A Systematic Mixed Studies Review of the Intersections of Social–Ecological Factors and HIV Stigma in People Living With HIV in the U.S. South

Ingram, LaDrea; Stafford, Crystal; Deming, Michelle E.; Anderson, J; Robillard, Alyssa G.; Li, Xiaoming

doi:10.1097/jnc.0000000000000076

Cited by 21 publications

(14 citation statements)

References 70 publications

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“…Such identities include a range of sexual orientation and gender diverse identities. A wealth of literature suggests the intersection of racial, sexual orientation, gender, and other multiple marginalized statuses is associated with a range of negative physical and mental health [28,39,40] and resilience [41][42][43] outcomes. Likewise, literature suggests that marginalized identities of sexual orientation minority (e.g., lesbian, gay, bisexual) and gender minority (e.g., transgender and gender non-conforming) are at higher risk for SRB compared to heterosexual and cisgender counterparts, respectively [44][45][46].…”

Section: Relationship Orientation Marginalized Identity and Preferementioning

confidence: 99%

Preferences in Information Processing, Marginalized Identity, and Non-Monogamy: Understanding Factors in Suicide-Related Behavior among Members of the Alternative Sexuality Community

Cramer

Langhinrichsen‐Rohling

Kaniuka

et al. 2020

IJERPH

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Suicide-related behavior (SRB) is a mental health disparity experienced by the alternative sexuality community. We assessed mental health, relationship orientation, marginalized identities (i.e., sexual orientation minority, gender minority, racial minority, ethnic minority, and lower education), and preferences in information processing (PIP) as factors differentiating lifetime SRB groups. An online cross-sectional survey study was conducted in 2018. Members of the National Coalition for Sexual Freedom (NCSF; n = 334) took part. Bivariate analyses identified the following SRB risk factors: female and transgender/gender non-binary identity, sexual orientation minority identity, lower education, suicide attempt/death exposure, Need for Affect (NFA) Avoidance, depression, and anxiety. Monogamous relationship orientation was a protective factor. Multi-nomial regression revealed the following: (1) monogamous relationship orientation was a protective factor for suicidal ideation and attempt; (2) lower education was a risk factor for suicide attempt; (3) anxiety was a risk factor for suicide attempt; and (4) depression was a risk factor for suicidal ideation. A two-way interaction showed that elevated NFA Approach buffered the negative impacts of depression. Relationship orientation, several marginalized identities (i.e., based on gender, sexual orientation, and educational level), and PIP all contributed uniquely to SRB. Further study is necessary to understand the role of relationship orientation with suicide. Health education and suicide prevention efforts with NCSF should be tailored to account for marginalized identity, mental health, and NFA factors.

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Section: Relationship Orientation Marginalized Identity and Preferementioning

confidence: 99%

Preferences in Information Processing, Marginalized Identity, and Non-Monogamy: Understanding Factors in Suicide-Related Behavior among Members of the Alternative Sexuality Community

Cramer

Langhinrichsen‐Rohling

Kaniuka

et al. 2020

IJERPH

View full text Add to dashboard Cite

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“…The evidence in the literature is growing, regarding the interplay between stigma experienced by marginalized populations and mental health conditions see ( 39 ). From the current study, quantitative assessments revealed significant relationships between adherence to ARV and to HIV viral load suppression and HIV-related stigma, depressive symptoms, and resilience.…”

Section: Discussionmentioning

confidence: 99%

Pills, PrEP, and Pals: Adherence, Stigma, Resilience, Faith and the Need to Connect Among Minority Women With HIV/AIDS in a US HIV Epicenter

Duthely

Sanchez‐Covarrubias

Brown

et al. 2021

Front. Public Health

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Background: Ending HIV/AIDS in the United States requires tailored interventions. This study is part of a larger investigation to design mCARES, a mobile technology-based, adherence intervention for ethnic minority women with HIV (MWH).Objective: To understand barriers and facilitators of care adherence (treatment and appointment) for ethnic MWH; examine the relationship between these factors across three ethnic groups; and, explore the role of mobile technologies in care adherence.Methods: Cross-sectional, mixed-methods data were collected from a cohort of African-American, Hispanic-American and Haitian-American participants. Qualitative data were collected through a focus group (n = 8) to assess barriers and facilitators to care adherence. Quantitative data (n = 48) surveyed women on depressive symptomology (PHQ-9), HIV-related stigma (HSS) and resiliency (CD-RISC25). We examined the relationships between these factors and adherence to treatment and care and across groups.Findings: Qualitative analyses revealed that barriers to treatment and appointment adherence were caregiver-related stressors (25%) and structural issues (25%); routinization (30%) and religion/spirituality (30%) promoted adherence to treatment and care. Caregiver role was both a hindrance (25%) and promoter (20%) of adherence to treatment and appointments. Quantitatively, HIV-related stigma differed by ethnic group; Haitian-Americans endorsed the highest levels while African-Americans endorsed the lowest. Depression correlated to stigma (R = 0.534; p < 0.001) and resiliency (R = −0.486; p < 0.001). Across ethnic groups, higher depressive symptomology and stigma were related to viral non-suppression (p < 0.05)—a treatment adherence marker; higher resiliency was related to viral suppression. Among Hispanic-Americans, viral non-suppression was related to depression (p < 0.05), and among African-Americans, viral suppression was related to increased resiliency (p < 0.04).Conclusion: Multiple interrelated barriers to adherence were identified. These findings on ethnic group-specific differences underscore the importance of implementing culturally-competent interventions. While privacy and confidentiality were of concern, participants suggested additional intervention features and endorsed the use of mCARES as a strategy to improve adherence to treatment and appointments.

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“…Use of an intersectional framework in HIV-related research is a developing field, and its quantitative application to understanding how multiple social identities influence uptake of HIV-related programming is under explored. Quantitatively, intersectionality has been utilized to help explain the experience of different types of stigma [65][66][67][68] and HIV testing [69]. Intersectionality framework has been used most frequently in qualitative studies with regards to HIV and has examined experiences related to stigma [70], PrEP usage [71], and access to care [72].…”

Section: Discussionmentioning

confidence: 99%

Understanding Technology Fit Among People with HIV Based on Intersections of Race, Sex, and Sexual Behavior: An Equitable Approach to Analyzing Differences Across Multiple Social Identities

et al. 2021

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HIV disproportionately impacts individuals based on intersecting categories (e.g. gender, race/ethnicity, behavior), with groups most at-risk deemed priority populations. Using weighted effects coding to account for differential group sizes, this study used multilevel mixed logistic models to investigate differences in eHealth use and willingness to use eHealth for HIVrelated information among priority populations. Compared to the sample average, Black men who had sex with women were less likely to use all technologies except cellphones with text-messaging and less likely to be willing to use computers and tablets. White and Hispanic men who had sex with men were more likely to use all technologies. No significant differences existed for use or willingness to use cellphones with text-messaging. Future research should consider approaches used here to account for equity and multiple intersecting social identities; practitioners may use these findings or similar local data to ensure fit between eHealth programs and priority populations.

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A Systematic Mixed Studies Review of the Intersections of Social–Ecological Factors and HIV Stigma in People Living With HIV in the U.S. South

Cited by 21 publications

References 70 publications

Preferences in Information Processing, Marginalized Identity, and Non-Monogamy: Understanding Factors in Suicide-Related Behavior among Members of the Alternative Sexuality Community

Preferences in Information Processing, Marginalized Identity, and Non-Monogamy: Understanding Factors in Suicide-Related Behavior among Members of the Alternative Sexuality Community

Pills, PrEP, and Pals: Adherence, Stigma, Resilience, Faith and the Need to Connect Among Minority Women With HIV/AIDS in a US HIV Epicenter

Understanding Technology Fit Among People with HIV Based on Intersections of Race, Sex, and Sexual Behavior: An Equitable Approach to Analyzing Differences Across Multiple Social Identities

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