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AIDS and Behavior
Published in: AIDS and Behavior 8/2019

01-08-2019 | Original Paper

HIV-Related Stigma and Viral Suppression Among African-American Women: Exploring the Mediating Roles of Depression and ART Nonadherence

Authors: Lauren Lipira, Emily C. Williams, David Huh, Christopher G. Kemp, Paul E. Nevin, Preston Greene, Joseph M. Unger, Patrick Heagerty, Audrey L. French, Susan E. Cohn, Janet M. Turan, Michael J. Mugavero, Jane M. Simoni, Michele P. Andrasik, Deepa Rao

Published in: AIDS and Behavior | Issue 8/2019

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Abstract

We used baseline data from a sample of African-American women living with HIV who were recruited to participate in a stigma-reduction intervention in Chicago and Birmingham (2013–2015) to (1) evaluate the relationship between HIV-related stigma and viral suppression, and (2) assess the role of depression and nonadherence to antiretroviral therapy (ART) as mediators. Data from women were included in this secondary analysis if they were on ART, had viral load data collected within 8-weeks of study entry and had complete covariate data. We used logistic regression to estimate the total effect of HIV-related stigma (14-item Stigma Scale for Chronic Illness) on viral suppression (< 200 copies/mL), and serial mediation analysis to estimate indirect effects mediated by depressive symptoms (8-item Patient Health Questionnaire) and ART nonadherence (number of days with missed doses). Among 100 women who met study inclusion criteria, 95% reported some level of HIV-related stigma. In adjusted models, higher levels of HIV-related stigma were associated with lower odds of being virally suppressed (AOR = 0.93, 95% CI = 0.89–0.98). In mediation analysis, indirect effects through depression and ART nonadherence were not significant. Findings suggest that HIV-related stigma is common among African-American women living with HIV, and those who experience higher levels of stigma are less likely to be virally suppressed. However, the mechanisms remain unclear.
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Metadata
Title
HIV-Related Stigma and Viral Suppression Among African-American Women: Exploring the Mediating Roles of Depression and ART Nonadherence
Authors
Lauren Lipira
Emily C. Williams
David Huh
Christopher G. Kemp
Paul E. Nevin
Preston Greene
Joseph M. Unger
Patrick Heagerty
Audrey L. French
Susan E. Cohn
Janet M. Turan
Michael J. Mugavero
Jane M. Simoni
Michele P. Andrasik
Deepa Rao
Publication date
01-08-2019
Publisher
Springer US
Published in
AIDS and Behavior / Issue 8/2019
Print ISSN: 1090-7165
Electronic ISSN: 1573-3254
DOI
https://doi.org/10.1007/s10461-018-2301-4

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