The Impact of HIV-Related Stigma among Adults Living with HIV and Disability in Florida, 2015-2016

• Main Author: Williams, Renessa Shamar
• Format: Dissertation
• Language: English
• Published: ProQuest Dissertations & Theses 01-01-2020
• Subjects: Disability studies; Mental health; Nursing
• ISBN: 9798357545138

Human Immunodeficiency Virus (HIV) disproportionately affects the Southern United States, accounting for approximately 46% of people living with HIV (PLWH). HIV-related stigma is recognized as a barrier to testing, treatment, and prevention efforts. However, little is known about HIV-related stigma experiences in Florida. The purpose of this study is to examine the association between HIV-related stigma, disability, and key individual characteristics in PLWH using a mixed methods approach. In the first manuscript, utilizing data from the 2015-2016 Florida Medical Monitoring project, we sought to examine individual characteristics associated with HIV-related stigma. Multivariate regression models were used to determine the individual characteristics associated with the HIV Stigma Scale. Overall stigma, negative self-image, and anticipated stigma were significantly associated with depression, while other individual characteristics appeared to be uniquely associated with each of the three dimensions of HIV-related stigma. The second manuscript identifies the prevalence of HIV-related stigma among people living with HIV and disability(s) (PLWH-D) compared to PLWH without disabilities. Using data collected from 2015-2016 Florida Medical Monitoring Project, crude and adjusted prevalence ratios were calculated. The prevalence of HIV-related stigma was revealed to be higher among PLWH-D compared to PWLH without disability, even after adjusting for potential confounders. Finally, using semi-structured interviews guided by the HIV-related Stigma, Engagement in Care, and Health Outcomes framework, 13 African American women living with HIV were interviewed about their perceptions and meaning of HIV-related stigma. A majority of women redefined stigmatizing behaviors as ignorance and perceived these circumstances as opportunities to either educate, advocate, or avoid friends, family, and/or coworkers. Overall, a comprehensive analysis of the complexity of HIV-related stigma was obtained by exploring the influences of individual characteristics and disability using a mixed methods approach.