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The Impact of HIV-Related Stigma on Racial/Ethnic Disparities in Retention in HIV Care Among Adults Living with HIV in Florida.

Authors
  • Forney, Derrick J1, 2, 3
  • Sheehan, Diana M4, 5
  • Dale, Sannisha K6, 7
  • Li, Tan4, 8
  • De La Rosa, Mario4
  • Spencer, Emma C9
  • Sanchez, Mariana10, 4
  • 1 Department of Health Promotion and Disease Prevention, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, USA. [email protected].
  • 2 Center for Research on U.S. Latino HIV/AIDS and Drug Abuse (CRUSADA), Florida International University, Miami, USA. [email protected].
  • 3 Center for HIV Research and Mental Health (CHARM), University of Miami, Coral Gables, USA. [email protected].
  • 4 Center for Research on U.S. Latino HIV/AIDS and Drug Abuse (CRUSADA), Florida International University, Miami, USA.
  • 5 Department of Epidemiology, Robert Stempel College of Public Health & Social Work, Miami, USA.
  • 6 Center for HIV Research and Mental Health (CHARM), University of Miami, Coral Gables, USA.
  • 7 Department of Psychology, University of Miami, Coral Gables, Miami, USA.
  • 8 Department of Biostatistics, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, USA.
  • 9 Florida Department of Health, Tallahassee, USA.
  • 10 Department of Health Promotion and Disease Prevention, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, USA.
Type
Published Article
Journal
Journal of racial and ethnic health disparities
Publication Date
Jul 26, 2023
Identifiers
DOI: 10.1007/s40615-023-01715-1
PMID: 37495905
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Our study examines the effects of distinct HIV stigma subtypes on retention in care and racial-ethnic differences among persons with HIV (PWH). Using Florida Medical Monitoring Project 2015-2017 data, we analyzed patients' clinical and behavioral characteristics. We analyzed 89,889 PWH in Florida (50.0% non-Hispanic Blacks, 20.8% Hispanics, 29.2% non-Hispanic whites). HIV stigma subtypes, negative self-image, anticipated stigma, personalized stigma, and retention in care were examined with logistic regressions. People with high negative self-image and anticipated stigma were less likely to be retained (CI: 0.84-0.92; 0.47-0.53). The association between HIV-related stigma subtypes and retention in care differed between Black, White, and Hispanic participants. Negative self-image was associated with higher retention rates among Hispanics (CI: 5.64-9.26) and Whites (CI: 1.04-1.27), while low retention rates among Blacks (0.617-0.686). The likelihood of staying in care was lower across all racial-ethnic groups when the anticipated stigma was high or moderate. In contrast, personalized stigma increased retention across all racial-ethnic groups. Results showed that distinct types of HIV stigma differentially impact retention, and these associations differ by race and ethnicity. Future interventions should address the effect HIV stigma subtypes have on racially minoritized PWH retention. © 2023. W. Montague Cobb-NMA Health Institute.

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