Journal Article

Stigma, depression and viral suppression among African-American women with HIV

A sample of 100 African-American women living with HIV in Chicago and Birmingham in the period 2013-2015 was recruited for participation in a stigma-reduction intervention. The primary goal of the study was to investigate the relationship between HIV-related stigma and viral suppression. A secondary goal was to determine if depression and nonadherence might play an intermediary role between stigma and viral suppression.  The presence of stigma was determined by a14-item stigma scale for chronic illness, and participants were deemed virally suppressed with less than 200 copies/ml. The 8-item Patient Health Questionnaire measured depression, and the number of days with missed doses of ART the participants estimated nonadherence.  Some level of HIV-related stigma was reported by 95% of the participants.  Higher levels of HIV-related stigma were associated with statistically significant lower viral suppression.  However, a separate analysis to estimate the indirect effects of depression and ART nonadherenceon the relationship found no significant intermediary effect.  Because HIV-related stigma is common in African American women, approaches to reducing stigma are justified, although the mechanism of the relationship still needs to be explained. Also, the presence and attention to depression in this population cannot be underestimated.

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