Factors Associated With Stigma and Depression Among People Living With HIV and Food Insecurity in the Dominican Republic

Abstract

Food insecurity, depression, and HIV stigma adversely affect people with HIV and women face heightened vulnerability. Limited evidence exists regarding the factors associated with HIV internalized and experienced stigmas and depression for people with HIV and food insecurity in the Dominican Republic (DR). Using an HIV clinic-based sample of people with food insecurity in the DR (n = 115), we found that depressive symptoms and internalized and experienced stigmas were highly prevalent. A cross-sectional, multivariate linear regression analysis found that women, Haitians, and those with a detectable viral load had higher internalized stigma; those reporting intimate partner violence had higher internalized and experienced stigmas, while those reporting stronger social support had lower stigma scores for both types; finally, those with an undetectable viral load, better physical health, and better antiretroviral therapy adherence had reduced depression symptom severity. Targeting inequities related to gender, nationality and/or ethnicity, and HIV disease progression may mitigate internalized HIV stigma, and addressing the correlates of HIV stigmas and depression may improve HIV outcomes.