (CI) were estimated using logistic regression models. The odds of nonadherence to ART was not significantly greater for those reporting low/moderate or high levels of general enacted HIV-related stigma (vs. no stigma) [AOR = 1.30, CI: (0.87-1.95), p = 0.198; AOR = 1.17, CI: (0.65-2.11), p = 0.600, respectively]. Moreover, the odds of nonviral suppression were not significantly greater for those reporting low/moderate or high levels of general enacted HIV-related stigma (vs. no stigma) [AOR = 0.92, CI: (0.60-1.42), p = 0.702; AOR = 1.16, CI: (0.64-2.13), p = 0.622, respectively]. However, ever experiencing health care-specific enacted HIV-related stigma was associated with both nonadherence [AOR = 2.29, CI: (1.25-4.20), p = 0.008] and nonsuppression [AOR = 2.16, CI: (1.19-3.92), p = 0.011]. Despite limitations, the results suggest that the perpetuation of stigma by health care workers may have a larger impact on continuum of care outcomes of PLWH than other sources of enacted stigma. Based on the results, there is a need to develop and evaluate interventions for health care workers intended to reduce experienced stigma among PLWH and improve health outcomes. |
