Stigma, mental health, and CD4 count among young HIV-positive women

Study Objective: This study aimed to examine the relationship between HIV stigma, mental health, and CD4 count among young women with HIV. Methods: 181 primarily Black and Latina women with behaviorally acquired HIV in five U.S. cities completed ACASI questionnaires assessing self-reported mental health, HIV-related stigma, and homelessness. CD4 counts were assessed via medical records. Results: Participants included women with a mean age of 20.6 years (SD=2.1, range 14-24), 71.8% of whom were African-American, and 20.4% Latina. 28.8% had current anxiety disorder diagnosis, 9.2% had current depressive diagnosis, 10.3% had substance use diagnosis, and 29.9% reported having ever been homeless. HIV stigma was significantly higher among women with anxiety, depressive, and substance abuse disorders. There was a significant interaction between stigma, anxiety disorder diagnosis, and CD4 count (p = .001). Among women with an anxiety disorder, greater HIV stigma was significantly associated with a lower CD4 count, but this relationship was not demonstrated in women without an anxiety disorder. There were no main effects or interactions between depressive disorder or substance use with stigma and CD4 count. Rates of anxiety disorders were high among women who reported having ever been homeless (OR = 2.73, 95% CI 1.34-5.58), but homelessness was not associated with CD4 count. Conclusions: These data support previous research linking biological measures of health, such as CD4 count, with HIV stigma and mental health. Mental health services should target HIV stigma reduction, particularly for young women with anxiety disorders.