Avoidant Coping Mediates the Relationship Between Self-Efficacy for HIV Disclosure and Depression Symptoms Among Men Who Have Sex with Men Newly Diagnosed with HIV
HIV diagnosis presents a critical opportunity to reduce secondary transmission, improve engagement in care, and enhance overall well-being. To develop relevant interventions, research is needed on the psychosocial experiences of newly diagnosed individuals. This study examined avoidant coping, self-efficacy for HIV disclosure decisions, and depression among 92 newly diagnosed men who have sex with men who reported recent sexual risk behavior. It was hypothesized that avoidant coping would mediate the relationship between self-efficacy and depression. Cross-sectional surveys were collected from participants 3 months after HIV diagnosis. To test for mediation, multiple linear regressions were conducted while controlling for HIV disclosure to sexual partners. Self-efficacy for HIV disclosure decisions showed a negative linear relationship to depression symptoms, and 99% of this relationship was mediated by avoidant coping. The index of mediation of self-efficacy on depression indicated a small-to-medium effect. Higher self-efficacy was related to less avoidant coping, and less avoidant coping was related to decreased depression symptoms, all else held constant. These findings highlight the role of avoidant coping in explaining the relationship between self-efficacy for HIV disclosure decisions and depression.
KeywordsHIV Coping Self-efficacy Depression MSM
This research was funded by the NIH Grant R01-MH078731. We are grateful for our longstanding collaboration with Callen-Lorde Community Health Center and the individuals who offered their participation in the study. We thankfully acknowledge Arlene Kochman, Allyson De Lorenzo, Jessica MacFarlane, Gal Mayer, Anya Drabkin, and William Nazareth for their contributions to this research. In addition, we acknowledge the Duke Center for AIDS Research (NIAID P30-AI064518) for the support in the conduct of this study and preparation of the manuscript.
This research was funded by the NIH Grant R01-MH078731.
Compliance with Ethical Standards
Conflict of interest
Emily M. Cherenack declares that she has no conflict of interest. Kathleen J. Sikkema declares that she has no conflict of interest. Melissa H. Watt declares that she has no conflict of interest. Nathan B. Hansen declares that he has no conflict of interest. Patrick A. Wilson. declares that he has no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all participants included in the study.
- 1.Centers for Disease Control and Prevention. HIV in the United States: at a glance [Internet]. 2016. http://www.cdc.gov/hiv/statistics/overview/ataglance.html. Accessed 25 July 2016.
- 3.Mimiaga MJ, O’Cleirigh C, Biello KB, Robertson AM, Safren SA, Coates TJ, et al. The effect of psychosocial syndemic production on 4-year HIV incidence and risk behavior in a large cohort of sexually active men who have sex with men. J Acquir Immune Defic Syndr. 2015;68:329–36.CrossRefPubMedCentralGoogle Scholar
- 8.Grinsztejn B, Hosseinipour MC, Ribaudo HJ, Swindells S, Eron J, Chen YQ, et al. Effects of early versus delayed initiation of antiretroviral treatment on clinical outcomes of HIV-1 infection: results from the phase 3 HPTN 052 randomised controlled trial. Lancet Infect Dis. 2014;14:281–90.CrossRefPubMedCentralGoogle Scholar
- 13.Hult JR, Mauer SA, Moskowitz JT. “I’m sorry, you’re positive”: a qualitative study of individual experiences of testing positive for HIV. AIDS Care. 2009;21(185–188):4p.Google Scholar
- 22.Hult JR, Wrubel J, Bränström R, Acree M, Moskowitz JT. Disclosure and nondisclosure among people newly diagnosed with HIV: an analysis from a stress and coping perspective. AIDS Patient Care STDs. 2012;26(181–190):10p.Google Scholar
- 27.Lazarus RS, Folkman S. Stress, appraisal, and coping. New York: Springer; 1984.Google Scholar
- 42.Bandura A. Social cognitive theory and exercise of control over hiv infection. In: DiClemente RJ, Peterson JL, editors. Prev. AIDS [Internet]. Springer US; 1994. p. 25–59. http://link.springer.com/chapter/10.1007/978-1-4899-1193-3_3. Accessed 28 Mar 2016.CrossRefGoogle Scholar
- 48.Tucker A, Liht J, de Swardt G, Jobson G, Rebe K, McIntyre J, et al. An exploration into the role of depression and self-efficacy on township men who have sex with men’s ability to engage in safer sexual practices. AIDS Care. 2013;25(1227–1235):9p.Google Scholar
- 59.Yusoff N, Low WY, Yip CH. Reliability and validity of the Brief COPE Scale (English version) among women with breast cancer undergoing treatment of adjuvant chemotherapy: a Malaysian study. Med J Malays. 2010;65:41–4.Google Scholar
- 61.Corp IBM. IBM SPSS statistics. Armonk: IBM Corp; 2014.Google Scholar
- 65.Hayes AF. Introduction to mediation, moderation, and conditional process analysis: a regression-based approach. 1st ed. New York: Guilford Press; 2013.Google Scholar
- 76.Johnson MO, Charlebois E, Morin SF, Remien RH, Chesney MA, National Institute of Mental Health Healthy Living Project Team. Effects of a behavioral intervention on antiretroviral medication adherence among people living with HIV: the healthy living project randomized controlled study. J Acquir Immune Defic Syndr. 1999;2007(46):574–80.Google Scholar
- 80.Cherenack EM, Wilson PA, Kreuzman AM, Price GN, The Adolescent Medicine Trials Network for HIV/AIDS Interventions. The feasibility and acceptability of using technology-based daily diaries with HIV-infected young men who have sex with men: a comparison of internet and voice modalities. AIDS Behav. 2016;20:1744–53.CrossRefPubMedCentralGoogle Scholar