Examining the Associations Between Immigration Status and Perceived Stress Among HIV-Infected and Uninfected Women

J Community Health. 2018 Dec;43(6):1172-1181. doi: 10.1007/s10900-018-0537-6.


Stress is associated with poor mental and physical health outcomes. In the United States (U.S.), little is known about perceived stress and associated factors among HIV-infected and immigrant women. Here, we examine these associations within a sample of 305 HIV-infected and uninfected, U.S.-born and non-U.S.-born women who were part of the Women's Interagency HIV Study (WIHS) at three sites (New York, Chicago, and Los Angeles). Perceived stress was measured using the 10-item Perceived Stress Scale (PSS-10); HIV infection was serologically confirmed, and nativity status was self-reported. Bivariate and multivariable logistic regression were used to identify associations with perceived stress. The majority of participants were U.S.-born (232, 76.1%) and were HIV-infected (212, 68.5%). Mutlivariable analyses found the odds of perceived stress to be lower for those employed [adjusted odds ratio (AOR) = 0.31, 95% confidence interval (CI) = (0.15-0.63)], with high levels of social support (AOR = 0.45, 95% CI 0.26-0.79), and HIV-infected (AOR = 0.44, 95% CI 0.24-0.79). Perceived stress was positively associated with living in unstable housing (AOR = 2.54, 95% CI 1.17-5.51). Here, immigration status was not associated with perceived stress. We identified stress to be higher among women who were unemployed, unstably housed, or who had low social support. Community-based programs should tailor interventions to include stress reduction strategies for participants with identified risk factors to improve mental and physical health outcomes.

Keywords: Afro-Caribbean; HIV; Hispanics; Immigrant; Perceived stress; Women.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Emigrants and Immigrants / psychology
  • Emigrants and Immigrants / statistics & numerical data*
  • Emigration and Immigration / statistics & numerical data*
  • Female
  • HIV Infections / complications
  • HIV Infections / diagnosis*
  • HIV Infections / ethnology
  • HIV Infections / prevention & control
  • Humans
  • Mass Screening / statistics & numerical data
  • Middle Aged
  • Patient Acceptance of Health Care / psychology*
  • Patient Acceptance of Health Care / statistics & numerical data
  • Risk Factors
  • Social Support
  • United States
  • Women's Health / ethnology*