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

  • Original Article
  • Published:
Annals of Behavioral Medicine

Abstract

Background

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

Purpose

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

Methods

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.

Results

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.

Conclusions

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.

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Acknowledgments

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.

Funding

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.

Author information

Authors and Affiliations

  1. Harvard Medical School, Boston, MA, USA

    Sae Takada Ph.D., M.H.S., Jessica E. Haberer M.D., M.S., David R. Bangsberg M.D., M.P.H. & Alexander C. Tsai M.D., Ph.D.

  2. Division of HIV/AIDS and Positive Health Program, University of California at San Francisco, San Francisco, CA, USA

    Sheri D. Weiser M.D., M.A., M.P.H. & Peter W. Hunt M.D.

  3. Mbarara University of Science and Technology, Mbarara, Uganda

    Elias Kumbakumba M.D., Conrad Muzoora M.D., Annet Kawuma M.D. & David R. Bangsberg M.D., M.P.H.

  4. Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, CA, USA

    Jeffrey N. Martin M.D., M.P.H.

  5. Center for Global Health, Massachusetts General Hospital, Boston, MA, USA

    Jessica E. Haberer M.D., M.S., David R. Bangsberg M.D., M.P.H. & Alexander C. Tsai M.D., Ph.D.

  6. Chester M. Pierce MD Division of Global Psychiatry, Massachusetts General Hospital, Boston, MA, USA

    Alexander C. Tsai M.D., Ph.D.

Authors
  1. Sae Takada Ph.D., M.H.S.
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  2. Sheri D. Weiser M.D., M.A., M.P.H.
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  3. Elias Kumbakumba M.D.
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  4. Conrad Muzoora M.D.
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  5. Jeffrey N. Martin M.D., M.P.H.
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  6. Peter W. Hunt M.D.
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  7. Jessica E. Haberer M.D., M.S.
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  8. Annet Kawuma M.D.
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  9. David R. Bangsberg M.D., M.P.H.
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  10. Alexander C. Tsai M.D., Ph.D.
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Corresponding author

Correspondence to Sae Takada Ph.D., M.H.S..

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Takada, S., Weiser, S.D., Kumbakumba, E. et al. The Dynamic Relationship Between Social Support and HIV-Related Stigma in Rural Uganda. ann. behav. med. 48, 26–37 (2014). https://doi.org/10.1007/s12160-013-9576-5

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  • DOI: https://doi.org/10.1007/s12160-013-9576-5

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