Intersectional Stigma, Fear of Negative Evaluation, Depression, and ART Adherence Among Women Living with HIV Who Engage in Substance Use: A Latent Class Serial Mediation Analysis.

Autor: Stringer KL; Department of Health and Human Performance, Community and Public Health, Middle Tennessee State University, Murfreesboro, TN, 37132, USA. Kristi.stringer@Mtsu.edu., Norcini Pala A; Columbia School of Social Work, Columbia University, New York, NY, USA., Cook RL; Department of Epidemiology, Colleges of Public Health and Health Professions and Medicine, University of Florida, Gainesville, FL, USA., Kempf MC; Schools of Nursing, Public Health, and Medicine, University of Alabama at Birmingham, Birmingham, AL, USA., Konkle-Parker D; Schools of Nursing, Medicine and Population Health, University of Mississippi Medical Center, Oxford, MS, USA., Wilson TE; Department of Community Health Sciences, School of Public Health, State University of New York Downstate Health Sciences University, Brooklyn, NY, USA., Tien PC; Department of Medicine, Department of Veteran Affairs Medical Center, University of California, San Francisco and Medical Service, San Francisco, CA, USA., Wingood G; Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York City, NY, USA., Neilands TB; Division of Prevention Science, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA., Johnson MO; Division of Prevention Science, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA., Logie CH; Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, USA.; Women's College Research Institute, Women's College Hospital, Toronto, ON, USA., Weiser SD; Division of HIV, ID and Global Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA., Turan JM; Department of Health Policy and Organization, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.; Department of Public Health, School of Medicine, Koc University, Istanbul, Turkey., Turan B; College of Social Sciences and Humanities, Psychology, Koc University, Istanbul, Turkey.; Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA.
Jazyk: angličtina
Zdroj: AIDS and behavior [AIDS Behav] 2024 Jun; Vol. 28 (6), pp. 1882-1897. Date of Electronic Publication: 2024 Mar 15.
DOI: 10.1007/s10461-024-04282-6
Abstrakt: Women Living with HIV (WLHIV) who use substances face stigma related to HIV and substance use (SU). The relationship between the intersection of these stigmas and adherence to antiretroviral therapy (ART), as well as the underlying mechanisms, remains poorly understood. This study aimed to examine the association between intersectional HIV and SU stigma and ART adherence, while also exploring the potential role of depression and fear of negative evaluation (FNE) by other people in explaining this association. We analyzed data from 409 WLHIV collected between April 2016 and April 2017, Using Multidimensional Latent Class Item Response Theory analysis. We identified five subgroups (i.e., latent classes [C]) of WLHIV with different combinations of experienced SU and HIV stigma levels: (C1) low HIV and SU stigma; (C2) moderate SU stigma; (C3) higher HIV and lower SU stigma; (C4) moderate HIV and high SU stigma; and (C5) high HIV and moderate SU stigma. Medication adherence differed significantly among these classes. Women in the class with moderate HIV and high SU stigma had lower adherence than other classes. A serial mediation analysis suggested that FNE and depression symptoms are mechanisms that contribute to explaining the differences in ART adherence among WLHIV who experience different combinations of intersectional HIV and SU stigma. We suggest that FNE is a key intervention target to attenuate the effect of intersectional stigma on depression symptoms and ART adherence, and ultimately improve health outcomes among WLHIV.
(© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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