TY  - JOUR
PY  - 2019//
TI  - A longitudinal study of associations between HIV-related stigma, recent violence and depression among women living with HIV in a Canadian cohort study
JO  - Journal of the international AIDS society
A1  - Logie, Carmen H.
A1  - Marcus, Natania
A1  - Wang, Ying
A1  - Kaida, Angela
A1  - O'Campo, Patricia
A1  - Ahmed, Uzma
A1  - O'Brien, Nadia
A1  - Nicholson, Valerie
A1  - Conway, Tracey
A1  - de Pokomandy, Alexandra
A1  - Fernet, Mylene
A1  - Loutfy, Mona
SP  - e25341
EP  - e25341
VL  - 22
IS  - 7
N2  - INTRODUCTION: Women living with HIV (WLHIV) experience stigma and elevated exposure to violence in comparison with HIV-negative women. We examined the mediating role of experiencing recent violence in the relationship between stigma and depression among WLHIV in Canada. <br><br>METHODS: We conducted a cohort study with WLHIV in three Canadian provinces. Recent violence was assessed through self-reported experiences of control, physical, sexual or verbal abuse in the past three months. At Time 1 (2013-2015) three forms of stigma were assessed (HIV-related, racial, gender) and at Time 2 (2015-2017) only HIV-related stigma was assessed. We conducted structural equation modelling (SEM) using the maximum likelihood estimation method with Time 1 data to identify direct and indirect effects of gender discrimination, racial discrimination and HIV-related stigma on depression via recent violence. We then conducted mixed effects regression and SEM using Time 1 and Time 2 data to examine associations between HIV-related stigma, recent violence and depression. <br><br>RESULTS: At Time 1 (n = 1296), the direct path from HIV-related stigma (direct effect: β = 0.200, p < 0.001; indirect effect: β = 0.014, p < 0.05) to depression was significant; recent violence accounted for 6.5% of the total effect. Gender discrimination had a significant direct and indirect effect on depression (direct effect: β = 0.167, p < 0.001; indirect effect: β = 0.050, p < 0.001); recent violence explained 23.15% of the total effect. Including Time 1 and Time 2 data (n = 1161), mixed-effects regression results indicate a positive relationship over time between HIV-related stigma and depression (Acoef: 0.04, 95% CI: 0.03, 0.06, p < 0.001), and recent violence and depression (Acoef: 1.95, 95% CI: 0.29, 4.42, p < 0.05), controlling for socio-demographics. There was a significant interaction between HIV-related stigma and recent violence with depression (Acoef: 0.04, 95% CI: 0.01, 0.07, p < 0.05). SEM analyses reveal that HIV-related stigma had a significant direct and indirect effect on depression over time (direct effect: β = 0.178, p < 0.001; indirect effect: β = 0.040, p < 0.001); recent violence experiences accounted for 51% of the total effect. <br><br>CONCLUSIONS: Our findings suggest that HIV-related stigma is associated with increased experiences of recent violence, and both stigma and violence are associated with increased depression among WLHIV in Canada. There is an urgent need for trauma-informed stigma interventions to address stigma, discrimination and violence.<br><br>© 2019 The Authors. Journal of the International AIDS Society published by John Wiley & Sons Ltd on behalf of the International AIDS Society.<p />  <p>Language: en</p>
LA  - en
SN  - 1758-2652
UR  - http://dx.doi.org/10.1002/jia2.25341
ID  - ref1
ER  -