Intersectional health-related stigma in persons living with HIV and chronic pain: implications for depressive symptoms

Goodin, Burel R.; Owens, Michael A.; White, Dyan M.; Strath, Larissa J.; Gonzalez, Cesar E.; Rainey, R.; Okunbor, Jennifer I.; Heath, Sonya L.; Turan, Janet M.; Merlin, Jessica S.

doi:10.1080/09540121.2018.1468012

Cited by 40 publications

(39 citation statements)

References 45 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The term “intersectionality” is often credited to Dr. Kimberlé Crenshaw () in her seminal essay proposing that the burdens Black women face are greater than that of their race or sex alone. Although it began as a legal argument, the concept of intersectionality—that one must consider the whole of a person's identities to best understand their experiences—has expanded into numerous academic and applied disciplines, including psychology (Else‐Quest & Hyde, ; Rosenthal, ; Williams & Fredrick, ), public health (Bowleg, ; Goodin et al, ), and even the common vernacular, as it was added to Webster's Dictionary in 2017 (Merriam‐Webster, ). Accordingly, researchers have recently used an intersectional approach to study discrimination (e.g., Lewis & Van Dyke, ; Liu & Wong, ; Sugarman et al, ), sexual and domestic violence (e.g., Armstrong, Gleckman‐Krut, & Johnson, ; Conwill, ; Powell, Hlavka, & Mulla, ), as well as physical and mental health (e.g., Dlugonski, Martin, Mailey, & Pineda, ; Goodin et al, ; Lewis & Van Dyke, ; Velez, Moradi, & DeBlaere, ), among others.…”

Section: Introductionmentioning

confidence: 99%

Cumulative consequences of stigma: Possessing multiple concealable stigmatized identities is associated with worse quality of life

Reinka

Pan-Weisz

Lawner

et al. 2020

J Applied Social Pyschol

View full text Add to dashboard Cite

Large health disparities exist between stigmatized and nonstigmatized groups. In addition to experiencing and anticipating greater discrimination, members of stigmatized groups also tend to demonstrate greater ruminative tendencies in response, which may lead to these poor health outcomes. Even among stigmatized groups, differences in the visibility of stigma lead to different mechanisms through which stigma takes its toll. Previous work has primarily focused on the impact of belonging to a single marginalized group; however, people often belong to multiple marginalized groups, and this likely affects both their health outcomes and their anticipation of stigma. In the current study, we focused on individuals with concealable stigmatized identities (CSIs)—socially stigmatized identities that are not immediately apparent to others—and created a measure of concealable marginalization that captures multiple group memberships. We predicted that those possessing a greater number of CSIs would anticipate more stigma from others, and, in turn, ruminate more about the stigma, which would negatively impact the health. Surveying N = 288 adults with CSIs, we found that possessing a greater number of marginalized concealable identities predicted worse self‐reported physical quality of life. These relationships were partially mediated by greater anticipated stigma and brooding rumination in regard to their CSI. This work illuminates a more complete picture of how living with CSIs can take its toll on health.

show abstract

Section: Introductionmentioning

confidence: 99%

Cumulative consequences of stigma: Possessing multiple concealable stigmatized identities is associated with worse quality of life

Reinka

Pan-Weisz

Lawner

et al. 2020

J Applied Social Pyschol

View full text Add to dashboard Cite

show abstract

“…Whilst the mean BDI score for this cohort (19; SD 8) was greater than that reported by healthy controls (9; SD 8), it was similar to another cohort of HIV-positive South Africans (17; SD 12). 21,27 It is worth considering that individuals living with both HIV and chronic pain live with two stigmatised conditions and this may have compounded both their depressive symptoms and pain intensity, 28 leading to the high scores seen here.…”

Section: Discussionmentioning

confidence: 96%

A preliminary analysis of the association between perceived stigma and HIV-related pain in South Africans living with HIV

Wadley

Pincus

Evangeli

2019

Afr. j. prim. health care fam. med.

View full text Add to dashboard Cite

Background: Stigma related to the human immunodeficiency virus (HIV) remains common and has been associated with severity of HIV-related symptoms. Associations between HIV stigma and HIV-related pain, one of the most common symptoms in HIV, have however not been investigated. Data from low back pain populations suggest that stigma is associated with worse pain intensity and so we hypothesised that the same would be the case in HIV.Aim: The goal of this study was to assess the association between HIV stigma and pain intensity in people living with HIV (PLWH) with chronic pain whilst controlling for depression, a well-established correlate of pain.Setting: The study took place at an HIV clinic in Johannesburg, South Africa.Methods: Mediation analysis was used to assess the effect of depression on the relationship between stigma and pain intensity in a cross-sectional cohort of 50 PLWH and chronic pain (pain most days of the week for > 3 months). All participants were assessed using the HIV/AIDS Stigma Instrument – PLWA, an 11-point numerical pain rating scale and the Beck Depression Inventory II.Results: In all, 88% (44/50) of participants reported experiencing some form of HIV stigma (HIV stigma scale score ≥ 1). Worst pain intensity and depressive symptoms individually correlated with total stigma score (Spearman’s r = 0.33, p = 0.02 for both). The mediation analysis highlighted that mediation of the relationship by depression was equivocal (b = -0.002, bootstrapped confidence interval -0.02 to 0.00).Conclusion: Whilst these preliminary data are marginal, they do suggest that associations between HIV stigma and HIV-related pain warrant further investigation. Future study should also include potential mechanisms, which may include mediation through depression.

show abstract

“…9,37 To illustrate, recent research completed by our study team has found that PLWH with chronic pain experience a high degree of stigma related to their chronic pain, as well as their HIV status. 19…”

Section: Discussionmentioning

confidence: 99%

Social support buffers the negative influence of perceived injustice on pain interference in people living with HIV and chronic pain

Penn

Trost

Parker

et al. 2019

PR9

Self Cite

View full text Add to dashboard Cite

Introduction: A growing literature attests to the overwhelming prevalence of disabling chronic pain among people living with HIV (PLWH), yet very little is known about psychosocial contributors to poor chronic pain outcomes in this population. Pain-related perception of injustice may promote pain interference by hindering engagement in daily activities among individuals with chronic pain. Social support has been shown to buffer the negative impact of harmful beliefs on well-being and facilitate adjustment to chronic pain. Objective: This cross-sectional study tested the buffering hypothesis of social support to determine whether increasing levels of social support mitigate the negative influence of perceived injustice on pain interference. Methods: A total of 60 PLWH with chronic pain completed measures of perceived injustice, social support, pain severity, and interference, as well as depressive symptoms. Results: In a regression-based model adjusted for age, sex, depressive symptoms, and pain severity, results indicated that social support significantly moderated (ie, buffered) the association between perceived injustice and pain interference ( P = 0.028). Specifically, it was found that perceived injustice was significantly associated with greater pain interference among PLWH with low levels of social support ( P = 0.047), but not those with intermediate ( P = 0.422) or high levels of social support ( P = 0.381). Conclusion: Pain-related injustice perception reflects harmful beliefs regarding severity of loss consequent to chronic pain development, a sense of unfairness, and irreparability of loss. Access to a social support network may provide an adaptive means of mitigating the negative effects of perceived injustice.

show abstract

Intersectional health-related stigma in persons living with HIV and chronic pain: implications for depressive symptoms

Cited by 40 publications

References 45 publications

Cumulative consequences of stigma: Possessing multiple concealable stigmatized identities is associated with worse quality of life

Cumulative consequences of stigma: Possessing multiple concealable stigmatized identities is associated with worse quality of life

A preliminary analysis of the association between perceived stigma and HIV-related pain in South Africans living with HIV

Social support buffers the negative influence of perceived injustice on pain interference in people living with HIV and chronic pain

Contact Info

Product

Resources

About