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A Structural Equation Model of Factors Contributing to Quality of Life Among African and Caribbean Women Living with HIV in Ontario, Canada.
AIDS Res Hum Retroviruses. 2017 03; 33(3):290-297.AR

Abstract

African and Caribbean Black (ACB) women in Canada are disproportionately impacted by new HIV infections. ACB women's HIV vulnerability is shaped by contexts of stigma and discrimination. HIV-related stigma compromises quality of life (QOL) among women living with HIV (WLWH), yet scant research has examined concomitant effects of racial discrimination and HIV-related stigma on QOL. We used data from a cross-sectional survey with ACB WLWH in Ontario (n = 173) to test a conceptual model of pathways between HIV-related stigma, racial discrimination, depression, social support, and QOL. We conducted structural equation modeling using maximum likelihood estimation to test the model. In independent models, HIV-related stigma was associated with lower QOL, and depression partially mediated the association between HIV-related stigma and QOL. In the simultaneous model, HIV-related stigma had significant direct effects on depression, social support, and an indirect effect on QOL. When social support was added as a mediator, the direct effect between HIV-related stigma and QOL was no longer significant, suggesting mediation. Racial discrimination had significant direct effects on HIV-related stigma, depression, and social support and an indirect effect on QOL. QOL was associated with higher social support and lower depression scores. The model fit the data well: χ2 = 203.266, degrees of freedom (DF): 112, p < .0001; Comparative Fit Index (CFI): 0.929, Tucker-Lewis Index (TLI): 0.912, Root-Mean Square Error of Approximation (RMSEA): 0.071. We found racial discrimination was associated with increased HIV-related stigma, and HIV-related stigma and racial discrimination compromised QOL. Findings suggest the need for multilevel interventions to reduce stigma and discrimination, address depression, and build social support to improve QOL among ACB WLWH.

Authors+Show Affiliations

1 Factor-Inwentash Faculty of Social Work, University of Toronto , Toronto, Canada . 2 Women's College Research Institute, Women's College Hospital , Toronto, Canada .1 Factor-Inwentash Faculty of Social Work, University of Toronto , Toronto, Canada .3 Women's Health in Women's Hands Community Health Centre , Toronto, Canada .2 Women's College Research Institute, Women's College Hospital , Toronto, Canada .

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

27750027

Citation

Logie, Carmen H., et al. "A Structural Equation Model of Factors Contributing to Quality of Life Among African and Caribbean Women Living With HIV in Ontario, Canada." AIDS Research and Human Retroviruses, vol. 33, no. 3, 2017, pp. 290-297.
Logie CH, Ahmed U, Tharao W, et al. A Structural Equation Model of Factors Contributing to Quality of Life Among African and Caribbean Women Living with HIV in Ontario, Canada. AIDS Res Hum Retroviruses. 2017;33(3):290-297.
Logie, C. H., Ahmed, U., Tharao, W., & Loutfy, M. R. (2017). A Structural Equation Model of Factors Contributing to Quality of Life Among African and Caribbean Women Living with HIV in Ontario, Canada. AIDS Research and Human Retroviruses, 33(3), 290-297. https://doi.org/10.1089/AID.2016.0013
Logie CH, et al. A Structural Equation Model of Factors Contributing to Quality of Life Among African and Caribbean Women Living With HIV in Ontario, Canada. AIDS Res Hum Retroviruses. 2017;33(3):290-297. PubMed PMID: 27750027.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A Structural Equation Model of Factors Contributing to Quality of Life Among African and Caribbean Women Living with HIV in Ontario, Canada. AU - Logie,Carmen H, AU - Ahmed,Uzma, AU - Tharao,Wangari, AU - Loutfy,Mona R, Y1 - 2016/11/14/ PY - 2016/10/18/pubmed PY - 2017/12/19/medline PY - 2016/10/18/entrez KW - Blacks KW - HIV/AIDS KW - health disparities KW - mental health KW - quality of life KW - social stigma KW - women SP - 290 EP - 297 JF - AIDS research and human retroviruses JO - AIDS Res. Hum. Retroviruses VL - 33 IS - 3 N2 - African and Caribbean Black (ACB) women in Canada are disproportionately impacted by new HIV infections. ACB women's HIV vulnerability is shaped by contexts of stigma and discrimination. HIV-related stigma compromises quality of life (QOL) among women living with HIV (WLWH), yet scant research has examined concomitant effects of racial discrimination and HIV-related stigma on QOL. We used data from a cross-sectional survey with ACB WLWH in Ontario (n = 173) to test a conceptual model of pathways between HIV-related stigma, racial discrimination, depression, social support, and QOL. We conducted structural equation modeling using maximum likelihood estimation to test the model. In independent models, HIV-related stigma was associated with lower QOL, and depression partially mediated the association between HIV-related stigma and QOL. In the simultaneous model, HIV-related stigma had significant direct effects on depression, social support, and an indirect effect on QOL. When social support was added as a mediator, the direct effect between HIV-related stigma and QOL was no longer significant, suggesting mediation. Racial discrimination had significant direct effects on HIV-related stigma, depression, and social support and an indirect effect on QOL. QOL was associated with higher social support and lower depression scores. The model fit the data well: χ2 = 203.266, degrees of freedom (DF): 112, p < .0001; Comparative Fit Index (CFI): 0.929, Tucker-Lewis Index (TLI): 0.912, Root-Mean Square Error of Approximation (RMSEA): 0.071. We found racial discrimination was associated with increased HIV-related stigma, and HIV-related stigma and racial discrimination compromised QOL. Findings suggest the need for multilevel interventions to reduce stigma and discrimination, address depression, and build social support to improve QOL among ACB WLWH. SN - 1931-8405 UR - https://www.unboundmedicine.com/medline/citation/27750027/A_Structural_Equation_Model_of_Factors_Contributing_to_Quality_of_Life_Among_African_and_Caribbean_Women_Living_with_HIV_in_Ontario_Canada_ L2 - https://www.liebertpub.com/doi/full/10.1089/AID.2016.0013?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -