2015 APHA Annual Meeting & Expo

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Online Program

329955
Self-silencing in relation to HAART adherence as moderated by race and abuse history in women with HIV


Monday, November 2, 2015 : 11:30 a.m. - 11:50 a.m.

Dana Bruck-Segal, MA, Psychological and Brain Sciences, Boston University, Boston, MA
Rebecca Schwartz, PhD, Population Health, North Shore LIJ-Hofstra School of Medicine, Great Neck, NY
Yudelki M. Firpo-Perretti, MA, Department of Psychological and Brain Sciences, Boston University, Boston,, MA
Mardge H. Cohen, MD, Departments of Medicine/CORE Center at John H. Stroger Jr Hospital of Cook County, Cook County Health & Hospital System, Chicago, IL
Kathleen Weber, RN, Departments of Medicine/CORE Center at John H. Stroger Jr Hospital of Cook County, Cook County Health & Hospital System, Chicago, IL
Mary Young, MD, Medical Center, Georgetown University, Washington, DC
Jane Burke-Miller, PhD
Leslie Brody, PhD, Department of Psychological and Brain Sciences, Boston University, Boston, MA
Audio (mp3) recording Recorded Presentation (mp4)
Goals: Investigate the relationship between self-silencing (suppressing feelings to avoid relationship loss/conflict) and HAART adherence in HIV+ women, as moderated by race and abuse history.

Methods: 534 HIV+ women (73% African-American, mean age-45) from the Women’s Interagency HIV Study completed the Silencing the Self Scale (STSS), with 4 subscales (Silencing the Self (SS; suppressing self-expression), Divided Self (DS; behaving in gender-stereotypic ways incongruent with values), Care As Self Sacrifice (CS; prioritizing care for others over self-care) and Externalized Self Perception (EXP; self judgment based on external standards).  Outcome was self-reported HAART adherence (cutoff >95% over past 6 months) and moderators were self-reported race/ethnicity and any history of sexual/physical/emotional abuse.

Results: Controlling for race and demographics, logistic regressions revealed that for all women, any abuse related to higher likelihood of self-silencing(STSS) (OR=1.34, 95% CI= 1.09-1.65, p<.01) and higher total self-silencing(STSS) related to lower likelihood of adherence (OR=0.79, 95% CI= 0.64-0.99, p<.05). However, SS-subscale related to lower likelihood of adherence only in African-Americans (OR= 0.68, 95% CI= 0.54-0.87, p<.005). DS-subscale related to lower likelihood of adherence only in women with abuse (OR= 0.69, 95% CI=0.54-0.89, p<.005). Controlling for abuse, Whites were more likely to be adherent than African-Americans (OR=1.32, 95% CI= 1.04-1.68, p<.05), although Whites and Hispanics were more likely to have higher self-silencing(STSS) than African-Americans (ORwhite=1.27, 95% CI=1.04-1.56 ,p<.05; ORHispanic=1.27, 95% CI= 1.03-1.57).  

Conclusions: Public health efforts to promote adherence in HIV+ women may be enhanced by implementing interventions to decrease self-silencing, particularly DS and SS, in minority and abused women.

Learning Areas:

Social and behavioral sciences

Learning Objectives:
Describe the complex relationship between race, self- silencing, abuse and HAART adherence in women with HIV.

Keyword(s): Women and HIV/AIDS

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a second year clinical psychology PhD candidate supervised by Drs. Leslie Brody and Mardge Cohen on the Women's Interagency HIV study (WIHS). For the past year and a half I have been conducting analyses on the relationship between abuse, race, gender roles and adherence in HIV positive women in the WIHS study.
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.

Back to: 3188.0: Learning from Women with HIV: Coping Strategies, Gender Role Behaviors and Parenting