Annals of Behavioral Medicine

, Volume 48, Issue 1, pp 26–37 | Cite as

The Dynamic Relationship Between Social Support and HIV-Related Stigma in Rural Uganda

  • Sae TakadaEmail author
  • Sheri D. Weiser
  • Elias Kumbakumba
  • Conrad Muzoora
  • Jeffrey N. Martin
  • Peter W. Hunt
  • Jessica E. Haberer
  • Annet Kawuma
  • David R. Bangsberg
  • Alexander C. Tsai
Original Article



Cross-sectional studies show that human immunodeficiency virus (HIV) stigma is negatively correlated with social support.


The purpose of this study is to examine the bidirectional relationship between social support and HIV stigma.


We collected quarterly data from a cohort of 422 people living with HIV in Uganda, followed for a median of 2.1 years. We used multilevel regression to model the contemporaneous and 3-month-lagged associations between social support and both enacted and internalized stigma.


Lagged enacted stigma was negatively correlated with emotional and instrumental social support, and lagged instrumental social support was negatively correlated with enacted stigma. Internalized stigma and emotional social support had reciprocal lagged associations.


Interventions to reduce enacted stigma may strengthen social support for people living with HIV. Improved social support may in turn have a protective influence against future enacted and internalized stigma.


HIV/AIDS Stigma Social support Uganda 



We thank the Uganda AIDS Rural Treatment Outcomes study participants who made this study possible by sharing their experiences; and Anna Baylor and Nozmo Mukiibi for study coordination and support. We also thank James O'Malley for statistical advice. While these individuals are acknowledged for their assistance, no endorsement of manuscript contents or conclusions should be inferred.


This study was funded by US National Institutes of Health K23MH079713, R01MH054907, and P30AI27763. The authors also acknowledge the following additional sources of salary support: the Walker Foundation, the Burke Family Foundation, T32AI007433, K23MH087228, K24MH087227, and K23MH096620.

Conflict of Interest

The authors have no conflict of interest to disclose.

Supplementary material

12160_2013_9576_MOESM1_ESM.docx (79 kb)
ESM 1 (DOCX 78 kb)


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Copyright information

© The Society of Behavioral Medicine 2013

Authors and Affiliations

  • Sae Takada
    • 1
    Email author
  • Sheri D. Weiser
    • 2
  • Elias Kumbakumba
    • 3
  • Conrad Muzoora
    • 3
  • Jeffrey N. Martin
    • 4
  • Peter W. Hunt
    • 2
  • Jessica E. Haberer
    • 1
    • 5
  • Annet Kawuma
    • 3
  • David R. Bangsberg
    • 1
    • 3
    • 5
  • Alexander C. Tsai
    • 1
    • 5
    • 6
  1. 1.Harvard Medical SchoolBostonUSA
  2. 2.Division of HIV/AIDS and Positive Health ProgramUniversity of California at San FranciscoSan FranciscoUSA
  3. 3.Mbarara University of Science and TechnologyMbararaUganda
  4. 4.Department of Epidemiology and BiostatisticsUniversity of California at San FranciscoSan FranciscoUSA
  5. 5.Center for Global HealthMassachusetts General HospitalBostonUSA
  6. 6.Chester M. Pierce MD Division of Global PsychiatryMassachusetts General HospitalBostonUSA

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