Self-esteem, adverse life events, and mental health diagnoses among Black women living with HIV

ABSTRACT

Purpose:

Black women in the U.S. are disproportionately impacted by HIV and adverse life events (ALE). High self-esteem has been noted as a protective factor and low self-esteem has been linked to mental health diagnoses. However, the existing literature is limited in the examination of how self-esteem may buffer relationships between ALE and mental health diagnoses among Black women living with HIV (BWLWH).

Methods:

One hundred and nineteen BWLWH completed self-report measures on self-esteem (Rosenberg Self-Esteem Scale) and ALE (Life Events Checklist for DSM-5) (e.g. sexual assault, physical assault, accidents, natural disaster) as well as a clinical interview (via Mini-International Neuropsychiatric Inventory) to diagnose current depression, PTSD, and suicidality.

Results:

Multivariable logistic regressions indicated that higher self-esteem was associated with lower likelihood of current depression (OR = .894, p < .01), PTSD (OR = .838, p < .001) and suicidality (OR = .889, p < .05). Interactions between self-esteem and total ALE significantly predicted current depression (OR = .000003, p < .05) and PTSD (OR = 2.7182 × 10⁻⁹, p < .001); and higher total ALE related to higher likelihood of current PTSD only among BWLWH reporting lower self-esteem (OR = 1.21, p < .05).

Conclusion:

Interventions addressing mental health diagnoses among BWLWH should incorporate strategies to enhance self-esteem.

KEYWORDS:

• Black women
• HIV
• self-esteem
• adverse life events
• mental health

Acknowledgements

We would like to express our utmost gratitude to the women who participated in this study, research staff members, and community stakeholders. The content of this publication is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Availability of data and material

The data is currently unavailable as key findings are awaiting publication.

Disclosure statement

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

Ethics review

All human studies have been approved by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Additional information

Funding

The research reported in this publication and the principal investigator (Dr. Sannisha Dale) were funded by K23MH108439 and R56MH121194 from the National Institute of Mental Health.