scholarly journals Impact of experienced HIV stigma on health is mediated by internalized stigma and depression: results from the people living with HIV stigma index in Ontario

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jason M. Lo Hog Tian ◽  
James R. Watson ◽  
Francisco Ibáñez-Carrasco ◽  
Billy Tran ◽  
Janet A. Parsons ◽  
...  
Keyword(s):  
Multiple Regression ◽  
Hiv Stigma ◽  
People Living With Hiv ◽  
Internalized Stigma ◽  
Mediation Model ◽  
Health And Wellbeing ◽  
Self Rated Health ◽  
The People ◽  
Enacted Stigma ◽  
Living With Hiv

Abstract Background Experiences of HIV stigma remain prevalent across Canada, causing significant stress and negatively affecting the health and wellbeing of people living with HIV. While studies have consistently demonstrated that stigma negatively impacts health, there has been limited research on the mechanisms behind these effects. This study aims to identify which dimensions of stigma have significant relationships with self-rated health and examine the mechanisms by which those types of stigma impact self-rated health. Methods We recruited 724 participants to complete the People Living with HIV Stigma Index in Ontario, designed by people living with HIV to measure nuanced changes in stigma and discrimination. The present study utilizes data from externally validated measures of stigma and health risks that were included in the survey. First, we conducted multiple regression analyses to examine which variables had a significant impact on self-rated health. Results from the multiple regression guided the mediation analysis. A parallel mediation model was created with enacted stigma as the antecedent, internalized stigma and depression as the mediators, and self-rated health as the outcome. Results In the multiple regression analysis, internalized stigma (coefficient = −0.20, p < 0.01) and depression (coefficient = −0.07, p < 0.01) were both significant and independent predictors of health. Mediation analyses demonstrated that the relationship between enacted stigma and self-rated health is mediated in parallel by both internalized stigma [coefficient = −0.08, se = 0.03, 95% CI (−0.14, −0.02)] and depression [coefficient = −0.16, se = 0.03, 95% CI (−0.22, −0.11)]. Conclusions We developed a mediation model to explain how HIV-related stigma negatively impacts health. We found that that enacted stigma, or experiences of prejudice or discrimination, can lead to internalized stigma, or internalization of negative thoughts regarding one’s HIV status and/or increased depressive symptoms which then may lead to worse overall health. Highlighting the importance of internalized stigma and depression has the potential to shape the development of targeted intervention strategies aimed at reducing the burden of stigma and improving the health and wellbeing of people living with HIV.

scholarly journals Impact of Experienced HIV Stigma on Health is Mediated by Internalized Stigma and Depression: Results from the People Living with HIV Stigma Index in Ontario

2020 ◽  
Author(s):  
Jason Lo Hog Tian ◽  
James R Watson ◽  
Francisco Ibáñez-Carrasco ◽  
Billy Tran ◽  
Janet A Parsons ◽  
...  
Keyword(s):  
Multiple Regression ◽  
Hiv Stigma ◽  
People Living With Hiv ◽  
Internalized Stigma ◽  
Mediation Model ◽  
Health And Wellbeing ◽  
Self Rated Health ◽  
The People ◽  
Enacted Stigma ◽  
Living With Hiv

Abstract Background: Experiences of HIV stigma remain prevalent across Canada, causing significant stress and negatively affecting the health and wellbeing of people living with HIV. While studies have consistently demonstrated that stigma negatively impacts health, there has been limited research on the mechanisms behind these effects. This study aims to identify which dimensions of stigma have significant relationships with self-rated health and examine the mechanisms by which those types of stigma impact self-rated health and by extension, key real-life health outcomes.Methods: We recruited 724 participants to complete the People Living with HIV Stigma Index in Ontario, designed by people living with HIV to measure nuanced changes in stigma and discrimination. The present study utilizes data from externally validated measures of stigma and health risks that were included in the survey. First, we conducted multiple regression analyses to examine which variables had a significant impact on self-rated health. Results from the multiple regression guided the mediation analysis. A parallel mediation model was created with enacted stigma as the antecedent, internalized stigma and depression as the mediators, and self-rated health as the outcome. Results: In the multiple regression analysis, internalized stigma (coefficient = -0.20, p<0.01) and depression (coefficient = -0.07, p<0.01) were both significant and independent predictors of health. We found through mediation analyses that the relationship between enacted stigma and self-rated health is mediated in parallel by both internalized stigma [coefficient = -0.08, se = 0.03, 95% CI (-0.14, -0.02)] and depression [coefficient = -0.16, se = 0.03, 95% CI (-0.22, -0.11)].Conclusions: We developed a mediation model to explain how HIV stigma negatively impacts health. We found that that experiences of prejudice or discrimination (enacted stigma) can lead to internalization of negative thoughts regarding one’s HIV status (internalized stigma) and/or increased depressive symptoms which then may lead to worse overall health. Highlighting the importance of internalized stigma and depression has the potential to shape the development of targeted intervention strategies aimed at reducing the burden of stigma and improving the health and wellbeing of people living with HIV.

Impact of Experienced HIV Stigma on Health is Mediated by Internalized Stigma and Depression: Results From the People Living With HIV Stigma Index in Ontario

2020 ◽  
Author(s):  
Jason Lo Hog Tian ◽  
James R Watson ◽  
Francisco Ibáñez-Carrasco ◽  
Billy Tran ◽  
Janet A Parsons ◽  
...  
Keyword(s):  
Multiple Regression ◽  
Hiv Stigma ◽  
People Living With Hiv ◽  
Internalized Stigma ◽  
Mediation Model ◽  
Health And Wellbeing ◽  
Self Rated Health ◽  
The People ◽  
Enacted Stigma ◽  
Living With Hiv

Abstract Background: Experiences of HIV stigma remain prevalent across Canada, causing significant stress and negatively affecting the health and wellbeing of people living with HIV. While studies have consistently demonstrated that stigma negatively impacts health, there has been limited research on the mechanisms behind these effects. This study aims to identify which dimensions of stigma have significant relationships with self-rated health and examine the mechanisms by which those types of stigma impact self-rated health and by extension, key real-life health outcomes.Methods: We recruited 724 participants to complete the People Living with HIV Stigma Index in Ontario, designed by people living with HIV to measure nuanced changes in stigma and discrimination. The present study utilizes data from externally validated measures of stigma and health risks that were included in the survey. First, we conducted multiple regression analyses to examine which variables had a significant impact on self-rated health. Results from the multiple regression guided the mediation analysis. A parallel mediation model was created with enacted stigma as the antecedent, internalized stigma and depression as the mediators, and self-rated health as the outcome. Results: In the multiple regression analysis, internalized stigma (coefficient = -0.20, p<0.01) and depression (coefficient = -0.07, p<0.01) were both significant and independent predictors of health. We found through mediation analyses that the relationship between enacted stigma and self-rated health is mediated in parallel by both internalized stigma [coefficient = -0.08, se = 0.03, 95% CI (-0.14, -0.02)] and depression [coefficient = -0.16, se = 0.03, 95% CI (-0.22, -0.11)].Conclusions: We developed a mediation model to explain how HIV stigma negatively impacts health. We found that that experiences of prejudice or discrimination (enacted stigma) can lead to internalization of negative thoughts regarding one’s HIV status (internalized stigma) and/or increased depressive symptoms which then may lead to worse overall health. Highlighting the importance of internalized stigma and depression has the potential to shape the development of targeted intervention strategies aimed at reducing the burden of stigma and improving the health and wellbeing of people living with HIV.

scholarly journals Associations Between Experienced and Internalized HIV Stigma, Adversarial Growth, and Health Outcomes in a Nationwide Sample of People Aging with HIV in Germany

2020 ◽  
Author(s):  
Jochen Drewes ◽  
Phil C. Langer ◽  
Jennifer Ebert ◽  
Dieter Kleiber ◽  
Burkhard Gusy
Keyword(s):  
Health Outcomes ◽  
Indirect Effect ◽  
Cross Sectional Study ◽  
Hiv Stigma ◽  
People Living With Hiv ◽  
Internalized Stigma ◽  
Sectional Study ◽  
Cross Sectional ◽  
Adversarial Growth ◽  
Living With Hiv

Abstract HIV-related stigmatization and adversarial growth are known to influence health outcomes in people living with HIV. But not much is known how these psychosocial factors are related to each other and how they interact to influence health outcomes. We tested whether the effect of experienced and internalized stigma on mental health and self-rated health is mediated by adversarial growth, and whether each of these factors is uniquely associated with health outcomes. In our sample of 839 people aging with HIV in Germany based on a cross-sectional study design we did not find an indirect effect of experienced HIV stigma on health outcomes and a very small indirect effect of internalized HIV stigma. All variables were significant predictors of health outcomes in multiple regression analyses.

scholarly journals Measuring intersecting stigma among key populations living with HIV: implementing the people living with HIV Stigma Index 2.0

2018 ◽  
Vol 21 ◽  
pp. e25131 ◽  
Author(s):  
Barbara A Friedland ◽  
Laurel Sprague ◽  
Laura Nyblade ◽  
Stefan D Baral ◽  
Julie Pulerwitz ◽  
...  
Keyword(s):  
Hiv Stigma ◽  
People Living With Hiv ◽  
Key Populations ◽  
The People ◽  
Living With Hiv

An Antidote to Stigma? The People Living with HIV Stigma Index in Malawi and the United Kingdom (UK)

2013 ◽  
pp. 337-355
Author(s):  
Lucy Stackpool-Moore ◽  
Maureen Leah Chirwa ◽  
Sam de Croy ◽  
Alastair Hudson ◽  
David Kamkwamba ◽  
...  
Keyword(s):  
United Kingdom ◽  
Hiv Stigma ◽  
People Living With Hiv ◽  
The United Kingdom ◽  
The People ◽  
Living With Hiv

scholarly journals The People Living with HIV Stigma Index 2.0: generating critical evidence for change worldwide

AIDS ◽  
2020 ◽  
Vol 34 (1) ◽  
pp. S5-S18 ◽  
Author(s):  
Barbara A. Friedland ◽  
Ann Gottert ◽  
Julian Hows ◽  
Stefan D. Baral ◽  
Laurel Sprague ◽  
...  
Keyword(s):  
Hiv Stigma ◽  
People Living With Hiv ◽  
The People ◽  
Living With Hiv

scholarly journals Access to HIV Care and Resilience in a Long Term Conflict Setting. A Pilot Qualitative Assessment of the Experiences of Living with Diagnosed HIV in Mogadishu, Somali

2017 ◽  
Author(s):  
Asli Kulane ◽  
John O. A. Owuor ◽  
Douglas Sematimba ◽  
Sacdia Abdisamad Abdulahi ◽  
Hamdi Moalim Yusuf ◽  
...  
Keyword(s):  
Access To Care ◽  
Economic Security ◽  
Hiv Treatment ◽  
Small Sample ◽  
Hiv Stigma ◽  
Hiv Care ◽  
Qualitative Assessment ◽  
People Living With Hiv ◽  
The People ◽  
Living With Hiv

Background: Human Immnodeficiency virus (HIV) continues to take a heavy toll on the lives of many people with worst impact on health and wellbeing for the affected individuals in fragile states. The HIV situation in Somalia is not clearly known and experiences of the people living with HIV in this war-torn region unexpressed. This pilot qualitative study sought to explore the experiences of people living with diagnosed HIV in Mogadishu and their resilience in access to care and social support. Method: Face-to-face in-depth interviews were conducted in Somali in May 2013 among patients who were receiving Antiretroviral therapy (ART) from the HIV clinic in Mogadishu. Participants were recruited through drug dispensers at the HIV clinic in Benader Hospital. These were tape recorded, transcribed and translated for content analysis. Results: Three women and four men who were living with HIV shared the following narratives. Their perception was that they had either got HIV from their spouces or through health care contamination. They were very knowledgable about the realities of HIV, how the medication works, nutritional requirements and drug adherence. They were always willing to go an extra mile to secure a good life for themselves. However the external HIV stigma impacted their access to care. They faced challenges in their homes and at work which compelled them to seek support from non-governmental organisations (NGOs) or close family members. This stigma often affected their disclosure to the wider community due to the uncertainity of the repercussions, leading to a life of extreme loneliness and financial difficulties. The participants&rsquo; coping mechansms included living together and starting their own NGO for support with very strong optimism about their prognosis. Conclusions: The people living with diagnosed HIV in Mogadishu are highly knowledgeable about HIV transmission, the realities of living with diagnosed HIV infection and efficacy of HIV treatment. Our small sample suggests adequate access to ART through NGOs. However, widespread HIV stigma limits HIV status disclosure to the families and communities which creates a risk of self isolation and ill health. But affected individuals have developed resilient mechanisms of managing the risks. They strive to remain employed for economic security, adhere to HIV treatment, engage in support groups and maintain utmost optimism about their prognosis.

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