Mediators of HIV-related stigma and risk behavior in HIV infected young women

Abstract

Stigma in HIV positive persons has been associated with numerous negative sequelae, including decreased social support, depressive symptoms, and engagement in risk behaviors. Few studies examined the interrelationships of these factors to facilitate understanding of the mechanisms by which HIV stigma influences risk behavior, thus the current study focuses on identifying pathways between HIV-related stigma and risk behavior in 147 young HIV positive women. Depression and social support were hypothesized to mediate between HIV-related stigma and risk behavior. Structural equation modeling was used to test these hypothesized pathways, results suggested that depression was a significant mediator between HIV-related stigma and risk behavior. Implications for interventions with young HIV positive women who report high levels of HIV-related stigma include a focus on depression as a method of reducing engagement in risk behavior and improving mental health and health behaviors in persons living with HIV.

Keywords:

• adolescent
• HIV
• risk behavior
• stigma
• women

Acknowledgements

The Adolescent Trials Network for HIV/AIDS Interventions (ATN) is funded by grant No. U01 HD40533 from the National Institutes of Health through the National Institute of Child Health and Human Development (A. Rogers, R. Nugent, L. Serchuck), with supplemental funding from the National Institutes on Drug Abuse (N. Borek), Mental Health (A. Forsyth, P. Brouwers), and Alcohol Abuse and Alcoholism (K. Bryant).

We acknowledge the contribution of the investigators and staff at the following ATN sites that participated in this study: Children's Hospital of Los Angeles, Los Angeles, CA (M. Belzer, D. Tucker, N. Flores); Montefiore Medical Center, Bronx, NY (D. Futterman, E. Enriquez-Bruce, M. Marquez); Stroger Hospital of Cook County, Chicago, IL (J. Martinez, C. Williamson, A. McFadden); Tulane University Health Sciences Center Department of Pediatrics (S. E. Abdalian, T. Jeanjacques, L. Kozina); and University of Miami School of Medicine, Division of Adolescent Medicine, Miami, FL (L. Friedman, D. Mafut, M. Moo-Young);

The study was scientifically reviewed by the ATN's Community Leadership Group. Network scientific and logistical support was provided by the ATN Coordinating Center (C. Wilson, C. Partlow), at University of Alabama at Birmingham. Network operations and analytic support was provided by the ATN Data and Operations Center at Westat, Inc. (J. Ellenberg, K. Joyce). The investigators are grateful to the members of the ATN Community Advisory Board for their insight and counsel and are particularly indebted to the youth who participated in this study.