Kathleen J. Sikkema

Bio: Kathleen J. Sikkema is an academic researcher from Duke University. The author has contributed to research in topics: Acquired immunodeficiency syndrome (AIDS) & Population. The author has an hindex of 55, co-authored 213 publications receiving 10206 citations. Previous affiliations of Kathleen J. Sikkema include National Institutes of Health & Yale University.

Internalized Stigma Among People Living with HIV-AIDS

Abstract: HIV is recognized as a highly stigmatized disease; however, there has been a lack of research on the internalization of this stigma by seropositive people. This study examined internalized stigma among HIV-positive men and women (N = 268) in Milwaukee and Madison, Wisconsin, and New York City. The majority of the sample experienced internalized stigma related to their HIV status. Individuals who experienced high internalized HIV stigma (IHS) had been diagnosed with HIV more recently, their families were less accepting of their illness, they were less likely to ever have attended an HIV support group, and they knew fewer people with HIV. Individuals with high IHS also worried more about spreading their infection to others. Heterosexuals and participants from Wisconsin experienced higher levels of IHS. Hierarchical regression analyses showed that IHS contributed significantly to levels of depression, anxiety, and hopelessness after controlling for the effects of key behavioral and psychosocial variables.

Outcomes of a randomized community-level HIV prevention intervention for women living in 18 low-income housing developments.

Abstract: Objectives. Women in impoverished inner-city neighborhoods are at high risk for contracting HIV. A randomized, multisite community-level HIV prevention trial was undertaken with women living in 18 low-income housing developments in 5 US cities. Methods. Baseline and 12-month follow-up population risk characteristics were assessed by surveying 690 women at both time points. In the 9 intervention condition housing developments, a community-level intervention was undertaken that included HIV risk reduction workshops and community HIV prevention events implemented by women who were popular opinion leaders among their peers. Results. The proportion of women in the intervention developments who had any unprotected intercourse in the past 2 months declined from 50% to 37.6%, and the percentage of women's acts of intercourse protected by condoms increased from 30.2% to 47.2%. Among women exposed to intervention activities, the mean frequency of unprotected acts of intercourse in the past 2 months tended to be lower at follow-up (mean = 4.0) than at baseline (mean = 0.6). These changes were corroborated by changes in other risk indicators. Conclusions. Community-level interventions that involve and engage women in neighborhood-based HIV prevention activities can bring about reductions in high-risk sexual behaviors.

The NIMH multisite HIV prevention trial: Reducing HIV sexual risk behavior

Abstract: The efficacy of a behavioral intervention to reduce human immunodeficiency virus (HIV) risk behaviors was tested in a randomized, controlled trial with three high-risk populations at 37 clinics from seven sites across the United States. Compared with the 1855 individuals in the control condition, the 1851 participants assigned to a small-group, seven-session HIV risk reduction program reported fewer unprotected sexual acts, had higher levels of condom use, and were more likely to use condoms consistently over a 12-month follow-up period. On the basis of clinical record review, no difference in overall sexually transmitted disease (STD) reinfection rate was found between intervention and control condition participants. However, among men recruited from STD clinics, those assigned to the intervention condition had a gonorrhea incidence rate one-half that of those in the control condition. Intervention condition participants also reported fewer STD symptoms over the 12-month follow-up period. Study outcomes suggest that behavioral interventions can reduce HIV-related sexual risk behavior among low-income women and men served in public health settings. Studies that test strategies for reducing sexual risk behavior over longer periods of time are needed, especially with populations that remain most vulnerable to HIV infection.

Perceived discrimination and health: a meta-analytic review.

Abstract: Perceived discrimination has been studied with regard to its impact on several types of health effects. This meta-analysis provides a comprehensive account of the relationships between multiple forms of perceived discrimination and both mental and physical health outcomes. In addition, this meta-analysis examines potential mechanisms by which perceiving discrimination may affect health, including through psychological and physiological stress responses and health behaviors. Analysis of 134 samples suggests that when weighting each study's contribution by sample size, perceived discrimination has a significant negative effect on both mental and physical health. Perceived discrimination also produces significantly heightened stress responses and is related to participation in unhealthy and nonparticipation in healthy behaviors. These findings suggest potential pathways linking perceived discrimination to negative health outcomes.