The Interaction between Race, Ethnicity, Gender, Sexual Orientation, and Age on Internalized HIV-related Stigma in the DC Cohort
Related Experiment Videos
Lauren F O'Connor1, Tamara Taggart2,3, Yun Ji2
1The Milken Institute School of Public Health, George Washington University, 950 New Hampshire Avenue, Washington, DC, 20052, USA. laurenoconnor@gwu.edu.
Background:
Internalized HIV-related stigma can have a negative impact on health outcomes among people with HIV (PWH). A multilevel model, informed by an intersectional framework, is needed to evaluate the interactions between various aspects of one's identity and their impact on internalized HIV-related stigma. Therefore, we used a Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy (MAIHDA) to evaluate internalized stigma among PWH.
Methods:
We evaluated a subset of participants in the DC Cohort longitudinal study on PWH who completed a patient reported outcomes (PROs) survey. Participants were sorted into 24 strata of race/ethnicity, gender, sexual orientation, and age. Stigma was evaluated using a self-reported 4-item instrument. We evaluated the individual and strata level impacts of these variables on internalized stigma using MAIHDA.
Results:
We evaluated 1,540 DC Cohort participants with complete strata information, most of which were non-Hispanic Black (80.3%), male (73.1%), gay/lesbian/bisexual (52.1%), and had a mean age of 52.3 years old. Based on the null model, the strata explain 6.96% of the total variance in stigma. This variance was reduced to 1.67% after adjusting for the individual effects of race/ethnicity, gender, sexual orientation, and age. This shows that the main effects of these covariates jointly account for 77.27% of the between-strata stigma variance, while the remaining 22.73% of the between-strata variance is potentially due to the intersectional effects between the covariates.
Conclusion:
Although the individual effects of race/ethnicity, gender, sexual orientation, and age did not explain a large portion of the variance in stigma, nearly a quarter of the between-strata variance in stigma is potentially attributable to the interaction between these covariates.
Related Concept Videos
Stereotypes, Prejudice, and Discrimination
Ethnic Identity within a Larger Culture
Surveys
Relationship Formation
Impact of Social Context on Individuals
Social Identity