Exploring the Impact of Experiences with Everyday and Major Discrimination and HIV-Related Stigma on Engagement in HIV Care Among Older African Americans Living with HIV.

IF 2.4 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Journal of Racial and Ethnic Health Disparities Pub Date : 2023-08-01 DOI:10.1007/s40615-022-01373-9
Timothy N Crawford, Sydney Silverstein, Tiffani Spaulding, Desby Cheribin, Tamiel Murray, Josef Rivera, Katherine Wilcher
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引用次数: 3

Abstract

Objectives: The purpose of this pilot study was to explore the effect of HIV-related stigma and everyday major experiences of discrimination on medication and clinic visit adherence among older African Americans living with HIV in Ohio.

Methods: We collected data from 53 individuals who were living with HIV in Ohio, ≥ 50 years of age, and who identified as Black or African American. We conducted logistic regression models to examine the impact of HIV-related stigma and experiences of discrimination on medication and visit adherence. Each model controlled for age, time since diagnosis, and sexual orientation.

Results: The average age was 53.6 ± 2.1 years and 94.3% were men. Almost half (49.1%) of the participants reported poor medication adherence and almost a third (31.4%) reported poor visit adherence. HIV-related stigma (adjusted odds ratio (aOR) = 1.39; 95% confidence interval (CI) = 1.02-1.89) and major experiences of discrimination (aOR = 1.70; 95% CI = 1.11-2.60) were associated with a greater odds of poor medication adherence. Additionally, major experiences of discrimination were associated with a threefold increase in the odds of poor visit adherence (aOR = 3.24; 95% CI = 1.38-7.64).

Conclusions: HIV-related stigma and major experiences of discrimination impede optimal medication and HIV clinic visit adherence for older African Americans living with HIV. To reduce the impact of stigma and discrimination on HIV care engagement, our first step must be in understanding how intersecting forms of stigma and discrimination impact engagement among older African Americans living with HIV.

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探索日常和重大歧视和艾滋病相关耻辱的经历对老年非洲裔美国人艾滋病毒感染者艾滋病毒护理的影响。
目的:本初步研究的目的是探讨HIV相关的污名和日常主要歧视经历对俄亥俄州老年非裔美国HIV感染者服药和就诊依从性的影响。方法:我们收集了来自俄亥俄州的53名HIV感染者的数据,这些人年龄≥50岁,被认定为黑人或非裔美国人。我们使用逻辑回归模型来检验hiv相关的污名和歧视经历对药物治疗和就诊依从性的影响。每个模型都控制了年龄、诊断后的时间和性取向。结果:平均年龄53.6±2.1岁,男性占94.3%。几乎一半(49.1%)的参与者报告服药依从性差,几乎三分之一(31.4%)的参与者报告就诊依从性差。hiv相关的耻辱感(校正优势比(aOR) = 1.39;95%可信区间(CI) = 1.02-1.89)和主要歧视经历(aOR = 1.70;95% CI = 1.11-2.60)与药物依从性差的几率较大相关。此外,主要的歧视经历与就诊依从性差的几率增加三倍相关(aOR = 3.24;95% ci = 1.38-7.64)。结论:艾滋病毒相关的耻辱和主要的歧视经历阻碍了老年非洲裔美国人感染艾滋病毒的最佳药物治疗和艾滋病毒门诊依从性。为了减少耻辱和歧视对艾滋病毒护理参与的影响,我们的第一步必须是了解耻辱和歧视的交叉形式如何影响感染艾滋病毒的老年非洲裔美国人的参与。
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来源期刊
Journal of Racial and Ethnic Health Disparities
Journal of Racial and Ethnic Health Disparities PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
7.30
自引率
5.10%
发文量
263
期刊介绍: Journal of Racial and Ethnic Health Disparities reports on the scholarly progress of work to understand, address, and ultimately eliminate health disparities based on race and ethnicity. Efforts to explore underlying causes of health disparities and to describe interventions that have been undertaken to address racial and ethnic health disparities are featured. Promising studies that are ongoing or studies that have longer term data are welcome, as are studies that serve as lessons for best practices in eliminating health disparities. Original research, systematic reviews, and commentaries presenting the state-of-the-art thinking on problems centered on health disparities will be considered for publication. We particularly encourage review articles that generate innovative and testable ideas, and constructive discussions and/or critiques of health disparities.Because the Journal of Racial and Ethnic Health Disparities receives a large number of submissions, about 30% of submissions to the Journal are sent out for full peer review.
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