Impact of HIV-Related Stigma on Health Behaviors and Psychological Adjustment Among HIV-Positive Men and Women
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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.
KEY WORDS:Stigma HIV sexual behavior adherence depression disclosure
This work was supported by the National Institute of Mental Health Grant R21-MH65865. The authors thank the staff at University Hospital for their support of this work. Special thanks are extended to Missy Albert, Linda Bartlett, Mary Beth Cavalieri, Kelley Flood, Lois Needham, Paul Preczewski, Pamela Wickham, Judy Rees, Craig Withers, Jennifer Lewis, and Jennifer Brown for their assistance.
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