Abstract:
:Among places where people living with HIV experience and anticipate HIV-related stigma, stigma in health care settings may be particularly harmful. Utilizing an exploratory sequential mixed methods approach, we conducted interviews (n = 76) and questionnaires (N = 460) with older adult women living with HIV enrolled in the Women's Interagency HIV Study in Birmingham, AL; Jackson, MS; Atlanta, GA; and San Francisco, CA. Interviews addressed facilitators and barriers to HIV treatment adherence, including HIV-related stigma. Qualitative data were coded using thematic analysis. Questionnaires assessed self-reported antiretroviral therapy (ART) adherence and experienced and anticipated HIV-related stigma from various sources (i.e., health care personnel, family, partner, and community). Covariate-adjusted logistic regression analyses examined total and mediated effects of stigma on ART adherence. Interviewees described fears and experiences of stigma in health care settings; including privacy violations, disrespect for patient autonomy, and reproductive coercion; and how these influenced their adherence to HIV treatment recommendations. Experienced and anticipated HIV-related stigma in health care settings were associated with suboptimal (or <95%) ART adherence in separate models controlling for experienced or anticipated stigma, respectively, from other sources. When entered together, only anticipated stigma in health care settings was associated with suboptimal ART adherence, controlling for anticipated and experienced stigma from other sources. The effect of anticipated stigma in health care settings on suboptimal ART adherence may work through the pathways of lower adherence self-efficacy, higher depressive symptoms, and higher coping by substance use. These findings indicate that interventions should promote cultures of acceptance within health care settings and resilience-based strategies for women to combat stigma and promote life-sustaining behaviors.
journal_name
AIDS Patient Care STDSjournal_title
AIDS patient care and STDsauthors
Rice WS,Turan B,Fletcher FE,Nápoles TM,Walcott M,Batchelder A,Kempf MC,Konkle-Parker DJ,Wilson TE,Tien PC,Wingood GM,Neilands TB,Johnson MO,Weiser SD,Turan JMdoi
10.1089/apc.2018.0282subject
Has Abstractpub_date
2019-04-01 00:00:00pages
184-195issue
4eissn
1087-2914issn
1557-7449journal_volume
33pub_type
杂志文章abstract::Mortality rates have decreased in medically compliant patients with HIV. More HIV-positive patients are requesting procedures that improve their quality of life. Reduction mammoplasty has been proven to predictably relieve back, neck, and shoulder pain related to macromastia. A case report is presented demonstrating a...
journal_title:AIDS patient care and STDs
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journal_title:AIDS patient care and STDs
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journal_title:AIDS patient care and STDs
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journal_title:AIDS patient care and STDs
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journal_title:AIDS patient care and STDs
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journal_title:AIDS patient care and STDs
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journal_title:AIDS patient care and STDs
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journal_title:AIDS patient care and STDs
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journal_title:AIDS patient care and STDs
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journal_title:AIDS patient care and STDs
pub_type: 杂志文章
doi:10.1089/apc.2012.0089
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journal_title:AIDS patient care and STDs
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journal_title:AIDS patient care and STDs
pub_type: 杂志文章
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journal_title:AIDS patient care and STDs
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journal_title:AIDS patient care and STDs
pub_type: 杂志文章,评审
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journal_title:AIDS patient care and STDs
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journal_title:AIDS patient care and STDs
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journal_title:AIDS patient care and STDs
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journal_title:AIDS patient care and STDs
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journal_title:AIDS patient care and STDs
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journal_title:AIDS patient care and STDs
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journal_title:AIDS patient care and STDs
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journal_title:AIDS patient care and STDs
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journal_title:AIDS patient care and STDs
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journal_title:AIDS patient care and STDs
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