ArticleSocial science & medicine (1982)2025
Association of experienced stigma in healthcare settings with health outcomes among Black women living with HIV: Mediating roles of internalized stigma, anticipated stigma, and trust in HIV care.
Article in Social science & medicine (1982), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it.
- A Systematic Review of Obstetric Mistreatment Among Women Living With HIV.Nursing & health sciences · 2026Pooled it
- Trial
- Experiences of Full Body Skin Examinations among Sexual and Gender Minority Patients in Dermatology: A Qualitative Study.Research square · 2026Article
- Structural and Social Drivers of Pre-Exposure Prophylaxis (PrEP) Literacy Disparities Among Men who have Sex with Men in China: A PrEP Care Cascade Analysis.AIDS and behavior · 2026Article
- Unsuppressed viral load and its associated factors among people living with HIV on antiretroviral therapy: a cross-sectional study.BMC infectious diseases · 2026Article
- Socio-demographic and Psychosocial Determinants of HIV Knowledge and Attitudes Towards HIV among Black Sub-Saharan African Migrants in Australia: A Cross-sectional Quantitative Study.Journal of racial and ethnic health disparities · 2026Article
- Article
- The process and mechanism of help-seeking behavior among people living with HIV: a qualitative analysis based on grounded theory.BMC public health · 2026Article
- Psychosocial Determinants of Mental Health in Older Adults Living With HIV: The Protective Role of Resilience Against Internalized Stigma.Journal of aging research · 2026Article
- Real-world experience of barriers to diagnosis, early detection and disease management among migrants living with HIV in Spain: a qualitative study.Annals of medicine · 2025Article
- Political conservatism and social distancing from people living with HIV among Medical students: mediating roles of negative stereotypes and negative Intergroup emotions.BMC medical education · 2025Article
- Psychological and Clinical Risk Factors for Substance Use in People With and Without HIV.Journal of the International Association of Providers of AIDS CareArticle
- Managing HIV care in daily life: A qualitative study of ART adherence and retention barriers and facilitators among people attending two urban ART clinics in Panama.Therapeutic advances in infectious diseaseArticle
- "All They See Is Those Three Letters": Exploring the Effects of Stigma Among Older Black Women Living with HIV.Global qualitative nursing researchArticle
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Authors and funding
16 authors.
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Abstract
backgroundBlack women living with HIV (WLHIV) often have suboptimal ART adherence due to a multitude of social and structural barriers, including HIV-related stigma. Trust in healthcare providers plays a significant role in adhering to ART and is likely lower among Black WLHIV compared to their White counterparts. This study examined the relationship between experienced stigma in healthcare settings and ART adherence and viral suppression through anticipated stigma in healthcare settings, internalized stigma, and medical mistrust. PARTICIPANTS/PROCEDURES: Participants included Black WLHIV from the Women's Interagency HIV Study (WIHS). We conducted serial mediation analyses where experienced HIV stigma in healthcare settings is associated with higher anticipated or internalized HIV stigma, leading to higher mistrust in HIV care providers, and ultimately, to lower ART adherence and viral suppression, adjusting for demographic and clinical covariates.
resultsOf the 1,060 WLHIV, approximately 84% achieved optimal ART adherence, and 65% had an undetectable viral load. Serial mediation analyses suggested significant indirect associations between experienced stigma in healthcare settings and ART adherence or viral suppression. Specifically, experienced stigma was associated with higher anticipated or internalized stigma, which was associated with mistrust in HIV care providers, resulting in lower ART adherence and reduced likelihood of undetectable viral load.
conclusionsInterventions could focus on training healthcare providers to address implicit biases and create supportive healthcare environments. Integrating mental health support to reduce internalized stigma and using community engagement and education to address anticipated stigma may further improve trust in providers, leading to better health behaviors and outcomes.
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