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Journal article
Rapid or Immediate ART, HIV Stigma, Medical Mistrust, and Retention in Care: An Exploratory Mixed Methods Pilot Study
AIDS and behavior, v 27(10), pp 3430-3446
01 Oct 2023
PMID: 37071333
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Rapid or immediate antiretroviral therapy (iART) after HIV diagnosis improves linkage to care and time to viral suppression. However, iART may affect or be affected by HIV-related stigma and medical mistrust. In this mixed-methods pilot study, we examined the bi-directional role of HIV stigma, medical mistrust, and visit adherence (VA) in the context of iART in a diverse, newly diagnosed patient population. Participants were recruited from an HIV clinic in New York City and we utilized a convergent parallel design integrating quantitative data from demographic surveys, the HIV Stigma Survey (HIVSS), the Medical Mistrust Index (MMI) and electronic medical records, and qualitative data from in-depth interviews. Among the sample (N = 30), 26% (N = 8) initiated ART same-day or within 3 days, while the majority (N = 17) initiated between 4 and 30 days, and 17% (N = 5) initiated ART > 30 days. The median (range) age was 35, and most were English-speaking, Black or Hispanic men and identified as gay. Time to ART initiation was associated with time to linkage to care and time to viral suppression. Day 0-3 group's major theme was iART as stigma prevention, and they had the highest mean HIVSS, lowest MMI score, and a visit adherence of 0.86. Day 4-30 group's major theme was alleviation of internalized stigma, and they had the lowest mean HIVSS score, and highest visit adherence of 0.91. Day > 30 group's major theme was exacerbation of perceived or anticipated stigma, had the highest MMI score and a visit adherence of 0.85. iART implementation requires equitable strategies that address HIV-stigma and mistrust.
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Details
- Title
- Rapid or Immediate ART, HIV Stigma, Medical Mistrust, and Retention in Care: An Exploratory Mixed Methods Pilot Study
- Creators
- Ofole Mgbako - NYU Langone Hlth, Dept Internal Med, Div Infect Dis & Immunol, New York, NY 10016 USAClaire Loughran - Columbia University Irving Medical CenterRachel Mathu - Columbia UniversityDelivette Castor - Columbia University Irving Medical CenterJacob McLean - Columbia University Irving Medical CenterMagdalena E. Sobieszczyk - Columbia University Irving Medical CenterSusan Olender - Columbia University Irving Medical CenterPeter Gordon - Columbia University Irving Medical CenterJavier Lopez-Rios - Drexel University, Community Health and PreventionRobert H. Remien - New York Psychoanalytic Society and Institute
- Publication Details
- AIDS and behavior, v 27(10), pp 3430-3446
- Publisher
- Springer Nature
- Number of pages
- 17
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Community Health and Prevention
- Web of Science ID
- WOS:000971499200002
- Scopus ID
- 2-s2.0-85153074371
- Other Identifier
- 991021861306504721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Public, Environmental & Occupational Health
- Social Sciences, Biomedical