Effects of HIV-Related Discrimination on Psychosocial Syndemics and Sexual Risk Behavior among People Living with HIV
Abstract
:1. Introduction
1.1. Syndemic Theory
1.2. HIV and Discrimination in Hong Kong
1.3. The Present Study
2. Methods
2.1. Participants
2.2. Procedure
2.3. Measures
2.4. Data Analysis
3. Results
3.1. HIV-Related Discrimination and Psychosocial Syndemics
3.2. Condom Use with Steady and Casual Partners
3.3. A Mediation Model of HIV-Related Discrimination on Sexual Risk Behavior
4. Discussion
4.1. Relevance to Local Context
4.2. Strengths and Limitations
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Demographic Characteristics | n (%)/M (SD) |
---|---|
Gender | |
Male | 277 (95.8%) |
Female | 12 (4.2%) |
Age | 41.8 years (11.1 years) |
Ethnicity | |
Chinese | 271 (94.8%) |
South Asian | 6 (2.1%) |
Caucasian | 6 (2.1%) |
Others | 3 (1.0%) |
Education | |
Secondary education or less | 138 (48.3%) |
Tertiary education | 133 (46.5%) |
Employment status | |
Full-time employment | 183 (63.3%) |
Part-time or irregular employment | 46 (15.9%) |
Unemployed | 36 (12.5%) |
Others | 24 (8.3%) |
Marital status | |
Single | 194 (67.4%) |
Cohabiting/Married | 76 (26.4%) |
Separated/Divorced/Widowed | 20 (6.9%) |
Sexual orientation | |
Heterosexual | 68 (23.7%) |
Gay | 141 (49.1%) |
Bisexual | 70 (24.4%) |
Questioning | 8 (2.8%) |
Length of being diagnosed with HIV infection | 5.25 years (4.70 years) |
Use of antiretroviral therapy | |
Yes | 254 (90.1%) |
No | 28 (9.9%) |
Number of psychosocial syndemic problem(s) | |
0 | 86 (29.6%) |
1 | 126 (43.3%) |
2 | 54 (18.6%) |
3 | 21 (7.2%) |
4 | 4 (1.4%) |
Condom use with steady partners | |
Consistent condom use | 28 (25.9%) |
Inconsistent condom use | 80 (74.1%) |
Condom use with casual partners | |
Consistent condom use | 20 (18.7%) |
Inconsistent condom use | 87 (81.3%) |
Variable | All Participants (N = 291) | Had HIV-Related Discrimination (n = 94) | Did not Have HIV-Related Discrimination (n = 197) | Independent Samples t-Test | Pearson Correlation Coefficients | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Mean | SD | Skewness | Kurtosis | Mean (SD) | Mean (SD) | t-Value | Cohen’s d | 1 | 2 | 3 | 4 | |
1. Depression (1–6) | 2.41 | 0.90 | 0.79 | 1.34 | 2.70 (0.95) | 2.28 (0.84) | 3.81 ** | 0.47 | - | |||
2. Anxiety (1–6) | 2.57 | 0.87 | 0.37 | −0.06 | 2.76 (0.82) | 2.49 (0.88) | 2.50 * | 0.32 | 0.78 ** | - | ||
3. Social isolation (1–7) | 3.27 | 1.08 | 0.52 | 0.36 | 3.57 (1.14) | 3.12 (1.02) | 3.39 ** | 0.42 | 0.31 ** | 0.32 ** | - | |
4. Self-stigma (1–6) | 3.82 | 1.16 | −0.34 | −0.53 | 4.00 (1.19) | 3.74 (1.14) | 1.80 | 0.22 | 0.36 ** | 0.35 ** | 0.31 ** | - |
Variable | Psychosocial Syndemics (N = 291) | Inconsistent Condom Use with Steady Partners (n = 108) | Inconsistent Condom Use with Casual Partners (n = 107) | |||
---|---|---|---|---|---|---|
IRR | (95% CI) | AOR | (95% CI) | AOR | (95% CI) | |
HIV-related discrimination | ||||||
Yes | 1.47 ** | (1.14, 1.89) | 5.40 * | (1.09, 26.70) | 3.24 | (0.70, 15.00) |
No (reference category) | 1.00 | 1.00 | 1.00 | |||
Psychosocial syndemics | - | - | 3.09 * | (1.22, 7.82) | 0.95 | (0.48, 1.90) |
Gender | ||||||
Male | 1.73 | (0.79, 3.78) | 14.54 | (0.40, 524.99) | - | - |
Female (reference category) | 1.00 | 1.00 | - | - | ||
Age | 1.00 | (0.99, 1.01) | 0.98 | (0.89, 1.07) | 1.05 | (0.97, 1.13) |
Ethnicity | ||||||
Chinese | 1.05 | (0.58, 1.89) | 0.32 | (0.02, 4.74) | - | - |
Ethnic minority (reference category) | 1.00 | 1.00 | - | - | ||
Education | ||||||
Secondary education or less (reference category) | 1.00 | 1.00 | 1.00 | |||
Tertiary education | 0.76 | (0.58, 1.00) | 2.62 | (0.52, 13.20) | 0.99 | (0.23, 4.36) |
Employment status | ||||||
Full-/part-time employment | 0.94 | (0.69, 1.27) | 0.30 | (0.05, 1.91) | 1.90 | (0.37, 9.68) |
Not in employment | 1.00 | 1.00 | 1.00 | |||
Marital status | ||||||
Single (reference category) | 1.00 | 1.00 | 1.00 | |||
Cohabiting/Married | 0.88 | (0.64, 1.22) | 0.11 * | (0.02, 0.58) | 0.24 * | (0.06, 0.99) |
Separated/Divorced/Widowed | 0.98 | (0.57, 1.69) | 0.09 | (0.01, 1.19) | - | - |
Sexual orientation | ||||||
Heterosexual | 1.06 | (0.76, 1.50) | 0.13 * | (0.02, 0.94) | 1.33 | (.13, 13.79) |
Sexual minority (reference category) | 1.00 | 1.00 | 1.00 | |||
Length of being diagnosed with HIV infection | 1.00 | (1.00, 1.00) | 1.00 | (0.99, 1.02) | 0.98 * | (0.97, 1.00) |
Antiretroviral medication use | ||||||
Yes | 1.37 | (0.85, 2.20) | 3.98 | (0.38, 41.80) | 1.61 | (0.14, 18.41) |
No (reference category) | 1.00 | 1.00 | 1.00 |
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Chan, R.C.H.; Operario, D.; Mak, W.W.S. Effects of HIV-Related Discrimination on Psychosocial Syndemics and Sexual Risk Behavior among People Living with HIV. Int. J. Environ. Res. Public Health 2020, 17, 1924. https://doi.org/10.3390/ijerph17061924
Chan RCH, Operario D, Mak WWS. Effects of HIV-Related Discrimination on Psychosocial Syndemics and Sexual Risk Behavior among People Living with HIV. International Journal of Environmental Research and Public Health. 2020; 17(6):1924. https://doi.org/10.3390/ijerph17061924
Chicago/Turabian StyleChan, Randolph C. H., Don Operario, and Winnie W. S. Mak. 2020. "Effects of HIV-Related Discrimination on Psychosocial Syndemics and Sexual Risk Behavior among People Living with HIV" International Journal of Environmental Research and Public Health 17, no. 6: 1924. https://doi.org/10.3390/ijerph17061924