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Navigating Stigma Trajectory and Mental Health Among Young Adults Living with Perinatal HIV in New York City

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Abstract

Perceived HIV stigma and mental health are fluid across the lifespan for people living with perinatally-acquired HIV (PHIV). The process of navigating discredited identities over time in the context of other life demands potentially exerts a toll on the mental health of adolescents and young adults living with PHIV (AYAPHIV). Based on data from a longitudinal study in New York City examining mental health and health risk behaviors among 182 AYAPHIV, we examined if increased perceived HIV stigma predicted mental health, future orientation, HIV-disclosure, and healthcare transition over time (2003–2018). Findings from linear mixed-effects modeling indicated that older age predicted poorer mental health, less future orientation, more HIV-serostatus disclosure, and adult medical services utilization. Perceived stigma was the only significant predictor of mental health and mediated the association between age and mental health—highlighting the importance of addressing stigma across development for AYAPHIV while addressing systems that perpetuate them.

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Notes

  1. In the results reported here, the SD of each variable used for standardization was calculated from the entire set of aggregate measurements and applied consistently to all regression results even if only a subset of data was analyzed. For example, the SD of age that standardized the coefficients of a model predicting mental health was obtained from all age measurements even if only a subset of those coincided with mental health measurements.

  2. The size of data used for this mediation analysis was smaller than that used for the analysis of the age effect on mental health reported separately. The number of per-individual measurements of both stigma and CBCL was only three.

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Acknowledgments

This research was supported by a grant from the National Institute of Mental Health (NIMH; R01-MH69133, Principal Investigator: Claude Ann Mellins, Ph.D.) and a center grant from NIMH to the HIV Center for Clinical and Behavioral Studies at NY State Psychiatric Institute and Columbia University (P30-MH43520; Principal Investigator: Robert H. Remien, Ph.D.). We are also grateful for the helpful editorial suggestions we received from Cabrina Kang. This paper is dedicated to the memory of Jacqueline Brinney, RN, a nurse and loving caretaker for generations of children, adolescents, and now adults living with perinatal HIV in Harlem. The content is solely the responsibility of the authors and does not necessarily represent the official views of NIMH or the National Institutes of Health.

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Authors and Affiliations

  1. Department of Psychology, Howard University, 2041 Georgia Ave, Northwest, Washington, DC, 20059, USA

    Ezer Kang, Woojae Kim & Christine Kindler

  2. HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, Columbia University, New York, USA

    Claude A. Mellins, Curtis Dolezal & Cheng-Shiun Leu

  3. ICAP at Columbia, Mailman School of Public Health, Columbia University, New York, USA

    Elaine J. Abrams

  4. College of Physicians & Surgeon, Columbia University, New York, USA

    Elaine J. Abrams

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  1. Ezer Kang
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  2. Claude A. Mellins
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  3. Woojae Kim
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  4. Curtis Dolezal
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  6. Cheng-Shiun Leu
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  7. Elaine J. Abrams
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Correspondence to Ezer Kang.

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Kang, E., Mellins, C.A., Kim, W. et al. Navigating Stigma Trajectory and Mental Health Among Young Adults Living with Perinatal HIV in New York City. AIDS Behav 25, 3712–3720 (2021). https://doi.org/10.1007/s10461-021-03166-3

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