Stigma Reduction Among African American Women With HIV

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Abstract

<div class="section"> <a class="named-anchor" id="S1">  </a> <h5 class="section-title" id="d8661432e182">Introduction</h5> <p id="P1">African American women encounter disproportionately high rates of HIV-related morbidity and mortality which is partially mediated through stigma and its effect on HIV treatment adherence. </p> </div><div class="section"> <a class="named-anchor" id="S2">  </a> <h5 class="section-title" id="d8661432e187">Objective</h5> <p id="P2">To assess the effect of the UNITY peer support workshop on HIV-related stigma among African American women living with HIV, compared to a time and attention control group. </p> </div><div class="section"> <a class="named-anchor" id="S3">  </a> <h5 class="section-title" id="d8661432e192">Methods</h5> <p id="P3">African American women living with HIV were randomized to the UNITY workshop or a breast cancer education control group. Interventions took place in HIV clinics in Chicago, IL and Birmingham, AL. Participants self-reported HIV-related stigma and social support at baseline, post-workshop, and 4 follow-up visits over 12 months. </p> </div><div class="section"> <a class="named-anchor" id="S4">  </a> <h5 class="section-title" id="d8661432e197">Results</h5> <p id="P4">239 participants (UNITY n=124; breast cancer education n=115) were assessed over one year. Both arms experienced decreases in mean stigma scores over time. Our model estimated that allocation to UNITY was not associated with a significant difference in stigma points over time. Post-hoc analysis suggested that preceding increases in perceived social support are associated with decreased HIV-related stigma in this population. </p> </div><div class="section"> <a class="named-anchor" id="S5">  </a> <h5 class="section-title" id="d8661432e202">Conclusions</h5> <p id="P5">Although UNITY did not significantly reduce HIV-related stigma in this population, our findings suggest that social support may be key to HIV-related stigma reduction. </p> </div>

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Most cited references 18

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From conceptualizing to measuring HIV stigma: a review of HIV stigma mechanism measures.

Valerie Earnshaw, Stephenie Chaudoir (2009)

Recent analyses suggest that lack of clarity in the conceptualization and measurement of HIV stigma at an individual level is a significant barrier to HIV prevention and treatment efforts. In order to address this concern, we articulate a new framework designed to aid in clarifying the conceptualization and measurement of HIV stigma among individuals. The HIV Stigma Framework explores how the stigma of HIV elicits a series of stigma mechanisms, which in turn lead to deleterious outcomes for HIV uninfected and infected people. We then apply this framework to review measures developed to gauge the effect of HIV stigma since the beginning of the epidemic. Finally, we emphasize the utility of using three questions to guide future HIV stigma research: who is affected by, how are they affected by, and what are the outcomes of HIV stigma?

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Framing Mechanisms Linking HIV-Related Stigma, Adherence to Treatment, and Health Outcomes.

Bulent Turan, Abigail Hatcher, Sheri D Weiser … (2017)

We present a conceptual framework that highlights how unique dimensions of individual-level HIV-related stigma (perceived community stigma, experienced stigma, internalized stigma, and anticipated stigma) might differently affect the health of those living with HIV. HIV-related stigma is recognized as a barrier to both HIV prevention and engagement in HIV care, but little is known about the mechanisms through which stigma leads to worse health behaviors or outcomes. Our conceptual framework posits that, in the context of intersectional and structural stigmas, individual-level dimensions of HIV-related stigma operate through interpersonal factors, mental health, psychological resources, and biological stress pathways. A conceptual framework that encompasses recent advances in stigma science can inform future research and interventions aiming to address stigma as a driver of HIV-related health.

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Kenneth E Freedland, David Mohr, Karina Davidson … (2011)

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