TY - JOUR
T1 - The Relationship Between Intersectional Drug Use and HIV Stigma and HIV Care Engagement Among Women Living with HIV in Ukraine
AU - Owczarzak, Jill
AU - Fuller, Shannon
AU - Coyle, Catelyn
AU - Davey-Rothwell, Melissa
AU - Kiriazova, Tetiana
AU - Tobin, Karin
N1 - Funding Information:
This research was supported by funding from the National Institutes of Health/Fogarty International Center (Grant No. 1R21TW011060-01). We also thank the staff at Club Eney and Convictus for their support of this project and their commitment to serving people living with HIV. We are also grateful to our study participants who generously shared their time and experiences to this project.
Funding Information:
This research was supported by funding from the National Institutes of Health/Fogarty International Center (Grant No. 1R21TW011060-01).
Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2023/6
Y1 - 2023/6
N2 - This study used an intersectional approach to explore the association between enacted and internalized drug use and HIV stigma on HIV care outcomes among HIV-positive women who inject drugs in Ukraine. Surveys were conducted in Kyiv in 2019–2020. Among the 306 respondents, 55% were engaged in HIV care. More than half (52%) of participants not engaged in care reported internalized stigma related to both drug use and HIV status (i.e., intersectional stigma), compared to only 35% of those who were engaged in HIV care. Among those engaged in care, 36% reported intersectional enacted stigma compared to 44% of those not engaged in care; however, this difference was not statistically significant in the univariable analysis (p = 0.06). In the univariable analysis, participants who reported intersectional internalized stigma had 62% lower odds of being engaged in HIV care (OR 0.38, 95% CI 0.22, 0.65, p < 0.001). In the adjusted model, reported intersectional internalized stigma (aOR 0.52, 95% CI 0.30, 0.92, p = 0.026), reported intersectional enacted stigma (aOR 0.47, 95% CI 0.23, 0.95, p = 0.036), and knowing their HIV status for more than 5-years (aOR 2.29, 95% CI 1.35, 3.87, p = 0.002) were significant predictors of HIV care engagement. These findings indicate that interventions to improve HIV care engagement must address women’s experiences of both HIV and drug use stigma and the different mechanisms through which stigma operates.
AB - This study used an intersectional approach to explore the association between enacted and internalized drug use and HIV stigma on HIV care outcomes among HIV-positive women who inject drugs in Ukraine. Surveys were conducted in Kyiv in 2019–2020. Among the 306 respondents, 55% were engaged in HIV care. More than half (52%) of participants not engaged in care reported internalized stigma related to both drug use and HIV status (i.e., intersectional stigma), compared to only 35% of those who were engaged in HIV care. Among those engaged in care, 36% reported intersectional enacted stigma compared to 44% of those not engaged in care; however, this difference was not statistically significant in the univariable analysis (p = 0.06). In the univariable analysis, participants who reported intersectional internalized stigma had 62% lower odds of being engaged in HIV care (OR 0.38, 95% CI 0.22, 0.65, p < 0.001). In the adjusted model, reported intersectional internalized stigma (aOR 0.52, 95% CI 0.30, 0.92, p = 0.026), reported intersectional enacted stigma (aOR 0.47, 95% CI 0.23, 0.95, p = 0.036), and knowing their HIV status for more than 5-years (aOR 2.29, 95% CI 1.35, 3.87, p = 0.002) were significant predictors of HIV care engagement. These findings indicate that interventions to improve HIV care engagement must address women’s experiences of both HIV and drug use stigma and the different mechanisms through which stigma operates.
KW - Drug use
KW - HIV care engagement
KW - Intersectional stigma
KW - Ukraine
KW - Women living with HIV
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U2 - 10.1007/s10461-022-03925-w
DO - 10.1007/s10461-022-03925-w
M3 - Article
C2 - 36441406
AN - SCOPUS:85142874621
SN - 1090-7165
VL - 27
SP - 1914
EP - 1925
JO - AIDS and behavior
JF - AIDS and behavior
IS - 6
ER -