How does antiretroviral treatment attenuate the stigma of HIV? Evidence from a cohort study in rural Uganda.

Journal: AIDS and behavior

Volume: 17

Issue: 8

Year of Publication: 2014

Affiliated Institutions:  Chester M. Pierce, MD Division of Global Psychiatry, Department of Psychiatry, Massachusetts General Hospital (MGH), Center for Global Health, Room -E, Cambridge Street, th floor, Boston, MA, , USA, actsai@partners.org.

Abstract summary 

Program implementers and qualitative researchers have described how increasing availability of HIV antiretroviral therapy (ART) is associated with improvements in psychosocial health and internalized stigma. To determine whether, and through what channels, ART reduces internalized stigma, we analyzed data from 262 HIV-infected, treatment-naïve persons in rural Uganda followed from ART initiation over a median of 3.4 years. We fitted Poisson regression models with cluster-correlated robust estimates of variance, specifying internalized stigma as the dependent variable, adjusting for time on treatment as well as socio-demographic, clinical, and psychosocial variables. Over time on treatment, internalized stigma declined steadily, with the largest decline observed during the first 2 years of treatment. This trend remained statistically significant after multivariable adjustment (χ(2) = 28.3; P = 0.03), and appeared to be driven by ART-induced improvements in HIV symptom burden, physical and psychological wellbeing, and depression symptom severity.

Authors & Co-authors:  Tsai Alexander C AC Bangsberg David R DR Bwana Mwebesa M Haberer Jessica E JE Frongillo Edward A EA Muzoora Conrad C Kumbakumba Elias E Hunt Peter W PW Martin Jeffrey N JN Weiser Sheri D SD

Study Outcome 

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Statistics
Citations :  Weiser SD, Gupta R, Tsai AC, Frongillo EA, Grede N, Kumbakumba E, et al. Changes in food insecurity, nutritional status, and physical health status after antiretroviral therapy initiation in rural Uganda. J Acquir Immune Defic Syndr. 2012;61(2):179–86.
Authors :  10
Identifiers
Doi : 10.1007/s10461-013-0503-3
SSN : 1573-3254
Study Population
Male,Female
Mesh Terms
Adult
Other Terms
Study Design
Cohort Study,Cross Sectional Study
Study Approach
Qualitative
Country of Study
Uganda
Publication Country
United States