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The Role of HIV Stigma in ART Adherence and Quality of Life Among Rural Women Living with HIV in India

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Abstract

HIV stigma continues to be a barrier to physical and mental health among people living with HIV globally, especially in vulnerable populations. We examined how stigma is associated with health outcomes and quality of life among rural women living with HIV in South India (N = 600). Interviewer-administered measures assessed multiple dimensions of stigma, as well as loneliness, social support, ART adherence, time since diagnosis, and quality of life. Internalized stigma and a lack of social support were associated with a lower quality of life, while the association between internalized stigma and adherence was mediated by the use of stigma-avoidant coping strategies, suggesting that keeping one’s diagnosis a secret may make it more difficult to take one’s medications. These findings suggest that these women constitute a vulnerable population who need additional services to optimize their health and who might benefit from peer support interventions and stigma-reduction programs for family and community members.

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Acknowledgements

Support for this research was provided by an Award R01MH098729 from the National Institute on Mental Health.

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Authors and Affiliations

  1. University of California, San Francisco, 550 16th St, 3rd floor, San Francisco, CA, 94158, USA

    Maria L. Ekstrand, Elsa Heylen, Amanda Mazur & Wayne T. Steward

  2. St John’s Research Institute, Bangalore, India

    Maria L. Ekstrand

  3. University of California, Los Angeles, USA

    Catherine Carpenter

  4. University of California, Irvine, USA

    Kartik Yadav & Adey Nyamathi

  5. All India Institute of Medical Sciences, New Delhi, India

    Sanjeev Sinha

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  1. Maria L. Ekstrand
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  2. Elsa Heylen
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Correspondence to Maria L. Ekstrand.

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Ekstrand, M.L., Heylen, E., Mazur, A. et al. The Role of HIV Stigma in ART Adherence and Quality of Life Among Rural Women Living with HIV in India. AIDS Behav 22, 3859–3868 (2018). https://doi.org/10.1007/s10461-018-2157-7

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