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Stigma and Quality of Life in African American Women Living with HIV Infection Through the Lens of Intersectionality

  • Author(s): Kaihura, Alphoncina John
  • Advisor(s): Waters, Catherine M
  • et al.
Abstract

African American women (AAW) experience the trifecta of intersections: Black, female, and live with HIV infection at a disproportionately higher rate compared to other women. Yet, little is known about these intersections on the stigmatizing and quality of life (QOL) experiences of AAW living with HIV infection. The purposes of this secondary research were to describe HIVstigma and QOL, explore the association between HIVstigma and QOL, and determine the influence of social (age, education, income, and partner status) and health (CD4 count, comorbidities, and emergency department admission) contextual factors on HIVstigma and QOL in a sample of 169 AAW with HIV infection living in Cleveland, OH and the San Francisco Bay Area, CA. Results are discussed through the lens of intersectionality and Black feminism.

The sample was a middle-aged group of AA mothers who were low-income, not partnered, educated beyond high school, on public healthinsurance, unemployed, and lived in permanent housing.They reported a moderate level of HIV QOL and stigma. Partnered, college-educated women with less comorbidities reported better QOL, particularly for life satisfaction. Regardless of social background and health issues, women felt stigmatized by their community and healthcare professionals. HIV-QOL (disclosure of HIV, burden of HIV medications, and life satisfaction) was associated with HIV-stigma. Results of regression analyses of the social and health predictors of stigma and QOL indicate women with less comorbidities reported less personal and public stigma; and, college-educated women reported better overall QOL, better health, and less burden of taking HIV medications.

Conclusions are stigma can be a major obstacle for HIV/AIDS prevention and treatment; and,social support such as having a partner or being married, having a college education, and limiting comorbidities can have a positive effect on QOL and stigma.This study addressed a gap in science by considering social and health characteristics on stigma and QOL as perceived by AAW living with HIV infection. These findings may help in the development of HIV/AIDS health education interventions and policies that are holistic, gender-appropriate, culturally acceptable, and address the unique personal, social, and health concerns of and support needed by AAW.

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