The Mediating Role of Social Support and Resilience Between HIV-Related Stigmas and Patient Activation Among Young Black Women Living With HIV in the Southern United States: A Cross-sectional Study

Lambert C. C., Fazeli P. L., Yiğit İ., Elopre L., King K., Kempf M., ...More

JANAC-JOURNAL OF THE ASSOCIATION OF NURSES IN AIDS CARE, vol.33, no.1, pp.78-88, 2022 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 33 Issue: 1
  • Publication Date: 2022
  • Doi Number: 10.1097/jnc.0000000000000312
  • Journal Name: JANAC-JOURNAL OF THE ASSOCIATION OF NURSES IN AIDS CARE
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Social Sciences Citation Index (SSCI), Scopus, ASSIA, CINAHL, EMBASE, MEDLINE, Psycinfo
  • Page Numbers: pp.78-88
  • Keywords: anticipated stigma, discrimination, enacted stigma, internalized stigma, mental health, self-management behaviors, HEALTH-CARE SETTINGS, ANTIRETROVIRAL THERAPY, MEDICATION ADHERENCE, TREATMENT OUTCOMES, MISSED VISITS, MIXED-METHODS, DISPARITIES, ASSOCIATION, MECHANISMS, FAILURE
  • TED University Affiliated: No

Abstract

Little is known about the construct of patient activation for engaging in favorable self-management behaviors in people with HIV. We conducted a cross-sectional study among young Black women with HIV (n = 84) to examine the association between stigma and patient activation and the mediating role of social support and resilience. Social support mediated the relationship between the following dimensions of stigma and patient activation: internalized (beta = -0.20, SE = 0.08, CI [-0.369 to -0.071]) and anticipated in health care settings (beta = -0.06, SE = 0.04, CI [-0.177 to -0.001]). Resilience mediated the relationship between the following dimensions of stigma and patient activation: anticipated in health care (beta = -0.20, SE = 0.08, CI [-0.387 to -0.057]) and community settings (beta = -0.15, SE = 0.08, CI [-0.318 to -0.017]), and enacted in community settings (beta = -0.14, SE = 0.09, CI [-0.332 to -0.001]). Our findings suggest intrapersonal and interpersonal mechanisms by which various dimensions of stigma contribute to patient activation, thus identifying social support, resilience, and patient activation as potential intervention targets.