Annals of Behavioral Medicine

, Volume 42, Issue 2, pp 227–234 | Cite as

Prospective Associations Between HIV-Related Stigma, Transmission Risk Behaviors, and Adverse Mental Health Outcomes in Men Who Have Sex with Men

  • Mark L. HatzenbuehlerEmail author
  • Conall O’Cleirigh
  • Kenneth H. Mayer
  • Matthew J. Mimiaga
  • Steven A. Safren
Original Article



The vast majority of research on HIV-related stigma has been cross sectional, and few studies have examined whether experiencing stigma is associated with sexual risk behaviors.


The purpose of this study is to examine the prospective relationships between experiencing HIV-related stigma and symptoms of anxiety and depression, as well as sexual transmission risk behavior.


The sample included HIV-infected men who have sex with men (n = 314) who participated in a secondary HIV-prevention study at their primary care site. Participants were assessed at baseline, and then completed follow-up assessments at 3, 6, 9, and 12 months.


Experiencing HIV-related stigma was prospectively associated with symptoms of depression (β = 0.16, p < .001), panic (β = 0.11, p = .01), and generalized anxiety (β = 0.05, p = .05). In addition, perceiving HIV-related stigma was prospectively associated with transmission risk behaviors, including unprotected receptive or insertive anal intercourse with HIV-seronegative or status unknown partners (β = 0.06, p = .047).


Experiencing HIV-related stigma may increase risk for sexual transmission risk behavior and mental health problems.


HIV-related stigma HIV risk behaviors Depression Anxiety MSM 



This study was supported by NIMH grant 5R01MH068746-05 and HRSA grant H97HA01293 awarded to Drs. Kenneth H. Mayer and Steven A. Safren.

Conflicts of Interest Statement

The authors have no conflicts of interest to report.


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Copyright information

© The Society of Behavioral Medicine 2011

Authors and Affiliations

  • Mark L. Hatzenbuehler
    • 1
    • 2
    • 3
    Email author
  • Conall O’Cleirigh
    • 2
    • 3
  • Kenneth H. Mayer
    • 2
    • 4
  • Matthew J. Mimiaga
    • 2
    • 3
    • 5
  • Steven A. Safren
    • 2
    • 3
  1. 1.Department of PsychologyYale UniversityNew HavenUSA
  2. 2.Department of PsychiatryMassachusetts General Hospital/Harvard Medical SchoolBostonUSA
  3. 3.Fenway Institute, Fenway HealthBostonUSA
  4. 4.Departments of Medicine and Community HealthBrown UniversityProvidenceUSA
  5. 5.Department of EpidemiologyHarvard School of Public HealthBostonUSA

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