Doctor of Philosophy (PhD)
First Advisor's Name
Gladys E Ibanez
First Advisor's Committee Title
Second Advisor's Name
Diana M Sheehan
Second Advisor's Committee Title
Third Advisor's Name
Kristopher P Fennie
Third Advisor's Committee Title
Fourth Advisor's Name
Fourth Advisor's Committee Title
HIV-related stigma, antiretroviral therapy adherence, viral suppression, anxiety, depression, preexposure prophylaxis-related stigma
Date of Defense
Persistent increases of HIV incidence in Florida has made it essential to study ways to improve HIV prevention strategies. Treatment as Prevention (TasP) and Preexposure Prophylaxis (PrEP) are two recent methods in HIV prevention; however, their success may be limited due to barriers such as stigma. This dissertation explored the relationship between HIV-related stigma and 1) antiretroviral therapy adherence and viral suppression and 2) symptoms of anxiety and depression. Additionally, it sought to develop and validate a scale to measure community PrEP-related stigma.
We used data from the Florida Cohort Study which include 932 people living with HIV (PLWH). The odds of non-adherence to ART was not significantly greater for those reporting low/moderate or high levels of general enacted HIV-related stigma (vs no stigma) (p=0.198 and p=0.600, respectively). Moreover, the odds of non-viral suppression was not significantly greater for those reporting low/moderate or high levels of general enacted HIV-related stigma (vs no stigma) (p=0.702 and p=0.622, respectively). However, ever experiencing healthcare specific enacted HIV-related stigma was associated with both non-adherence [p=0.008] and non-suppression [p=0.011]. Between HIV-related stigma and symptoms of anxiety and depression, we found that higher levels of enacted HIV-related stigma was significantly associated with higher levels of both anxiety (vs no stigma) (p=0.006 and p
To develop and validate the community PrEP-related stigma scale (community-PSS) we used data from an ongoing study among 108 sexual and gender minority men in Florida. The scale was found to have high internal consistency (α=0.86) and had 4 factors (stigma of actions outside of sex, stigma of sexual actions, extreme stigma perceptions, and positive community perception). The community-PSS was valid; meeting 4/5 hypotheses and in the expected direction.
Research that focuses on specific constructs of HIV-related stigma can better inform future stigma reduction interventions. The community-PSS is a valid and reliable tool with potential of assessing stigma’s impact on PrEP knowledge, uptake, and adherence. Future research should focus on the intersectionality of stigma on HIV risk outcomes.
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This work is licensed under a Creative Commons Attribution 4.0 License.
Algarin, Angel B., "Examining Stigma and Its Effect on HIV Prevention & Care among People Living in Florida" (2020). FIU Electronic Theses and Dissertations. 4481.
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