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HIV, substance use, and intersectional stigma: Associations with mental health among persons living with HIV who inject drugs in Russia.
Hook, Kimberly; Sereda, Yuliia; Rossi, Sarah; Koberna, Sarah; Vetrova, Marina V; Lodi, Sara; Lunze, Karsten.
Afiliação
  • Hook K; Department of Psychiatry, Boston Medical Center, Boston, MA, USA. kimberly.hook@bmc.org.
  • Sereda Y; Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA. kimberly.hook@bmc.org.
  • Rossi S; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA. kimberly.hook@bmc.org.
  • Koberna S; Ukrainian Institute on Public Health Policy, Kyiv, Ukraine.
  • Vetrova MV; Department of Medicine, Boston Medical Center, Boston, MA, USA.
  • Lodi S; Department of Medicine, Boston Medical Center, Boston, MA, USA.
  • Lunze K; First Pavlov State Medical, University of Saint Petersburg, St. Petersburg, Russia.
AIDS Behav ; 27(2): 431-442, 2023 Feb.
Article em En | MEDLINE | ID: mdl-35913589
ABSTRACT
HIV stigma is associated with negative physical and mental health outcomes. Intersectional stigma among persons living with HIV (PLHIV) results from interrelated, synergistic impacts of experiencing multiple stigma forms. Its relation with mental health outcomes is still an emerging area of study in this key population. This study aimed to evaluate associations of intersectional stigma, defined as endorsing high levels of HIV and substance use stigmas, with depressive and anxiety symptoms in a cohort of 111 PLHIV who inject drugs in St. Petersburg, Russia. Over a third of participants (37%) reported experiencing intersectional stigma (i.e., both stigma scores above the median). In adjusted analysis, lower Patient Health Questionnaire depression scale (PHQ-9) scores (beta (ß=-4.31, 95% CI -7.11 - -1.51, p = 0.003) and Generalized Anxiety Disorders Scale (GAD-7) scores (ß=-3.64, 95% CI -5.57 - -1.71, p < 0.001) were associated with having low scores for both HIV and substance use stigmas. Lower PHQ-9 scores (ß=-3.46, 95% CI -5.72 - -1.19, p = 0.003) and GAD-7 scores (ß=-3.06, 95% CI -4.62 - -1.50, p < 0.001) were also associated with high stigma on either HIV or substance use stigma scales. Controlling for demographics, depressive symptoms approximately linearly increased from both forms of stigma low to experiencing either form of stigma high to experiencing intersectional stigma, while levels of anxiety symptoms were comparable among participants with both types of stigma low and one stigma high. Participants who experienced intersectional stigma reported the greatest severity of both depressive and anxiety symptoms, as compared to individuals who endorsed low stigma scores (i.e., low stigma on both HIV and substance use stigma scales) or high scores of only one form of stigma. This suggests that intersectional stigma in this population of PLHIV who inject drugs in Russia is linked with worsened mental health outcomes, exceeding the effects of experiencing one form of stigma alone. Interventions to help people cope with intersectional stigma need to consider affective symptoms and tailor coping strategies to address impacts of multiple forms of mental health distress.
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Texto completo: 1 Bases de dados: MEDLINE Assunto principal: Infecções por HIV / Transtornos Relacionados ao Uso de Substâncias Tipo de estudo: Risk_factors_studies Limite: Humans País/Região como assunto: Asia / Europa Idioma: En Revista: AIDS Behav Assunto da revista: CIENCIAS DO COMPORTAMENTO / SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS) Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Estados Unidos

Texto completo: 1 Bases de dados: MEDLINE Assunto principal: Infecções por HIV / Transtornos Relacionados ao Uso de Substâncias Tipo de estudo: Risk_factors_studies Limite: Humans País/Região como assunto: Asia / Europa Idioma: En Revista: AIDS Behav Assunto da revista: CIENCIAS DO COMPORTAMENTO / SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS) Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Estados Unidos