266187 Traditional gender roles and disempowering coping strategies among women with HIV predict low treatment adherence and poor health outcomes

Monday, October 29, 2012 : 1:15 PM - 1:30 PM

Sannisha Dale, MA, EdM , Psychology Department, Boston University, Boston, MA
Gwendolyn Kelso, MA , Psychology Department, Boston University, Boston, MA
Ruth Cruise, MA , Psychology Department, Boston University, Boston, MA
Kathleen Weber, RN , Departments of Medicine/CORE Center at John H. Stroger Jr Hospital of Cook County, Cook County Health & Hospital System, Chicago, IL
Mardge H. Cohen, MD , The CORE Center at John H. Stroger Jr. Hospital of Cook County, Hektoen Institute of Medicine, Chicago, IL
Leslie Brody, Phd , Psychology Department, Boston University, Boston, MA
Background: This study investigated how traditional gender roles (TGR), specifically silencing the self in order to avoid relational loss and rejection, interacted with coping strategies of denial and behavioral disengagement (BD) to predict depression, quality of life, and HAART adherence.

Method: Participants were 89 HIV+ women from the Women Interagency HIV Study (WIHS) Chicago site (93.3% were African American, mean age =44.75, and median income=$6000-12,000). Silencing the Self Scale (STSS) with four subscales (self-silencing, divided self, care as self-sacrifice, and externalized self) captured gender roles, Brief Coping Inventory measured denial and BD, Medical Outcome Study-HIV form assessed quality of life, and CESD measured depressive symptoms. Two WIHS self-report measures were used to calculate mean HAART/ART adherence across bi-annual visits.

Results: Hierarchical multiple regressions indicated that higher traditional roles (STSS and subscales) significantly predicted greater denial and depression, and lower quality of life and ARV adherence. Denial and BD significantly predicted or tended to predict lower quality of life and depression. STSS and subscales significantly interacted with denial and BD to predict depression and quality of life and tended to predict ARV adherence. BD and denial significantly or tended to predict depression, quality of life and HAART/ARV adherence only for women scoring high on TGR but not for others.

Conclusion/Implications: It is important for care providers to intervene with HIV positive women who endorse high TGR and use denial and BD because they may be at risk for higher depression, lower quality of life and lower medication adherence.

Learning Areas:
Chronic disease management and prevention

Learning Objectives:
Describe how traditional gender roles and disempowering copings strategies relate to medication adherence and health outcomes in HIV+ women.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: For 4 yrs I have been a graduate student researcher in the traditional gender roles substudy collaboration between Boston University and the Women Interagency HIV Study Chicago Site.
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.

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