Abstract: HIV Treatment Engagement As a Moderator of the Relationship between HIV Stigma and Depression Severity Among Black and Latine Emerging Adults (Society for Social Work and Research 29th Annual Conference)

Schedule:

Saturday, January 18, 2025

Issaquah B, Level 3 (Sheraton Grand Seattle)

* noted as presenting author

Dget Downey, MSW, PhD Student, New York University, NY

Kiara Moore, PhD, Assistant Professor, New York University, New York

Marya Gwadz, PhD, Professor and Associate Dean for Research, NYU Silver School of Social Work, New York, NY

Leo Wilton, PhD, Professor, State University of New York at Binghamton, NY

Samantha Serrano, Affiliate, New York University

Dawa Sherpa, Data Manager and Assessment Coordinator, New York University, NY

Michelle Munson, PhD, Professor, New York University, NY

Background and Purpose: Increasing engagement in HIV-related care is vital for minimizing new cases and ending the HIV epidemic in the United States. Youth and emerging adults of color with HIV (YEA-LWH) face a double-bind of HIV-related stigma and a disproportionate vulnerability to depression. However, research has yet to explore the particular role of HIV care engagement in the relationship between HIV-related stigma and depression severity. This study aims to understand the interaction between treatment engagement and HIV stigma as a unique predictor of depression to inform future interventions and practice for Black and Latine YEA-LWH. We evaluate the previously unexplored moderating mechanism of HIV care engagement on the relationship between HIV-related stigma and depression. By doing so, we can more accurately inform interventions that target and treat HIV-related stigma and depression for YEA of color LWH at any engagement level of HIV-related treatment.

Methods: With the data from a study focused on Black, African American, Hispanic, and Latino/e young adults (ages 19-28) living with HIV in New York City and Newark, NJ (N = 244), we ran hierarchical OLS regressions to explore the factors associated with depression severity and assess the moderation effect of HIV treatment engagement on the relationship between depression and HIV-related stigma, using viral load suppression status as a proxy for HIV care engagement. Participants were recruited using purposive sampling methods, and data was collected from 2021 to May 2023.

Results: The results demonstrated that 1) higher levels of HIV stigma were associated with more severe depression (r = .352, p < 0.001), 2) the level of HIV stigma did not differ for treatment-engaged and non-treatment-engaged individuals (r = 0.07, p = 0.260), 3) treatment engagement alone did not predict depression severity (r = -0.04, p = 0.532), and lastly, 4) results indicated a statistically significant interaction effect associated with HIV stigma and care engagement (B = 0.30, SE = 0.015, p = 0.049; R² = 0.21).

Conclusions and Implications: YEA-LWH more engaged in care experienced less severe depression in the face of HIV stigma, while those who were less engaged were more vulnerable to stigma’s adverse effects on mental health via depression. Consistent with previous literature, HIV stigma was significantly associated with depression severity. The significant moderation effect indicates that the relationship between HIV stigma and depression severity was not the same for everyone. Instead, it depends on whether individuals are actively engaged in managing their HIV. These novel findings demonstrate the importance of multicomponent approaches to treatment for Black and Latine YEA-LWH. The nuanced relationship between depression, HIV-related stigma, and treatment engagement revealed by this study provides critical information as to how and where to intervene for Black and Latine YEA-LWH to better address the impacts of HIV stigma on depression as a mental health outcome.