Exploring HIV-Related Stigma as a Determinant of Engagement in HIV Care by African American Women.
Katryna McCoy, Lauren Lipira, Christopher G Kemp and 9 others
PMID 31725104WHAT IT FOUND
HIV-related stigma did not predict whether African American women living with HIV attended their medical appointments.
Age, education, social support, and the type of clinic they attended were the factors associated with engagement in care.
Key findings
01Neither internalized nor enacted HIV-related stigma was associated with engagement in HIV care after adjusting for covariates.
02Older age, higher education levels, and higher social support were significantly associated with greater rates of engagement in HIV care.
03Women at the public hospital-affiliated clinic had a 25% lower rate of engagement in HIV care compared to those at the private university-based clinic.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Participants were already engaged in care, so the study cannot determine if stigma affects initial linkage to care. Repeated questioning about engagement in care during the parent trial may have influenced participants' behavior. Appointment adherence data was abstracted from medical records, which may vary in documentation practices across clinics. The analysis focused on individual-level factors, potentially missing clinic-level influences on engagement.
Declared interests
The authors report no real or perceived vested interests related to this article that could be construed as a conflict of interest.
The easy way to misread this
Do not conclude that stigma is irrelevant to HIV care engagement. This study only examined women already linked to care; stigma may still be a major barrier to initial linkage, which this analysis could not assess.