Posted on January 29, 2002 at 9:30 a.m.

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BIRMINGHAM, AL — HIV-positive women with children are more likely than men to suffer from chronic sorrow related to their illness, fear of death, poverty and social isolation, according to a study published in the January 29th issue of the journal AIDS Patient Care and STD’s. In addition, African-American women experience depression at twice the rate of whites. Bronwen Lichtenstein, Ph.D., a research assistant professor of sociology at the University of Alabama at Birmingham (UAB) was the lead author of the study.

Chronic sorrow is a profound sadness resulting from long-term disability, ill health or impairment. The study used the concept of chronic sorrow to examine the social support needs of HIV-positive men and women.

“We found that depression is especially common in HIV-positive persons who are stigmatized and those who lack social support, especially women,” Lichtenstein said.

The study reported that the stigma of HIV resulted in social isolation and that women were likely to be stigmatized “because of their association with ‘dirty sex,’ contagion and moral threat in the heterosexual communities. Men, however, were often shielded from the worst effects of stigma because of their ties to the gay community and associated health networks.”

The study, funded by two grants from UAB, was conducted through the UAB 1917 AIDS Clinic. Researchers interviewed 21 HIV-positive, men and women, black and white, ranging in age from 24 to 58, with an average age of 40. Most of the men in the study described themselves as homosexual. There were no African-American men in this study. Researchers also used the Center of Epidemiological Studies on Depression Scale (CES-D) to measure the level of each respondent’s depression.

In particular, the study found that women scored significantly higher than men as depressed. Seven of the nine women in the study were depressed, while fewer than half of the men, five out of 11, were depressed. Seventy-eight percent of the women in the study complained of being isolated from society and stigmatized by family and friends. Only 18 percent of the men complained of being stigmatized and 63 percent complained of being isolated from society, mainly through illness, rather than stigma.

Sixty-three percent of the men reported having positive family support, whereas only 9 percent of the women reported having positive family support. Most women in the study faced rejection by family members, some were no longer allowed to visit their family.

The African-American women in the study were significantly more depressed than white men or women. Using the CES-D scale, overall, African-American women averaged a mean depression score nearly twice that of whites.

The depression for most of the women in the study, both black and white, was made worse because they were mothers. Eight of the nine women in the study were full or part-time caregivers for children. The mothers reported mourning not only the loss of their own health and relationships, but feared what the future would bring for their children.

“However, given the small study, it is not known if these results would replicate the needs and experiences of the larger HIV-positive population. Further, larger scale research is needed into the differences in support needs and depression between HIV-positive men and women, and between African-Americans and whites.”

The study concludes that health care workers and AIDS organizations must design support programs for clients that take into account the social isolation and stigma experienced by many AIDS patients.

“AIDS workers should also be aware that stigmatizing attitudes and one-size-fits-all programs may further marginalize people with AIDS and undermine patient health. More needs to be done to make social services and volunteers who make home visits to AIDS patients more aware of the high rates of depression in HIV-positive persons.

“Particular attention should be paid to such stressors as motherhood, poverty, lack of social support, especially for HIV-positive women,” Lichtenstein said.

Other researchers who collaborated on the study were UAB associate professor of sociology Jeffrey Clair, Ph.D., and Mary K. Laska, Ph.D., a doctoral student in sociology at UAB at the time of the study.

NOTE: We are the University of Alabama at Birmingham. Please use UAB on second reference. We are not to be confused with the University of Alabama, which is a separate, independent campus.