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Mastery Moderates the Negative Effect of Stigma on Depressive Symptoms in People Living with HIV

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Abstract

Stigma continues to have a negative effect on the care, treatment, and support of people living with HIV. This study presents baseline data from 825 participants taking part in a cohort study that collects data on the clinical profile and social determinants of health of people with HIV. We performed multivariate regression analysis to evaluate whether mastery and social support moderated the negative effect of stigma on depressive symptoms. Stigma was associated with depressive symptoms after controlling for potential demographic and clinical confounders. In addition, higher levels of mastery and social support were associated with lower levels of depression. However, only mastery moderated the negative effects of stigma on depressive symptoms. For individuals with high levels of mastery, greater exposure to stigma does not translate into greater distress. Interventions targeting the mental health concerns of people with HIV should increase their focus on improving people’ sense of personal control.

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Acknowledgments

The OHTN Cohort Study (Principal Investigator, Dr. Sean B. Rourke) is supported by the AIDS Bureau—Ontario Ministry of Health and Long-Term Care. Data collection sites include: Toronto General Hospital (Drs. Irving Salit and Janet Raboud), St. Michael’s Hospital (Dr. Ahmed Bayoumi), Maple Leaf Medical Clinic (Drs. Mona Loutfy and Fred Crouzat), Sunnybrook Health Sciences Centre (Drs. Anita Rachlis and Nicole Mittmann), Kingston General Hospital (Dr. Wendy Wobeser), Ottawa General Hospital (Dr. Curtis Cooper), St Joseph’s Hospital, Hamilton (Dr. Marek Smieja), St Clair Medical Associates (Dr. Ken Logue), University of Ottawa Health Services (Dr. Don Kilby), St. Joseph’s Health Care, London (Dr. Edward Ralph), Sudbury Regional Hospital (Dr. Roger Sandre) and Windsor Regional Hospital (Dr. Jeffrey Cohen). OCS research studies are developed by investigators through Working Group and Scientific Steering Committee discussions and approved by the OCS Governance Committee, the members of which include a majority of people living with HIV. We gratefully acknowledge all of the people living with HIV who volunteered to participate in the OHTN Cohort Study and the work and support of the inaugural OCS Governance Committee: Darien Taylor (Chair), Dr. Evan Collins, Dr. Greg Robinson, Shari Margolese, Patrick Cupido, Tony Di Pede, Rick Kennedy, Michael Hamilton, Ken King, Brian Finch, Lori Stoltz, Dr. Ahmed Bayoumi, Dr. Clemon George, and Dr. Curtis Cooper. We thank all the interviewers, data collectors, research associates and coordinators, nurses and physicians who provide support for data collection and extraction. The authors wish to thank the OHTN staff and their teams for data management and IT support (Mark Fisher, Director, Data Systems) and OCS management and coordination (Virginia Waring, Project Manager, OCS). The viral load data in the OCS was supplemented through a linkage with the viral load database of the Ontario Agency for Health Protection and Promotion.

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There are no conflicts of interest related to this paper and project.

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Authors and Affiliations

  1. The Ontario HIV Treatment Network (OHTN), 1300 Yonge Street, Suite 600, Toronto, ON, M4T 1X3, Canada

    Sergio Rueda, Sean B. Rourke, Tsegaye Bekele & Sandra Gardner

  2. Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada

    Sergio Rueda

  3. Faculty of Medicine, University of Calgary, Calgary, AB, Canada

    Katherine Gibson

  4. Department of Psychiatry, University of Toronto, Toronto, ON, Canada

    Sean B. Rourke

  5. Centre for Research on Inner City Health and The Keenan Research Centre in the Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON, Canada

    Sean B. Rourke

  6. Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada

    Sandra Gardner

  7. Department of Family Medicine and Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada

    John Cairney

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  1. Sergio Rueda
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Correspondence to Sergio Rueda.

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Rueda, S., Gibson, K., Rourke, S.B. et al. Mastery Moderates the Negative Effect of Stigma on Depressive Symptoms in People Living with HIV. AIDS Behav 16, 690–699 (2012). https://doi.org/10.1007/s10461-010-9878-6

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