Abstract
Stress is associated with poor mental and physical health outcomes. In the United States (U.S.), little is known about perceived stress and associated factors among HIV-infected and immigrant women. Here, we examine these associations within a sample of 305 HIV-infected and uninfected, U.S.-born and non-U.S.-born women who were part of the Women’s Interagency HIV Study (WIHS) at three sites (New York, Chicago, and Los Angeles). Perceived stress was measured using the 10-item Perceived Stress Scale (PSS-10); HIV infection was serologically confirmed, and nativity status was self-reported. Bivariate and multivariable logistic regression were used to identify associations with perceived stress. The majority of participants were U.S.-born (232, 76.1%) and were HIV-infected (212, 68.5%). Mutlivariable analyses found the odds of perceived stress to be lower for those employed [adjusted odds ratio (AOR) = 0.31, 95% confidence interval (CI) = (0.15–0.63)], with high levels of social support (AOR = 0.45, 95% CI 0.26–0.79), and HIV-infected (AOR = 0.44, 95% CI 0.24–0.79). Perceived stress was positively associated with living in unstable housing (AOR = 2.54, 95% CI 1.17–5.51). Here, immigration status was not associated with perceived stress. We identified stress to be higher among women who were unemployed, unstably housed, or who had low social support. Community-based programs should tailor interventions to include stress reduction strategies for participants with identified risk factors to improve mental and physical health outcomes.
Similar content being viewed by others
Change history
18 July 2018
The original version of this article unfortunately published with the incorrect article title.
References
Cabaj, R. P. (1996). Management of anxiety and depression in HIV-infected patients. Journal of the International Association of Physicians in AIDS Care, 2(6), 11–16.
Hand, G. A., Phillips, K. D., & Dudgeon, W. D. (2006). Perceived stress in HIV-infected individuals: Physiological and psychological correlates. AIDS Care, 18(8), 1011–1017.
Pascoe, E. A., & Richman, L. S. (2009). Perceived discrimination and health: A meta-analytic review. Psychological Bulletin, 135(4), 531–554.
Van, E. M., Berkhof, H., Nicolson, N., & Sulon, J. (1996). The effects of perceived stress, traits, mood states, and stressful daily events on salivary cortisol. Psychosomatic Medicine, 58(5), 447–458.
Arnold, S. V., Smolderen, K. G., Buchanan, D. M., Li, Y., & Spertus, J. A. (2012). Perceived stress in myocardial infarction: Long-term mortality and health status outcomes. Journal of the American College of Cardiology, 60(18), 1756–1763.
Thoits, P. A. (2010). Stress and health: Major findings and policy implications. Journal of Health and Social Behavior, 51(S), S41–S53.
Berry, J. W. (2005). Acculturation: Living successfully in two cultures. International Journal of Intercultural Relations, 29(6), 697–712.
Cavazos-Rehg, P. A., Zayas, L. H., & Spitznagel, E. L. (2007). Legal status, emotional well-being and subjective health status of Latino immigrants. Journal of the National Medical Association, 99(10).
Chen, W. T., Guthriea, B., Shiub, C. S., et al. (2014). Acculturation and perceived stress in HIV+ immigrants: Depression symptomatology in Asian and Pacific Islanders. AIDS Care: Psychological and Socio-medical Aspects of AIDS/HIV, 26, 1581–1585.
Hovey, J. D. (1999). Psychosocial predictors of acculturative stress in Central American immigrants. Journal of Immigrant Health, 1(4), 187–194.
Hovey, J. D., & Magaña, C. (2000). Acculturative stress, anxiety, and depression among Mexican immigrant farmworkers in the Midwest United States. Journal of Immigrant Health, 2(3), 119–131.
Hovey, J. D., & Magana, C. (2000). Acculturative stress, anxiety, and depression among Mexican immigrant farmworkers in the Midwest United States. Journal of Immigrant Health, 2(3), 119–131.
Passel, J. S., & Cohn, D. V. (2009). A portrait of unauthorized immigrants in the United States (pp. 1–52). Washington, DC: Pew Hispanic Center.
Kennedy, C. A. (1995).Gender differences in HIV-related psychological distress in heterosexual couples. AIDS Care: Psychological and Socio-medical Aspects of AIDS/HIV, 7(1), 33–38.
McIntosh, R. C., & Rosselli, M. (2012). Stress and coping in women living with HIV: A meta-analytic review. AIDS and Behavior, 16(8), 2144–2159.
Chopel, A. M., Minkler, M., Nuru-Jeter, A., & Dunbar, A. (2015). Social determinants of late stage HIV diagnosis and its distributions among African Americans and Latinos: A critical literature review. Journal of Health Disparities Research and Practice, 8(4), 1–29.
Marc, L. G., Patel-Larson, A., Hall, H. I., et al. (2010). HIV among Haitian-born persons in the United States, 1985–2007. AIDS, 24(13), 2089–2097.
Passel, J. S., & Cohn, D. (2008). U.S. population projections: 2005–2050 (pp. 1–49). Washington, DC: Pew Research Center.
Flores, E., Tschann, J. M., Dimas, J. M., Bachen, E. A., Pasch, L. A., & De Groat, C. L. (2008). Perceived discrimination, perceived stress, and mental and physical health among Mexican-origin adults. Hispanic Journal of Behavioral Sciences, 30(4), 401–424.
Derose, K. P., Escarce, J. J., & Lurie, N. (2007). Immigrants and healthcare: Sources of vulnerability. Health Affairs, 26(5), 1258–1268.
Page, R. K., & Polk, S. (2017). Chilling effect? Post-election health care use by undocumented and mixed-status families. The New England Journal of Medicine, 376(12), e20(21)–e20(23).
Kawachi, I., & Berkman, L. F. (2001). Social ties and mental health. Journal of Urban Health, 78(3), 458–467.
Ornelas, I. J., & Perreira, K. M. (2011). The role of migration in the development of depressive symptoms among Latino immigrant parents in the USA. Social Science and Medicine, 73(8), 1169–1177.
Skinner, D. G., Correa, V., Skinner, M., & Bailey, D. B. (2001). Role of religion in the lives of Latino families of young children with developmental delays. American Journal of Mental Retardation, 106(4), 297–313.
D’Alonzo, K. T. (2010). Getting started in CBPR: Lessons in building community partnerships for new researchers. Nursing Inquiry, 7(4), 282–288.
Hudson, A. L., Lee, K. A., Miramontes, H., & Portillo, C. J. (2001). Social interactions, perceived support, and level of distress in HIV-positive women. Journal of the Association of Nurses in AIDS Care, 12(4), 68–76.
Catz, S. L., Gore-Felton, C., & Mcclure, J. B. (2002). Psychological distress among minority and low-income women living with HIV. Behavioral Medicine, 28(2), 53–60.
Finch, B. K., & Vega, W. A. (2003). Acculturation stress, social support, and self-rated health among Latinos in California. Journal of Immigrant Health, 5(3), 109–117.
Singh, G. K., & Siahpush, M. (2002). Ethnic-immigrant differentials in health behaviors, morbidity, and cause-specific mortality in the United States: An analysis of two national data bases. Human Biology, 74(1), 83–109.
Sánchez, M., Rice, E., Stein, J., Milburn, N. G., & Rotheram-Borus, M. J. (2010). Acculturation, coping styles, and health risk behaviors among HIV positive Latinas. AIDS and Behavior, 14(2), 401–409.
Abraído-Lanza, A. F., Chao, M. T., & Flórez, K. R. (2005). Do healthy behaviors decline with greater acculturation? Implications for the Latino mortality paradox. Social Science & Medicine, 61(6), 1243–1255.
Gundersen, D. A., Echeverria, S. E., Lewis, M. J., Giovino, G. A., Ohman-Strickland, P., & Delnevo, C. D. (2012). Heterogeneity in past year cigarette smoking quit attempts among Latinos. Journal of Environmental and Public Health, 2012, 1–9.
Deren, S., Shedlin, M., Kang, S. Y., & Cortes, D. E. (2011). HIV risk and prevention among Hispanic immigrants in New York: The salience of diversity. Substance Use & Misuse, 46(2–3), 254–263.
Hernandez, A. M., Zule, W. A., Karg, R. S., Browne, F. A., & Wechsberg, W. M. (2012). Factors that influence HIV risk among hispanic female immigrants and their implications for HIV prevention interventions. International Journal of Family Medicine, 2011, 876381.
Hoffman, S., Higgins, J. A., Beckford-Jarrett, S. T., et al. (2011). Contexts of risk and networks of protection: NYC West Indian immigrants’ perceptions of migration and vulnerability to sexually transmitted diseases. Culture, Health & Sexuality, 13(5), 513–528.
Bacon, M. C., Wyl, V. V., Alden, C., et al. (2005). The Women’s Interagency HIV Study: An observational cohort brings clinical sciences to the bench. Clinical and Diagnostic Laboratory Immunology, 12, 1013–1019.
Barkan, S. E., Melnick, S. L., Preston-Martin, S., et al. (1998). The Women’s Interagency HIV study. WIHS Collaborative Study Group. Epidemiology, 9(2), 117–125.
Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health & Social Behavior, 24, 385–396.
Cutrona, C. E., & Russell, D. W. (1987). The provisions of social relationships and adoptions to stress. Advances in Personal Relationships, 1, 37–67.
Massad, L. S., Agniel, D., Watts, D. H., et al. (2011). Impact of stress and depression on the frequency of squamous intraepithelial lesions. Journal of Lower Genital Tract Disease, 15(1), 42–47.
Rubin, L. H., Cook, A. J., Weber, M. K., et al. (2015). The association of perceived stress and verbal memory is greater in HIV-infected versus HIV-uninfected women. Journal of Neurovirology, 21(4), 422–432.
Turner, R. J., Lloyd, D. A., & Taylor, J. (2006). Stress burden, drug dependence and the nativity paradox among U.S. Hispanics. Drug and Alcohol Dependence, 83, 79–89.
Campos, B., Schetter, C. D., Abdou, C. M., Hobel, C., Glynn, L. M., & Sandman, C. A. (2008). Familialism,social support, and stress: Positive implications for pregnant Latinas. Cultural Diversity and Ethnic Minority Psychology, 14(2), 155–162.
D’Alonzo, K. T. (2012). The influence of marianismo beliefs on physical activity of immigrant Latinas. Journal of Transcultural Nursing, 23(2), 124–133.
Ayers, J. W., Hofstetter, C. R., Usita, P., Irvin, V. L., Kang, S., & Hovell, M. F. (2009). Sorting out the competing effect of acculturation, immigrant stress and social support on depression: A report on Korean women in California. Journal of Nervous and Mental Disease, 197(10), 742–747.
Hunt, L. M., Schneider, S., & Comer, B. (2004). Should “acculturation” be a variable in health research? A critical review of research on US Hispanics. Social Science and Medicine, 59(5), 973–986.
Fox, J. A., & Kim-Godwin, Y. (2011). Stress and depression among Latina women in rural southeastern North Carolina. Journal of Community Health Nursing, 28(4), 223–232.
Hernández, D., Phillips, D., & Siegel, E. L. (2016). Exploring the housing and household energy pathways to stress: A mixed methods study. International Journal of Environmental Research and Public Health, 13, 916.
Santiago, C. D., Wadsworth, M. E., & Stump, J. (2011). Socioeconomic status, neighborhood disadvantage, and poverty-related stress: Prospective effects on psychological syndromes among diverse low-income families. Journal of Economic Psychology, 32, 218–230.
Lassetter, J. H., & Callister, L. C. (2009). The impact of migration on the health of voluntary migrants in western societies: A review of the literature. Journal of the Association of Nurses in AIDS Care Transcultural Nursing, 20(1), 93–104.
Benjamin, E. J., Blaha, M. J., Chiuve, S. E., et al. (2017). Heart disease and stroke statistics—2017 update: A report from the American Heart Association. Circulation, 135, e146–e603.
Budhwani, H., Hearld, K. R., & Chavez-Yenter, D. (2015). Generalized anxiety disorderinracial and ethnic minorities: A case of nativity and contextual factors. Journal of Affective Disorders, 175, 275–280.
Taylor, R. J., Nguyen, A. W., Sinkewicz, M., Joe, S., & Chatters, l. M. (2013). Comorbid mood and anxiety disorders, suicidal behavior, and substance abuse among Black Caribbeans in the U.S.A. Journal of African American Studies, 17, 409–425.
Abraido-Lanza, A. F., Chao, M. T., & Florez, K. R. (2005). Do healthy behaviors decline with greater acculturation? Implications for the Latino mortality paradox. Social Science & Medicine, 61(6), 1243–1255.
Derose, K. P., Bogart, L. M., Kanouse, D. E., et al. (2014). An intervention to reduce HIV-related stigma in partnership with African American and Latino churches. AIDS Education and Prevention, 26(1), 28–42.
Hummer, R. A., Rogers, R. G., Amir, S. H., Forbes, D., & Frisbie, W. P. (2000). Adult mortality differentials among Hispanic subgroups and non-Hispanic whites. Social Science Quarterly, 81(1), 459–476.
Lin, C. C., Rogot, E., Johnson, N. J., Sorlie, P. D., & Arias, E. (2003). A further study of life expectancy by socioeconomic factors in the National Longitudinal Mortality Study. Ethnicity and Disease, 13(2), 240–247.
Sorlie, P. D., Backlund, E., Johnson, N. J., & Rogot, E. (1993). Mortality by Hispanic status in the United States. JAMA, 270(20), 2464–2468.
Carlisle, S. K. (2012). Nativity differences in chronic health conditions between nationally representative samples of Asian American, Latino American, and Afro-Caribbean American respondents. Journal of Immigrant and Minority Health, 14, 903–911.
Ovbiagele, B., Saver, J. L., Fredieu, A., et al. (2004). In-hospital initiation of secondary stroke prevention therapies yields high rates of adherence at follow-up. Stroke, 35, 2879–2883.
Acknowledgements
Data in this manuscript were collected by the Women’s Interagency HIV Study (WIHS). The contents of this publication are solely the responsibility of the authors and do not represent the official views of the National Institutes of Health (NIH). WIHS (Principal Investigators): Brooklyn WIHS (Howard Minkoff and Deborah Gustafson), U01-AI-031834; Chicago WIHS (Mardge Cohen and Audrey French), U01-AI-034993; WIHS Data Management and Analysis Center (Stephen Gange and Elizabeth Golub), U01-AI-042590; Southern California WIHS (Joel Milam), U01-HD-032632 (WIHS I–WIHS IV). The WIHS is funded primarily by the National Institute of Allergy and Infectious Diseases (NIAID), with additional co-funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the National Cancer Institute (NCI), the National Institute on Drug Abuse (NIDA), and the National Institute on Mental Health (NIMH). Targeted supplemental funding for specific projects is also provided by the National Institute of Dental and Craniofacial Research (NIDCR), the National Institute on Alcohol Abuse and Alcoholism (NIAAA), the National Institute on Deafness and other Communication Disorders (NIDCD), and the NIH Office of Research on Women’s Health. WIHS data collection is also supported by UL1-TR000004 (UCSF CTSA), UL1-TR000454 (Atlanta CTSA), and P30-AI-050410 (UNC CFAR).
Disclaimer
The contents of this publication are solely the responsibility of the authors and do not represent the official views of the National Institutes of Health (NIH).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Additional information
The original version of this article was revised: The correct title has been updated in this version.
Rights and permissions
About this article
Cite this article
Gousse, Y., Bruno, D., Joseph, M.A. et al. Examining the Associations Between Immigration Status and Perceived Stress Among HIV-Infected and Uninfected Women. J Community Health 43, 1172–1181 (2018). https://doi.org/10.1007/s10900-018-0537-6
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10900-018-0537-6