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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 and Depressive Symptoms Among Women Living With HIV in the United States
상세정보
- 자료유형
- 학위논문 서양
- 최종처리일시
- 20260202105258
- ISBN
- 9798270296803
- DDC
- 614.4
- 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
- 기타저자
- The University of North Carolina at Chapel Hill Epidemiology
- 기본자료저록
- Dissertations Abstracts International. 87-07A.
- 전자적 위치 및 접속
- 로그인 후 원문을 볼 수 있습니다.
MARC
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■006m o d
■007cr#unu||||||||
■020 ▼a9798270296803
■035 ▼a(MiAaPQ)AAI32280074
■040 ▼aMiAaPQ▼cMiAaPQ
■0820 ▼a614.4
■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.


