Abstract

CDB316 - Publication only

Empowerment, adherence and perceived stigma among women living with HIV: exploratory analysis of interactions

C. Zorrilla, V. Tamayo-Agrait, I. Febo, P. Piovanetti, L. Colon, S. Garced, M. Picon, A. Alemañy, M. Herrera, J. Martínez

UPR School of Medicine, Ob-Gyn Dept, Maternal Infant Studies Center (CEMI), San Juan, Puerto Rico

Background: We define Empowerment as a process of awareness throughout which women recognize their capacity to achieve individual and social changes. This process involves a mental and spiritual awareness that enables them to gain greater control of the physical, psychological, and social dimensions of the healing process. Our clinic's activities include participation in a series of workshops to increase personal knowledge and empowerment. We focus on adherence and healthier lifestyles because of the longer life expectancy associated with improvements in care and access to HAART. We believe that empowerment will lead to greater adherence, and a shift from external (“for my children and family”) to internal (“to feel better”, “for my health”) motivation for adherence. Empowerment will lead to feeling of less stigmatization as well. These will favor improved health.
Methods: A sample of 169 women living with HIV completed questionnaires for adherence (3-days), perceived stigma, empowerment, lifestyles and depression prior to the intervention. HAART use, HIV RNA viral load, CD4 counts, anthropometric measures, Pap smears and medical complications was included.
Results: The mean age was 39 (range 17-63), half had been diagnosed > 10 years and 47.5% had a normal BMI. Internalized stigma was reported by 60.8% with 26% in the moderate to severe category. Complete adherence was reported by 85% and 62% of them were considered empowered by the scale. Empowerment was associated with the following variables: Internal motivation (P=0.04); currently having a partner (p=0.045); self-perception of empowerment (p< 0.0001); low (< 75) HIV RNA viral load (p=0.01); and age > 50 years (p=0.01). Adherence was associated with the following: non-smoking (p=0.02) and internal motivation (p=0.04)
Conclusions: Positive associations between empowerment, internal motivation for adherence, biologic markers of control, age>50 and non-smoking were observed. Some associations did not reach statistical significance because of the large proportion of adherent and empowered women.
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