1. Household Food Insecurity as Mediator of the Association Between Internalized Stigma and Opportunistic Infections.
- Author
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Shin, Sanghyuk S, Carpenter, Catherine L, Ekstrand, Maria L, Yadav, Kartik, Shah, Saanchi V, Ramakrishnan, Padma, Pamujula, Suresh, Sinha, Sanjeev, and Nyamathi, Adeline M
- Subjects
Humans ,Opportunistic Infections ,HIV Infections ,Skin Diseases ,Cross-Sectional Studies ,Social Support ,Socioeconomic Factors ,Food Supply ,Adult ,Middle Aged ,Rural Population ,India ,Female ,Male ,Social Stigma ,Adherence ,Antiretroviral therapy ,Dermatoses ,Fungal infections ,Nutrition ,Infectious Diseases ,Clinical Research ,HIV/AIDS ,Behavioral and Social Science ,Infection ,Zero Hunger ,Public Health and Health Services ,Social Work ,Public Health - Abstract
Internalized HIV stigma can affect health outcomes, but the mechanism underlying this relationship is poorly understood. We investigated the potential pathways for the association between internalized stigma and opportunistic infections (OIs) among women living with HIV in rural India. We conducted a cross-sectional study involving in-person interviews with 600 participants. We modeled two outcome variables, total number of OIs and fungal dermatoses, which was the most frequently reported OI. Causal mediation analysis was performed to estimate the total effect, direct effect, and indirect effect through mediators while controlling for confounders. Food insecurity was a strong mediator of the association between internalized stigma and the number of OIs (70% of the total effect) and fungal dermatoses (83% of the total effect), while the indirect effect of stigma through adherence was minimal for both outcomes. Household food insecurity may be an important mediator of the impact of HIV-related stigma on opportunistic infections.
- Published
- 2018