Background: In the US, Women, especially Black and Latina women living in disadvantaged environments, are disproportionally affected by HIV. Women living with HIV (WLHIV) have higher rates of suboptimal antiretroviral therapy (ART) adherence, and detectable viral load (VL). Experiences of intersectional poverty, HIV, gender, and racial stigmas may increase the rates of detectable VL through suboptimal ART adherence.
Aims: To explore longitudinal associations between intersectional stigmas, ART adherence, and detectable VL using multidimensional latent transition item response analysis.
Participants: WLHIV (N = 459) in the [masked] sub-study of the [masked], from sites in Birmingham, AL, Jackson, MS, Atlanta, GA, and San Francisco, CA.
Assessment: Experienced poverty, HIV, gender, and racial stigma, self-report ART adherence, and VL were assessed at four yearly follow-ups between 2016 and 2020.
Results: We identified five classes of WLHIV with different combinations of experienced intersectional stigmas. Longitudinally, WLHIV with higher levels of poverty, gender, and racial stigma had higher odds of suboptimal ART adherence (<90%) (OR = 3.59, p < 0.001) and detectable VL (OR = 2.08, p = 0.028) compared to WLHIV with lower/moderately low stigmas levels. WLHIV in the highest stigma classes had higher odds of detectable VL, independently of ART adherence (Class 3: OR = 1.38, p = 0.016; Class 5: OR = 1.31, p = 0.046). These findings underscore the compounded effects of intersectional stigmas on HIV treatment outcomes.
Conclusion: Intersecting experiences of HIV, racial, gender, and poverty stigmas can increase detectable VL risk through suboptimal ART adherence, although other mechanisms may also be involved. Recognizing the complexity of intersectional stigmas is essential for developing approaches to improve WLHIV's HIV treatment outcomes.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.socscimed.2024.117643 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Correction: Compliance with reporting standards in Mobile App interventions for ART adherence among PLHIV.
AIDS Res Ther
January 2025
Digital Health Africa, Abuja, Nigeria.
Factors associated with adherence to antiretroviral therapy among HIV-positive adolescents and young adult patients attending HIV care and treatment clinic at Bombo Hospital in Tanga region-Tanzania.
PLoS One
January 2025
School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
Background: Adherence to HIV treatment regimens involves the consistent and correct intake of all prescribed medications. The implementation of antiretroviral therapy (ART) program has significantly reduced mortality among adolescents living with HIV. However, adherence to ART is lower among adolescents compared to other sub-populations and even lower in sub-Saharan Africa.
View Article and Find Full Text PDFCROI 2024: The Challenges of Sustained Viral Suppression, Advanced HIV Disease, and Ending the HIV Epidemic Targets.
Top Antivir Med
August 2024
New York Blood Center, New York, New York, USA.
Data on the HIV care cascade demonstrated challenges in achieving Ending the HIV Epidemic (EHE) targets across all 18 EHE focus metropolitan areas, but innovative adherence interventions using point-of-care tenofovir testing and motivational interviewing support care cascade outcomes in Namibia and South Africa, respectively. Data on treatment with long-acting injectable (LAI) antiretroviral therapy (ART) demonstrated high acceptability, retention, and virologic suppression including in groups that were not well represented in clinical trials including persons born female and persons with detectable viral loads. The adjuvanted hepatitis B vaccine appeared to be safe and appeared to be superior to conventional hepatitis B vaccines in persons with HIV (PWH) who were prior nonresponders to the hepatitis B vaccine.
View Article and Find Full Text PDFLongitudinal associations between intersectional stigmas, antiretroviral therapy adherence, and viral load among women living with HIV using multidimensional latent transition item response analysis.
Soc Sci Med
December 2024
Department of Psychology, Koc University, Istanbul, Turkey; Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA.
Background: In the US, Women, especially Black and Latina women living in disadvantaged environments, are disproportionally affected by HIV. Women living with HIV (WLHIV) have higher rates of suboptimal antiretroviral therapy (ART) adherence, and detectable viral load (VL). Experiences of intersectional poverty, HIV, gender, and racial stigmas may increase the rates of detectable VL through suboptimal ART adherence.
View Article and Find Full Text PDFVirological outcomes of antiretroviral therapy and its determinants among HIV patients in Ethiopia: Implications for achieving the 95-95-95 target.
PLoS One
January 2025
Department of Nursing, College of Health Science, Woldia University, Woldia, Ethiopia.
Background: Despite significant advancements in HIV treatment, virological outcomes remain a critical issue. Ethiopia did not meet the 90:90:90 targets set for 2020, which aimed for 90% of people on antiretroviral therapy to achieve viral suppression. As the country shifts its focus toward the 95:95:95 targets for 2030-seeking to achieve 95% viral suppression among those on ART-it is crucial to deepen our understanding of viral suppression and the factors that influence it.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!