PMID- 29135650
OWN - NLM
STAT- In-Data-Review
LR  - 20180210
IS  - 1944-7884 (Electronic)
IS  - 1525-4135 (Linking)
VI  - 77
IP  - 2
DP  - 2018 Feb 1
TI  - Pathways From HIV-Related Stigma to Antiretroviral Therapy Measures in the HIV
      Care Cascade for Women Living With HIV in Canada.
PG  - 144-153
LID - 10.1097/QAI.0000000000001589 [doi]
AB  - BACKGROUND: Associations between HIV-related stigma and reduced antiretroviral
      therapy (ART) adherence are widely established, yet the mechanisms accounting for
      this relationship are underexplored. There has been less attention to HIV-related
      stigma and its associations with ART initiation and current ART use. We examined 
      pathways from HIV-related stigma to ART initiation, current ART use, and ART
      adherence among women living with HIV in Canada. METHODS: We used baseline survey
      data from a national cohort of women living with HIV in Canada (n = 1425).
      Structural equation modeling using weighted least squares estimation methods was 
      conducted to test the direct effects of HIV-related stigma dimensions
      (personalized, negative self-image, and public attitudes) on ART initiation,
      current ART use, and 90% ART adherence, and indirect effects through depression
      and HIV disclosure concerns, adjusting for sociodemographic factors. RESULTS: In 
      the final model, the direct paths from personalized stigma to ART initiation
      (beta = -0.104, P < 0.05) and current ART use (beta = -0.142, P < 0.01), and
      negative self-image to ART initiation (beta = -0.113, P < 0.01) were significant,
      accounting for the mediation effects of depression and HIV disclosure concerns.
      Depression mediated the pathways from personalized stigma to ART adherence, and
      negative self-image to current ART use and ART adherence. Final model fit indices
      suggest that the model fit the data well [chi(25) = 90.251, P < 0.001;
      comparative fit index = 0.945; root-mean-square error of approximation = 0.044]. 
      CONCLUSIONS: HIV-related stigma is associated with reduced likelihood of ART
      initiation and current ART use, and suboptimal ART adherence. To optimize the
      benefit of ART among women living with HIV, interventions should reduce
      HIV-related stigma and address depression.
FAU - Logie, Carmen H
AU  - Logie CH
AD  - Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario,
      Canada.
AD  - Women's College Research Institute, Women's College Hospital, Toronto, Ontario,
      Canada.
FAU - Lacombe-Duncan, Ashley
AU  - Lacombe-Duncan A
AD  - Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario,
      Canada.
FAU - Wang, Ying
AU  - Wang Y
AD  - Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario,
      Canada.
FAU - Kaida, Angela
AU  - Kaida A
AD  - Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia,
      Canada.
FAU - Conway, Tracey
AU  - Conway T
AD  - Women's College Research Institute, Women's College Hospital, Toronto, Ontario,
      Canada.
FAU - Webster, Kath
AU  - Webster K
AD  - Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia,
      Canada.
FAU - de Pokomandy, Alexandra
AU  - de Pokomandy A
AD  - Department of Family Medicine, McGill University, Montreal, Quebec, Canada.
AD  - Chronic Viral Illness Service, McGill University Health Centre, Montreal, Quebec,
      Canada.
FAU - Loutfy, Mona R
AU  - Loutfy MR
AD  - Women's College Research Institute, Women's College Hospital, Toronto, Ontario,
      Canada.
AD  - Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
FAU - Anema, Aranka
AU  - Anema A
FAU - Becker, Denise
AU  - Becker D
FAU - Brotto, Lori
AU  - Brotto L
FAU - Carter, Allison
AU  - Carter A
FAU - Cardinal, Claudette
AU  - Cardinal C
FAU - Colley, Guillaume
AU  - Colley G
FAU - Ding, Erin
AU  - Ding E
FAU - Duddy, Janice
AU  - Duddy J
FAU - Gataric, Nada
AU  - Gataric N
FAU - Hogg, Robert S
AU  - Hogg RS
FAU - Hosward, Terry
AU  - Hosward T
FAU - Jabbari, Shahab
AU  - Jabbari S
FAU - Jones, Evin
AU  - Jones E
FAU - Kestler, Mary
AU  - Kestler M
FAU - Langlois, Andrea
AU  - Langlois A
FAU - Lima, Viviane
AU  - Lima V
FAU - Lloyd-Smith, Elisa
AU  - Lloyd-Smith E
FAU - Medjuck, Melissa
AU  - Medjuck M
FAU - Miller, Cari
AU  - Miller C
FAU - Money, Deborah
AU  - Money D
FAU - Nicholson, Valerie
AU  - Nicholson V
FAU - Ogilvie, Gina
AU  - Ogilvie G
FAU - Patterson, Sophie
AU  - Patterson S
FAU - Pick, Neora
AU  - Pick N
FAU - Roth, Eric
AU  - Roth E
FAU - Salters, Kate
AU  - Salters K
FAU - Sanchez, Margarite
AU  - Sanchez M
FAU - Sas, Jacquie
AU  - Sas J
FAU - Sereda, Paul
AU  - Sereda P
FAU - Summers, Marcie
AU  - Summers M
FAU - Tom, Christina
AU  - Tom C
FAU - Wang, Lu
AU  - Wang L
FAU - Webster, Kath
AU  - Webster K
FAU - Zhang, Wendy
AU  - Zhang W
FAU - Abdul-Noor, Rahma
AU  - Abdul-Noor R
FAU - Angel, Jonathan
AU  - Angel J
FAU - Barry, Fatimatou
AU  - Barry F
FAU - Bauer, Greta
AU  - Bauer G
FAU - Beaver, Kerrigan
AU  - Beaver K
FAU - Benoit, Anita
AU  - Benoit A
FAU - Bertozzi, Breklyn
AU  - Bertozzi B
FAU - Borton, Sheila
AU  - Borton S
FAU - Bourque, Tammy
AU  - Bourque T
FAU - Brophy, Jason
AU  - Brophy J
FAU - Burchell, Ann
AU  - Burchell A
FAU - Carlson, Allison
AU  - Carlson A
FAU - Cioppa, Lynne
AU  - Cioppa L
FAU - Cohen, Jeffrey
AU  - Cohen J
FAU - Conway, Tracey
AU  - Conway T
FAU - Cooper, Curtis
AU  - Cooper C
FAU - Cotnam, Jasmine
AU  - Cotnam J
FAU - Cousineau, Janette
AU  - Cousineau J
FAU - Fraleigh, Annette
AU  - Fraleigh A
FAU - Gagnier, Brenda
AU  - Gagnier B
FAU - Gasingirwa, Claudine
AU  - Gasingirwa C
FAU - Greene, Saara
AU  - Greene S
FAU - Hart, Trevor
AU  - Hart T
FAU - Islam, Shazia
AU  - Islam S
FAU - Kaushic, Charu
AU  - Kaushic C
FAU - Kennedy, Logan
AU  - Kennedy L
FAU - Kerr, Desiree
AU  - Kerr D
FAU - Kiboyogo, Maxime
AU  - Kiboyogo M
FAU - Kwaramba, Gladys
AU  - Kwaramba G
FAU - Leonard, Lynne
AU  - Leonard L
FAU - Lewis, Johanna
AU  - Lewis J
FAU - Logie, Carmen
AU  - Logie C
FAU - Margolese, Shari
AU  - Margolese S
FAU - Muchenje, Marvelous
AU  - Muchenje M
FAU - Ndung'u, Mary
AU  - Ndung'u M
FAU - O'Brien, Kelly
AU  - O'Brien K
FAU - Ouellette, Charlene
AU  - Ouellette C
FAU - Powis, Jeff
AU  - Powis J
FAU - Quan, Corinna
AU  - Quan C
FAU - Raboud, Janet
AU  - Raboud J
FAU - Rachlis, Anita
AU  - Rachlis A
FAU - Ralph, Edward
AU  - Ralph E
FAU - Rourke, Sean
AU  - Rourke S
FAU - Rueda, Sergio
AU  - Rueda S
FAU - Sandre, Roger
AU  - Sandre R
FAU - Smaill, Fiona
AU  - Smaill F
FAU - Smith, Stephanie
AU  - Smith S
FAU - Tigere, Tsitsi
AU  - Tigere T
FAU - Tharao, Wangari
AU  - Tharao W
FAU - Walmsley, Sharon
AU  - Walmsley S
FAU - Wobeser, Wendy
AU  - Wobeser W
FAU - Yee, Jessica
AU  - Yee J
FAU - Yudin, Mark
AU  - Yudin M
FAU - Baril, Jean-Guy
AU  - Baril JG
FAU - Burke, Nora Butler
AU  - Burke NB
FAU - Clement, Pierrette
AU  - Clement P
FAU - Dayle, Janice
AU  - Dayle J
FAU - Dubuc, Daniele
AU  - Dubuc D
FAU - Fernet, Mylene
AU  - Fernet M
FAU - Groleau, Danielle
AU  - Groleau D
FAU - Hot, Aurelie
AU  - Hot A
FAU - Klein, Marina
AU  - Klein M
FAU - Martin, Carrie
AU  - Martin C
FAU - Massie, Lyne
AU  - Massie L
FAU - Menard, Brigitte
AU  - Menard B
FAU - O'Brien, Nadia
AU  - O'Brien N
FAU - Otis, Joanne
AU  - Otis J
FAU - Peltier, Doris
AU  - Peltier D
FAU - Pierre, Alie
AU  - Pierre A
FAU - Proulx-Boucher, Karene
AU  - Proulx-Boucher K
FAU - Rouleau, Danielle
AU  - Rouleau D
FAU - Savoie, Edenia
AU  - Savoie E
FAU - Tremblay, Cecile
AU  - Tremblay C
FAU - Trottier, Benoit
AU  - Trottier B
FAU - Trottier, Sylvie
AU  - Trottier S
FAU - Tsoukas, Christos
AU  - Tsoukas C
FAU - Gahagan, Jacqueline
AU  - Gahagan J
FAU - Hankins, Catherine
AU  - Hankins C
FAU - Masching, Renee
AU  - Masching R
FAU - Ogunnaike-Cooke, Susanna
AU  - Ogunnaike-Cooke S
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Acquir Immune Defic Syndr
JT  - Journal of acquired immune deficiency syndromes (1999)
JID - 100892005
PMC - PMC5770113
EDAT- 2017/11/15 06:00
MHDA- 2017/11/15 06:00
CRDT- 2017/11/15 06:00
PHST- 2017/11/15 06:00 [pubmed]
PHST- 2017/11/15 06:00 [medline]
PHST- 2017/11/15 06:00 [entrez]
AID - 10.1097/QAI.0000000000001589 [doi]
PST - ppublish
SO  - J Acquir Immune Defic Syndr. 2018 Feb 1;77(2):144-153. doi:
      10.1097/QAI.0000000000001589.