title: Age, Stigma, Adherence and Clinical Indicators in HIV-Infected Women.
abstract: Stigma has become a gendered phenomenon that affects increasing numbers of HIV-infected women worldwide. This study examined the role of age as a possible moderator of the relationship between stigma and antiretroviral therapy adherence, CD4% and viral load among 120 HIV-infected women. A secondary analysis was conducted using data from the Keeping Healthy and Active with Risk Reduction and Medication Adherence (KHARMA) Project, an National Institutes of Health (NIH) funded randomized controlled trial to improve Antiretroviral treatment (ART) adherence and reduce risky behaviors in HIV-infected women at five clinical sites in a South-eastern city from 2005 to 2008. Stigma was measured using the Perceived Personal Stigma of Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome (HIV/AIDS) scale. Among participants <50 years old (n=90), age was significantly associated with viral load (rho=-.24, p=.02) and stigma was negatively associated with CD4% (r =-.26, p=.02). For the 30 participants >50 years old, age was not significantly associated with viral load, stigma or CD4%, and there was no significant association between stigma and CD4% (r=.07, p=.70). These findings indicate the need for further study regarding this potential moderating effect and possible interventions to address the susceptibility of younger women to the harmful effects of stigma.
authors.affiliation: Assistant Professor, School of Nursing & Health Studies, University of Washington Bothell, Bothell, Washington, USA.
authors.forename: Katryna
authors.initials: K
authors.lastname: McCoy
authors.affiliation: Associate Research Professor, Senior Biostatistician, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA.
authors.forename: Melinda
authors.initials: M
authors.lastname: Higgins
authors.affiliation: Assistant Professor, School of Nursing, The University of Texas at Austin, Austin, Texas, USA.
authors.forename: Julie Ann
authors.initials: JA
authors.lastname: Zuñiga
authors.affiliation: Professor and Marcia Stanhope Professor in Public Health, Nell Hodgson Woodruff School of Nursing; Assistant Director for Clinical and Social Science Integration, Emory Center for AIDS Research, Emory University, Atlanta, Georgia, USA.
authors.forename: Marcia McDonnell
authors.initials: MM
authors.lastname: Holstad
keywords: Adherence; Aging; Antiretroviral therapy; HIV; Stigma; Women