Armenta Gabriela, Han Bing, Palar Kartika, Then-Paulino Amarilis, Wagner Glenn J, Derose Kathryn P
RAND Corporation, Santa Monica, CA, USA.
Pardee RAND Graduate School, Santa Monica, CA, USA.
Community Health Equity Res Policy. 2025 Aug 25:2752535X251369101. doi: 10.1177/2752535X251369101.
Food insecurity, depression, and HIV stigma adversely affect people with HIV and women face heightened vulnerability. Limited evidence exists regarding the factors associated with HIV internalized and experienced stigmas and depression for people with HIV and food insecurity in the Dominican Republic (DR). Using an HIV clinic-based sample of people with food insecurity in the DR ( = 115), we found that depressive symptoms and internalized and experienced stigmas were highly prevalent. A cross-sectional, multivariate linear regression analysis found that women, Haitians, and those with a detectable viral load had higher internalized stigma; those reporting intimate partner violence had higher internalized and experienced stigmas, while those reporting stronger social support had lower stigma scores for both types; finally, those with an undetectable viral load, better physical health, and better antiretroviral therapy adherence had reduced depression symptom severity. Targeting inequities related to gender, nationality and/or ethnicity, and HIV disease progression may mitigate internalized HIV stigma, and addressing the correlates of HIV stigmas and depression may improve HIV outcomes.
粮食不安全、抑郁症和艾滋病毒污名化对艾滋病毒感染者产生不利影响,而女性面临的脆弱性更高。关于多米尼加共和国(DR)粮食不安全的艾滋病毒感染者中,与艾滋病毒内化耻辱感、经历的耻辱感和抑郁症相关的因素,现有证据有限。我们以DR地区粮食不安全的艾滋病毒感染者为样本( = 115),发现抑郁症状、内化耻辱感和经历的耻辱感非常普遍。一项横断面多变量线性回归分析发现,女性、海地人以及病毒载量可检测到的人内化耻辱感更高;报告亲密伴侣暴力的人内化耻辱感和经历的耻辱感更高,而报告社会支持更强的人两种耻辱感得分更低;最后,病毒载量不可检测、身体健康状况更好且抗逆转录病毒疗法依从性更好的人抑郁症状严重程度降低。针对与性别、国籍和/或种族以及艾滋病毒疾病进展相关的不平等现象,可能会减轻艾滋病毒内化耻辱感,解决艾滋病毒耻辱感和抑郁症的相关因素可能会改善艾滋病毒治疗结果。