Persons living with HIV (PLWH) with socio-economic vulnerabilities are especially vulnerable to HIV stigma and adverse HIV outcomes. Stigma related to HIV may intersect with marginalized socio-economic conditions to negatively affect social networks. HIV stigma may limit the ability of individuals to sustain social relationships. This study examined the potential cross-sectional and longitudinal associations between HIV stigma and the quality and quantity of social networks for PLWH. PLWH (n = 1,082) who were experiencing housing, employment, and medical care-related difficulties were recruited to participate in a one-year navigation and system coordination intervention to improve housing stability and employment. Neither stigma reduction nor social networks were the main components of the intervention. A series of latent growth curves were estimated to assess the cross-sectional and longitudinal relationships among internalized and anticipated HIV stigma and social networks. Anticipated HIV stigma predicted social networks both cross-sectionally and longitudinally. Internalized HIV stigma predicted social networks cross-sectionally but not longitudinally in this population. These data support the HIV Stigma Framework and suggest that anticipated stigma seems to have a strong association with social networks. As anticipated stigma decreases over time, social network scores increase. Interventions to decrease anticipated HIV stigma as a mechanism of improving social networks warrants further investigation.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Price excludes VAT (USA)
Tax calculation will be finalised during checkout.
Availability of Data
Data are available as part of this manuscript.
Department of Health and Human Services. HIV National Strategic Plan for the United States: A roadmap to end the HIV epidemic (2021–2025). 2021. Available at: https://www.hiv.gov/. Accessed May 10, 2021.
Centers for Disease Control and Prevention. HIV infection, risk, prevention, and testing behaviors among heterosexually active adults at increased risk for HIV infection—National HIV behavioral surveillance: 23 U.S. cities. 2019. Available at: http://www.cdc.gov/hiv/library/reports/hiv-surveillance.html. Accessed May 10, 2021.
Sullivan PS, Satcher Johnson A, Pembleton ES, et al. Epidemiology of HIV in the USA: epidemic burden, inequities, contexts, and responses. The Lancet. 2021;397(10279):1095–1106. Available at: https://doi.org/10.1016/S0140-6736(21)00395-0.
Pellowski JA, Kalichman SC, Matthews KA, Adler N. A pandemic of the poor: Social disadvantage and the U.S. HIV epidemic. American Psychologist. 2013;68(4):197–209. Available at: https://doi.org/10.1037/a0032694.
Bagchi AD, Holzemer W, Peavy D. Predictors of enacted, internal, and anticipated stigma among PLHIV in New Jersey. AIDS Care - Psychol Socio-Medical Asp AIDS/HIV. 2019;31(7):827 – 35. Available at: https://doi:https://doi.org/10.1080/09540121.2018.1554242.
Hatzenbuehler ML, Phelan JC, Link BG. Stigma as a fundamental cause of population health inequalities. American Journal of Public Health. 2013;103(5):813–21. Available at: https://doi.org/10.2105/AJPH.2012.301069.
Palar K, Frongillo EA, Escobar J, et al. Food insecurity, internalized stigma, and depressive symptoms among women living with HIV in the United States. AIDS Behav. 2018;22(12):3869-78. Available at: doi:https://doi.org/10.1007/s10461-018-2164-8.
Aidala AA, Wilson MG, Shubert V, et al. Housing status, medical care, and health outcomes among people living with HIV/AIDS: A systematic review. American Journal of Public Health. 2016;106(1):e1–e23. Available at: https://doi.org/10.2105/AJPH.2015.302905.
Maulsby CH, Ratnayake A, Hesson D, et al. A scoping review of employment and HIV. AIDS and Behavior. 2020;24(10):2942–55. Available at: https://doi.org/10.1007/s10461-020-02845-x.
Spinelli MA, Frongillo EA, Sheira LA, et al. Food Insecurity is associated with poor HIV outcomes among women in the United States. AIDS and Behavior. 2017;21(12):3473–7. Available at: https://doi.org/10.1007/s10461-017-1968-2.
Turan JM, Elafros MA, Logie CH, et al. Challenges and opportunities in examining and addressing intersectional stigma and health. BMC Medicine. 2019;17(1). Available at: https://doi.org/10.1186/s12916-018-1246-9.
Perkins JM, Subramanian SV, Christakis NA. Social networks and health: a systematic review of sociocentric network studies in low-and middle-income countries. Soc Sci Med. 2015;125:60–78.
Marziali ME, McLinden T, Card KG, et al. Social isolation and mortality among people living with HIV in British Columbia, Canada. AIDS and Behavior, 2021;25(2):377–88. Available at: https://doi.org/10.1007/s10461-020-03000-2.
Marziali ME, Card KG, McLinden T, et al. Correlates of social isolation among people living with HIV in British Columbia, Canada. AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV. 2021;33(5):566–74. Available at: https://doi.org/10.1080/09540121.2020.1757607.
Takada S, Nyakato V, Nishi A, et al. The social network context of HIV stigma: population-based, sociocentric network study in rural Uganda. Soc Sci Med. 2019;233:229–36.
Chan BT, Tsai AC. Personal contact with HIV-positive persons is associated with reduced HIV‐related stigma: cross‐sectional analysis of general population surveys from 26 countries in sub‐Saharan Africa. J Int AIDS Soc. 2017;20(1):21395.
Rzeszutek M, Gruszczyńska E. Posttraumatic growth among people living with HIV: A systematic review. J Psychosom Res. 2018;114:81–91. doi:https://doi.org/10.1016/j.jpsychores.2018.09.006. Available at.
Brener L, Broady T, Cama E, Hopwood M, de Wit JBF, Treloar C. The role of social support in moderating the relationship between HIV centrality, internalised stigma and psychological distress for people living with HIV. AIDS Care - Psychol Socio-Medical Asp. AIDS/HIV. 2020;32(7):850–57. Available at: doi:https://doi.org/10.1080/09540121.2019.1659914.
Casale M, Wild L. Effects and processes linking social support to caregiver health among HIV/AIDS-affected carer-child dyads: A critical review of the empirical evidence. AIDS Behav. 2013;17(5):1591 – 611. Available at: doi:https://doi.org/10.1007/s10461-012-0275-1.
Kane JC, Elafros MA, Murray SM, et al. A scoping review of health-related stigma outcomes for high-burden diseases in low- and middle-income countries. BMC Med. 2019;17(1):1–40. doi:https://doi.org/10.1186/s12916-019-1250-8. Available at:.
Turan B, Hatcher AM, Weiser SD, et al. Framing mechanisms linking HIV-related stigma, adherence to treatment, and health outcomes. American Journal of Public Health. 2017;107(6):863–9. Available at: https://doi.org/10.2105/AJPH.2017.303744.
Earnshaw VA, Smith LR, Chaudoir SR, et al. HIV stigma mechanisms and well-being among PLWH: a test of the HIV stigma framework. AIDS and Behavior. 2013;17(5):1785-95. Available at: https://doi.org/10.1007/s10461-013-0437-9 PMID: 23456594.
Earnshaw VA, Chaudoir SR. From conceptualizing to measuring HIV stigma: a review of HIV stigma mechanism measures. AIDS and Behavior. 2009;13(6):1160–77. Available at: https://doi.org/10.1007/s10461-009-9593-3.
Rueda S, Mitra S, Chen S, et al. Examining the associations between HIV-related stigma and health outcomes in people living with HIV/AIDS: a series of meta-analyses. BMJ Open. 2016;6(7):e011453. Available at: doi:https://doi.org/10.1136/bmjopen-2016-011453.
Takada S, Weiser SD, Kumbakumba E, et al. The dynamic relationship between social support and HIV-related stigma in rural Uganda. Annals of Behavioral Medicine. 2014;48(1):26–37. Available at: https://doi.org/10.1007/s12160-013-9576-5.
Turan B, Smith W, Cohen MH, et al. Mechanisms for the negative effects of internalized HIV-related stigma on antiretroviral therapy adherence in women: the mediating roles of social isolation and depression. J Acquir Immune Defic Syndr. 2016;72(2):198–205. doi:https://doi.org/10.1097/QAI.0000000000000948. Available at.
Health Resources and Services Administration. SPNS Initiative: improve HIV health outcomes through the coordination of supportive employment and housing services, 2017–2020. Available at: https://hab.hrsa.gov/about-ryan-white-hivaids-program/spns-initiative-improving-hiv-health-outcomes.html. Accessed August 2, 2021.
Earnshaw VA, Smith LR, Chaudoir SR, et al. HIV stigma mechanisms and well-being among PLWH: a test of the HIV stigma framework. AIDS and Behavior. 2013;17,1785-95. Available at: doi:https://doi.org/10.1007/s10461-013-0437-9.
Lubben J, Blozik E, Gillmann G, et al. Performance of an abbreviated version of the Lubben Social Network Scale among three European community-dwelling older adult populations. Gerontologist. 2006;46(4):503–13.
Schnurr P, Vielhauer M, Weathers F, Findler M. The Brief Trauma Questionnaire (BTQ) 1999. Available at: http://www.ptsd.va.gov.
World Health Organization. The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST): development, reliability and feasibility. Addiction. 2002;97(9):1183–94. Available at: https://doi. https://doi.org/10.1046/j.1360-0443.2002.00185.x PMID: 12199834 21.
Blumberg SJ, Bialostosky K, Hamilton WL, Briefel RR. The effectiveness of a short form of the Household Food Security Scale. American Journal of Public Health. 1999 Aug;89(8):1231-4. Available at: https://doi.org/10.2105/ajph.89.8.1231 PMID: 10432912 20.
Radloff LS. The CESD Scale: a self-report depression scale for research in the general population. Applied Psychological Measurement. 1977;1:385–401. Available at: https://doi.org/10.1371/journal.pone.0252783.
Spitzer RL, Kronenke K, Williams JBW, Lowe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Archives of Internal Medicine. 2006; 166(10):1092-7. Available at: doi: https://doi.org/10.1001/archinte.166.10.1092.
Mitchell CM, Beals J, Kaufman CE. Alcohol use, outcome expectancies, and HIV risk status among American Indian youth: A latent growth curve model with parallel processes. Journal of Youth and Adolescence. 2006 Oct 1;35(5):726 – 37.
Li H, Tucker JD, Ma W, Kim ES, Marley G, Wang J, Kang D, Liao M, Tang W, Jiang B. Mediation analysis of peer norms, self-efficacy, and condom use among Chinese men who have sex with men: a parallel process latent growth curve model. Arch Sex Behav. 2020 Jan;49(1):287–97.
Kline RB. Structural Equation Modeling. New York: Guilford; 2006.
SPSS Inc. Released 2019. IBM SPSS Statistics for Windows, Version 26.0. Armonk, NY: IBM Corp.
Muthén LK, Muthén BO. Mplus User’s Guide. 6th ed. Los Angeles: Muthén & Muthén; 2011.
Turan B, Budhwani H, Fazeli PL, et al. How does stigma affect people living with HIV? The mediating roles of internalized and anticipated HIV stigma in the effects of perceived community stigma on health and psychosocial outcomes. AIDS and Behavior. 2017;21(1):283 – 91. Available at: doi:https://doi.org/10.1007/s10461-016-1451-5.
Travaglini LE, Himelhoch SS, Fang LJ. HIV stigma and Its relation to mental, physical and social health among Black women living with HIV/AIDS. AIDS and Behavior. 2018;22(12):3783-94. Available at: doi:https://doi.org/10.1007/s10461-018-2037-1.
Rajabiun S, Tryon J, Feaster M, et al. The influence of housing status on the HIV continuum of care: Results from a multisite study of patient navigation models to build a medical home for people living with HIV experiencing homelessness. American Journal of Public Health. 2018;108(57):S539-45. Available at: https://doi.org/10.2105/AJPH.2018.304736.
Maskay MH, Cabral HJ, Davila JA, et al. Longitudinal stigma reduction in people living with HIV experiencing homelessness or unstable housing diagnosed with mental health or substance use disorder: An intervention study. American Journal of Public Health. 2018;108(57):S546-51. Available at: https://doi.org/10.2105/AJPH.2018.304774.
Cabral HJ, Davis-Plourde K, Sarango M, et al. Peer support and the HIV continuum of care: result from a multi-site randomized clinical trial of three urban clinics in the United States. AIDS Behav. 2018;22(8):2627–39.
Fekete EM, Williams SL, Skinta MD. Internalised HIV-stigma, loneliness, depressive symptoms and sleep quality in people living with HIV. Psychology and Health. 2018;33(3),398–415. Available at: https://doi.org/10.1080/08870446.2017.1357816.
Ware D, Rueda S, Plankey M, et al. The longitudinal impact of employment, retirement and disability status on depressive symptoms among men living with HIV in the Multicenter AIDS Cohort Study. PLoS ONE. 2020;15(10):e0239291.
Spies G, Konkiewitz EC, Seedat S. Incidence and persistence of depression among women living with and without HIV in South Africa: a longitudinal study. AIDS and Behavior. 2018;22(10):3155-65. Available at: https://doi.org/10.1007/s10461-018-2072-y.
Kinyanda E, Weiss HA, Levin J, et al. Incidence and persistence of major depressive disorder among people living with HIV in Uganda. AIDS and Behavior. 2017;21(6):1641-54. Available at: https://doi.org/10.1007/s10461-016-1575-7.
Richards CM, Sharif F, Eischen S, et al. Retention of homeless smokers in the power to quit study. Nicotine Tob Res. 2014 Oct;9(9):1104–11. 17(.
We would like to thank all of the participants of this study and the sites for their continued service to the HIV community.
This project was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant numbers H89HA00028 and U90HA31449, Special Projects of National Significance (SPNS) Initiative, Improving Health Outcomes through the Coordination of Supportive Employment & Housing Services, awarded to the City of Kansas City, MO and Boston University, respectively. No percentage of this project was financed with non-governmental sources. This information or content and conclusions are those of the authors and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.
Conflict of Interest
All sites were approved by independent institutional review boards.
All participants consented to participate in the study.
Consent for Publication
Authors consent to publishing the data and supporting materials.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Electronic Supplementary Material
Below is the link to the electronic supplementary material.
About this article
Cite this article
Lightner, J.S., Cabral, H.J., Flaherty, J. et al. Does HIV Stigma Predict Social Networks Over Time: A Latent Growth Curve Analysis. AIDS Behav 26, 3667–3678 (2022). https://doi.org/10.1007/s10461-022-03695-5