Volume 11, Issue 1 (3-2022)
JCHR 2022, 11(1): 12-21 |
Back to browse issues page
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Guy A, Woodward H, Kannout L, Du Bois S. Investigating changes in internalized stigma and avoidant coping among African American adults living with HIV and serious mental illness following a peer-led intervention. JCHR 2022; 11 (1) :12-21
URL: http://jhr.ssu.ac.ir/article-1-706-en.html
URL: http://jhr.ssu.ac.ir/article-1-706-en.html
1- Alcohol Research Center on HIV, Center for Alcohol and Addiction Studies, Brown University School of Public Health and Department of Psychiatry and Human Behavior, Alpert Medical School at Brown University , arryn_guy@brown.edu
2- Department of Psychology, Illinois Institute of Technology
2- Department of Psychology, Illinois Institute of Technology
Abstract: (1507 Views)
Background: Individuals living with HIV navigate the health implications of HIV and HIV discrimination. This study aimed to examine changes in internalized stigma and avoidant coping among African American adults living with HIV and serious mental illness (SMI) following a peer-led intervention.
Methods: In this quasi-experimental study, 16 patients were recruited using convenience sampling from an HIV clinic in an urban hospital setting in the United States for a community-based participatory research (CBPR) developed peer-led intervention pilot. Participants answered questions about their experiences of HIV-related discrimination, internalized stigma, and cognitive escape coping before and after participating in four 90-minute peer-led weekly group sessions. For data analysis, paired-samples t-test and linear regression with Hayes’ PROCESS Macro in SPSS 27 were used at a 5% significance level.
Results: There was a significant indirect effect of HIV-related discrimination on cognitive escape coping through internalized stigma (b = 0.28, 95% CI [0.03, 0.61]). Post-intervention non-significant associations suggest that a CBPR-developed peer-led intervention may buffer against the effects of HIV-related discrimination.
Conclusion: Our study provides initial support that community and peer support approaches may buffer against the effects of discrimination on internalized stigma and avoidant coping among African American individuals living with HIV and SMI.
Methods: In this quasi-experimental study, 16 patients were recruited using convenience sampling from an HIV clinic in an urban hospital setting in the United States for a community-based participatory research (CBPR) developed peer-led intervention pilot. Participants answered questions about their experiences of HIV-related discrimination, internalized stigma, and cognitive escape coping before and after participating in four 90-minute peer-led weekly group sessions. For data analysis, paired-samples t-test and linear regression with Hayes’ PROCESS Macro in SPSS 27 were used at a 5% significance level.
Results: There was a significant indirect effect of HIV-related discrimination on cognitive escape coping through internalized stigma (b = 0.28, 95% CI [0.03, 0.61]). Post-intervention non-significant associations suggest that a CBPR-developed peer-led intervention may buffer against the effects of HIV-related discrimination.
Conclusion: Our study provides initial support that community and peer support approaches may buffer against the effects of discrimination on internalized stigma and avoidant coping among African American individuals living with HIV and SMI.
Review: Research |
Subject:
Public Health
Received: 2020/12/5 | Accepted: 2022/03/28 | Published: 2022/03/30
Received: 2020/12/5 | Accepted: 2022/03/28 | Published: 2022/03/30
References
1. 1. Centers for Disease Control. Estimated HIV incidence and prevalence in the United States, 2010-2016 [Internet]. Centers for Disease Control; 2019 Feb [cited 2020 Apr 15] p. 89. (HIV Surveillance Supplemental Report). Report No.: 1. Available from: http://www.cdc.gov/ hiv/library/reports/hiv-surveillance.html.
2. Siddiqi A-A, Hu X, Hall HI. Centers for Disease Control and Prevention (CDC). Mortality among blacks or African Americans with HIV infection--United States, 2008-2012. MMWR Morb Mortal Wkly Rep. 6;64(4):81-6.
3. Kaholokula JK. Racism and physical health disparities. In: The cost of racism for people of color: Contextualizing experiences of discrimination. Washington, DC, US: American Psychological Association; 2016. p. 163-88. (Cultural, racial, and ethnic psychology book series). [DOI:10.1037/14852-008]
4. Stockton MA, Giger K, Nyblade L. A scoping review of the role of HIV-related stigma and discrimination in noncommunicable disease care. PloS One. 2018;13(6):e0199602. [DOI:10.1371/journal.pone.0199602]
5. Pantelic M, Sprague L, Stangl AL. It's not "all in your head": critical knowledge gaps on internalized HIV stigma and a call for integrating social and structural conceptualizations. BMC Infect Dis. 2019;19(1):210. [DOI:10.1186/s12879-019-3704-1]
6. Yeji F, Klipstein-Grobusch K, Newell M-L, et al. Are social support and HIV coping strategies associated with lower depression in adults on antiretroviral treatment? Evidence from rural KwaZulu-Natal, South Africa. AIDS Care. 2014;26(12):1482-9. [DOI:10.1080/09540121.2014.931561]
7. Adams JL, Gaynes BN, McGuinness T, et al. Treating Depression Within the HIV "Medical Home": A Guided Algorithm for Antidepressant Management by HIV Clinicians. AIDS Patient Care STDs. 2012 Nov;26(11):647-54. [DOI:10.1089/apc.2012.0113]
8. Skalski LM, Sikkema KJ, Heckman TG, et al. Coping Styles and Illicit Drug Use in Older Adults with HIV/AIDS. Psychol Addict Behav J Soc Psychol Addict Behav [Internet]. 2013 Dec [cited 2020 Dec 14];27(4). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3872502/ [DOI:10.1037/a0031044]
9. Du Bois SN, McKirnan DJ. A longitudinal analysis of HIV treatment adherence among men who have sex with men: A cognitive escape perspective. AIDS Care. 2012 Nov;24(11):1425-31. [DOI:10.1080/09540121.2011.650676]
10. Hoyt MA, Nemeroff CJ, Huebner DM. The effects of HIV-related thought suppression on risk behavior: Cognitive escape in men who have sex with men. Health Psychol. 2006 Jul;25(4):455-61. [DOI:10.1037/0278-6133.25.4.455]
11. Pérez AE, Wray TB, Celio MA, et al. HIV-related thought avoidance, sexual risk, and alcohol use among men who have sex with men. AIDS Care. 2018;30(7):930-5. [DOI:10.1080/09540121.2018.1426828]
12. Earnshaw VA, Bogart LM, Laurenceau J, et al. Internalized HIV stigma, ART initiation and HIV‐1 RNA suppression in South Africa: exploring avoidant coping as a longitudinal mediator. J Int AIDS Soc [Internet]. 2018 Oct 26 [cited 2020 Dec 9];21(10). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6202800/ [DOI:10.1002/jia2.25198]
13. Tang TS, Funnell MM, Sinco B, et al. Peer-Led, Empowerment-Based Approach to Self-Management Efforts in Diabetes (PLEASED): A Randomized Controlled Trial in an African American Community. Ann Fam Med. 2015 Aug 1;13(Suppl_1):S27-35. [DOI:10.1370/afm.1819]
14. Coughlin SS, Smith SA. A review of community-based participatory research studies to promote physical activity among African Americans. J Ga Public Health Assoc. 2016;5(3):220-7. [DOI:10.20429/jgpha.2016.050305]
15. Earnshaw VA, Bogart LM, Dovidio JF, et al. Stigma and racial/ethnic HIV disparities: Moving toward resilience. Am Psychol. 2013;68(4):225-36. [DOI:10.1037/a0032705]
16. Rao D, Feldman BJ, Fredericksen RJ, et al. A Structural Equation Model of HIV-Related Stigma, Depressive Symptoms, and Medication Adherence. AIDS Behav. 2012 1;16(3):711-6. [DOI:10.1007/s10461-011-9915-0]
17. Webb Hooper M, Baker EA, McNutt MD. Associations between coping, affect, and social support among low-income African American smokers. Addict Behav. 2013 Nov 1;38(11):2736-40. [DOI:10.1016/j.addbeh.2013.07.005]
18. Meyer IH. Prejudice, Social Stress, and Mental Health in Lesbian, Gay, and Bisexual Populations: Conceptual Issues and Research Evidence. Psychol Bull. 2003 Sep;129(5):674-97. [DOI:10.1037/0033-2909.129.5.674]
19. Guy AA, Du Bois SN, Thomas N "Novie,", et al. Testing Prepare2Thrive: A Community-Based Participatory Research Pilot Intervention. Prog Community Health Partnersh. in press;14(4).
20. Du Bois SN, Guy AA, Manser KA, et al. Developing Prepare2Thrive, a community-based intervention targeting treatment engagement among African American individuals living with HIV and serious mental illness. AIDS Care. 2020 Jan 28;1-9. [DOI:10.1080/09540121.2020.1717420]
21. Magidson JF, Seitz-Brown CJ, Safren SA, et al. Implementing behavioral activation and life-steps for depression and HIV medication adherence in a community health center. Cogn Behav Pract. 2014;21(4):386-403. [DOI:10.1016/j.cbpra.2013.10.002]
22. Holzemer WL, Uys LR, Chirwa ML, et al. Validation of the HIV/AIDS Stigma Instrument-PLWA (HASI-P). AIDS Care. 2007 Sep;19(8):1002-12. [DOI:10.1080/09540120701245999]
23. Maluccio JA, Wu F, Rokon RB, et al Assessing the Impact of Food Assistance on Stigma Among People Living with HIV in Uganda Using the HIV/AIDS Stigma Instrument-PLWA (HASI-P). AIDS Behav. 2017 Mar;21(3):766-82. [DOI:10.1007/s10461-016-1476-9]
24. Carver CS. You Want to Measure Coping But Your Protocol's Too Long: Consider the Brief COPE. International Journal of Behavioral Medicine. 1997;4:92-100. [DOI:10.1207/s15327558ijbm0401_6]
25. Nemeroff CJ, Hoyt MA, Huebner DM, et al. The Cognitive Escape Scale: Measuring HIV-related Thought Avoidance. AIDS Behav. 2008;12(2):305-20. [DOI:10.1007/s10461-007-9345-1]
26. Hayes AF. Introduction to Mediation, Moderation, and Conditional Process Analysis, Second Edition: A Regression-Based Approach. Guilford Publications; 2017. 713 p.
27. Fazeli PL, Turan JM, Budhwani H, et al. Moment-to-moment within-person associations between acts of discrimination and internalized stigma in people living with HIV: An experience sampling study. Stigma Health. 2017 Aug;2(3):216-28. [DOI:10.1037/sah0000051]
28. Crockett KB, Kalichman SC, Kalichman MO. Experiences of HIV-related discrimination and consequences for internalised stigma, depression, and alcohol use. Psychol Health. 2019 Jul;34(7):796-810. [DOI:10.1080/08870446.2019.1572143]
29. McKirnan DJ, Ostrow DG, Hope B. Sex, drugs and escape: A psychological model of HIV-risk sexual behaviours. AIDS Care. 1996 Dec;8(6):655-70. [DOI:10.1080/09540129650125371]
30. Fredriksen-Goldsen KI, Simoni JM, Kim H-J, et al. The health equity promotion model: Reconceptualization of lesbian, gay, bisexual, and transgender (LGBT) health disparities. Am J Orthopsychiatry. 2014 Nov;84(6):653-63. [DOI:10.1037/ort0000030]
31. Crenshaw K. Mapping the Margins: Intersectionality, Identity Politics, and Violence against Women of Color. Stanford Law Rev. 1990 1991;43:1241. [DOI:10.2307/1229039]
32. Schmitz RM, Robinson BA, Tabler J, et al. LGBTQ+ Latino/a Young People's Interpretations of Stigma and Mental Health: An Intersectional Minority Stress Perspective. Soc Ment Health. 2020 Jul 1;10(2):163-79. [DOI:10.1177/2156869319847248]
33. Cerezo A, Ramirez A. Perceived Discrimination, Alcohol Use Disorder and Alcohol-Related Problems in Sexual Minority Women of Color. J Soc Serv Res. 2020 Jan 21;0(0):1-14. [DOI:10.1080/01488376.2019.1710657]
34. Shangani S, Gamarel KE, Ogunbajo A, et al. Intersectional minority stress disparities among sexual minority adults in the USA: the role of race/ethnicity and socioeconomic status. Cult Health Sex. 2020 Apr 2;22(4):398-412. [DOI:10.1080/13691058.2019.1604994]
35. Shiyanbola OO, Tarfa A, Song A, et al. Preliminary Feasibility of a Peer-supported Diabetes Medication Adherence Intervention for African Americans. Health Behav Policy Rev. 2019 Nov 1;6(6):558-69. [DOI:10.14485/HBPR.6.6.2]
36. Freimuth VS, Quinn SC, Thomas SB, et al. African Americans' views on research and the Tuskegee Syphilis study. Soc Sci Med. 2001;52(5):797-808. [DOI:10.1016/S0277-9536(00)00178-7]
37. Corrigan PW. Community-based participatory research (CBPR), stigma, and health. Stigma Health. 2020;5(2):123-4. [DOI:10.1037/sah0000175]
38. Barajas CB, Jones SCT, Milam AJ, et al. Coping, Discrimination, and Physical Health Conditions Among Predominantly Poor, Urban African Americans: Implications for Community-Level Health Services. J Community Health. 2019 Oct 1;44(5):954-62. [DOI:10.1007/s10900-019-00650-9]
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution 4.0 International License. |
