Among HIV-positive African-American women, experiencing stigma related to the virus is associated with having a higher viral load.

Publishing their findings in the journal AIDS, a research team led by Christopher G. Kemp, PhD, of the Department of Global Health at the University of Washington in Seattle, analyzed data from a randomized trial of an intervention to reduce HIV-related stigma among 234 African-American women living with the virus in Chicago and Birmingham, Alabama.

The study collected sociodemographic and psychological data at up to six study visits over a 14-month period. Data on viral loads were drawn from medical records.

The study authors analyzed the association between viral load and the women’s experience with overall, internalized and enacted HIV-related stigma. Internalized stigma refers to an individual’s acceptance of negative attitudes or beliefs related to their HIV status, while enacted stigma refers to actual experiences of prejudice and discrimination due to their serostatus.

After controlling the data to account for various differences among the participants, the investigators found that overall stigma was associated with a higher viral load. When the researchers compared outcomes between the participants and when they just looked at data pertaining to individuals, they found that enacted stigma was also associated with viral load.

Neither social support nor depressive symptoms were significantly associated with viral load.

The study is limited by the fact that the researchers were not able to control for alcohol or substance abuse, or for homelessness or housing insecurity—factors that are all associated with higher viral load. Additionally, because this analysis drew data from a study of women participating in an intervention to reduce HIV-related stigma, it may not be representative of the wider population of African-American women living with the virus.

“Ongoing experiences of HIV stigmatization may contribute to increased viral load among African-American women in primary HIV care,” the study authors concluded. “Interventions should aim to alleviate the consequences of stigma experienced by patients and prevent future stigmatization.”

To read the study abstract, click here.