Journal article
Latent Healthcare Stigma Profiles and Their Association With Human Immunodeficiency Virus (HIV) Treatment and Care Outcomes Among Women With HIV in the United States: An Intersectional Analysis
Open forum infectious diseases, v 12(8), ofaf414
06 Aug 2025
PMID: 40799782
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background
Stigma is a barrier to human immunodeficiency virus (HIV) care among women with HIV (WWH) in the United States (US). We estimated associations between latent stigma profiles and HIV outcomes among WWH in the Women's Interagency HIV Study.
Methods
From 2018 to 2019, participants (N = 1407) completed semi-annual assessments on sociodemographics, substance use, HIV-related, anticipated, and race-related stigma in healthcare, and suboptimal antiretroviral therapy adherence (<95%), and underwent HIV RNA testing. Latent profile analysis and multinomial logistic regression were used to examine adjusted associations between profiles and several covariates. Structural equation modeling estimated longitudinal associations between profiles, suboptimal adherence, and viral nonsuppression (HIV-1 RNA ≥20 copies/mL).
Results
We identified 3 profiles: high stigma (3%), low stigma (86%), and anticipated stigma (11%). Membership in the high stigma profile was greater for Black WWH who use drugs (adjusted odds ratio [aOR], 3.6 [95% confidence interval {CI}, 1.1–12.1]), non-Black WWH who use drugs (aOR, 4.8 [95% CI, 1.3–18]), and those who reported suboptimal adherence (aOR, 2.2 [95% CI, 1–4.8]), drug use (aOR, 2.6 [95% CI, 1.3–5.1]), noninjection drug use (aOR, 2.2 [95% CI, 1.1–4.4]), opioid use treatment (aOR, 4.07 [95% CI, 1.47–11.26]), depression (aOR, 5.8 [95% CI, 2.8–11.9]), stress (aOR, 1.09 [95% CI, 1.05–1.1]), and high post-traumatic stress disorder (aOR, 10.6 [95% CI, 4.3–25.7]). In the longitudinal model, suboptimal adherence was lowest for the low stigma profile and predicted future viral nonsuppression.
Conclusions
Reducing stigma and integrating HIV, substance use, and mental health treatment is crucial for improving health outcomes among US WWH.
Metrics
1 Record Views
Details
- Title
- Latent Healthcare Stigma Profiles and Their Association With Human Immunodeficiency Virus (HIV) Treatment and Care Outcomes Among Women With HIV in the United States: An Intersectional Analysis
- Creators
- Jennifer P Jain (Corresponding Author) - Unity Health SystemNadra E Lisha - University of California, San FranciscoJae Sevelius - Columbia UniversityTorsten B Neilands - University of California, San FranciscoCarol Dawson-Rose - Unity Health SystemMallory O Johnson - University of California, San FranciscoAyden Scheim - Drexel UniversityBulent Turan - Koç UniversityAdebola Adedimeji - Albert Einstein College of MedicineMirjam-Colette Kempf - University of Alabama at BirminghamGypsyamber D’Souza - Johns Hopkins UniversityMichelle Floris-Moore - University of North Carolina at Chapel HillSeble Kassaye - Georgetown UniversityAnandi Sheth - Emory UniversityAzure Thompson - SUNY Downstate Health Sciences UniversityDeborah Jones Weiss - University of MiamiPhyllis C Tien - University of California, San Francisco
- Publication Details
- Open forum infectious diseases, v 12(8), ofaf414
- Publisher
- Oxford University Press
- Number of pages
- 12
- Grant note
- ; P30-AI-073961 / ; P30-AI-050409 / ; KL2-TR001432 / ; P30-AI-027767 / ; P30-MH-116867 / ; P30-AI-050410 / ; 5K01DA056306 / ; UL1-TR001409 / ; UL1-TR003098 / ;
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Urban Health Collaborative; Epidemiology and Biostatistics
- Web of Science ID
- WOS:001548895200001
- Scopus ID
- 2-s2.0-105013198751
- Other Identifier
- 991022076044904721
UN Sustainable Development Goals (SDGs)
This publication has contributed to the advancement of the following goals:
InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Immunology
- Infectious Diseases
- Microbiology