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

J Assoc Nurses AIDS Care. 2020 Mar-Apr;31(2):167-175. doi: 10.1097/JNC.0000000000000140.

Abstract

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 (incidence rate ratio [IRR] = 1.01, 95% confidence interval [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 = .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.

Publication types

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

MeSH terms

  • Adult
  • Black People
  • Black or African American / psychology*
  • Depression / epidemiology
  • Depression / psychology*
  • Female
  • HIV Infections / ethnology
  • HIV Infections / psychology*
  • Health Status Disparities*
  • Humans
  • Middle Aged
  • Patient Acceptance of Health Care / ethnology
  • Patient Acceptance of Health Care / psychology*
  • Patient Participation*
  • Social Stigma*
  • Social Support
  • Stereotyping