Stigma in health care settings can have negative consequences on women living with HIV, such as increasing the likelihood of missed visits and reducing trust in their clinical providers. Informed by prior stigma research and considering knowledge gaps related to the effect of patient–provider race concordance, we conducted this study to assess if patient–provider race concordance moderates the expected association between HIV-related stigma in health care settings and patients' trust in their providers. Moderation analyses were conducted using Women's Interagency HIV Study data ( N = 931). We found significant main effects for patient–provider race concordance. Higher experienced stigma was associated with lower trust in providers in all patient–provider race combinations [White–White: B = −0.89, standard error (SE) = 0.14, p = 0.000, 95% confidence interval, CI (−1.161 to −0.624); Black patient–White provider: B = −0.19, SE = 0.06, p = 0.003, 95% CI (−0.309 to −0.062); and Black–Black: B = −0.30, SE = 0.14, p = 0.037, 95% CI (−0.575 to −0.017)]. Higher anticipated stigma was also associated with lower trust in providers [White–White: B = −0.42, SE = 0.07, p = 0.000, 95% CI (−0.552 to −0.289); Black patient–White provider: B = −0.17, SE = 0.03, p = 0.000, 95% CI (−0.232 to −0.106); and Black–Black: B = −0.18, SE = 0.06, p = 0.002, 95% CI (−0.293 to −0.066)]. Significant interaction effects indicated that the negative associations between experienced and anticipated HIV-related stigma and trust in providers were stronger for the White–White combination compared with the others. Thus, we found that significant relationships between HIV-related experienced and anticipated stigma in health care settings and trust in providers exist and that these associations vary across different patient–provider race combinations. Given that reduced trust in providers is associated with antiretroviral medication nonadherence and higher rates of missed clinical visits, interventions to address HIV-related stigma in health care settings may improve continuum of care outcomes.

Engaging in regular physical activity (PA) is important in maintaining health and increasing the overall quality of life of people living with HIV (PLWH). The deep south of the USA is known for its high rate of sedentary behavior although data on the activity levels and perceptions of the benefits and barriers to exercise in women living with HIV in the deep south are lacking. Understanding the perceived benefits and barriers to exercise can guide the development of PA interventions. We conducted a cross-sectional study to determine the PA levels and perceived benefits and barriers to exercise associated with both age and depression level in a group of HIV+ women living in the deep south. We recruited a total of 50 participants from a cohort site for the Women’s Interagency HIV Study. Depression was assessed using the Center for Epidemiological Studies Depression Scale (CES-D) and benefits/barriers to exercise were measured using the Exercise Benefits and Barriers Scale (EBBS). We measured PA both subjectively and objectively using the International Physical Activity Questionnaire (IPAQ) and a Fitbit PA monitor, respectively. Our sample was predominantly African-American (96%) and the mean ±SD age, body mass index, and CES-D score were 42 ± 8.8 years, 36.6 ± 11.5 kg/m², and 15.6 ± 11.4, respectively. Both subjective and objective measures of PA indicated that our participants were sedentary. The greatest perceived benefit to exercise was physical performance and the greatest barrier to exercise was physical exertion. Higher overall perceived benefits were reported by women ≥43 years and women reporting higher levels of depression. There was no difference in overall barriers associated with age and depression level, but women with depression felt more fatigued by exercise. The results of this study can be helpful when designing and implementing PA interventions in women living with HIV in the deep south.

Weight and body mass index (BMI) change was assessed among women after switch to integrase inhibitors (INSTIs) and/or tenofovir alafenamide (TAF). From 2006 to 2019, 1,458 women living with HIV enrolled in the Women's Interagency HIV Study and on antiretroviral therapy (ART) with ≥1 study visit before and after switching to INSTIs and/or TAF were included. Weight and BMI were compared pre- and postswitch to INSTI (by class and type) and/or TAF using multivariable linear mixed effects models; all models were also stratified by preswitch presence or absence of obesity (BMI ≥30 vs. <30 kg/m ² ). Mean age preswitch was 47 ± 6 years, 64% were black, mean CD4 = 475 ± 201 cells/mm ³ , 56% had HIV RNA <200 copies/mL, 36% switched to TAF but not INSTI, 60% to INSTI but not TAF, and 3.5% to TAF+INSTI. Time from pre- to postswitch was 12.8 ± 11.8 months. The INSTI-only group but not TAF groups had small but significant increases in weight and BMI: mean 79.2–80.6 kg and 30.2–30.7 kg/m ² , p' s < .001, respectively, with congruent findings by INSTI type ( p' s ≤ .01). In stratified (preswitch BMI) analyses, only nonobese subgroups experienced increases in weight and BMI across all ART treatment groups ( p' s < .05). Significant, although small-to-medium, increases in weight and BMI occurred among nonobese women who switched to INSTIs and/or TAF over short follow-up. Given long-term health consequences of obesity particularly as a low-grade inflammatory condition, identifying women at highest risk of ART-associated weight gain is imperative.