AIDS and Behavior

, Volume 23, Issue 3, pp 661–674 | Cite as

Experienced HIV-Related Stigma and Psychological Distress in Peruvian Sexual and Gender Minorities: A Longitudinal Study to Explore Mediating Roles of Internalized HIV-Related Stigma and Coping Styles

  • Rachel Rinehart
  • Deep Rao
  • Rivet K. Amico
  • Eduardo Ruiz
  • Peter Brandes
  • Cecilia Correa
  • Siavash Pasalar
  • Javier R. Lama
  • Ann Duerr
  • Yamile MolinaEmail author
Original Paper


Experiencing HIV-related stigma has important impacts on the mental health of people living with HIV, which has implications for treatment adherence, disease progression, and health outcomes. The impacts of stigma are particularly important to consider among sexual and gender minorities, who often face a disproportionate burden of HIV. To address the implications of stigma in these key populations, we leveraged a longitudinal study conducted among Peruvian sexual and gender minorities to compare the relative effects of multiple mediators affecting the relationship between experienced HIV-related stigma and psychological distress: internalized HIV-related stigma, adaptive coping, and maladaptive coping. HIV-related stigma, coping, and distress were measured, respectively, at 24 weeks, 36 weeks, and 48 weeks post-diagnosis for 145 participants from the Sabes Study. HIV-related maladaptive coping largely mediated the relationship between experienced HIV-related stigma and distress. Our findings suggest interventions targeting maladaptive coping may alleviate the mental health consequences of experiencing HIV-related stigma.


HIV Stigma Coping Psychological distress 



This study was funded by National Institutes on Drug Abuse (RO1 DA032106; PI: Ann Duerr). Dr. Molina’s efforts were supported by the National Cancer Institute (K01CA193918). We acknowledge ART drug donation from Gilead Sciences Inc. and Merck & Co Inc.

Compliance with Ethical Standards

Conflict of interest

Rachel Rinehart declares that she has no conflict of interest. Deepa Rao declares that she has no conflict of interest. Rivet Amico declares that she has no conflict of interest. Eduardo Ruiz declares that he has no conflict of interest. Peter Brandes declares that he has no conflict of interest. Cecilia Correa declares that she has no conflict of interest. Siavash Pasalar declares that he has no conflict of interest. Javier Lama declares that he has no conflict of interest. Ann Duerr declares that she has no conflict of interest. Yamile Molina declares that she has no conflict of interest.

Ethical Approval

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

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Rachel Rinehart
    • 1
  • Deep Rao
    • 2
  • Rivet K. Amico
    • 3
  • Eduardo Ruiz
    • 4
  • Peter Brandes
    • 4
  • Cecilia Correa
    • 4
  • Siavash Pasalar
    • 1
  • Javier R. Lama
    • 4
  • Ann Duerr
    • 1
    • 2
  • Yamile Molina
    • 1
    • 5
    Email author
  1. 1.Fred Hutchinson Cancer Research CenterSeattleUSA
  2. 2.Department of Global HealthUniversity of WashingtonSeattleUSA
  3. 3.Department of Health Behavior and Health EducationUniversity of MichiganAnn ArborUSA
  4. 4.La Asociación Civil Impacta Salud y EducaciónLimaPeru
  5. 5.Division of Community Health SciencesUniversity of Illinois at ChicagoChicagoUSA

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