190525 Are Stigma, Psychological Distress, or Low Social Support Associated with Low Intentions for Care-Seeking among HIV+ Caribbean Immigrants?

Monday, October 27, 2008

Yusuf Ransome, BS , Health Behavior & Health Education, School of Public Health, University of Michigan, Ann Arbor, MI
Susie Hoffman, DrPH , Epidemiology Department, Columbia University, New York, NY
Jessica Adams-Skinner, MPH, EdD , Mailman School of Public Health, HIV Center for Clinical and Behavioral Studies at the NYS Psychiatric Institution and Columbia University, New York, NY
Steve Hemraj, BS , Community Healthcare Network, New York, NY
Marcia Bayne-Smith, DSW, MSW , Department of Urban Studies, Queens College of the City University of New York, Queens, NY
Susan E. Middlestadt, PhD , Department of Applied Health Science, Indiana University, Bloomington, IN

Seventy five percent of Caribbean immigrants in the US live in New York and Florida. The Caribbean population in these states has been disproportionately affected by HIV/AIDS. In New York City, Caribbean immigrants accounted for 49% of HIV diagnoses among foreign born heterosexuals in 2006. Many Caribbean immigrants face barriers to receiving HIV care in the US, including language barriers, lack of health insurance, and fear of deportation.

There is evidence that psychosocial factors such as stigma, psychological distress, and social support influence the health seeking behavior of people living with HIV/AIDS and that these factors may be especially prevalent among Caribbean immigrants. Using baseline data from a multi-site peer intervention to support HIV+ Caribbean immigrants to attend regular HIV primary care, we will test three hypotheses concerning the intention to seek care: (1) higher symptoms of psychological distress are associated with lower intention (2) higher social support is associated with higher intention; and (3) higher internalized HIV-related stigma is associated with lower intention.


Data are from 343 participants who completed a baseline questionnaire. Descriptive statistics will be conducted to characterize the population with respect to demographic characteristics, time in the US, and time since diagnosis. We will examine the bivariate relationships among all variables with a correlation matrix. Separate linear regression models will determine the association between each of the independent variables – stigma, psychological distress, social support – and the dependent variable, intention to seek HIV primary care, controlling for potential confounders.

Learning Objectives:
1. Participants who attend this session will learn about (a) Factors that may limit care-seeking among HIV+ Caribbean immigrants; (b) A Peer Model intervention that was tested to enable HIV+ Caribbean immigrants living in the US to access medical care services; (c) Whether three psychosocial factors (psychological distress, stigma, and social support) influence HIV+ Caribbean immigrant’s intention to seek care. 2. Participants after attending this session will be able to (a) List possible barriers HIV+ Caribbean immigrants face in seeking medical care; (b) Describe whether stigma, psychological distress, and social support are related to intention to seek care among HIV+ Caribbean immigrants in the US; (c) Recognize differences in care seeking between West Indians vs. Haitians; and (d) Apply these findings to understand health seeking behaviors of HIV+ Caribbean immigrants in other states or cities.

Keywords: Immigrants, Care Seeking

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a second year student in a Master of Public Health Program, and have taken enough courses to prepare me for presenting studies relating to Public Health. I have also have significant experience working with the Caribbean population whom im presenting on.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.