Poverty stigma is associated with suboptimal HIV care and treatment outcomes among women living with HIV in the United States

OBJECTIVES/SPECIFIC AIMS: Our primary objective was to understand the relationship between incident or recent stressful events and adherence to HIV care in the context of other person, environment, and HIV-specific stressors in a sample of Black women living with HIV (WLWH). METHODS/STUDY POPULATION: Thirty in-depth interviews were conducted with Black women living with HIV who receive care at an academic HIV primary care clinic in the Southern region of the United States to elicit stressful events influencing adherence to HIV care. Semi-structured interview guides were used to facilitate discussion regarding stressful events and adherence to HIV care. Interviews were audiotaped and transcribed verbatim. Transcripts were independently coded using a theme-based approach by two experienced coders, findings were compared, and discrepancies were resolved by discussion. RESULTS/ANTICIPATED RESULTS: Participants described frequently experiencing incident stressful events including death or serious illness of a close friend or family member, and relationship, financial, and employment difficulties. Furthermore, participants reported experiencing traumatic events such as sexual and physical abuse during childhood and adolescents. While experiencing traumatic events such as sexual and physical abuse during childhood and adolescence may be distressing, these events did not influence adherence to HIV care. However, incident stressful events as defined above did influence adherence to HIV care for some participants, but not for others. For participants who reported that stressful events did not influence adherence to HIV care, factors such as personal motivation, access to social support, and adaptive coping strategies facilitated their engagement in care. DISCUSSION/SIGNIFICANCE OF IMPACT: Experiencing stressful events, incident or traumatic, is common among Black WLWH and have the potential to negatively influence adherence to HIV care. Thus, Interventions aimed at identifying and addressing stress, social support, and coping are essential to improve adherence to HIV care behaviors.

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Sociocultural Factors Influencing The Transmission of HIV/AIDS in The United States

10.1093/med/9780199392742.003.0009 ◽

2017 ◽

Author(s):

Robert E Fullilove

Keyword(s):

United States ◽

Criminal Justice ◽

Correctional Facility ◽

The United States ◽

Hiv Care ◽

Sociocultural Factors ◽

Effective Interventions ◽

Persons Living With Hiv ◽

Living With Hiv ◽

Hiv Aids

This chapter discusses the unique impact that social disadvantage in general and the criminal justice systems in the United States in particular have on the conditions that drive the HIV/AIDS epidemic in this country. HIV/AIDS is classified as an important racial/ethnic health disparity because residents of marginalized black and Hispanic communities are overrepresented among persons living with HIV/AIDS in the United States. Members of black and Hispanic communities are also overrepresented in the criminal justice; in terms of the epidemic, approximately one out of seven persons living with HIV/AIDS will pass through a U.S. correctional facility in any given year. A history of incarceration is associated with poor treatment outcomes for HIV illness. Improving the quality of HIV care in correctional facilities and in the communities to which incarcerated persons will return is imperative, as is effective interventions in incarcerated populations and communities. Having AIDS activists, scientists, and healthcare workers join in efforts to reform incarceration policies and practices will improve efforts to prevent and treat HIV/AIDS, particularly in communities that confront high rates of HIV/AIDS and incarceration.

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Neighborhood Racial Diversity, Socioeconomic Status, and Perceptions of HIV-Related Discrimination and Internalized HIV Stigma Among Women Living with HIV in the United States

AIDS Patient Care and STDs ◽

10.1089/apc.2019.0004 ◽

2019 ◽

Vol 33 (6) ◽

pp. 270-281 ◽

Cited By ~ 2

Author(s):

Kaylee B. Crockett ◽

Andrew Edmonds ◽

Mallory O. Johnson ◽

Torsten B. Neilands ◽

Mirjam-Colette Kempf ◽

...

Keyword(s):

United States ◽

Socioeconomic Status ◽

Racial Diversity ◽

The United States ◽

Hiv Stigma ◽

Women Living With Hiv ◽

Living With Hiv

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884. Title: Factors Associated with Lack of Viral Suppression Among Women Living with HIV in the United States: An Integrative Review

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab466.1079 ◽

2021 ◽

Vol 8 (Supplement_1) ◽

pp. S533-S534

Author(s):

Titilola Labisi ◽

Nada Fadul ◽

Jason Coleman ◽

Anthony Podany ◽

Keyonna King

Keyword(s):

United States ◽

Substance Use ◽

Health Insurance ◽

Viral Suppression ◽

Common Factors ◽

The United States ◽

Related Factors ◽

Factors Associated ◽

Women Living With Hiv ◽

Living With Hiv

Abstract Background Women account for 19% of new HIV cases in the United States (US). Transgender women are 49 times more likely than other groups to be diagnosed with HIV. HIV is one of the top ten causes of death among women between 25 to 44 years. Adherence to antiretroviral therapy (ART) and consequent viral suppression (VS) are keys to preventing sexual transmission, risk of drug resistance, and improving health outcomes. Hence, it is essential to identify factors behind VS in women living with HIV (WLWH). Methods This review identified and synthesized peer-reviewed studies describing reasons for lack of VS among WLWH in the US. : Using the PRISMA model, we searched CINAHL, PubMed, Embase, Scopus, and PsycINFO, then selected US studies published from 2010 to April 2021. Studies that included men, non-adults, ongoing studies, and foreign studies were excluded. 1,359 studies were assessed and screened for duplicate and eligibility. PRISMA Model Results 15 studies were eligible for review; 8 included all WLWH, 5 focused on pregnant WLWH, 1 included only African American WLWH and 1 included only transgender WLWH. Based on study participants and findings, results were divided into pregnancy and non-pregnancy-related factors. Pregnancy-related factors: Early ART initiation and group prenatal care improved care retention and VS. WLWH in cities were more likely to be virally suppressed at delivery than those in rural regions. Intimate partner violence (IPV) was associated with poor ART adherence and time to achieve stable VS. Also, being postpartum was associated with high viral load regardless of ART. Non-pregnancy-related factors: The most reported common factors were substance use and IPV. Other factors included social determinants of health, age, race, health insurance, income, number of pills, and regimen. Transgender-specific factors were stress, race, age, relationship, transphobic experiences, gender satisfaction, and adherence to hormone therapy. Conclusion Substance use, income, mental health, health insurance, race, and ART regimen were the most common factors associated with VS in WLWH. There was paucity of data on transgender-specific VS factors. More research is needed to explore VS and treatment adherence amongWLWH, especially transgender women. Disclosures All Authors: No reported disclosures

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Detectable HIV RNA in late pregnancy associated with low tenofovir hair levels at time of delivery among women living with HIV in the United States

AIDS ◽

10.1097/qad.0000000000002730 ◽

2021 ◽

Vol 35 (2) ◽

pp. 267-274

Author(s):

Jillian Pintye ◽

Yanling Huo ◽

Deborah Kacanek ◽

Kevin Zhang ◽

Karen Kuncze ◽

...

Keyword(s):

United States ◽

Late Pregnancy ◽

The United States ◽

Hiv Rna ◽

Women Living With Hiv ◽

Living With Hiv

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Health insurance and AIDS Drug Assistance Program (ADAP) increases retention in care among women living with HIV in the United States

AIDS Care ◽

10.1080/09540121.2020.1849529 ◽

2020 ◽

pp. 1-8

Author(s):

Emma Sophia Kay ◽

Andrew Edmonds ◽

Christina Ludema ◽

Adaora Adimora ◽

Maria L. Alcaide ◽

...

Keyword(s):

United States ◽

Health Insurance ◽

Retention In Care ◽

The United States ◽

Assistance Program ◽

Women Living With Hiv ◽

Aids Drug Assistance Program ◽

Living With Hiv

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Adhering to antiretroviral therapy: A qualitative analysis of motivations for and obstacles to consistent use of antiretroviral therapy in people living with HIV

SAGE Open Medicine ◽

10.1177/2050312120915405 ◽

2020 ◽

Vol 8 ◽

pp. 205031212091540

Author(s):

Lisa Fleischer ◽

Ann Avery

Keyword(s):

United States ◽

Antiretroviral Therapy ◽

Qualitative Analysis ◽

The United States ◽

Care Team ◽

Hiv Care ◽

People Living With Hiv ◽

Care Clinic ◽

Main Motivation ◽

Living With Hiv

Objectives: Based on the 2015 U.S. Centers for Disease Control and Prevention data, 40% of people living with HIV in the United States with an HIV diagnosis and 18.5% of people living with HIV in HIV care in the United States are not virally suppressed. Many HIV care clinics have implemented recommendations to improve the percentage of people living with HIV on antiretroviral therapy. To understand what more could be done, we examine patients’ motivations and obstacles to maintaining adherence to antiretroviral therapy. Methods: We conducted qualitative analysis using a qualitative description framework of in-depth interviews with people living with HIV receiving care at an urban HIV care clinic in the midwestern United States. Results: We found that while many traditional barriers to care have been addressed by existing programs, there are key differences between those consistent with antiretroviral therapy and those inconsistent with antiretroviral therapy. In particular, self-motivation, diagnosis acceptance, treatment for depression, spiritual beliefs, perceived value of the HIV care team, and prior experience with health care distinguish these two groups. Most significantly, we found that people living with HIV consistent with antiretroviral therapy describe their main motivation as coming from themselves, whereas people living with HIV inconsistent with antiretroviral therapy more often describe their main motivation as coming from the HIV care team. Conclusion: Our results highlight the importance of the HIV care team’s encouragement of maintaining antiretroviral adherence, as well as encouraging treatment for depression.

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