One Year After ART Initiation: Psychosocial Factors Associated with Stigma Among HIV-Positive Mozambicans
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The pathways through which stigma is associated with psychological distress remains understudied in Africa. This study evaluates stigma among 277 Mozambicans who were on an antiretroviral therapy (ART) regimens for a full year. Using bivariate and multiple regression analyses, we examine psychosocial factors (disclosure decisions, perceived social support, and depression) associated with stigma, at ART initiation and 1 year later. We found 1 year after initiating ART, participants reported no change in stigma, a decrease in perceived social support, and an increase in depressive symptomology. Disclosing HIV status to friends (versus family or partner) was associated with lower levels of stigma. These findings suggest that HIV care in comparable settings should include counselling, support groups, and peer support, that includes stigma and disclosure concerns prior to and during the first year following diagnosis. Most importantly, assessment and treatment of depression should be incorporated into ongoing HIV care.
KeywordsStigma Disclosure HIV/AIDS Africa Depression
Funding for this research has been provided in part by the Stroum Endowed Minority Dissertation Fellowship funding to Pearson, a STD/AIDS Research Training Grant (NIH T32 AI07140) to Micek, a career development award (NIH K23 MH04551) to Rao, PEPFAR and TAP funding Grant No. 1440/TAP:HIV-AIDS/MS-DPC/GACOPI/04 to Gloyd. The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the University of Washington, the Mozambique Ministry of Health, or the NIH.
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