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5. Envisioning Women-Centered HIV Care: Perspectives from Women Living with HIV in Canada

Author

Anema, Aranka, Becker, Denise, Brotto, Lori, Carter, Allison, Cardinal, Claudette, Colley, Guillaume, Ding, Erin, Duddy, Janice, Gataric, Nada, Hogg, Robert S., Howard, Terry, Jabbari, Shahab, Jones, Evin, Kestler, Mary, Langlois, Andrea, Lima, Viviane, Lloyd-Smith, Elisa, Medjuck, Melissa, Miller, Cari, Money, Deborah, Nicholson, Valerie, Ogilvie, Gina, Patterson, Sophie, Pick, Neora, Roth, Eric, Salters, Kate, Sanchez, Margarite, Sas, Jacquie, Sereda, Paul, Summers, Marcie, Tom, Christina, Wang, Clara, Webster, Kath, Zhang, Wendy, Abdul-Noor, Rahma, Angel, Jonathan, Barry, Fatimatou, Bauer, Greta, Beaver, Kerrigan, Benoit, Anita, Bertozzi, Breklyn, Borton, Sheila, Bourque, Tammy, Brophy, Jason, Burchell, Ann, Carlson, Allison, Cioppa, Lynne, Cohen, Jeffrey, Conway, Tracey, Cooper, Curtis, Cotnam, Jasmine, Cousineau, Janette, Desbiens, Marisol, Fraleigh, Annette, Gagnier, Brenda, Gasingirwa, Claudine, Greene, Saara, Hart, Trevor, Islam, Shazia, Kaushic, Charu, Kennedy, Logan, Kerr, Desiree, Kwaramba, Gladys, Leonard, Lynne, Lewis, Johanna, Logie, Carmen, Margolese, Shari, Muchenje, Marvelous, Ndung'u, Mary (Muthoni), O’Brien, Kelly, Ouellette, Charlene, Powis, Jeff, Quan, Corinna, Raboud, Janet, Rachlis, Anita, Ralph, Edward, Rourke, Sean, Rueda, Sergio, Sandre, Roger, Smaill, Fiona, Smith, Stephanie, Tigere, Tsitsi, Tharao, Wangari, Walmsley, Sharon, Wobeser, Wendy, Yee, Jessica, Yudin, Mark, Bakombo, Dada Mamvula, Baril, Jean-Guy, Boucher, Marc, Boucoiran, Isabelle, Burke, Nora Butler, Clément, Pierrette, Côté, José, Dayle, Janice, Dubuc, Danièle, Fernet, Mylène, Gagnon, Marilou, Groleau, Danielle, Hot, Aurélie, Kiboyogo, Maxime, Klein, Marina, Lacasse, Gary, Lamarre, Valérie, Martin, Carrie, Massie, Lyne, Ménard, Brigitte, Monteith, Ken, O'Brien, Nadia, Otis, Joanne, Peltier, Doris, Pierre, Alie, Proulx-Boucher, Karène, Rouleau, Danielle, Rouleau, Geneviève, Savoie, Édénia, Tremblay, Cécile, Trottier, Benoit, Trottier, Sylvie, Tsoukas, Christos, Gahagan, Jacqueline, Hankins, Catherine, Masching, Renee, Ogunnaike-Cooke, Susanna, Kaufman, Elaina, Ennabil, Nourane, Andersson, Neil, Loutfy, Mona, de Pokomandy, Alexandra, and Kaida, Angela

Published
2017
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7. Pathways From HIV-Related Stigma to Antiretroviral Therapy Measures in the HIV Care Cascade for Women Living With HIV in Canada

Author

Logie, Carmen H., Lacombe-Duncan, Ashley, Wang, Ying, Kaida, Angela, Conway, Tracey, Webster, Kath, de Pokomandy, Alexandra, Loutfy, Mona R., Anema, Aranka, Becker, Denise, Brotto, Lori, Carter, Allison, Cardinal, Claudette, Colley, Guillaume, Ding, Erin, Duddy, Janice, Gataric, Nada, Hogg, Robert S., Hosward, Terry, Jabbari, Shahab, Jones, Evin, Kestler, Mary, Langlois, Andrea, Lima, Viviane, Lloyd-Smith, Elisa, Medjuck, Melissa, Miller, Cari, Money, Deborah, Nicholson, Valerie, Ogilvie, Gina, Patterson, Sophie, Pick, Neora, Roth, Eric, Salters, Kate, Sanchez, Margarite, Sas, Jacquie, Sereda, Paul, Summers, Marcie, Tom, Christina, Wang, Lu, Webster, Kath, Zhang, Wendy, Abdul-Noor, Rahma, Angel, Jonathan, Barry, Fatimatou, Bauer, Greta, Beaver, Kerrigan, Benoit, Anita, Bertozzi, Breklyn, Borton, Sheila, Bourque, Tammy, Brophy, Jason, Burchell, Ann, Carlson, Allison, Cioppa, Lynne, Cohen, Jeffrey, Conway, Tracey, Cooper, Curtis, Cotnam, Jasmine, Cousineau, Janette, Fraleigh, Annette, Gagnier, Brenda, Gasingirwa, Claudine, Greene, Saara, Hart, Trevor, Islam, Shazia, Kaushic, Charu, Kennedy, Logan, Kerr, Desiree, Kiboyogo, Maxime, Kwaramba, Gladys, Leonard, Lynne, Lewis, Johanna, Logie, Carmen, Margolese, Shari, Muchenje, Marvelous, Ndungʼu, Mary, OʼBrien, Kelly, Ouellette, Charlene, Powis, Jeff, Quan, Corinna, Raboud, Janet, Rachlis, Anita, Ralph, Edward, Rourke, Sean, Rueda, Sergio, Sandre, Roger, Smaill, Fiona, Smith, Stephanie, Tigere, Tsitsi, Tharao, Wangari, Walmsley, Sharon, Wobeser, Wendy, Yee, Jessica, Yudin, Mark, Baril, Jean-Guy, Burke, Nora Butler, Clément, Pierrette, Dayle, Janice, Dubuc, Danièle, Fernet, Mylène, Groleau, Danielle, Hot, Aurélie, Klein, Marina, Martin, Carrie, Massie, Lyne, Ménard, Brigitte, OʼBrien, Nadia, Otis, Joanne, Peltier, Doris, Pierre, Alie, Proulx-Boucher, Karène, Rouleau, Danielle, Savoie, Édénia, Tremblay, Cécile, Trottier, Benoit, Trottier, Sylvie, Tsoukas, Christos, Gahagan, Jacqueline, Hankins, Catherine, Masching, Renee, and Ogunnaike-Cooke, Susanna

Published
2018
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9. A longitudinal study of associations between HIV-related stigma, recent violence and depression among women living with HIV in a Canadian cohort study

Author

Logie, Carmen H., Marcus, Natania, Wang, Ying, Kaida, Angela, O'Campo, Patricia, Ahmed, Uzma, O'Brien, Nadia, Nicholson, Valerie, Conway, Tracey, Pokomandy, Alexandra, Fernet, Mylène, Loutfy, Mona, Anema, Aranka, Becker, Denise, Brotto, Lori, Carter, Allison, Cardinal, Claudette, Colley, Guillaume, Ding, Erin, Duddy, Janice, Gataric, Nada, Hogg, Robert S., Howard, Terry, Jabbari, Shahab, Jones, Evin, Kestler, Mary, Langlois, Andrea, Lima, Viviane, Lloyd?Smith, Elisa, Medjuck, Melissa, Miller, Cari, Money, Deborah, Ogilvie, Gina, Patterson, Sophie, Pick, Neora, Roth, Eric, Salters, Kate, Sanchez, Margarite, Sas, Jacquie, Sereda, Paul, Summers, Marcie, Tom, Christina, Wang, Lu, Webster, Kath, Zhang, Wendy, Abdul?Noor, Rahma, Angel, Jonathan, Barry, Fatimatou, Bauer, Greta, Beaver, Kerrigan, Benoit, Anita, Bertozzi, Breklyn, Borton, Sheila, Bourque, Tammy, Brophy, Jason, Burchell, Ann, Carlson, Allison, Cioppa, Lynne, Cohen, Jeffrey, Cooper, Curtis, Cotnam, Jasmine, Cousineau, Janette, Gagnier, Brenda, Gasingirwa, Claudine, Greene, Saara, Hart, Trevor, Islam, Shazia, Kennedy, Logan, Kerr, Desiree, Kiboyogo, Maxime, Kwaramba, Gladys, Leonard, Lynne, Lewis, Johanna, Margolese, Shari, Muchenje, Marvelous, O'Brien, Kelly, Ouellette, Charlene, Powis, Jeff, Quan, Corinna, Raboud, Janet, Rachlis, Anita, Ralph, Edward, Rourke, Sean, Rueda, Sergio, Sandre, Roger, Smaill, Fiona, Smith, Stephanie, Tigere, Tsitsi, Tharao, Wangari, Walmsley, Sharon, Wobeser, Wendy, Yee, Jessica, Yudin, Mark, Bakombo, Dada Mamvula, Baril, Jean?Guy, Burke, Nora Butler, Clément, Pierrette, Dayle, Janice, Dubuc, Danièle, Groleau, Danielle, Hot, Aurélie, Klein, Marina, Martin, Carrie, Massie, Lyne, Ménard, Brigitte, Otis, Joanne, Peltier, Doris, Pierre, Alie, Proulx?Boucher, Karène, Rouleau, Danielle, Savoie, Édénia, Tremblay, Cécile, Trottier, Benoit, Trottier, Sylvie, Tsoukas, Christos, Gahagan, Jacqueline, Hankins, Catherine, Masching, Renee, and Ogunnaike?Cooke, Susanna

Subjects
Care and treatment, Prevention, Analysis, Demographic aspects, HIV patients -- Care and treatment, Women's health -- Analysis, Domestic violence -- Demographic aspects -- Prevention, HIV carriers discrimination -- Prevention, Stigma (Social psychology) -- Analysis, Women -- Health aspects, Discrimination against AIDS virus carriers -- Prevention, Family violence -- Demographic aspects -- Prevention
Abstract

Introduction Gender?based violence (GBV) disproportionately impacts and compromises the wellbeing of women and girls across the world. A global participatory survey among women living with HIV (WLHIV) found that 89% [...], : Introduction: Women living with HIV (WLHIV) experience stigma and elevated exposure to violence in comparison with HIV?negative women. We examined the mediating role of experiencing recent violence in the relationship between stigma and depression among WLHIV in Canada. Methods: We conducted a cohort study with WLHIV in three Canadian provinces. Recent violence was assessed through self?reported experiences of control, physical, sexual or verbal abuse in the past three months. At Time 1 (2013?2015) three forms of stigma were assessed (HIV?related, racial, gender) and at Time 2 (2015?2017) only HIV?related stigma was assessed. We conducted structural equation modelling (SEM) using the maximum likelihood estimation method with Time 1 data to identify direct and indirect effects of gender discrimination, racial discrimination and HIV?related stigma on depression via recent violence. We then conducted mixed effects regression and SEM using Time 1 and Time 2 data to examine associations between HIV?related stigma, recent violence and depression. Results: At Time 1 (n = 1296), the direct path from HIV?related stigma (direct effect: ? = 0.200, p < 0.001; indirect effect: ? = 0.014, p < 0.05) to depression was significant; recent violence accounted for 6.5% of the total effect. Gender discrimination had a significant direct and indirect effect on depression (direct effect: ? = 0.167, p < 0.001; indirect effect: ? = 0.050, p < 0.001); recent violence explained 23.15% of the total effect. Including Time 1 and Time 2 data (n = 1161), mixed?effects regression results indicate a positive relationship over time between HIV?related stigma and depression (Acoef: 0.04, 95% CI: 0.03, 0.06, p < 0.001), and recent violence and depression (Acoef: 1.95, 95% CI: 0.29, 4.42, p < 0.05), controlling for socio?demographics. There was a significant interaction between HIV?related stigma and recent violence with depression (Acoef: 0.04, 95% CI: 0.01, 0.07, p < 0.05). SEM analyses reveal that HIV?related stigma had a significant direct and indirect effect on depression over time (direct effect: ? = 0.178, p < 0.001; indirect effect: ? = 0.040, p < 0.001); recent violence experiences accounted for 51% of the total effect. Conclusions: Our findings suggest that HIV?related stigma is associated with increased experiences of recent violence, and both stigma and violence are associated with increased depression among WLHIV in Canada. There is an urgent need for trauma?informed stigma interventions to address stigma, discrimination and violence.

Published
2019
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13. Help-Seeking to Cope With Experiences of Violence Among Women Living With HIV in Canada

Author

Gormley, Rebecca, primary, Nicholson, Valerie, additional, Parry, Rebeccah, additional, Lee, Melanie, additional, Webster, Kath, additional, Sanchez, Margarite, additional, Cardinal, Claudette, additional, Li, Jenny, additional, Wang, Lu, additional, Balleny, Rosa, additional, de Pokomandy, Alexandra, additional, Loutfy, Mona, additional, Kaida, Angela, additional, Abdul-Noor, Rahma, additional, Anema, Aranka, additional, Angel, Jonathan, additional, Bakombo, Dada Mamvula, additional, Barry, Fatimatou, additional, Bauer, Greta, additional, Beaver, Kerrigan, additional, Boucher, Marc, additional, Boucoiran, Isabelle, additional, Brophy, Jason, additional, Brotto, Lori, additional, Burchell, Ann, additional, Carter, Allison, additional, Cioppa, Lynne, additional, Conway, Tracey, additional, Côté, José, additional, Cotnam, Jasmine, additional, d’Ambrumenil, Cori, additional, Dayle, Janice, additional, Ding, Erin, additional, Dubuc, Danièle, additional, Duddy, Janice, additional, Fernet, Mylène, additional, Fraleigh, Annette, additional, Frank, Peggy, additional, Gagnier, Brenda, additional, Gagnon, Marilou, additional, Gahagan, Jacqueline, additional, Gasingirwa, Claudine, additional, Gataric, Nada, additional, Gormley, Rebecca, additional, Greene, Saara, additional, Groleau, Danielle, additional, Guerlotté, Charlotte, additional, Hart, Trevor, additional, Hankins, Catherine, additional, Hawa, Roula, additional, Heer, Emily, additional, Hogg, Robert S., additional, Howard, Terry, additional, Islam, Shazia, additional, Jean-Gilles, Joseph, additional, Jefferis, Hermione, additional, Jones, Evin, additional, Kaushic, Charu, additional, Kazemi, Mina, additional, Kestler, Mary, additional, Kiboyogo, Maxime, additional, Klein, Marina, additional, Kronfli, Nadine, additional, Kwaramba, Gladys, additional, Lacasse, Gary, additional, Lacombe-Duncan, Ashley, additional, Lee, Rebecca, additional, Lima, Viviane, additional, Lloyd-Smith, Elisa, additional, Logie, Carmen, additional, Maan, Evelyn, additional, Martel-Lafrenière, Valérie, additional, Martin, Carrie, additional, Masching, Renee, additional, Massie, Lyne, additional, Medjuck, Melissa, additional, Ménard, Brigitte, additional, Miller, Cari L., additional, Mitchell, Judy, additional, Mondragon, Gerardo, additional, Money, Deborah, additional, Monteith, Ken, additional, Muchenje, Marvelous, additional, Mukandamutsa, Florida, additional, Ndung’u, Mary, additional, O’Brien, Kelly, additional, O’Brien, Nadia, additional, Ogilvie, Gina, additional, Ogunnaike-Cooke, Susanna, additional, Otis, Joanne, additional, Patterson, Sophie, additional, Paul, Angela, additional, Peltier, Doris, additional, Pick, Neora, additional, Pierre, Alie, additional, Powis, Jeff, additional, Proulx-Boucher, Karène, additional, Quan, Corinna, additional, Rana, Jesleen, additional, Roth, Eric, additional, Rouleau, Danielle, additional, Rouleau, Geneviève, additional, Rueda, Sergio, additional, Salters, Kate, additional, Sandre, Roger, additional, Sas, Jacquie, additional, Savoie, Édénia, additional, Sereda, Paul, additional, Smith, Stephanie, additional, Summers, Marcie, additional, Tharao, Wangari, additional, Tom, Christina, additional, Tremblay, Cécile, additional, Trigg, Jason, additional, Trottier, Sylvie, additional, Underhill, Angela, additional, Wagner, Anne, additional, Walmsley, Sharon, additional, Wang, Clara, additional, Wobeser, Wendy, additional, Wozniak, Denise, additional, Yudin, Mark, additional, Zhang, Wendy, additional, and Zhu, Julia, additional

Published
2021
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14. Vaping-associated lung illness (VALI) in Canada: a descriptive analysis of VALI cases reported from September 2019 to December 2020.

Author

Baker, Melissa M., Procter, Theresa D., Belzak, Lisa, and Ogunnaike-Cooke, Susanna

Subjects
ELECTRONIC cigarettes, LUNG diseases, HEALTH risk assessment, PUBLIC health surveillance, DISEASE prevalence
Abstract

Introduction: The aim of this study was to explore demographic and clinical characteristics of vaping-associated lung illness (VALI) cases reported in Canada from September 2019 to December 2020; compare the epidemiology of VALI cases in Canada to e-cigarette or vaping product use-associated lung injury (EVALI) cases in the US; and examine possible explanations for differences between the two countries. Methods: A federal/provincial/territorial task group developed a national outbreak definition, minimum dataset and case report form for identification and surveillance of VALI cases in Canada. Descriptive analysis explored the characteristics and epidemiology of reported VALI cases. Results: Of the 20 VALI cases reported, none resulted in a death. Of all cases, 5 (25%) involved youth aged 15 to 19 years, 10 (50%) adults aged 20 to 49 years and 5 (25%) aged 50 years and older. Sixty percent of patients were men. Half (50%) required breathing assistance. Three-quarters (75%) reported using nicotine-containing vaping products, and 40% reported use of cannabis-containing vaping products; of those who reported frequency of vaping, most (71%) reported vaping daily. VALI cases were reported at a lower prevalence (0.9 per million) than EVALI (8.5 per million). Demographics and vaping behaviour also differed. Conclusion: VALI cases were reported in Canada between September 2019 and December 2020; however, there was a much lower prevalence and they may have been caused by different factors from the EVALI outbreak in the US. The factors influencing VALI in Canada are complex and multifactorial. Research is needed to understand the short- and long-term health effects of nicotine and cannabis vaping. [ABSTRACT FROM AUTHOR]

Published
2022
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15. Envisioning Women-Centered HIV Care: Perspectives from Women Living with HIV in Canada

Author

O'Brien, Nadia, primary, Greene, Saara, additional, Carter, Allison, additional, Lewis, Johanna, additional, Nicholson, Valerie, additional, Kwaramba, Gladys, additional, Ménard, Brigitte, additional, Kaufman, Elaina, additional, Ennabil, Nourane, additional, Andersson, Neil, additional, Loutfy, Mona, additional, de Pokomandy, Alexandra, additional, Kaida, Angela, additional, Anema, Aranka, additional, Becker, Denise, additional, Brotto, Lori, additional, Cardinal, Claudette, additional, Colley, Guillaume, additional, Ding, Erin, additional, Duddy, Janice, additional, Gataric, Nada, additional, Hogg, Robert S., additional, Howard, Terry, additional, Jabbari, Shahab, additional, Jones, Evin, additional, Kestler, Mary, additional, Langlois, Andrea, additional, Lima, Viviane, additional, Lloyd-Smith, Elisa, additional, Medjuck, Melissa, additional, Miller, Cari, additional, Money, Deborah, additional, Ogilvie, Gina, additional, Patterson, Sophie, additional, Pick, Neora, additional, Roth, Eric, additional, Salters, Kate, additional, Sanchez, Margarite, additional, Sas, Jacquie, additional, Sereda, Paul, additional, Summers, Marcie, additional, Tom, Christina, additional, Wang, Clara, additional, Webster, Kath, additional, Zhang, Wendy, additional, Abdul-Noor, Rahma, additional, Angel, Jonathan, additional, Barry, Fatimatou, additional, Bauer, Greta, additional, Beaver, Kerrigan, additional, Benoit, Anita, additional, Bertozzi, Breklyn, additional, Borton, Sheila, additional, Bourque, Tammy, additional, Brophy, Jason, additional, Burchell, Ann, additional, Carlson, Allison, additional, Cioppa, Lynne, additional, Cohen, Jeffrey, additional, Conway, Tracey, additional, Cooper, Curtis, additional, Cotnam, Jasmine, additional, Cousineau, Janette, additional, Desbiens, Marisol, additional, Fraleigh, Annette, additional, Gagnier, Brenda, additional, Gasingirwa, Claudine, additional, Hart, Trevor, additional, Islam, Shazia, additional, Kaushic, Charu, additional, Kennedy, Logan, additional, Kerr, Desiree, additional, Leonard, Lynne, additional, Logie, Carmen, additional, Margolese, Shari, additional, Muchenje, Marvelous, additional, Ndung'u, Mary (Muthoni), additional, O’Brien, Kelly, additional, Ouellette, Charlene, additional, Powis, Jeff, additional, Quan, Corinna, additional, Raboud, Janet, additional, Rachlis, Anita, additional, Ralph, Edward, additional, Rourke, Sean, additional, Rueda, Sergio, additional, Sandre, Roger, additional, Smaill, Fiona, additional, Smith, Stephanie, additional, Tigere, Tsitsi, additional, Tharao, Wangari, additional, Walmsley, Sharon, additional, Wobeser, Wendy, additional, Yee, Jessica, additional, Yudin, Mark, additional, Bakombo, Dada Mamvula, additional, Baril, Jean-Guy, additional, Boucher, Marc, additional, Boucoiran, Isabelle, additional, Burke, Nora Butler, additional, Clément, Pierrette, additional, Côté, José, additional, Dayle, Janice, additional, Dubuc, Danièle, additional, Fernet, Mylène, additional, Gagnon, Marilou, additional, Groleau, Danielle, additional, Hot, Aurélie, additional, Kiboyogo, Maxime, additional, Klein, Marina, additional, Lacasse, Gary, additional, Lamarre, Valérie, additional, Martin, Carrie, additional, Massie, Lyne, additional, Monteith, Ken, additional, O'Brien, Nadia, additional, Otis, Joanne, additional, Peltier, Doris, additional, Pierre, Alie, additional, Proulx-Boucher, Karène, additional, Rouleau, Danielle, additional, Rouleau, Geneviève, additional, Savoie, Édénia, additional, Tremblay, Cécile, additional, Trottier, Benoit, additional, Trottier, Sylvie, additional, Tsoukas, Christos, additional, Gahagan, Jacqueline, additional, Hankins, Catherine, additional, Masching, Renee, additional, and Ogunnaike-Cooke, Susanna, additional

Published
2017
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17. Pathways From HIV-Related Stigma to Antiretroviral Therapy Measures in the HIV Care Cascade for Women Living With HIV in Canada.

Author

Logie CH, Lacombe-Duncan A, Wang Y, Kaida A, Conway T, Webster K, de Pokomandy A, Loutfy MR, Anema A, Becker D, Brotto L, Carter A, Cardinal C, Colley G, Ding E, Duddy J, Gataric N, Hogg RS, Hosward T, Jabbari S, Jones E, Kestler M, Langlois A, Lima V, Lloyd-Smith E, Medjuck M, Miller C, Money D, Nicholson V, Ogilvie G, Patterson S, Pick N, Roth E, Salters K, Sanchez M, Sas J, Sereda P, Summers M, Tom C, Wang L, Webster K, Zhang W, Abdul-Noor R, Angel J, Barry F, Bauer G, Beaver K, Benoit A, Bertozzi B, Borton S, Bourque T, Brophy J, Burchell A, Carlson A, Cioppa L, Cohen J, Conway T, Cooper C, Cotnam J, Cousineau J, Fraleigh A, Gagnier B, Gasingirwa C, Greene S, Hart T, Islam S, Kaushic C, Kennedy L, Kerr D, Kiboyogo M, Kwaramba G, Leonard L, Lewis J, Logie C, Margolese S, Muchenje M, Ndungʼu M, OʼBrien K, Ouellette C, Powis J, Quan C, Raboud J, Rachlis A, Ralph E, Rourke S, Rueda S, Sandre R, Smaill F, Smith S, Tigere T, Tharao W, Walmsley S, Wobeser W, Yee J, Yudin M, Baril JG, Burke NB, Clément P, Dayle J, Dubuc D, Fernet M, Groleau D, Hot A, Klein M, Martin C, Massie L, Ménard B, OʼBrien N, Otis J, Peltier D, Pierre A, Proulx-Boucher K, Rouleau D, Savoie É, Tremblay C, Trottier B, Trottier S, Tsoukas C, Gahagan J, Hankins C, Masching R, and Ogunnaike-Cooke S

Subjects
Adult, Antiretroviral Therapy, Highly Active, Canada, Cross-Sectional Studies, Female, Humans, Middle Aged, Anti-Retroviral Agents therapeutic use, HIV Infections drug therapy, HIV Infections psychology, Medication Adherence psychology, Social Stigma
Abstract

Background: Associations between HIV-related stigma and reduced antiretroviral therapy (ART) adherence are widely established, yet the mechanisms accounting for this relationship are underexplored. There has been less attention to HIV-related stigma and its associations with ART initiation and current ART use. We examined pathways from HIV-related stigma to ART initiation, current ART use, and ART adherence among women living with HIV in Canada., Methods: We used baseline survey data from a national cohort of women living with HIV in Canada (n = 1425). Structural equation modeling using weighted least squares estimation methods was conducted to test the direct effects of HIV-related stigma dimensions (personalized, negative self-image, and public attitudes) on ART initiation, current ART use, and 90% ART adherence, and indirect effects through depression and HIV disclosure concerns, adjusting for sociodemographic factors., Results: In the final model, the direct paths from personalized stigma to ART initiation (β = -0.104, P < 0.05) and current ART use (β = -0.142, P < 0.01), and negative self-image to ART initiation (β = -0.113, P < 0.01) were significant, accounting for the mediation effects of depression and HIV disclosure concerns. Depression mediated the pathways from personalized stigma to ART adherence, and negative self-image to current ART use and ART adherence. Final model fit indices suggest that the model fit the data well [χ(25) = 90.251, P < 0.001; comparative fit index = 0.945; root-mean-square error of approximation = 0.044]., Conclusions: HIV-related stigma is associated with reduced likelihood of ART initiation and current ART use, and suboptimal ART adherence. To optimize the benefit of ART among women living with HIV, interventions should reduce HIV-related stigma and address depression.

Published
2018
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