Mental Health and Treatment Engagement among Low-Income Women of Color Living with HIV

ABSTRACT

Low-income women of color are disproportionately more likely to contract HIV, struggle with treatment adherence, and have compromised health as a result of HIV infections in comparison to White and more affluent women. The current study is a secondary analysis aimed at examining the association between stress, symptoms of depression, trauma exposure, healthcare engagement, and adherence self-efficacy, among low-income women of color with human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS). Structural equation modeling is used to identify latent mental health symptoms that may influence one another, as well as outcomes involving treatment engagement. Participants contributing to this dataset (n = 134) were low income, women of color (primarily African American) living with HIV or AIDS, receiving care at a major medical center in the northeastern United States. Findings indicate significant indirect associations between perceived stress and the outcome of medical appointment attendance. Significant mediators of this indirect relationship include depressive symptoms, parenting stress, and adherence self-efficacy. Implications for health and behavioral health practice and policy interventions are drawn. Areas in need of future research are identified.

KEYWORDS:

• African American
• women of color
• HIV
• AIDS
• poverty
• mental health
• maternal

Acknowledgments

We would like to acknowledge the participants and staff of the Mothers Health Project.

We would also like to acknowledge funding from the Office of AIDS Research, Substance Abuse and Mental Health Services Administration to the Special Needs Clinic at New York Presbyterian Hospital (5UD5-SM51688 PI: Havens, M.D.), and one with the NIMH (P50-MH43520: PI: Ehrhardt, Ph.D.; administrative supplement led by Claude Ann Mellins, Ph.D.).

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The work was supported by the National Institute of Mental Health [P50-MH43520]; Office of AIDS Research, Substance Abuse and Mental Health Services Administration (SAMHSA) to the Special Needs Clinic at New York Presbyterian Hospital [5UD5-SM51688].