Examining stigma, social support, and gender differences in unsuppressed HIV viral load among participants in HPTN 065

Successful navigation of the HIV care continuum is necessary to maintain viral suppression. We explored gender-stratified correlates of being virally unsuppressed in the Prevention for Positives (P4P) component of HPTN 065. The outcome of interest was unsuppressed viral load (> 40 copies/mL) amon...

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Bibliographic Details
Published in:Journal of behavioral medicine 2021-04, Vol.44 (2), p.159-171
Main Authors: Maragh-Bass, Allysha C., Gamble, Theresa, El-Sadr, Wafaa M., Hanscom, Brett, Tolley, Elizabeth E.
Format: Article
Language:English
Subjects:
Adherence
Aged
Care and treatment
Demographic aspects
Drugs
Family Medicine
Female
Gender
Gender differences
General Practice
Health aspects
Health Psychology
HIV
HIV infection
HIV Infections - drug therapy
Human immunodeficiency virus
Humans
Male
Management
Medical diagnosis
Medication Adherence
Medicine
Medicine & Public Health
Men
Navigation
Patient compliance
Regression analysis
Sex Characteristics
Sex differences
Sexual behavior
Social aspects
Social interactions
Social networks
Social Stigma
Social Support
Stigma
Stigma (Social psychology)
Viral Load
Women
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Summary:Successful navigation of the HIV care continuum is necessary to maintain viral suppression. We explored gender-stratified correlates of being virally unsuppressed in the Prevention for Positives (P4P) component of HPTN 065. The outcome of interest was unsuppressed viral load (> 40 copies/mL) among individuals already living with HIV. Correlates included medication adherence factors, social support and stigma. Logistic regression models were stratified by gender ( N  = 673). Men-specific correlates of being virally unsuppressed included opposite-sex partners, older age and HIV disclosure stigma. Women-specific correlates included time since diagnosis, and personal-level barriers to medication adherence. When more individuals knew about their HIV status, women had over twice the likelihood of being virally unsuppressed; no such association was seen among men. Additionally, higher levels of social support were not associated with viral suppression among women. Interventions should consider gender-specific approaches to engaging social support in de-stigmatization of HIV and promotion of medication adherence and subsequent viral suppression.
ISSN:0160-7715
1573-3521
DOI:10.1007/s10865-020-00186-7