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AIDS and Behavior
Published in: AIDS and Behavior 3/2019

01-10-2019 | Care | Original Paper

The Relationship of HIV-related Stigma and Health Care Outcomes in the US Deep South

Authors: Susan Reif, Elena Wilson, Carolyn McAllaster, Brian Pence

Published in: AIDS and Behavior | Special Issue 3/2019

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Abstract

HIV-related stigma is prevalent in the US Deep South; however, information regarding the types of stigma and their effects on HIV-related outcomes is limited. This study examined the prevalence of different forms of stigma and the association of stigma with medication and medical visit adherence in the Deep South. Survey participants included 201 individuals living with HIV recruited from Infectious Diseases Clinics (ID) and AIDS Service Organizations (ASOs) in four Deep South states. Study participants reported high levels of experienced, perceived, and internalized stigma. Multivariable analysis revealed that internalized stigma and recent stigmatizing experiences were significantly associated with poorer HIV medication adherence. Internalized stigma was also associated with having missed an HIV medical care visit in the last 6 months. These findings suggest the need to identify and develop effective interventions to address internalized HIV-related stigma and to address community HIV stigma to improve outcomes for individuals living with HIV.
Footnotes
1
Alabama, Florida, Louisiana, Mississippi, North Carolina, South Carolina, Mississippi, Tennessee, and Texas.
 
Literature
1.
Reif S, Safley D, McAllaster C, Wilson E, Whetten K. State of HIV in the US Deep South. J Community Health. 2017;42(5):844–53.CrossRef
2.
3.
4.
Gilman B, Bouchery E, Hogan P, Negrusa S, Trent-Adams S, Cheever L. The HIV clinician workforce in the United States. HIV Spec. 2016;8(3):2–9.
5.
Heumann C, Cohn S, Krishnan S, et al. Regional variation in HIV clinical trials participation in the United States. South Med J. 2015;108(2):107–16.PubMedPubMedCentral
6.
National Alliance of State and Territorial AIDS Directors. Stigma and the Impact on Public Health. Ryan White HIV/AIDS Program Grantee Meeting. Washington DC; 2012.
7.
Kerr J, Valois R, DiClemente R, et al. HIV-related stigma among African-American youth in the northeast and southeast US. AIDS Behav. 2014;18:1063–7.CrossRef
8.
9.
Sweeney S, Vanable P. The association of HIV-related stigma to HIV medication adherence: a systematic review and synthesis of the literature. AIDS Behav. 2016;20:29–50.CrossRef
10.
Turan B, Budhwani H, Fazeli P, et al. How does stigma affect people living with HIV? The mediating roles of internalized and anticipated HIV stigma in the effects of perceived community stigma on health and psychosocial outcomes. AIDS Behav. 2017;21:283–91.CrossRef
11.
Waite K, Paasche-Orlow M, Rintamaki L, Davis T, Wolf M. Literacy, social stigma and HIV medication adherence. J Gen Intern Med. 2008;23(9):1367–72.CrossRef
12.
13.
Earnshaw V, Chaudoir S. From conceptualizing to measuring HIV stigma: a review of HIV stigma mechanim measures. AIDS Behav. 2009;13(6):1160–77.CrossRef
14.
Earnshaw V, Smith L, Chaudoir S, Amico K, Copenhaver M. HIV stigma mechanisms and well-being among PLWH: a test of the HIV stigma framework. AIDS Behav. 2013;17(5):1785–95.CrossRef
15.
White J, Gordon J, Mimiaga J. The role of substance use and mental health problems in medication adherence among HIV-infected MSM. LGBT Health. 2014;1(4):319–22.CrossRef
16.
Chitsaz E, Meyer J, Krishman A, Springer S, Marcus R, Zaller N. Contribution of substance use disorders on HIV treatment outcomes and antiretroviral medication adherence among HIV-infected persons entering jail. AIDS Behav. 2013;17(Supplement 2):118–27.CrossRef
17.
Gonzalez J, Batchelder A, Psaros C, Safren S. Depression and HIV/AIDS treatment nonadherence: a review and meta-analysis. J Acquir Immune Defic Syndr. 2011;58(2):181–7.CrossRef
18.
Rao D, Feldmans B, Fredricksen R, Crane P, Simoni J, Kitahata M. A structural equation model of HIV-related stigma, depressive symptoms, and medication adherene. AIDS Behav. 2012;16(3):711–6.CrossRef
19.
Sayles J, Wong M, Kinsler J, Martings D, Cunningham W. The association of stigma with self-reported access to medical care and antiretroviral therapy adherence in persons living with HIV/AIDS. J Gen Intern Med. 2009;24(10):1101–8.CrossRef
20.
Mitzel L, Vanable P, Brown J, Bostwick R, Sweeney S, Carey M. Depressive symptoms mediate the effect of HIV-related stigmatization on medication adherence among HIV-infected men who have sex with men. AIDS Behav. 2015;19(8):1454–9.CrossRef
21.
Harvey P. Race, culture, and religion in the American South. Oxford research encyclopedia of religion. Oxford: Oxford University Press; 2015.
22.
Brunn S, Webster G, Archer J, Reif S. The bible belt in a changing south:shrinking, relocating and multiple buckes, vol. 51. Chapel Hill: The University of North Carolina Press; 2011. p. 513–49.
23.
Pew Research Center. Religious landscape study. Washington: Pew Research Center; 2014.
24.
25.
O’Connell H. The impact of slavery on racial inequality in poverty in the contemporary US South. Soc Forces. 2012;90(3):713–34.CrossRef
26.
Acharyn A, Blackwell M, Sen M. The political legacy of American slavery. J Polit. 2016;78(3):621–41.CrossRef
27.
Adimora A, Schoenback V, Doherty I. HIV and African Americans in the southern United States: sexual networks and social context. Sex Transm Dis. 2006;33(7):39–45.CrossRef
28.
Berger B, Ferrans C, Lashley F. Measuring stigma in people with HIV: psychometric assessment of the HIV Stigma Scale. Res Nurs Health. 2001;24(6):518–29.CrossRef
29.
Buseh A, Keber S, Hewitt J, Stevens P. Perceived stigma and life satisfaction: experiences of urban African-American men living with HIV/AIDS. Int J Men’s Health. 2006;5(1):35–51.CrossRef
30.
Holzemer W, Uys L, Chirwa M, et al. Validation of the HIV/AIDS Stigma Instrument - PLWA (HASI-P). AIDS Care. 2007;19(8):1002–12.CrossRef
31.
Nunnally C, Bernstein I. Psychometric theory. 3rd ed. New York: McGraw-Hill; 1994.
32.
Kalichman S, Amaral CM, Swetzes C, et al. A simple single-item rating scale to measure medication adherence: further evidence for convergent validity. J Int Assoc Phys AIDS Care. 2009;8(6):367–74.CrossRef
33.
Sherbourne C, Stewart A. The MOS social support survey. Soc Sci Med. 1991;32:705–14.CrossRef
34.
Kroenke K, Spitzer R, Williams J. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606–13.CrossRef
35.
Smith P, Schmidt S, Allensworth-Davies D, Saitz R. A single-question screening test for drug use in primary care. Arch Intern Med. 2010;170(13):1155–60.CrossRef
36.
37.
Baron R, Kenny D. The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. J Pers Soc Psychol. 1986;51:1173–82.CrossRef
38.
Baugher A, Beer L, Fagan J, et al. Prevalence of internalized HIV-related stigma among HIV-infected adults in care, United States, 2011–2013. AIDS Behav. 2017;21(9):2600–8.CrossRef
39.
Gonzalez J, Batchelder A, Psaros C, Safren S. Depression and HIV/AIDS treatment nonadherence: a review and meta-analysis. J Acquir Immune Defic Syndr. 2013;58(2):181–7.CrossRef
40.
Rao D, Desmond M, Andrasik M, et al. Feasibility, acceptability, and preliminary efficacy of the unity workshop: an internalized stigma reduction intervenion for African American women living with HIV. AIDS Patient Care STDs. 2012;26(10):614–20.CrossRef
41.
Batey D, Whitfield D, Mulla M, et al. Intervention to reduce HIV-related stigma among healthcare workers in the United States: piloting of the FRESH Workshop. AIDS Patient Care STDs. 2016;30(11):519–27.CrossRef
Metadata
Title
The Relationship of HIV-related Stigma and Health Care Outcomes in the US Deep South
Authors
Susan Reif
Elena Wilson
Carolyn McAllaster
Brian Pence
Publication date
01-10-2019
Publisher
Springer US
Published in
AIDS and Behavior / Issue Special Issue 3/2019
Print ISSN: 1090-7165
Electronic ISSN: 1573-3254
DOI
https://doi.org/10.1007/s10461-019-02595-5

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