Abstract
Despite the disproportionate impact of HIV, microaggressions, and discrimination among Black women living with HIV (BWLWH), BWLWH have demonstrated resilience by mobilizing religious and other coping strategies. The current study sought to examine whether racism-related or religious coping moderates the relationship between latent gendered racial microaggressions (GRMs), antiretroviral therapy (ART) adherence and viral load (VL) among 119 BWLWH. Data was collected via self-report measures of GRMs and coping. ART adherence was measured via self-report and electronic monitoring and VL was measured via blood specimens. Structural equation modeling showed significant main effects of religious coping on adherence and VL. Furthermore, GRMs × racism-related coping and GRMs × religious coping significantly predicted adherence and VL. Our findings indicate the unique and culturally salient role of religious and racism-related coping among BWLWH in the context of GRMs. Such findings may be optimized in the development of culturally relevant multilevel interventions for BWLWH.
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The details and findings of the clinical trial, under which these research findings are subsumed, are available for open access at clinicaltrials.gov (Trial Registration Number: NCT02764853; Date of Registration: May 3, 2016).
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Acknowledgements
We would like to extend extensive gratitude to the women who devoted their time and energy to participate in this study – without them, there would be no research study. We express gratitude to our community stakeholders who played a key role in recruitment and engagement of women and supported us in many ways. We also thank the research staff and volunteers who facilitated the collection of this data and made it available for use in this project. The research reported in this publication was funded by K23MH108439 and the principal investigator Dr. Sannisha Dale was additionally funded by R56MH121194 and R01MH121194 from the National Institute of Mental Health. Thanks to Dr. Maria Llabre for the consultation she provided regarding aspects of data analysis. The content of this publication is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Funding
The research reported in this publication was funded by K23MH108439 and the principal investigator Dr. Sannisha Dale was additionally funded by R56MH121194 and R01MH121194 from the National Institute of Mental Health.
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All persons listed as an author have participated adequately in this work and take responsibility for the content of this manuscript. Rachelle Reid participated in the collection, analysis and interpretation of data, writing and revisions of the manuscript. As PI, Dr. Sannisha Dale conceptualized the design of the study and oversaw and participated in data collection, participated in the analysis and interpretation of the data, and provided revisions and guidance on drafts of the manuscript.
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Unrelated to data in this manuscript, Dr. Dale is a co-investigator on a Merck & Co. funded project on " A Qualitative Study to Explore Biomedical HIV Prevention Preferences, Challenges and Facilitators among Diverse At-Risk Women Living in the United States” and has served as a workgroup consultant on engaging people living with HIV for Gilead Sciences, Inc. All other authors declare that they do not have relevant financial, non-financial interests nor competing interests to disclose.
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This study was performed in accordance with the principles of the Declaration of Helsinki. All study procedures and materials were approved by the Institutional review Board at the University of Miami (5/8/2017, No. 20170281).
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Reid, R., Dale, S.K. Structural equation modeling of microaggressions, religious and racism-related coping, medication adherence, and viral load among Black women living with HIV. J Behav Med 46, 837–848 (2023). https://doi.org/10.1007/s10865-023-00403-z
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DOI: https://doi.org/10.1007/s10865-023-00403-z