Overweight and Obesity in Persons Living with HIV: Stigma and Health

Objective: Both obesity and HIV are highly stigmatized diseases; however, little is known about the psychological experience of individuals at the intersection of these two conditions. This cross-sectional study examined whether PLWH with overweight or obesity endorsed and experienced less anticipated and enacted stigma due to their weight status. Methods: PLWH (n = 671; 428 male and 196 females) were recruited from a holiday donation center in Atlanta, Georgia. Self-reports of medical history, HIV and weight stigma, body image, perceptions of weight status, and nutritional intake were collected. Results: 26.8% were overweight (BMI \u3e25-25.9 kg/m2) and 32.4% were obese (BMI \u3e30 kg/m2). No differences were seen in levels of anticipated or enacted stigma across weight categories. Body image across weight categories was also relatively equal. Post hoc analyses displayed a meditational effect of body image on internalized HIV stigma and BMI. BMI also served as a moderator on body image and internalized weight stigma, as body image increased so did internalized stigma. Differences were also seen in perceptions of weight status, with individuals that were overweight or obese perceiving themselves to be slightly underweight or about the right weight. Conclusion: Results suggests there were no differences in anticipated or experienced HIV stigma as a result of weight status; however, internalized stigma was closely related to body image. Overweight and obesity were the norm in this sample as well as poor dietary quality, emphasizing the need for weight management interventions that are sensitive to the unique challenges of PLWH

The Steps to Growing Up Healthy Study: Barriers to Initial Behavior Change in a Primary Care Based Obesity Prevention/Reversal Program for Young Children

BACKGROUND: Children of color are disproportionately affected by obesity creating a need for effective prevention/reversal programs. This study investigated a first dose response to a pediatric primary care-based obesity prevention program (Steps to Growing Up Healthy) targeting Hispanic and Black children. We examined whether mothers experienced barriers to behavior change and if maternal, child, environmental, or intervention variables predicted barrier status. METHODS: Hispanic and Black mothers and their children (N=234; 51%F; 88.9% Hispanic; 35.4±8.7months) were recruited from an urban pediatric primary care clinic. The intervention utilized brief motivational counseling delivered by clinicians and nurses with the goal of decreasing obesogenic behaviors. During a routine clinic visit, the medical team facilitated the selection of a specific goal (e.g., reduce SSB) that was meaningful to the mothers and taught mothers simple behavioral strategies (e.g., self-monitoring). Study staff conducted follow-up telephone calls 5-7 days after the visit, reviewed the selected goal, and assessed whether the mother experienced a barrier to behavior change. RESULTS: 16.8% of mothers reported a barrier to behavior change in the week following the first intervention dose. Logistic regression models identified mother’s confidence (pand child sex (p\u3c.01) as predictors of barrier status. Mothers who were “somewhat” or “not confident” were 6.21 times more likely to report a barrier than mothers who were very confident and mothers were 0.351 times more likely to identify a barrier if their child was male. CONCLUSION: Obesity prevention/reversal programs may be well served to address maternal confidence levels especially with regard to changing their son’s obesogenic behaviors

Service priorities and unmet service needs among people living with HIV/AIDS: Results from a nationwide interview of HIV/AIDS housing organizations

Housing for people living with HIV/AIDS has been linked to a number of positive physical and mental health outcomes, in addition to decreased sexual and drug-related risk behavior. The current study identified service priorities for people living with HIV/AIDS, services provided by HIV/AIDS housing agencies, and unmet service needs for people living with HIV/AIDS through a nationwide telephone survey of HIV/AIDS housing agencies in the United States. Housing, alcohol/drug treatment, and mental health services were identified as the three highest priorities for people living with HIV/AIDS and assistance finding employment, dental care, vocational assistance, and mental health services were the top needs not being met. Differences by geographical region were also examined. Findings indicate that while housing affords people living with HIV/AIDS access to services, there are still areas (e.g., mental health services) where gaps in linkages to care exist