Skip to main content
Top
Published in: International Journal of Behavioral Medicine 1/2012

01-03-2012

Ethnic Identity and Perceived Stress in HIV+ Minority Women: The Role of Coping Self-Efficacy and Social Support

Authors: Corina R. Lopez, Michael H. Antoni, Erin M. Fekete, Frank J. Penedo

Published in: International Journal of Behavioral Medicine | Issue 1/2012

Login to get access

Abstract

Background

Ethnic minority women living with HIV (WLWH) face multiple stigmas that can contribute to overwhelming levels of stress, which could hamper their ability to manage their chronic disease. Little is known about whether having a greater sense of ethnic identity might insulate WLWH from stress. It is also possible that certain cognitive and interpersonal factors (i.e., coping self-efficacy and perceived social support) may act as mediators of this relationship. We hypothesized that WLWH with a greater sense of ethnic identity would report less stress because they access these cognitive and interpersonal resources to better manage stressors.

Purpose

The present study (1) related ethnic identity to perceived stress and (2) examined coping self-efficacy and social support as co-mediators of this relationship in a sample of low-income minority WLWH.

Method

Ninety-two minority women (89% African American) completed self-report psychosocial measures including the Multigroup Ethnic Identity Measure (MEIM), Perceived Stress Scale (PSS), Cognitive Coping Self-efficacy Scale (CCSE), and Social Provision Scale (SPS).

Results

Greater ethnic identity was associated with less perceived stress, and this relationship was mediated by greater levels of both coping self-efficacy and social support.

Conclusions

WLWH who identify more with their ethnic group may experience less stress via their access to more cognitive and interpersonal resources.
Literature
1.
go back to reference Centers for Disease Control and Prevention. Racial/ethnic disparities in diagnoses of HIV/AIDS—33states, 2001–2005. MMWR, 2007;56,189. Centers for Disease Control and Prevention. Racial/ethnic disparities in diagnoses of HIV/AIDS—33states, 2001–2005. MMWR, 2007;56,189.
2.
go back to reference Galvan F et al. HIV stigma and social support among African Americans. J AIDS Patient Care STD’s. 2008;22:423–36.CrossRef Galvan F et al. HIV stigma and social support among African Americans. J AIDS Patient Care STD’s. 2008;22:423–36.CrossRef
3.
go back to reference Sandelowski M, Lambe C, Barrosso J. Stigma in HIV positive women. JNS. 2004;36:122–8.CrossRef Sandelowski M, Lambe C, Barrosso J. Stigma in HIV positive women. JNS. 2004;36:122–8.CrossRef
4.
go back to reference Kang E, Rapkin B, DeAlmeida C. Are psychological consequences of stigma enduring or transitory? A longitudinal study of HIV stigma and distress among Asians and Pacific Islanders living with HIV illness. AIDS Patient Care ST. 2006;20:712–23.CrossRef Kang E, Rapkin B, DeAlmeida C. Are psychological consequences of stigma enduring or transitory? A longitudinal study of HIV stigma and distress among Asians and Pacific Islanders living with HIV illness. AIDS Patient Care ST. 2006;20:712–23.CrossRef
5.
go back to reference Phinney J. When we talk about American ethnic groups, what do we mean? Am Psychol. 1996;51:918–27.CrossRef Phinney J. When we talk about American ethnic groups, what do we mean? Am Psychol. 1996;51:918–27.CrossRef
6.
go back to reference Anderson P. Acculturative stress: a theory of relevance to Black Americans. Clin Psychol Rev. 1991;11:685–702.CrossRef Anderson P. Acculturative stress: a theory of relevance to Black Americans. Clin Psychol Rev. 1991;11:685–702.CrossRef
7.
go back to reference Myers HF. Ethnicity and socio-economic status related stresses in context: an integrative conceptual model. J Behav Med. 2009;32:9–19.PubMedCrossRef Myers HF. Ethnicity and socio-economic status related stresses in context: an integrative conceptual model. J Behav Med. 2009;32:9–19.PubMedCrossRef
8.
go back to reference Mossakowski K. Coping with perceived discrimination: does ethnic identity protect mental health? J Health Soc Behav. 2003;44:318–31.PubMedCrossRef Mossakowski K. Coping with perceived discrimination: does ethnic identity protect mental health? J Health Soc Behav. 2003;44:318–31.PubMedCrossRef
9.
go back to reference Sellers R et al. Racial identity, perceived stress, and psychological distress among African American young adults. J Health Soc Behav. 2003;44:302–17.PubMedCrossRef Sellers R et al. Racial identity, perceived stress, and psychological distress among African American young adults. J Health Soc Behav. 2003;44:302–17.PubMedCrossRef
10.
go back to reference Utsey S et al. Effect of ethnic group membership on ethnic identity, race-related stress, and quality of life. Cultur Divers Ethnic Minor Psychol. 2002;4:366–77.CrossRef Utsey S et al. Effect of ethnic group membership on ethnic identity, race-related stress, and quality of life. Cultur Divers Ethnic Minor Psychol. 2002;4:366–77.CrossRef
11.
go back to reference Williams DR, Spencer MS, Jackson JS. Race, stress, and physical health: the role of group identity. Rutg Self Soc Id, 1999;71–100. Williams DR, Spencer MS, Jackson JS. Race, stress, and physical health: the role of group identity. Rutg Self Soc Id, 1999;71–100.
12.
go back to reference Crawford I et al. The influence of dual-identity development on the psychosocial functioning of African-American gay and bisexual men. J Sex Res. 2002;3:179–89.CrossRef Crawford I et al. The influence of dual-identity development on the psychosocial functioning of African-American gay and bisexual men. J Sex Res. 2002;3:179–89.CrossRef
13.
go back to reference Yoo HC, Lee RM. Ethnic identity and approach type coping as moderators of the racial discrimination/well being relation in Asian Americans. J Counsel Psychol. 2005;52:497–506.CrossRef Yoo HC, Lee RM. Ethnic identity and approach type coping as moderators of the racial discrimination/well being relation in Asian Americans. J Counsel Psychol. 2005;52:497–506.CrossRef
14.
go back to reference Lagos VI et al. Social-cognitive aspects of underserved Latinas preparing to undergo genetic cancer risk assessment for hereditary breast and ovarian cancer. Psycho oncol. 2008;17:774–82.CrossRef Lagos VI et al. Social-cognitive aspects of underserved Latinas preparing to undergo genetic cancer risk assessment for hereditary breast and ovarian cancer. Psycho oncol. 2008;17:774–82.CrossRef
15.
go back to reference Benight CC et al. Coping self-efficacy buffers psychological and physiological disturbances in HIV infected men following a natural disaster. Health Psychol. 1997;16:248–55.PubMedCrossRef Benight CC et al. Coping self-efficacy buffers psychological and physiological disturbances in HIV infected men following a natural disaster. Health Psychol. 1997;16:248–55.PubMedCrossRef
16.
go back to reference Chesney MA et al. Coping effectiveness training for men living with HIV: results from a randomized clinical trial testing a group based intervention. Psychosom Med. 2003;65:1038–46.PubMedCrossRef Chesney MA et al. Coping effectiveness training for men living with HIV: results from a randomized clinical trial testing a group based intervention. Psychosom Med. 2003;65:1038–46.PubMedCrossRef
17.
go back to reference Ironson G et al. The impact of improved self-efficacy on HIV viral load and distress in culturally diverse women living with AIDS: the SMART/EST Women’s Project. AIDS Care. 2005;17:222–36.PubMedCrossRef Ironson G et al. The impact of improved self-efficacy on HIV viral load and distress in culturally diverse women living with AIDS: the SMART/EST Women’s Project. AIDS Care. 2005;17:222–36.PubMedCrossRef
18.
go back to reference First MB et al. Structured clinical interview for DSM-IV patient edition (SCID-I/P, version 2.0). New York: Biometrics Research Department, New York State Psychiatric Institute; 1995. First MB et al. Structured clinical interview for DSM-IV patient edition (SCID-I/P, version 2.0). New York: Biometrics Research Department, New York State Psychiatric Institute; 1995.
19.
go back to reference Power C et al. HIV dementia scale: a rapid screening test. J Acquir Immune Defic Syndr Hum Retrovirol. 1995;8:273–8.PubMedCrossRef Power C et al. HIV dementia scale: a rapid screening test. J Acquir Immune Defic Syndr Hum Retrovirol. 1995;8:273–8.PubMedCrossRef
20.
go back to reference Weaver K et al. A stress and coping model of medication adherence and viral load in HIV+men and women on highly active antiretroviral therapy. Health Psychol. 2005;24:385–92.PubMedCrossRef Weaver K et al. A stress and coping model of medication adherence and viral load in HIV+men and women on highly active antiretroviral therapy. Health Psychol. 2005;24:385–92.PubMedCrossRef
21.
go back to reference Phinney J. The multi-group ethnic identity measure: a new scale for use with adolescents and you adults from diverse groups. J Adol Res. 1992;7:156–76.CrossRef Phinney J. The multi-group ethnic identity measure: a new scale for use with adolescents and you adults from diverse groups. J Adol Res. 1992;7:156–76.CrossRef
22.
go back to reference Ironson G et al. HIV coping/self-efficacy scale. Florida: University of Miami; 1986. Ironson G et al. HIV coping/self-efficacy scale. Florida: University of Miami; 1986.
23.
go back to reference Cutrona CE, Russell D. The provisions of social relationships and adaptation to stress. In: Jones WH, Perlman D, editors. Advances in personal relationships, vol. 1. Greenwich: JAI; 2002. p. 37–67. Cutrona CE, Russell D. The provisions of social relationships and adaptation to stress. In: Jones WH, Perlman D, editors. Advances in personal relationships, vol. 1. Greenwich: JAI; 2002. p. 37–67.
24.
go back to reference Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983;24:385–96.PubMedCrossRef Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983;24:385–96.PubMedCrossRef
25.
go back to reference Preacher KJ, Rucker DD, Hayes AF. Assessing moderated mediation hypotheses: strategies, methods, and prescriptions. Multivariate Behav Res. 2007;42:185–227.CrossRef Preacher KJ, Rucker DD, Hayes AF. Assessing moderated mediation hypotheses: strategies, methods, and prescriptions. Multivariate Behav Res. 2007;42:185–227.CrossRef
26.
go back to reference Sobel ME. Asymptotic confidence intervals for indirect effects in structural equation models. In: Leinhardt S, editor. Sociological methodology 1982. Washington: American Sociological Association; 1982. p. 290–312. Sobel ME. Asymptotic confidence intervals for indirect effects in structural equation models. In: Leinhardt S, editor. Sociological methodology 1982. Washington: American Sociological Association; 1982. p. 290–312.
27.
go back to reference Phinney JS. Ethnic identity and self-esteem: a review and integration. Hispanic J Behav Sci. 1991;13(2):193–208.CrossRef Phinney JS. Ethnic identity and self-esteem: a review and integration. Hispanic J Behav Sci. 1991;13(2):193–208.CrossRef
28.
go back to reference Leserman J. HIV disease progression: depression, stress, and possible mechanisms. Biol Psychiatry. 2003;54:296–306.CrossRef Leserman J. HIV disease progression: depression, stress, and possible mechanisms. Biol Psychiatry. 2003;54:296–306.CrossRef
29.
go back to reference Pereira D et al. Stress as a predictor of symptomatic genital herpes virus recurrence in women with human immunodeficiency virus. J Psychosom Res. 2003;54(3):237–44.PubMedCrossRef Pereira D et al. Stress as a predictor of symptomatic genital herpes virus recurrence in women with human immunodeficiency virus. J Psychosom Res. 2003;54(3):237–44.PubMedCrossRef
30.
go back to reference Evans D, Leserman J, Perkins D, Stern R. Severe life stress as a predictor of early disease progression in HIV infection. Am J Psychiatry. 1997;154(5):630–4.PubMed Evans D, Leserman J, Perkins D, Stern R. Severe life stress as a predictor of early disease progression in HIV infection. Am J Psychiatry. 1997;154(5):630–4.PubMed
31.
go back to reference Monroe S. Modern approaches to conceptualizing and measuring human life stress. Annu Rev Clin Psychol. 2008;4:33–52.PubMedCrossRef Monroe S. Modern approaches to conceptualizing and measuring human life stress. Annu Rev Clin Psychol. 2008;4:33–52.PubMedCrossRef
32.
go back to reference Quintana-Ortiz RA et al. Suicide attempts among Puerto Rican men and women with HIV/AIDS: a study of prevalence and risk factors. Ethnic Disparities. 2008;18:219–24. Quintana-Ortiz RA et al. Suicide attempts among Puerto Rican men and women with HIV/AIDS: a study of prevalence and risk factors. Ethnic Disparities. 2008;18:219–24.
33.
go back to reference Hatzenbuehler ML, Nolen-Hoeksema S, Erickson SJ. Minority stress predictors of HIV risk behavior, substance use, and depressive symptoms: results from a prospective study of bereaved gay men. Health Psychol. 2008;27:455–62.PubMedCrossRef Hatzenbuehler ML, Nolen-Hoeksema S, Erickson SJ. Minority stress predictors of HIV risk behavior, substance use, and depressive symptoms: results from a prospective study of bereaved gay men. Health Psychol. 2008;27:455–62.PubMedCrossRef
34.
go back to reference Golding JM, Burnam MA. Immigration, stress, and depressive symptoms in a Mexican-American Community. J Nerv Ment Dis. 1991;178:161–71. Golding JM, Burnam MA. Immigration, stress, and depressive symptoms in a Mexican-American Community. J Nerv Ment Dis. 1991;178:161–71.
35.
go back to reference Thompson CP, Anderson LP, Bakeman RA. Effects of racial socialization and racial identity on acculturative stress in African American college students. Cult Divers Ethnic Minor Psychol. 2000;6:196–210.CrossRef Thompson CP, Anderson LP, Bakeman RA. Effects of racial socialization and racial identity on acculturative stress in African American college students. Cult Divers Ethnic Minor Psychol. 2000;6:196–210.CrossRef
Metadata
Title
Ethnic Identity and Perceived Stress in HIV+ Minority Women: The Role of Coping Self-Efficacy and Social Support
Authors
Corina R. Lopez
Michael H. Antoni
Erin M. Fekete
Frank J. Penedo
Publication date
01-03-2012
Publisher
Springer US
Published in
International Journal of Behavioral Medicine / Issue 1/2012
Print ISSN: 1070-5503
Electronic ISSN: 1532-7558
DOI
https://doi.org/10.1007/s12529-010-9121-x

Other articles of this Issue 1/2012

International Journal of Behavioral Medicine 1/2012 Go to the issue