Coping strategies, life themes, and HIV nondisclosure in autobiographical narratives in relation to HIVviral load and HAART adherence in women with HIV
Methods: 100 Chicago women with HIV (91% African American, mean age 45 years) from the Women’s Interagency HIV Study (WIHS) narrated 3 life turning points, each coded reliably for themes (e.g. trauma, nondisclosure of HIV status) and coping strategies, including conflict avoidance (not confronting stressful situations), distraction (turning attention away from stress), and cognitive distortion (denying feelings/actions). Outcomes included VL (detectable/undetectable) and self-reported HAART adherence (cutoff >= 95%).
Results: The most frequent themes were stressful relationships and psychological distress (both N =96). Controlling for demographics and narrative word count, partial correlations indicated that HIV nondisclosure (N = 18) related to detectable VL (r = .22, p < .03) and conflict avoidance (r = .29, p < .004). Themes were related to coping strategies, but in regression analyses coping strategies contributed more variance to VL and adherence than did themes (VL was related to conflict avoidance (OR = 2.03, 95% CI= 1.12 – 3.68, p < .05) and distraction (OR = 2.81, 95% CI = 1.31 – 6.04, p < .05) and adherence was related to cognitive distortions (OR = .45, 95% CI = .25 – .82, p < .05)). Associations between coping and viral load remained significant after controlling for adherence.
Conclusions: Public health efforts to promote health in women with HIV can be improved by promoting non-avoidant coping whereby conflict and stress are directly acknowledged.
Learning Areas:Social and behavioral sciences
Describe the contributions of autobiographical life themes and avoidant coping strategies to HIV viral load, HAART adherence and nondisclosure of HIV status in women with HIV.
Keyword(s): Women and HIV/AIDS
Qualified on the content I am responsible for because: I have been the co-principal investigator of a federally funded grant (the Women's Interagency HIV study) focusing on coping strategies, gender roles and health outcomes in women with HIV and have published multiple papers on these topics.
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.