This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator.
SPECIFIC AIMS 1. To characterize HIV-related felt stigma in a cohort of Puerto Ricans LWHA. 2. To characterize experiences of abuse (emotional and physical), neglect, and domestic violence in Puerto Ricans LWHA. 3. To explore the relationship between HIV-related felt stigma and experiences of abuse. 4. To develop and evaluate the effect of an intervention model on reducing the impact of HIV-related felt stigma in a group of Puerto Ricans living with HIV/AIDS. 5. To assess the impact of the felt-stigma intervention model on risk behaviors, treatment adherence, and clinical outcomes in a group of Puerto Ricans living with HIV/AIDS. Significance of the Study: Stigma is a phenomenon known to undermine the quality of life of those affected by HIV, perpetrating health disparities in this underserved group. Although a great deal of research is devoted to understanding its complexities, much of it is directed toward the study of enacted stigma, meaning that information about the felt stigma dimension is scant. In Puerto Rico, there are research initiatives aimed at studying and reducing HIV-related enacted stigma. Nevertheless, these initiatives tend to ignore the felt-stigma dimension, leaving a gap that needs to be filled. The scientific contribution of this project relies on the knowledge generated regarding the association between having a history of abuse and the presence of HIV-related felt stigma. There is a great deal of evidence identifying experiences of abuse, particularly during childhood, as a risk factor for becoming infected with HIV. Nevertheless, this project expands the knowledge even further by presenting evidence of a significant relationship between experiences of abuse, including childhood abuse, and felt stigma. This piece of information is crucial when developing intervention models to reduce HIV felt stigma. It also guides the development of further research studies that could explore how this phenomenon manifests in other cultures or groups, for example. Another contribution of this study is the development of culturally sensitive and valid instruments to assess HIV-related felt stigma and experiences of abuse. Culturally sensitive and validated screening instruments increase the possibility of identifying true levels of felt stigma in PLWHA and of producing reliable findings. Also, this instrument can be used for the screening of other Hispanic patients living with HIV on the mainland. The short version of the scale also makes it suitable and more practical to be used in both clinical and research settings, considering the element of fatigue that long screening instruments may produce in participants. This study also serves as groundwork for the development of intervention strategies to reduce and/or prevent the impact of HIV-related felt stigma and abuse in the lives of PLWHA in Puerto Rico. Through the first phase of the study, depression and anxiety have appeared as potential mediating variables (in terms of mental health) for HIV felt-stigma. There is a scarcity of research exploring such variables and their interaction with treatment adherence in PLWHA in Puerto Rico.
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