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The Impact of New Awareness of a Sexually Transmitted Infection on Internalized HIV Stigma and Depressive Symptoms Among Women Living With HIV in the United States
The Impact of New Awareness of a Sexually Transmitted Infection on Internalized HIV Stigma...
The Impact of New Awareness of a Sexually Transmitted Infection on Internalized HIV Stigma and Depressive Symptoms Among Women Living With HIV in the United States

상세정보

자료유형  
 학위논문 서양
최종처리일시  
20260202105258
ISBN  
9798270296803
DDC  
614.4
저자명  
Filipowicz, Teresa R.
서명/저자  
The Impact of New Awareness of a Sexually Transmitted Infection on Internalized HIV Stigma and Depressive Symptoms Among Women Living With HIV in the United States
발행사항  
[Sl] : The University of North Carolina at Chapel Hill, 2025
발행사항  
Ann Arbor : ProQuest Dissertations & Theses, 2025
형태사항  
129 p
주기사항  
Source: Dissertations Abstracts International, Volume: 87-07, Section: A.
주기사항  
Advisor: Pence, Brian W.
학위논문주기  
Thesis (Ph.D.)--The University of North Carolina at Chapel Hill, 2025.
초록/해제  
요약Women living with HIV (WLWH) experience internalized HIV stigma (hereafter stigma) and increased depressive symptoms compared to women without HIV and men with HIV in the United States (US). Both psychological experiences impact WLWH's mental health, but their drivers remain underexplored. I postulated a new non-HIV sexually transmitted infection (STI) may increase stigma and depressive symptoms via retraumatization. Separately, causal effect estimates of a stigma reduction intervention on depressive symptoms remain unknown and warrant further investigation.Data from the Women's Interagency HIV Study (WIHS) included new STI awareness (chlamydia, gonorrhea, syphilis, herpes simplex 2, genital warts, or trichomoniasis), stigma scores, and depressive symptom scores. I modeled mean differences in stigma and depressive symptom scores, separately, at visits with an STI versus visits without using generalized linear models with generalized estimating equations, weighted for confounding and censoring. Results were stratified by race/ethnicity categories, and 95% confidence intervals (CIs) were bootstrapped. The g-formula simulated the effects of a stigma reduction intervention on depressive symptoms. The effect of the hypothetical intervention was calculated, at varying point reductions, for the total analysis population and a subset population with probable depression (CES-D ≥ 16). Mean differences in stigma scores between visits with and without an STI varied by race/ethnicity and ranged from -0.43 (95% CI: -1.18, 0.32) to 0.42 (-0.10, 0.93). All Hispanic ethnicity groups (White, Hispanic; Black, Hispanic; and Other, Hispanic) experienced increased scores at visits with STIs. Mean differences in CES-D scores between visits with and without an STI also varied by race/ethnicity. Black, non-Hispanic participants had a 1.46 (0.57, 2.34) point increase in CES-D scores at visits with a reported STI versus visits without. In the total population, decreases in stigma decreased depressive symptoms by varying degrees. A 0.50 decrease led to a mean difference in -1.45 (-2.33, 0.57) in CES-D scores in the total population. For WLWH, an STI affected stigma and CES-D scores differently by race/ethnicity group. Analyses suggested that increased mental health support following a new STI may reduce depressive symptom burden in some WLWH. Interventions focusing on stigma reduction are one potential way to improve WLWH's mental health.
일반주제명  
Epidemiology
일반주제명  
Mental health
일반주제명  
Psychology
일반주제명  
Womens studies
키워드  
Depressive symptoms
키워드  
Internalized HIV stigma
키워드  
Sexually transmitted infections
키워드  
Women living with HIV
기타저자  
The University of North Carolina at Chapel Hill Epidemiology
기본자료저록  
Dissertations Abstracts International. 87-07A.
전자적 위치 및 접속  
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MARC

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■1001  ▼aFilipowicz,  Teresa  R.
■24510▼aThe  Impact  of  New  Awareness  of  a  Sexually  Transmitted  Infection  on  Internalized  HIV  Stigma  and  Depressive  Symptoms  Among  Women  Living  With  HIV  in  the  United  States
■260    ▼a[Sl]▼bThe  University  of  North  Carolina  at  Chapel  Hill▼c2025
■260  1▼aAnn  Arbor▼bProQuest  Dissertations  &  Theses▼c2025
■300    ▼a129  p
■500    ▼aSource:  Dissertations  Abstracts  International,  Volume:  87-07,  Section:  A.
■500    ▼aAdvisor:  Pence,  Brian  W.
■5021  ▼aThesis  (Ph.D.)--The  University  of  North  Carolina  at  Chapel  Hill,  2025.
■520    ▼aWomen  living  with  HIV  (WLWH)  experience  internalized  HIV  stigma  (hereafter  stigma)  and  increased  depressive  symptoms  compared  to  women  without  HIV  and  men  with  HIV  in  the  United  States  (US).  Both  psychological  experiences  impact  WLWH's  mental  health,  but  their  drivers  remain  underexplored.  I  postulated  a  new  non-HIV  sexually  transmitted  infection  (STI)  may  increase  stigma  and  depressive  symptoms  via  retraumatization.  Separately,  causal  effect  estimates  of  a  stigma  reduction  intervention  on  depressive  symptoms  remain  unknown  and  warrant  further  investigation.Data  from  the  Women's  Interagency  HIV  Study  (WIHS)  included  new  STI  awareness  (chlamydia,  gonorrhea,  syphilis,  herpes  simplex  2,  genital  warts,  or  trichomoniasis),  stigma  scores,  and  depressive  symptom  scores.  I  modeled  mean  differences  in  stigma  and  depressive  symptom  scores,  separately,  at  visits  with  an  STI  versus  visits  without  using  generalized  linear  models  with  generalized  estimating  equations,  weighted  for  confounding  and  censoring.  Results  were  stratified  by  race/ethnicity  categories,  and  95%  confidence  intervals  (CIs)  were  bootstrapped.  The  g-formula  simulated  the  effects  of  a  stigma  reduction  intervention  on  depressive  symptoms.  The  effect  of  the  hypothetical  intervention  was  calculated,  at  varying  point  reductions,  for  the  total  analysis  population  and  a  subset  population  with  probable  depression  (CES-D  ≥  16).  Mean  differences  in  stigma  scores  between  visits  with  and  without  an  STI  varied  by  race/ethnicity  and  ranged  from  -0.43  (95%  CI:  -1.18,  0.32)  to  0.42  (-0.10,  0.93).  All  Hispanic  ethnicity  groups  (White,  Hispanic;  Black,  Hispanic;  and  Other,  Hispanic)  experienced  increased  scores  at  visits  with  STIs.  Mean  differences  in  CES-D  scores  between  visits  with  and  without  an  STI  also  varied  by  race/ethnicity.  Black,  non-Hispanic  participants  had  a  1.46  (0.57,  2.34)  point  increase  in  CES-D  scores  at  visits  with  a  reported  STI  versus  visits  without.  In  the  total  population,  decreases  in  stigma  decreased  depressive  symptoms  by  varying  degrees.  A  0.50  decrease  led  to  a  mean  difference  in  -1.45  (-2.33,  0.57)  in  CES-D  scores  in  the  total  population.  For  WLWH,  an  STI  affected  stigma  and  CES-D  scores  differently  by  race/ethnicity  group.  Analyses  suggested  that  increased  mental  health  support  following  a  new  STI  may  reduce  depressive  symptom  burden  in  some  WLWH.  Interventions  focusing  on  stigma  reduction  are  one  potential  way  to  improve  WLWH's  mental  health.
■590    ▼aSchool  code:  0153.
■650  4▼aEpidemiology
■650  4▼aMental  health
■650  4▼aPsychology
■650  4▼aWomens  studies
■653    ▼aDepressive  symptoms
■653    ▼aInternalized  HIV  stigma
■653    ▼aSexually  transmitted  infections
■653    ▼aWomen  living  with  HIV
■690    ▼a0766
■690    ▼a0347
■690    ▼a0621
■690    ▼a0453
■71020▼aThe  University  of  North  Carolina  at  Chapel  Hill▼bEpidemiology.
■7730  ▼tDissertations  Abstracts  International▼g87-07A.
■790    ▼a0153
■791    ▼aPh.D.
■792    ▼a2025
■793    ▼aEnglish
■85640▼uhttp://www.riss.kr/pdu/ddodLink.do?id=T17360062▼nKERIS▼z이  자료의  원문은  한국교육학술정보원에서  제공합니다.

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