Internalised stigma as durable social determinant of HIV care for transnational patients of Puerto Rican ancestry

ABSTRACT

Intersectional stigmas have been contributing barriers to linkage and retention in HIV care for Latinx communities. Our analysis examines whether reductions in HIV-related and other stigmas were associated (or not) with progression on the HIV continuum of care for Puerto Ricans living with HIV, patients of the U.S. Special Projects of National Significance (SPNS) initiative: ‘Culturally Appropriate Interventions of Outreach, Access and Retention among Latinx Populations from 2013 to 2018.’ We conducted multivariate regression modelling to test our primary hypotheses. Internalised (HIV and racial/ethnic) stigma scores and age at baseline were predictors of ART adherence at six months assessment. Internalised stigma (HIV and racial/ethnic), depression, and resiliency scores were predictors of the likelihood of detectable HIV viral load at six months assessment. Our study confirms the importance of understanding internalised stigma on its own terms, as a durable construct that has implications for HIV treatment disparities for Puerto Ricans living with HIV.

KEYWORDS:

• HIV stigma
• intersectional stigmas
• Latinx/Latino/Latina/Hispanic
• HIV care continuum
• transnational

Acknowledgments

The intervention studies presented above were sponsored by the Special Projects of National Significance (SPNS) initiative: Culturally Appropriate Interventions of Outreach, Access and Retention among Latino(a) Populations, 2013–2018 (https://hab.hrsa.gov/about-ryan-white-hivaids-program/spns-latino-populations), of the U.S. Department of Health Research Services Administration (HRSA). These intervention study in Philadelphia (https://targethiv.org/sites/default/files/supporting-files/Latino-SPNS-Clinica-Bienestar-Monograph_0.pdf), Pennsylvania, was the result of the interorganizational partnership collaboration amongst Philadelphia FIGHT (https://fight.org), Prevention Point Philadelphia (https://ppponline.org) and Temple University’s School of Social Work. The intervention study in New York City (https://targethiv.org/sites/default/files/supporting-files/Latino-SPNS-LINK-II-Monograph-508-7_0.pdf), New York, was sponsored by Gay Men’s Health Crisis (https://www.gmhc.org). The authors would like to thank the research participants and the members of each of the intervention and evaluation teams (Dr. Laura Bamford, Jose Benitez, Laura del Castillo, Tracy Esteves-Camacho, Lynette Ford, Andres Freire, Hannah Hirschland, Elby Katumkeeryil, Silvana Mazzella, Alexandra Ripkin, Pedro Rodriguez Jr, Elvis Rosado, and, Kalyani Sanchez). The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the SPNS, or HRSA.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by Health Resources and Services Administration: [Grant Number H97HA26504].