Healthy Choices Intervention is Associated with Reductions in Stigma Among Youth Living with HIV in the United States (A
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ORIGINAL PAPER
Healthy Choices Intervention is Associated with Reductions in Stigma Among Youth Living with HIV in the United States (ATN 129) Henna Budhwani1 · Gabriel Robles2 · Tyrel J. Starks3 · Karen Kolmodin MacDonell4 · Veronica Dinaj4 · Sylvie Naar5 Accepted: 21 October 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Considering the lack of validated stigma reduction interventions for youth living with HIV (YLWH), we evaluated effects of the Healthy Choices intervention on HIV-related stigma among YLWH. We analyzed data from the Adolescent Medicine Trials Network protocol 129, multi-site randomized controlled trial, applying latent growth curve modeling with two linear slopes estimating changes in Berger’s Stigma Scale pre-intervention, 16, 28, and 52 weeks post-intervention, as well as the trajectory of stigma scores over the follow-up period (N = 183). Expected value for the growth intercept was statistically significant (Bintercept = 2.53; 95% CI 2.32, 2.73; p 0.95. In the final model, we added a fixed effect of site and treatment condition as predictors of each latent growth factor. Missing data were handled within the context of full-information maximum likelihood estimation.
Measures Sociodemographic measures were age, ethnicity, race, gender, sexual orientation, education, and clinic location. Stigma was assessed using the 10-item version of Berger’s
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AIDS and Behavior
18 Stigma Scale [18, 48]. This scale consisted of four subscales. The first subscale on disclosure, included items, “you are very careful who you tell that you have HIV” and “you worry that people who know you have HIV will tell others.” The negative self-image sub-scale included three items, “you feel you are not as good a person as others because you have HIV,” “having HIV makes you feel unclean,” and “having HIV makes you feel that you are a bad person.” The public attitudes sub-scale included “most people think that a person with HIV is disgusting” and “most people with HIV are rejected when others find out.” The personalized sub-scale contained items, “you have been hurt by how people reacted to learning you have HIV,” “you have stopped socializing with some people because of their reactions to your having HIV,” and “you have lost friends by telling them you have HIV.” Response categories ranged from “strongly disagree” to “strongly agree” on a 4-point Likert scale.
Results Descriptive and Bivariate Statistics The mean age of participants was 21.38 years (SD = 1.86); 79.2% self-identified as male; 82.5% self-identified as Black or African American. Over half of the participants identified as gay or lesbian; 8.2% reported being infected with HIV perinatally. Bivariate analyses found no differences in gender identity (χ2 = 2.61, p = 0.271), race (χ2 = 3.78, p = 0.151), Hispanic ethnicity (χ2 = 0.02, p = 0.879), sexual orientation (χ2 = 0.24, p = 0.886), education (χ2 = 0.61, p = 0.739), contracting HIV prenatally (χ2 = 1.64, p = 0.200), clinic site location (χ2 = 1.67, p = 0.795), age (
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