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Member Research & Reports

Member Research & Reports

CUNY: Understanding Interrelationships Between Barriers to Timely HIV Treatment

For people living with HIV, especially in low-resource settings, three obstacles often stand in the way of timely HIV treatment: psychological distress, HIV-related stigma and low social support.


[Photo: Dr. Denis Nash]

Dr. Denis Nash, professor of epidemiology and biostatistics and executive director of the CUNY Institute for Implementation Science in Population Health (ISPH) and Dr. Angela Parcesepe, assistant professor at the University of North Carolina Gillings School of Public Health and affiliated investigator at ISPH, investigated the interrelationships among these known barriers to initiation of antiretroviral therapy (ART). The findings were published in the journal AIDS and Behavior.

The research team recruited patients initiating ART at HIV clinics in the Oromia region of Ethiopia. The patients answered questions on sociodemographics, psychological distress, HIV-related stigma, and social support.

Researchers found that each form of HIV-related stigma assessed (e.g., anticipatory, internalized, and enacted) was associated with increased psychological distress. Among those who reported having experienced enacted HIV-related stigma, social support was not associated with psychological distress. However, among those who did not report enacted HIV-related stigma, greater social support was associated with lower levels of psychological distress. They identified a need for further research to more fully understand the interrelationships between these three barriers. Evidence-based interventions that address HIV-related stigma and psychological distress should be integrated into HIV care, the researchers concluded.

“In addition to the high prevalence of psychological distress among our study population, this work highlights that psychological distress, HIV-related stigma, and low social support are interconnected in complicated ways that undoubtedly affect the achievement of optimal HIV care outcomes and general well-being,” Dr. Parcesepe said. “The findings suggest that interventions to mitigate the effects of each of these outcomes may be more effective when considered together.”

Parcesepe, A., Tymejczyk, O., Remien, R. et al. AIDS Behav (2018).