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Anticipated HIV-Related Stigma and HIV Treatment Adherence: The Indirect Effect of Medication Concerns

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Abstract

Although anticipated HIV-related stigma—the expectation that one will experience prejudice and discrimination in the future as a result of others learning his or her HIV positive status—is theorized to be a robust predictor of antiretroviral therapy (ART) non-adherence, the association between anticipated stigma and ART non-adherence has been inconsistent. It may be, however, that anticipated stigma reliably, but indirectly, contributes to poor ART adherence through other psychosocial mechanisms. In the current study, we examine whether anticipated stigma indirectly contributes to treatment non-adherence through increased medication concerns. In a cross-sectional study, 585 people living with HIV in Atlanta and Macon, Georgia completed measures of anticipated HIV-related stigma, HIV-medication concerns, and HIV-treatment adherence. A latent variable mediation analysis revealed that anticipated stigma was positively associated with increased medication concerns, which consequently contributed to treatment non-adherence. Results reveal a psychosocial mechanism by which anticipated stigma contributes to ART non-adherence.

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Funding

Gabriel Camacho was supported by the National Institute of Mental Health with a Research Training Fellowship (T32MH074387) and this research was supported by the National Institute of Alcohol Abuse and Alcoholism Grant R01-AA021471 and the National Institute on Drug Abuse Grant R01-DA033067.

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Authors and Affiliations

  1. Department of Psychological Sciences, University of Connecticut, 406 Babbidge Rd, U-1020, Storrs, CT, 06269-1020, USA

    Gabriel Camacho & Seth Kalichman

  2. Mercer University School of Medicine, Macon, GA, USA

    Harold Katner

Authors
  1. Gabriel Camacho
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  2. Seth Kalichman
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  3. Harold Katner
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Correspondence to Gabriel Camacho.

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Conflict of interest

Peter Vanable at Syracuse University served as the Action Editor on this paper. The Editor, Seth Kalichman, was uninvolved in the review and editorial decisions due to conflict of interest.

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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.

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

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Camacho, G., Kalichman, S. & Katner, H. Anticipated HIV-Related Stigma and HIV Treatment Adherence: The Indirect Effect of Medication Concerns. AIDS Behav 24, 185–191 (2020). https://doi.org/10.1007/s10461-019-02644-z

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