Internalized HIV-Related Stigma and Breast Health Beliefs Among African–American Women Receiving Care for HIV in the USA

Katrin Fabian, Yamilé Molina*, Christopher G. Kemp, Paul E. Nevin, Katryna McCoy, Jane M. Simoni, Michele Andrasik, Susan E. Cohn, Sandy Micci, Deepa Rao

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Objectives: African–American women suffer disproportionately from HIV, breast cancer, and other illnesses. Little is known about the relationship between internalized HIV-related stigma and health beliefs related to other illnesses, including breast cancer. Our study examined (1) the relationship between internalized HIV-related stigma and breast health beliefs over time and (2) the moderating effects of participating in a stigma reduction intervention and/or social support. Methods: Data from 239 African–American women receiving care for HIV in Chicago, IL, or Birmingham, AL, enrolled in the Unity randomized controlled trial, were used in this secondary analysis. Threat of breast cancer was measured in terms of perceived susceptibility, fear, and adverse consequences as well as an overall perceived threat of breast cancer. We used multivariate models with generalized estimating equations to examine the relationship between internalized HIV-related stigma and breast health beliefs across three time points (baseline, immediately post-workshop, and at 12-month follow-up) and to examine if the study arm (HIV stigma reduction vs. breast cancer education) or social support moderated the relationship. Results: Internalized HIV-related stigma was associated with greater overall perceived threat (p < 0.001), susceptibility (p = 0.03), fear (p < 0.001), and perceived adverse consequences (p < 0.001) of breast cancer. These associations remained consistent across study arms and across all levels of social support. Conclusions: Future studies that examine co-morbid health conditions among African–American women living with HIV should consider the impact of HIV-related stigma on attitudes and beliefs related to co-morbid conditions.

Original languageEnglish (US)
Pages (from-to)45-51
Number of pages7
JournalJournal of Racial and Ethnic Health Disparities
Volume7
Issue number1
DOIs
StatePublished - Feb 1 2020

Funding

The study was supported by the National Institutes of Health (NIH), National Institute of Mental Health under Grant R01MH098675 (PI, Rao), National Cancer Institute under Grants K01CA193918 (PI, Molina) and R25CA92408, and University of Washington/Fred Hutch Center for AIDS Research, Behavioral Science Core, an NIH-funded program under award number AI027757 (PI, Baeten) which is supported by the following NIH institutes and centers: NIAID, NCI, NIMH, NIDA, NICHD, NHLBI, NIA, NIGMS, and NIDDK.

Keywords

  • African–American women
  • Breast cancer
  • HIV
  • Stigma

ASJC Scopus subject areas

  • Health(social science)
  • Public Health, Environmental and Occupational Health
  • Anthropology
  • Health Policy
  • Sociology and Political Science

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