Resilience to Stigma in Medical, Social, and Employment Contexts Among People Who Inject Drugs in Rural Ohio
Adapting the 10-Item Connor-Davidson Resilience Scale
Bibliographic Data
| ID | 15338719 |
|---|---|
| Authors | Madison N Enderle (0000-0002-2592-0781, Wake Forest University, corresponding author), Rebecca H Neiberg (0000-0003-0719-6520, Wake Forest University), Stacy Endres‐Dighe (0000-0002-4192-2234, RTI International), Stacy M Endres-Dighe, Nisha Gottfredson O''Shea (0000-0002-4765-7179, RTI International), Vivian F Go (0000-0003-4828-6880, University of North Carolina at Chapel Hill), William C Miller (0000-0003-3060-0210, University of North Carolina at Chapel Hill), Kathryn E Lancaster (0000-0003-2389-6973, Wake Forest University) |
| Year | 2025 |
| Volume | 30 |
| Issue | 3 |
| Pages | 894-906 |
| Publication date | 2025-10-28 |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | AIDS and Behavior (JOURNAL) |
| Journal identifiers | ISSN: 1090-7165 • E-ISSN: 1573-3254 |
| Publisher | Springer Science+Business Media (PUBLISHER • DE) |
| DOI | 10.1007/s10461-025-04915-4 |
| PMID | 41148410 |
| OpenAlex | W4415621045 |
| Language | EN |
| References cited | 56 |
People who inject drugs (PWID) experience stigma related to drug use and HIV prevention, which can impede engagement with the HIV prevention continuum. Resilience may buffer against stigma's harmful effects, but limited research has examined how resilience operates across different social contexts and stigma types among PWID. Using qualitative interviews and cognitive interviews, we adapted the 10-item Connor-Davidson Resilience Scale to measure resilience to drug use-related stigma and HIV prevention-related stigma among PWID in rural Appalachian Ohio in three contexts: medical, social, and employment. To validate the scale adaptations, we administered a quantitative survey. We assessed internal consistency using Cronbach's alpha and fit Poisson regression models to test the association between high resilience and pre-exposure prophylaxis (PrEP) awareness and overdose response training. Among the 250 PWID who completed the quantitative survey, the six resilience scales demonstrated strong internal consistency. Examining frequency distributions, Bland-Altman plots, and factor analysis, we found the resilience responses varied by stigma type and context. Results of regression models indicated high resilience to HIV prevention-related stigma in the medical context was associated with PrEP awareness (adjusted prevalence ratio [aPR]: 1.37; 95% CI 1.05, 1.80) and overdose response training (aPR: 1.31; 95% CI 1.07, 1.61). Our study provides a novel approach to measuring context-specific resilience to stigma among PWID. Findings highlight the importance of tailoring interventions to both individual resilience and structural stigma, particularly in medical settings. Enhancing resilience and reducing stigma may support greater engagement with HIV prevention and harm reduction services in rural communities
Context (archaeology · Harm reduction · Health psychology · Psychological intervention · Psychological resilience · Public health · Scale (ratio · Stigma (botany · HIV, Drug Use, Sexual Risk · HIV/AIDS Research and Interventions · Opioid Use Disorder Treatment
Ggplot2
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| Highly cited | No |
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