Associations Between HIV-Related Stigma, Racial Discrimination, Gender Discrimination, and Depression Among HIV-Positive African, Caribbean, and Black Women in Ontario, Canada
Associations Between HIV-Related Stigma, Racial Discrimination, Gender Discrimination, and Depression Among HIV-Positive African, Caribbean, and Black Women in Ontario, Canada
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DOI：
10.1089/apc.2012.0296
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发表时间：
2013-02-01
影响因子：
4.9
通讯作者：
Loutfy, Mona
中科院分区：
文献类型：
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作者：
Logie, Carmen;James, Llana;Loutfy, Mona
与加拿大的一般人口相比，非洲、加勒比和黑人妇女在新的艾滋病毒感染者中所占比例过高。社会和结构性因素，如艾滋病毒相关的耻辱，性别歧视和种族歧视的汇合，增加艾滋病毒感染的脆弱性ACB妇女减少获得艾滋病毒预防服务。羞辱和歧视也是治疗、护理和支持的障碍，并可能导致心理健康问题。我们进行了一项横断面调查，艾滋病毒阳性ACB妇女（n = 173）在整个安大略，以研究艾滋病毒相关的耻辱，性别歧视，种族歧视和抑郁症之间的关系。三分之一的参与者使用贝克抑郁量表快速筛查指南报告了中度/重度抑郁评分。分层块回归，温和，和中介分析进行测量之间的关联独立（艾滋病毒相关的耻辱，性别歧视，种族歧视），主持人/调解人（社会支持，弹性应对），和依赖（抑郁症）变量。调查结果包括：（1）艾滋病相关污名与抑郁增加相关;（2）弹性应对与抑郁减少相关，但没有缓和艾滋病相关污名对抑郁的影响;（3）艾滋病相关污名对抑郁的影响部分通过弹性应对介导。与艾滋病毒相关的耻辱，性别歧视和种族歧视显着相关，彼此和抑郁症，突出检查多种交叉形式的耻辱的显着性。由于非随机抽样，调查结果的普遍性可能受到限制。研究结果强调了多成分干预的重要性，包括建立弹性应对技能，心理健康促进和评估，以及减少耻辱的计划。
African, Caribbean, and Black (ACB) women are greatly overrepresented in new HIV infections in comparison with Canada's general population. Social and structural factors such as HIV-related stigma, gender discrimination, and racial discrimination converge to increase vulnerability to HIV infection among ACB women by reducing access to HIV prevention services. Stigma and discrimination also present barriers to treatment, care, and support and may contribute to mental health problems. We administered a cross-sectional survey to HIV-positive ACB women (n = 173) across Ontario in order to examine the relationships between HIV-related stigma, gender discrimination, racial discrimination, and depression. One-third of participants reported moderate/severe depression scores using the Beck Depression Inventory Fast-Screen guidelines. Hierarchical block regression, moderation, and mediation analyses were conducted to measure associations between independent (HIV-related stigma, gender discrimination, racial discrimination), moderator/mediator (social support, resilient coping), and dependent (depression) variables. Findings included: (1) HIV-related stigma was associated with increased depression; (2) resilient coping was associated with reduced depression but did not moderate the influence of HIV-related stigma on depression; and (3) the effects of HIV-related stigma on depression were partially mediated through resilient coping. HIV-related stigma, gender discrimination, and racial discrimination were significantly correlated with one another and with depression, highlighting the salience of examining multiple intersecting forms of stigma. Generalizability of findings may be limited due to nonrandom sampling. Findings emphasize the importance of multi-component interventions, including building resilient coping skills, mental health promotion and assessment, and stigma reduction programs.