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Low Social Support and HIV-Related Stigma Are Highly Correlated among Adolescents Living With HIV in Western Kenya
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Poster Abstracts / 58 (2016) S63eS85
Sources of Support: Penn Mental Health AIDS Research Center (PMHARC), University of Pennsylvania (P30 MH 097488). 156. A PARTICIPATORY LEARNING AND ACTION (PLA) APPROACH TO ENHANCING LINKAGE TO HIV CARE AMONG YOUTH Ruth S. Buzi, PhD, Peggy B. Smith, PhD, Andrea Siceluff, BA. Baylor College of Medicine. Purpose: Early linkage to HIV care is critical for viral suppression and to prevent HIV transmission. However, people with HIV, and especially adolescents, delay linkage to care. Studies estimate between 66% and 75% of newly diagnosed HIV-positive individuals are linked to care. The purpose of this study was to utilize a Participatory Learning Action (PLA) approach to engage community members in identifying barriers to HIV linkage to care and creating an action plan. Methods: Over 50 individuals from various community organizations participated in a series of meetings to address HIV linkage to care barriers. Identified barriers were related to the health care system, lack of community collaborations, social factors such as stigma, and characteristics of risk populations. Results: dOne of the solutions identified to address individual barriers was the creation of an application (app) for smart phones that includes resources and how to access care. This app is a way to reach youth on a platform that they are familiar with using. The app was created and allows to search for various resources related to HIV/STD testing and care, directions to nearby services, and the ability to call linkage workers at various sites. Conclusions: HIV linkage to care is a major public health concern. Engaging community stakeholders through a PLA approach can be effective in improving engagement in care of people with HIV. The PLA approach has been shown to be an effective approach to mobilize the community and engage stakeholders in addressing a shared concern and make a collective impact. Sources of Support: Gilead Sciences Inc. 157. LOW SOCIAL SUPPORT AND HIV-RELATED STIGMA ARE HIGHLY CORRELATED AMONG ADOLESCENTS LIVING WITH HIV IN WESTERN KENYA Matthew E. Levy, BS 1, Patricia Ong’wen, MD, MPH 2, Maureen E. Lyon, PhD 3, Craig R. Cohen, MD, PH 4, Lawrence J. D’Angelo, MD, MPH, FSAHM 3, Zachary Kwena, PhD 2, Hilary T. Wolf, MD 5. 1 George Washington University Milken Institute School of Public Health; 2Kenya Medical Research Institute; 3Children’s National Medical Center; 4University California San Francisco; 5Georgetown University Medical Center.
Purpose: AIDS is the leading cause of mortality among adolescents in sub-Saharan Africa (SSA). Adolescents with HIV face barriers to retention in care and treatment adherence such as low social support and HIV-related stigma. The purpose of this study was to: (1) describe the degree of self-identified social support and HIVrelated stigma among Kenyan adolescents living with HIV, (2) assess the association between social support and stigma and (3) identify factors associated with social support and stigma. Methods: HIV-infected adolescents aged 15-19 in the Nyanza region of Kenya participated in an interviewer-administered questionnaire. Self-reported data were collected on socio-demographic
characteristics, social support and HIV-related stigma. Social support was measured using the Medical Outcomes Study Social Support Survey (MOS-SSS), with subscales for emotional/informational support, tangible support, affectionate support and positive social interaction. Stigma was measured using Berger’s abbreviated HIV-Stigma Scale (HSS), with subscales for personalized stigma, concerns with disclosing one’s status, negative selfimage and stigma related to public attitudes. The association between social support and stigma was assessed using Pearson’s correlation coefficient and correlates were assessed using simple and multiple linear regression. Results: Among 115 adolescents with HIV, the mean age was 16.8 years (SD¼1.4), 70% were female, 58% resided with a parent, 13% had a child, 72% attended school and 45% reported ever having vaginal, oral, or anal sex. In terms of social support (based on dichotomization of MOS-SSS subscales), 35.7% had low emotional/ informational support, 13.9% had low tangible support, 30.4% had low affectionate support and 20.0% had low interaction support. In terms of HIV-related stigma (based on dichotomization of HSS subscales), 25.2% had high personalized stigma, 72.2% had concerns with disclosing one’s status, 14.8% had negative self-image and 52.2% had high stigma related to public attitudes. There was a strong negative correlation between degree of social support and HIV-related stigma (Pearson’s r¼-0.60, p<0.001). In simple regression models, greater social support was significantly associated with not having a child (p¼0.007), which was no longer significant after adjusting for stigma (p<0.001). Greater HIVrelated stigma was significantly associated with female gender (p¼0.012), older age (p¼0.001), having a child (p¼0.003), not currently attending school (p¼0.036), ever having had vaginal, anal, or oral sex (p¼ 0.017), less time since learning one’s HIV status (p¼0.039), and lower social support (p<0.001). In multivariable analysis, female gender (b¼2.53, p¼0.008), older age (b¼ 0.73, p¼0.013) and lower social support (b¼4.54, p<0.001) remained significant predictors of HIV-related stigma. Conclusions: This study is among the first to quantify the degree of self-reported social support and HIV-related stigma among adolescents with HIV in SSA. Approximately one-third of participants reported low emotional/informational and affectionate forms of support and a majority reported stigma related to HIV disclosure and public attitudes. Future interventions aiming to improve HIV care outcomes for this population should simultaneously address low social support and HIV-related stigma. More research is needed to investigate interventions to improve social support and decrease stigma among Kenyan adolescents. Sources of Support: Georgetown University Medical Center, Department of Pediatrics; District of Columbia Center for AIDS Research (P30AI117970). 158. DIFFERENCES IN THE SEXUAL AND REPRODUCTIVE HEALTH NEEDS OF ADOLESCENTS IN THE US WITH PERINATALLYACQUIRED HIV AND BEHAVIORALLY-ACQUIRED HIV: PROVIDER PERSPECTIVES Cynthia D. Fair, DrPH, MSW 1, Olivia Varney, BA 2, Jamie N. Albright, BA 3. 1
Elon University; 2Children’s Hospital of Philadelphia; 3University of Virginia. Purpose: Adolescents living with HIV comprise two groups: those who acquired HIV perinatally (PHIV), and those who
Poster Abstracts / 58 (2016) S63eS85
Sources of Support: Penn Mental Health AIDS Research Center (PMHARC), University of Pennsylvania (P30 MH 097488). 156. A PARTICIPATORY LEARNING AND ACTION (PLA) APPROACH TO ENHANCING LINKAGE TO HIV CARE AMONG YOUTH Ruth S. Buzi, PhD, Peggy B. Smith, PhD, Andrea Siceluff, BA. Baylor College of Medicine. Purpose: Early linkage to HIV care is critical for viral suppression and to prevent HIV transmission. However, people with HIV, and especially adolescents, delay linkage to care. Studies estimate between 66% and 75% of newly diagnosed HIV-positive individuals are linked to care. The purpose of this study was to utilize a Participatory Learning Action (PLA) approach to engage community members in identifying barriers to HIV linkage to care and creating an action plan. Methods: Over 50 individuals from various community organizations participated in a series of meetings to address HIV linkage to care barriers. Identified barriers were related to the health care system, lack of community collaborations, social factors such as stigma, and characteristics of risk populations. Results: dOne of the solutions identified to address individual barriers was the creation of an application (app) for smart phones that includes resources and how to access care. This app is a way to reach youth on a platform that they are familiar with using. The app was created and allows to search for various resources related to HIV/STD testing and care, directions to nearby services, and the ability to call linkage workers at various sites. Conclusions: HIV linkage to care is a major public health concern. Engaging community stakeholders through a PLA approach can be effective in improving engagement in care of people with HIV. The PLA approach has been shown to be an effective approach to mobilize the community and engage stakeholders in addressing a shared concern and make a collective impact. Sources of Support: Gilead Sciences Inc. 157. LOW SOCIAL SUPPORT AND HIV-RELATED STIGMA ARE HIGHLY CORRELATED AMONG ADOLESCENTS LIVING WITH HIV IN WESTERN KENYA Matthew E. Levy, BS 1, Patricia Ong’wen, MD, MPH 2, Maureen E. Lyon, PhD 3, Craig R. Cohen, MD, PH 4, Lawrence J. D’Angelo, MD, MPH, FSAHM 3, Zachary Kwena, PhD 2, Hilary T. Wolf, MD 5. 1 George Washington University Milken Institute School of Public Health; 2Kenya Medical Research Institute; 3Children’s National Medical Center; 4University California San Francisco; 5Georgetown University Medical Center.
Purpose: AIDS is the leading cause of mortality among adolescents in sub-Saharan Africa (SSA). Adolescents with HIV face barriers to retention in care and treatment adherence such as low social support and HIV-related stigma. The purpose of this study was to: (1) describe the degree of self-identified social support and HIVrelated stigma among Kenyan adolescents living with HIV, (2) assess the association between social support and stigma and (3) identify factors associated with social support and stigma. Methods: HIV-infected adolescents aged 15-19 in the Nyanza region of Kenya participated in an interviewer-administered questionnaire. Self-reported data were collected on socio-demographic
characteristics, social support and HIV-related stigma. Social support was measured using the Medical Outcomes Study Social Support Survey (MOS-SSS), with subscales for emotional/informational support, tangible support, affectionate support and positive social interaction. Stigma was measured using Berger’s abbreviated HIV-Stigma Scale (HSS), with subscales for personalized stigma, concerns with disclosing one’s status, negative selfimage and stigma related to public attitudes. The association between social support and stigma was assessed using Pearson’s correlation coefficient and correlates were assessed using simple and multiple linear regression. Results: Among 115 adolescents with HIV, the mean age was 16.8 years (SD¼1.4), 70% were female, 58% resided with a parent, 13% had a child, 72% attended school and 45% reported ever having vaginal, oral, or anal sex. In terms of social support (based on dichotomization of MOS-SSS subscales), 35.7% had low emotional/ informational support, 13.9% had low tangible support, 30.4% had low affectionate support and 20.0% had low interaction support. In terms of HIV-related stigma (based on dichotomization of HSS subscales), 25.2% had high personalized stigma, 72.2% had concerns with disclosing one’s status, 14.8% had negative self-image and 52.2% had high stigma related to public attitudes. There was a strong negative correlation between degree of social support and HIV-related stigma (Pearson’s r¼-0.60, p<0.001). In simple regression models, greater social support was significantly associated with not having a child (p¼0.007), which was no longer significant after adjusting for stigma (p<0.001). Greater HIVrelated stigma was significantly associated with female gender (p¼0.012), older age (p¼0.001), having a child (p¼0.003), not currently attending school (p¼0.036), ever having had vaginal, anal, or oral sex (p¼ 0.017), less time since learning one’s HIV status (p¼0.039), and lower social support (p<0.001). In multivariable analysis, female gender (b¼2.53, p¼0.008), older age (b¼ 0.73, p¼0.013) and lower social support (b¼4.54, p<0.001) remained significant predictors of HIV-related stigma. Conclusions: This study is among the first to quantify the degree of self-reported social support and HIV-related stigma among adolescents with HIV in SSA. Approximately one-third of participants reported low emotional/informational and affectionate forms of support and a majority reported stigma related to HIV disclosure and public attitudes. Future interventions aiming to improve HIV care outcomes for this population should simultaneously address low social support and HIV-related stigma. More research is needed to investigate interventions to improve social support and decrease stigma among Kenyan adolescents. Sources of Support: Georgetown University Medical Center, Department of Pediatrics; District of Columbia Center for AIDS Research (P30AI117970). 158. DIFFERENCES IN THE SEXUAL AND REPRODUCTIVE HEALTH NEEDS OF ADOLESCENTS IN THE US WITH PERINATALLYACQUIRED HIV AND BEHAVIORALLY-ACQUIRED HIV: PROVIDER PERSPECTIVES Cynthia D. Fair, DrPH, MSW 1, Olivia Varney, BA 2, Jamie N. Albright, BA 3. 1
Elon University; 2Children’s Hospital of Philadelphia; 3University of Virginia. Purpose: Adolescents living with HIV comprise two groups: those who acquired HIV perinatally (PHIV), and those who