Skip to main content

Advertisement

SpringerLink
Log in

HIV Stigma and Its Relation to Mental, Physical and Social Health Among Black Women Living with HIV/AIDS

  • Original Paper
  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Abstract

Black women living with HIV/AIDS (LWHA) are a subgroup with the highest growing rates of HIV infection in the United States. Stigma and co-occurring mental and physical health problems have been reported among Black women LWHA, and research on the benefits of social and religious support, often major protective factors among Black women, has been met with mixed findings. The current study examined the relation between anticipated HIV stigma and mental and physical health symptoms and risk and protective factors (discrimination, coping, social support) among Black women LWHA (N = 220). Results showed that greater anticipated stigma was significantly related to poorer mental health status, greater discrimination, and greater use of negative coping strategies. Stigma was not related to physical health, perceived social support or use of positive coping strategies. This study lends support to the need for psychosocial interventions that reduce anticipated stigma among individuals LWHA, particularly Black women LWHA.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Centers for Disease Control and Prevention. Diagnoses of HIV infection in the United States and dependent areas, 2014. Centers for Disease Control and Prevention; 2016. p. 123.

  2. Centers for Disease Control and Prevention. HIV Basics: Centers for Disease Control and Prevention, 2015; http://www.cdc.gov/hiv/basics/index.html. Accessed 23 March, 2016

  3. Adimora AA, Schoenbach VJ, Martinson FE, et al. Heterosexually transmitted HIV infection among African Americans in North Carolina. J Acquir Immune Defic Syndr. 2006;41(5):616–23.

    Article  Google Scholar 

  4. Hodder SL, Justman J, Haley DF, et al. Challenges of a hidden epidemic: HIV prevention among women in the United States. J Acquir Immune Defic Syndr. 2010;55(Suppl 2):S69–73.

    Article  Google Scholar 

  5. Ivy W III, Miles I, Le B, Paz-Bailey G. Correlates of HIV infection among African American women from 20 cities in the United States. AIDS Behav. 2014;18(Suppl 3):266–75.

    Article  Google Scholar 

  6. Caiola C, Docherty S, Relf M, Barroso J. Using an intersectional approach to study the impact of social determinants of health for African American mothers living with HIV. ANS Adv Nurs Sci. 2014;37(4):287–98.

    Article  Google Scholar 

  7. Logie C, Gadalla TM. Meta-analysis of health and demographic correlates of stigma towards people living with HIV. AIDS Care. 2009;21(6):742–53.

    Article  CAS  Google Scholar 

  8. Smedley BD. The lived experience of race and its health consequences. Am J Public Health. 2012;102:933–5.

    Article  Google Scholar 

  9. Zierler S, Krieger N. Reframing women’s risk: social inequalities and HIV infection. Annu Rev Public Health. 1997;18:401–36.

    Article  CAS  Google Scholar 

  10. Meditz AL, MaWhinney S, Allshouse A, et al. Sex, race, and geographic region influence clinical outcomes following primary HIV-1 infection. J Infect Dis. 2011;203(4):442–51.

    Article  Google Scholar 

  11. Rosenberg SD, Goodman LA, Osher FC, et al. Prevalence of HIV, hepatitis B, and hepatitis C in people with severe mental illness. Am J Public Health. 2001;91:31–7.

    Article  CAS  Google Scholar 

  12. Brief DJ, Bollinger AR, Vielhauer MJ, et al. Understanding the interface of HIV, trauma, post-traumatic stress disorder, and substance use and its implications for health outcomes. AIDS Care. 2004;16(Suppl 1):S97–120.

    Article  Google Scholar 

  13. Kessler RC, Berglund P, Delmer O, et al. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatr. 2005;62(6):593–602.

    Article  Google Scholar 

  14. Kimerling R, Calhoun KS, Forehand R, et al. Traumatic stress in HIV-infected women. AIDS Educ Prev. 1999;11:321–30.

    CAS  PubMed  Google Scholar 

  15. Martinez A, Israelski D, Walker CK. Posttraumatic stress disorder in women attending human immunodeficiency virus outpatient clinic. AIDS Patient Care STDS. 2002;16:283–91.

    Article  Google Scholar 

  16. Leserman J, Whetten K, Lowe K, et al. How trauma, recent stressful events, and PTSD affect functional health status and health utilization in HIV-infected patients in the south. Psychosom Med. 2005;67:500–7.

    Article  Google Scholar 

  17. Kalichman S, Gore-Felton C, Benotsch E, et al. Trauma symptoms, sexual behaviors, and substance abuse: correlates of childhood sexual abuse and HIV risks among men who have sex with men. J Child Sex Abus. 2004;13(1):1–15.

    Article  Google Scholar 

  18. Boarts JM, Sledjeski EM, Bogart LM, Delahanty DL. The differential impact of PTSD and depression on HIV disease markers and adherence to HAART in people living with HIV. AIDS Behav. 2006;10:253–61.

    Article  Google Scholar 

  19. Whetten K, Reif S, Whetten R, Murphy-McMillan LK. Trauma, mental health, distrust, and stigma among HIV-positive persons: implications for effective care. Psychosom Med. 2008;70:531–8.

    Article  Google Scholar 

  20. Machtinger EL, Wilson TC, Haberer JE, Weiss DS. Psychological trauma and PTSD in HIV-positive women: a meta-analysis. AIDS Behav. 2012;16:2091–100.

    Article  CAS  Google Scholar 

  21. Corrigan PW. On the stigma of mental illness: Practical strategies for research and social change. Washington, DC: American Psychological Association; 2005.

    Book  Google Scholar 

  22. Meyer IH. Prejudice, social stress, and mental health in lesbian, gay and bisexual populations: conceptual issues and research evidence. Psychol Bull. 2003;129:674–97.

    Article  Google Scholar 

  23. Earnshaw VA, Chaudoi SR. From conceptualizing to measuring HIV stigma: a review of HIV stigma mechanism measures. AIDS Behav. 2009; 13(6):1160–77.

    Article  Google Scholar 

  24. Corrigan P. The impact of stigma on severe mental illness. Cogn Behav Pract. 1999;5(2):201–22.

    Article  Google Scholar 

  25. Corrigan P, Watson A. The paradox of self-stigma and mental illness. Clin Psychol Sci Pract. 2002;9:35–53.

    Article  Google Scholar 

  26. Katz S, Nevid JS. Risk factors associated with posttraumatic stress disorder symptomatology in HIV-infected women. AIDS Patient Care STDS. 2005;19(2):110–20.

    Article  Google Scholar 

  27. Vanable PA, Carey MP, Blair DC, Littlewood RA. Impact of HIV-related stigma on health behaviors and psychological adjustment among HIV-positive men and women. AIDS Behav. 2006;10(5):473–82.

    Article  Google Scholar 

  28. Wingood GM, Reddy P, Peterson SH, et al. HIV stigma and mental health status among women living with HIV in the Western Cape, South Africa. S Afr J Sci. 2008;104:237–40.

    Google Scholar 

  29. Hermann S, McKinnon E, Hyland NB, et al. HIV-related stigma and physical health symptoms have a persistent influence on health-related quality of life in Australians with HIV infection. Health Qual Life Outcomes. 2013;11:56–68.

    Article  Google Scholar 

  30. Derlega VJ, Winstead BA, Oldfield EC III, Barbee AP. Close relationships and social support in coping with HIV: a test of sensitive interaction systems theory. AIDS Behav. 2003;7(2):119–29.

    Article  Google Scholar 

  31. Hays RB, Catania JA, McKusick L, Coates TH. Help-seeking for AIDS-related concerns: a comparison of gay men with various HIV diagnoses. Am J Community Psychol. 1990;18(5):743–55.

    Article  CAS  Google Scholar 

  32. Simoni JM, Ortiz MZ. Mediational models of spirituality and depressive symptomatology among HIV-positive Puerto Rican women. Cultur Divers Ethnic Minor Psychol. 2003;9:3–15.

    Article  Google Scholar 

  33. Jenkins RA. Religion and HIV: implications for research and intervention. J Soc Issues. 1995;51(2):131–44.

    Article  Google Scholar 

  34. Zou J, Yamanaka Y, John M, et al. Religion and HIV in Tanzania: influence of religious beliefs on HIV stigma, disclosure, and treatment attitudes. BMC Public Health. 2009; 9:75).

  35. Genrich GL, Brathwaite BA. Response of religious groups to HIV/AIDS as a sexually transmitted infection in Trinidad. BMC Public Health. 2005; 5(121):online access.

  36. Cotton S, Puchalski CM, Sherman SN, et al. Spirituality and religion in patients with HIV/AIDS. J Gen Intern Med. 2006;21:S5–13.

    Article  Google Scholar 

  37. Edwards LV. Perceived social support and HIV/AIDS medication adherence among African American women. Qual Health Res. 2006;16(5):679–91.

    Article  Google Scholar 

  38. Israelski DM, Prentiss DE, Lubega S, et al. Psychiatric co-morbidity in vulnerable populations receiving primary care for HIV/AIDS. AIDS Care. 2007;19:220–5.

    Article  CAS  Google Scholar 

  39. Feist-Price S, Wright LB. African American women living with HIV/AIDS: mental health issues. Women & Therapy. 2003;26(1/2):27–44.

    Article  Google Scholar 

  40. Lincoln CE, Mamiya LH. The black church in the African American experience. Durham, NC: Duke University Press; 1990.

    Book  Google Scholar 

  41. Nooney J, Woodrum E. Religious coping and church-based social support as predictors of mental health outcomes: testing a conceptual model. J Sci Study Relig. 2002;41:359–68.

    Article  Google Scholar 

  42. Dalmida SG, Holstad MM, Dilorio C, Laderman G. Spiritual well-being and health-related quality of life among African-American women with HIV/AIDS. Appl Res Qual Life. 2011;6(2):139–57.

    Article  Google Scholar 

  43. Muturi N, An S. HIV/AIDS stigma and religiosity among African American women. J Health Commun. 2010;15(4):388–401.

    Article  Google Scholar 

  44. Heckman TG, Somlai AM, Kalichnan SC, et al. Psychosocial differences between urban and rural people living with HIV/AIDS. J Rural Health. 1998;14(2):138–45.

    Article  CAS  Google Scholar 

  45. Brownley JR, Fallot RD, Berley RW, Himelhoch SS. Trauma history in African-American women living with HIV: effects on psychiatric symptom severity and religious coping. AIDS Care. 2015;27(8):964–71.

    Article  Google Scholar 

  46. Foa EB, Tolin DF. Comparison of the PTSD symptom scale-interview version with the clinician-administered PTSD scale. J Trauma Stress. 2000;13:181–91.

    Article  CAS  Google Scholar 

  47. Tolin DF, Foa EB. Sex differences in trauma and posttraumatic stress disorder: a quantitative review of 25 years of research. Psychol Bull. 2006;132:959–92.

    Article  Google Scholar 

  48. Foa EB, Riggs DS, Dancu CV, Rothbaum BO. Reliability and validity of a brief instrument for assessment post-traumatic stress disorder. J Trauma Stress. 1993;6(4):459–73.

    Article  Google Scholar 

  49. Derogatis LR, Melisaratos N. The brief symptom inventory: an introductory report. Psychol Med. 1983;13:595–605.

    Article  CAS  Google Scholar 

  50. Aroian KJ, Patsdaughter CA. Multiple-method, cross-cultural assessment of psychological distress. IMAGE. J Nurs Scholarsh. 1989;21(2):90–3.

    Article  CAS  Google Scholar 

  51. Derogatis LR. BSI Brief Symptom Inventory. Administration, Scoring, and Procedures Manual. 4th Ed. Minneapolis, MN: National Computer Systems; 1993.

  52. Ware JE, Kosinski M, Keller SD. A, 12-item Short Form Health Survey. Construction of scales and preliminary tests of reliability and validity. Med Care. 1996;34:220–33.

    Article  Google Scholar 

  53. McHorney C, Kosinski M, Ware J. Comparisons of the costs and quality of norms for the SF-36 Health Survey collected by mail versus telephone interview; results from a national survey. Med Care. 1993;31(3):247–63.

    Article  CAS  Google Scholar 

  54. Ware J, Kosinski M, Keller S. SF-36 Phsyical and Mental Summary Scales: A User’s Manual. Boston, MA: The Health Institute; 1994.

    Google Scholar 

  55. Turner RJ, Frankel B, Levin D. Social support: conceptualization, measurement, and implications for mental health. Res Community Ment Health. 1983;3:67–111.

    Google Scholar 

  56. Anderson S, Donlan A, McDermott E, Zaff J. Ecology matters: neighborhood differences in the protective role of self-control and social support for adolescent antisocial behavior. Am J Orthopsychiatry. 2015;85(6):536–49.

    Article  Google Scholar 

  57. Heckman T, Kochman A, Sikkema K, et al. Late middle-aged and older men living with HIV/AIDS: race differences in coping, social support, and psychological distress. J Natl Med Assoc. 2000;92:436–44.

    CAS  PubMed  PubMed Central  Google Scholar 

  58. Heckman B, Berlin K, Heckman T, Feaster D. Psychometric characteristics and race-related measurement invariance of stress and coping measures in adults with HIV/AIDS. AIDS Behav. 2011;15(2):441–53.

    Article  Google Scholar 

  59. Carver CS. You want to measure coping but your protocol’s too long: consider the brief COPE. Int J Behav Med. 1997;4:92–100.

    Article  CAS  Google Scholar 

  60. Cooper C, Katona C, Livingston G. Validity and reliability of the Brief COPE in carers of people with dementia. J Nerv Ment Dis. 2008;196(11):838–43.

    Article  Google Scholar 

  61. Pargament KI, Smith B, Koenig HG, Perez L. Patterns of positive and negative religious coping with major life stressors. J Sci Study Relig. 1998;37:710–24.

    Article  Google Scholar 

  62. Pargament K, Feuille M, Burdzy D. The brief RCOPE: current psychometric status of a short measure of religious coping. Religions. 2011;2(1):51–76.

    Article  Google Scholar 

  63. Nyblade LC. Measuring HIV stigma: existing knowledge and gaps. Psychol Health Med. 2006;11(3):335–45.

    Article  Google Scholar 

  64. Gonzalez A, Locicero B, Mahaffey B, et al. Internalized HIV stigma and mindfulness: associations with PTSD symptom severity in trauma-exposed adults with HIV/AIDS. Behav Modif. 2016;40(1–2):144–63.

    Article  Google Scholar 

  65. Kamen C, Vorasarun C, Canning T, et al. The impact of stigma and social support on development of post-traumatic growth among persons living with HIV. J Clin Psychol Med Settings. 2016;23(2):126–34.

    Article  Google Scholar 

  66. Centers for Disease Control and Prevention. Intersection of intimate partner violence and HIV in women: Centers for Disease Control and Prevention; 2014. http://www.cdc.gov/violenceprevention/pdf/ipv/13_243567_green_aag-a.pdf. Accessed 16 March, 2015

Download references

Acknowledgements

This research is supported, in part, by the Department of Veterans Affairs Office of Academic Affiliations Advanced Fellowship Program in Mental Illness Research and Treatment. It is the result of work supported with resources and the use of facilities at the VA Capitol Health Care Network (VISN 5) MIRECC and the University of Maryland School of Medicine Department of Psychiatry. This article reflects the authors’ personal views and in no way represents the official view of the Department of Veterans Affairs of the U.S. Government.

Funding

This work was supported by the Substance Abuse and Mental Health Services Administration (Grant Number 5U79SM057654-04SM057654).

Author information

Authors and Affiliations

  1. VA Capital Healthcare Network Mental Illness Research, Education, and Clinical Center (MIRECC), 10 N. Greene St., Annex Building, 7th Floor, Baltimore, MD, 21201, USA

    Letitia E. Travaglini

  2. Department of Psychiatry, University of Kentucky College of Medicine, Lexington, KY, 40509, USA

    Seth S. Himelhoch

  3. Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, 21201, USA

    Letitia E. Travaglini & Li Juan Fang

Authors
  1. Letitia E. Travaglini
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Seth S. Himelhoch
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Li Juan Fang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Letitia E. Travaglini.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants involved in this study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Travaglini, L.E., Himelhoch, S.S. & Fang, L.J. HIV Stigma and Its Relation to Mental, Physical and Social Health Among Black Women Living with HIV/AIDS. AIDS Behav 22, 3783–3794 (2018). https://doi.org/10.1007/s10461-018-2037-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-018-2037-1

Keywords

Search

Navigation