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Intersectional HIV Stigma Among Black Women: Regional Differences and Implications From the Black Women First
Judith C Scott1, Melanie Rocco1, Madison Kitchen1
1Judith C. Scott is with the School of Social Work, Boston University, Boston, MA. Melanie Rocco and Linda Sprague Martinez are with the Health Disparities Institute, UConn Health, Hartford, CT. Madison Kitchen is with the Silver School of Social Work, New York University, New York, NY. Natalie A. Solomon-Brimage is with the Division of Policy and Data, HIV/AIDS Bureau, Clinical and Quality Branch, Health Resources and Services Administration, Rockville, MD. Clara A. Chen and Lindsey Furton are with Biostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health, Boston, MA. Jennifer M. Latimer, Jakevia Wheeler, and Ayesha Umrigar are with the Institute of Women and Ethnic Studies, New Orleans, LA. Gwen Davies is with Positive Impact Health Centers, Decatur, GA. Serena Rajabiun and Angela Wangari Walter are with the Department of Public Health, Zuckerberg College of Health Sciences, University of Massachusetts Lowell.
Abstract:
Objectives. To explore intersectional stigma and sociodemographic characteristics, with consideration of US regional differences, among Black women with HIV enrolled in the Black Women First (BWF) initiative. Methods. In this prospective, nonrandomized study, participants' stigma scale responses and sociodemographic data were collected between May 2021 and August 2023. Participants participated in bundled interventions tailored to Black women's needs and local contexts during this time. Repeated measure models, adjusted for site clustering, were conducted with consideration of regional differences. Results. There were significant sociodemographic and baseline stigma differences between Black women residing in the US South and other regions. By the 12-month follow-up timepoint, because of bundled interventions, stigma significantly reduced among Black women, especially women in the South and transgender women. Conclusions. Bundled interventions with stigma-reduction approaches that address intersectional stigma and consider geography may be an effective way to reduce and eliminate stigma for Black women with HIV. Public Health Implications. BWF aligns with the National HIV/AIDS Strategy (2022-2025), promoting the development and expansion of culturally sensitive, evidence-informed interventions to improve Black women's health outcomes. (Am J Public Health. 2025;115(S1):S75-S84. https://doi.org/10.2105/AJPH.2025.308037).
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