Associations Between Microaggressions, Discrimination, and Brain Health Among Black Women Living with HIV

INTRODUCTION: Despite advancements in the treatment of HIV, Black women living with HIV (BWLWH) experience significant disparities in brain health and related factors, which may be linked to microaggressions, systemic inequities, and discrimination. Factors such as functional activity, brain health, sleep, and diet also play a role in the overall health of an individual. This study examines how experiences of microaggressions are associated with brain health-related factors among BWLWH. METHODS: Utilizing cross-sectional data from 183 BWLWH, this study employed linear regressions to assess relationships between psychosocial stressors (microaggressions, discrimination) and brain health-related measures including the Functional Activities Questionnaire, The Healthy Brain 9, and Sleep Evaluation (night-time, treatments, and behaviors). RESULTS: Findings indicate that a higher frequency of HIV-related microaggressions (total direct and indirect) and gendered racial microaggressions were associated with cognitive function difficulties and sleep disturbances. Women who reported higher experiences of race-, gender-, and HIV-based discrimination also had cognitive function difficulties and sleep disturbances, but only race- and gender-related discrimination were related to lower global health ratings. CONCLUSION: This study highlights the role microaggressions and discrimination may play in brain health and related factors among BWLWH. Addressing these disparities requires targeted interventions that promote health equity, increase access to culturally competent care, and integrate community-based resilience strategies to support cognitive well-being.