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. 2019 Sep;23(9):2432-2442.
doi: 10.1007/s10461-019-02557-x.

Moderating Factors in an Anti-stigma Intervention for African American Women with HIV in the United States: A Secondary Analysis of the UNITY Trial

Katrin E Fabian  1 , David Huh  2 , Christopher G Kemp  3 , Paul E Nevin  3 , Jane M Simoni  4 , Michele Andrasik  5 , Janet M Turan  6 , Susan E Cohn  7 , Michael J Mugavero  8 , Deepa Rao  3   9
Affiliations

Moderating Factors in an Anti-stigma Intervention for African American Women with HIV in the United States: A Secondary Analysis of the UNITY Trial

Katrin E Fabian et al. AIDS Behav. 2019 Sep.

Abstract
in English, Spanish

African American women experience higher rates of HIV than other women in the United States, and stigma has been identified as an important determinant of engagement in HIV care. Our study examined whether key variables moderated the effect of an anti-stigma intervention on outcomes among African American women receiving treatment for HIV. Twelve potential moderators included: age, years lived with HIV, marital status, employment status, education level, PTSD diagnosis, alcohol use, social support, baseline CD4 count, baseline viral load, and number of children. Outcomes included changes in: HIV-related stigma, social support, depressive symptoms, PTSD symptoms, alcohol use, viral load, and engagement in HIV care. Results suggest that the intervention is associated with greater improvement in engagement in care among participants with PTSD or depression at baseline, and may help maintain engagement in care among participants experiencing certain mental health conditions. This provides opportunities to address discriminatory structural barriers that lead to stigma and drop-offs in HIV care.

En los Estados Unidos, mujeres afroamericanas experimentan tasas más altas de VIH que sus contrapartes no-negras, y el estigma ha sido identificado como un factor importante en esa diferencia. Este estudio analizó el efecto moderador de ciertas variables claves hacia una intervención anti-estigma para mujeres afroamericanas en los Estados Unidos. Del conocimiento previo sobre VIH y el estigma hacia mujeres afroamericanas con VIH, se derivaron doce posibles moderadores incluyendo: edad, años viviendo con VIH, estado civil, nivel de educación, diagnóstico de TEPT, puntuación de AUDIT, apoyo social, conteo de CD4, carga viral, y cantidad de hijos. Las variables clínicas observadas incluyeron estigma, apoyo social, síntomas de depresión y/o TEPT, uso de alcohol, carga viral, y el compromiso del paciente al tratamiento. Los resultados sugieren que la intervención anti-estigma está asociado con mayor mejoramiento en compromiso al tratamiento para esos participantes que padecían de TEPT o depresión al inicio del tratamiento. En adición, la intervención puede ayudar a mantener el compromiso al tratamiento para pacientes que padecen ciertas condiciones de salud mental.

Keywords: African American women; HIV; Moderation analysis; Stigma.

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Conflict of interest statement

Conflict of interest. The authors report no conflict of interest.

Figures

Figure 1.
Figure 1.
Moderation of intervention effect by (a) Marital status (Not married vs. Married), (b) Employment (Not employed vs. Employed), and (c) Education (Some high school or less, High graduate or greater). Non-overlapping confidence intervals correspond with a statistically significant difference at p < .05. HS = High school.
Figure 2.
Figure 2.
Moderation of intervention effect by (a) PTSD diagnosis (No PTSD diagnosis vs. PTSD diagnosis), (b) High depression symptoms (Low symptoms vs. High symptoms). Non-overlapping confidence intervals correspond with a statistically significant difference at p < .05.
See this image and copyright information in PMC

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