Intersectional Stigma, Fear of Negative Evaluation, Depression, and ART Adherence Among Women Living with HIV Who Engage in Substance Use: A Latent Class Serial Mediation Analysis.

Women Living with HIV (WLHIV) who use substances face stigma related to HIV and substance use (SU). The relationship between the intersection of these stigmas and adherence to antiretroviral therapy (ART), as well as the underlying mechanisms, remains poorly understood. This study aimed to examine t...

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Publicado en:AIDS & Behavior Vol. 28; no. 6; pp. 1882 - 1898
Autores principales: Stringer, Kristi Lynn, Norcini Pala, Andrea, Cook, Robert L., Kempf, Mirjam-Colette, Konkle-Parker, Deborah, Wilson, Tracey E., Tien, Phyllis C., Wingood, Gina, Neilands, Torsten B., Johnson, Mallory O., Logie, Carmen H., Weiser, Sheri D., Turan, Janet M., Turan, Bulent
Formato: research tables/charts Journal Article
Publicado: Springer Nature Jun2024
Acceso en línea:Ver este registro en EBSCOhost
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        10.1007/s10461-024-04282-6
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        atl: Intersectional Stigma, Fear of Negative Evaluation, Depression, and ART Adherence Among Women Living with HIV Who Engage in Substance Use: A Latent Class Serial Mediation Analysis.
      aug:
        au:
          Stringer, Kristi Lynn
          Norcini Pala, Andrea
          Cook, Robert L.
          Kempf, Mirjam-Colette
          Konkle-Parker, Deborah
          Wilson, Tracey E.
          Tien, Phyllis C.
          Wingood, Gina
          Neilands, Torsten B.
          Johnson, Mallory O.
          Logie, Carmen H.
          Weiser, Sheri D.
          Turan, Janet M.
          Turan, Bulent
        affil: https://ror.org/02n1hzn07 Department of Health and Human Performance, Community and Public Health, Middle Tennessee State University, 37132, Murfreesboro, TN, USA
      sug:
        subj:
          HIV-Positive Persons Psychosocial Factors
          HIV Infections Drug Therapy
          Substance Use Disorders Psychosocial Factors
          Substance Use Disorders Complications
          Antiretroviral Therapy, Highly Active Utilization
          Attitude to Medical Treatment
          Fear
          Depression
          Stigma
          Sex Factors
          Patient Compliance
          Women's Health
          Human
          Mediation Analysis
          Structural Equation Modeling
          Models, Statistical
          Female
          Comparative Studies
          Female
      ab: Women Living with HIV (WLHIV) who use substances face stigma related to HIV and substance use (SU). The relationship between the intersection of these stigmas and adherence to antiretroviral therapy (ART), as well as the underlying mechanisms, remains poorly understood. This study aimed to examine the association between intersectional HIV and SU stigma and ART adherence, while also exploring the potential role of depression and fear of negative evaluation (FNE) by other people in explaining this association. We analyzed data from 409 WLHIV collected between April 2016 and April 2017, Using Multidimensional Latent Class Item Response Theory analysis. We identified five subgroups (i.e., latent classes [C]) of WLHIV with different combinations of experienced SU and HIV stigma levels: (C1) low HIV and SU stigma; (C2) moderate SU stigma; (C3) higher HIV and lower SU stigma; (C4) moderate HIV and high SU stigma; and (C5) high HIV and moderate SU stigma. Medication adherence differed significantly among these classes. Women in the class with moderate HIV and high SU stigma had lower adherence than other classes. A serial mediation analysis suggested that FNE and depression symptoms are mechanisms that contribute to explaining the differences in ART adherence among WLHIV who experience different combinations of intersectional HIV and SU stigma. We suggest that FNE is a key intervention target to attenuate the effect of intersectional stigma on depression symptoms and ART adherence, and ultimately improve health outcomes among WLHIV.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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