Abstract
The Human Immunodeficiency Virus (HIV) has been a major public health concern since the 1980s and continues to be a major global health issue despite intense efforts to address this epidemic. This dissertation focused on Black Women Living with HIV (BWLWH), who have been disproportionately impacted by HIV. This dissertation utilized repeated psychosocial measurements of microaggression, discrimination, and resilience, and cross-sectional data on mental health status, COVID-19 impact on life, conduced measurement Invariance tests, 3-step approach, and Cross-Lagged Path Model (CLPM) to fulfill three study aims described below.
First, this dissertation identified three latent factors of microaggression, discrimination, and resilience, established measurement invariance across time, formed three latent classes, and then compared factor scores of three psychosocial domains over time, as well as across latent subgroups.
Second, to answer the question, “Does the impact of COVID-19 on life differ by constellation of microaggression, discrimination and resilience?” This dissertation utilized both variable-centered and person-centered approaches.
Third, this dissertation examined the reciprocal relationships between factor scores of discrimination, mental health, and resilience among BWLWH. The Cross-Lagged Path Model (CLPM) was applied. The first set of panel models were built to examine the relations between factor score of resilience and the count of the number of mental health diagnoses. The second set of panel models were built to examine the relations between factor scores of discrimination and resilience.
Collectively, this dissertation discovered complex relations between mental health, microaggression, resilience, discrimination, and impact of COVID-19 on life among 151 BWLWH from a longitudinal perspective. This study indicates that microaggressions and discrimination impacts mental health, and provides evidence on the role of resilience in coping with discrimination.