Impact of HIV-related Stigma on Health Behaviors and Psychological Adjustment Among HIV-positive Men and Women

Overview

Journal AIDS Behav

Specialty Infectious Diseases

Date 2006 Apr 11

PMID 16604295

Citations 241

Authors

Peter A Vanable

Michael P Carey

Donald C Blair

Rae A Littlewood

Affiliations

Soon will be listed here.

Abstract

HIV-related stigmatization remains a potent stressor for HIV-positive people. This study examined the relationships among stigma-related experiences and depression, medication adherence, serostatus disclosure, and sexual risk among 221 HIV-positive men and women. In bivariate analyses that controlled for background characteristics, stigma was associated with depressive symptoms, receiving recent psychiatric care, and greater HIV-related symptoms. Stigma was also associated with poorer adherence and more frequent serostatus disclosure to people other than sexual partners, but showed no association to sexual risk behavior. In a multivariate analysis that controlled for all correlates, depression, poor adherence, and serostatus disclosure remained as independent correlates of stigma-related experiences. Findings confirm that stigma is associated with psychological adjustment and adherence difficulties and is experienced more commonly among people who disclose their HIV status to a broad range of social contacts. Stigma should be addressed in stress management, health promotion, and medication adherence interventions for HIV-positive people.

Citing Articles

Identifying barriers and facilitators to psychosocial care for people living with HIV in Ireland: a mixed methods study.

Burke A, Davoren M, Arensman E, Harrington J BMC Public Health. 2025; 25(1):707.

PMID: 39979953 PMC: 11843745. DOI: 10.1186/s12889-025-21906-1.

Magnitude of Depression and Associated Factors in Women Living With HIV in Northwest, Ethiopia: Mediation Analysis.

Zeleke T, Ayele T, Denu Z, Mwanri L, Azale T AIDS Res Treat. 2025; 2025:9578192.

PMID: 39831266 PMC: 11737907. DOI: 10.1155/arat/9578192.

Factors Associated With Feeling Ashamed of Disclosure of HIV-Positive Status Among Women Who Self-Reported to Health Facilities for HIV Testing in Kenya: Analysis of 2022 Kenya Demographic and Health Survey.

Isiko I, Taremwa K, Nyegenye S, Mwesigwa A, Mutebi R, Okoro L Health Sci Rep. 2024; 7(12):e70234.

PMID: 39633839 PMC: 11615699. DOI: 10.1002/hsr2.70234.

Associations of stigma, loneliness, and treatment self-regulation with HIV medication adherence among individuals with substance use disorder using a mobile health application.

Tarfa A, Verinumbe T, Yang F, Shiyanbola O, Liebert C, Dietz S Front Public Health. 2024; 12:1440807.

PMID: 39564363 PMC: 11573518. DOI: 10.3389/fpubh.2024.1440807.

Perceived levels of social stigma following HIV notification: Insights from Brazilian blood centers.

Buccheri R, Miranda C, de Almeida-Neto C, Goncalez T, Preiss L, Amorim L Braz J Infect Dis. 2024; 28(6):104480.

PMID: 39547004 PMC: 11609526. DOI: 10.1016/j.bjid.2024.104480.

References

Leonard B . Stress, depression and the activation of the immune system. World J Biol Psychiatry. 2003; 1(1):17-25. DOI: 10.3109/15622970009150562. View

Gonzales V, Washienko K, Krone M, Chapman L, Arredondo E, Huckeba H . Sexual and drug-use risk factors for HIV and STDs: a comparison of women with and without bisexual experiences. Am J Public Health. 1999; 89(12):1841-6. PMC: 1509027. DOI: 10.2105/ajph.89.12.1841. View

Brown L, Macintyre K, Trujillo L . Interventions to reduce HIV/AIDS stigma: what have we learned?. AIDS Educ Prev. 2003; 15(1):49-69. DOI: 10.1521/aeap.15.1.49.23844. View

Angermeyer M, Beck M, Dietrich S, Holzinger A . The stigma of mental illness: patients' anticipations and experiences. Int J Soc Psychiatry. 2004; 50(2):153-62. DOI: 10.1177/0020764004043115. View

Catz S, McClure J, Jones G, Brantley P . Predictors of outpatient medical appointment attendance among persons with HIV. AIDS Care. 1999; 11(3):361-73. DOI: 10.1080/09540129947983. View

Eisenman D, Cunningham W, Zierler S, Nakazono T, Shapiro M . Effect of violence on utilization of services and access to care in persons with HIV. J Gen Intern Med. 2003; 18(2):125-7. PMC: 1494821. DOI: 10.1046/j.1525-1497.2003.20518.x. View

Weiser S, Wolfe W, Bangsberg D, Thior I, Gilbert P, Makhema J . Barriers to antiretroviral adherence for patients living with HIV infection and AIDS in Botswana. J Acquir Immune Defic Syndr. 2003; 34(3):281-8. DOI: 10.1097/00126334-200311010-00004. View

Stall R, Hoff C, Coates T, Paul J, Phillips K, Ekstrand M . Decisions to get HIV tested and to accept antiretroviral therapies among gay/bisexual men: implications for secondary prevention efforts. J Acquir Immune Defic Syndr Hum Retrovirol. 1996; 11(2):151-60. DOI: 10.1097/00042560-199602010-00006. View

Rosman S . Cancer and stigma: experience of patients with chemotherapy-induced alopecia. Patient Educ Couns. 2004; 52(3):333-9. DOI: 10.1016/S0738-3991(03)00040-5. View

10.

Ickovics J, Hamburger M, Vlahov D, Schoenbaum E, Schuman P, Boland R . Mortality, CD4 cell count decline, and depressive symptoms among HIV-seropositive women: longitudinal analysis from the HIV Epidemiology Research Study. JAMA. 2001; 285(11):1466-74. DOI: 10.1001/jama.285.11.1466. View

11.

Moskowitz J . Positive affect predicts lower risk of AIDS mortality. Psychosom Med. 2003; 65(4):620-6. DOI: 10.1097/01.psy.0000073873.74829.23. View

12.

Mansergh G, Marks G, Simoni J . Self-disclosure of HIV infection among men who vary in time since seropositive diagnosis and symptomatic status. AIDS. 1995; 9(6):639-44. DOI: 10.1097/00002030-199506000-00017. View

13.

Murphy D, Durako S, Moscicki A, Vermund S, Ma Y, Schwarz D . No change in health risk behaviors over time among HIV infected adolescents in care: role of psychological distress. J Adolesc Health. 2001; 29(3 Suppl):57-63. DOI: 10.1016/s1054-139x(01)00287-7. View

14.

Zierler S, Cunningham W, Andersen R, Shapiro M, Nakazono T, Morton S . Violence victimization after HIV infection in a US probability sample of adult patients in primary care. Am J Public Health. 2000; 90(2):208-15. PMC: 1446146. DOI: 10.2105/ajph.90.2.208. View

15.

. HIV-related knowledge and stigma--United States, 2000. MMWR Morb Mortal Wkly Rep. 2001; 49(47):1062-4. View

16.

Preston D, DAugelli A, Kassab C, Cain R, Schulze F, Starks M . The influence of stigma on the sexual risk behavior of rural men who have sex with men. AIDS Educ Prev. 2004; 16(4):291-303. DOI: 10.1521/aeap.16.4.291.40401. View

17.

Chesney M, Ickovics J, Chambers D, Gifford A, Neidig J, Zwickl B . Self-reported adherence to antiretroviral medications among participants in HIV clinical trials: the AACTG adherence instruments. Patient Care Committee & Adherence Working Group of the Outcomes Committee of the Adult AIDS Clinical Trials Group.... AIDS Care. 2000; 12(3):255-66. DOI: 10.1080/09540120050042891. View

18.

Heckman T, Somlai A, Kalichman S, Franzoi S, Kelly J . Psychosocial differences between urban and rural people living with HIV/AIDS. J Rural Health. 1998; 14(2):138-45. DOI: 10.1111/j.1748-0361.1998.tb00615.x. View

19.

Heckman B, Catz S, Heckman T, Miller J, Kalichman S . Adherence to antiretroviral therapy in rural persons living with HIV disease in the United States. AIDS Care. 2003; 16(2):219-30. DOI: 10.1080/09540120410001641066. View

20.

Justice A, Holmes W, Gifford A, Rabeneck L, Zackin R, Sinclair G . Development and validation of a self-completed HIV symptom index. J Clin Epidemiol. 2001; 54 Suppl 1:S77-90. DOI: 10.1016/s0895-4356(01)00449-8. View