1. Buffering Internalization of HIV Stigma
- Author
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Turan, Bulent, Crockett, Kaylee B, Buyukcan-Tetik, Asuman, Kempf, Mirjam-Colette, Konkle-Parker, Deborah, Wilson, Tracey E, Tien, Phyllis C, Wingood, Gina, Neilands, Torsten B, Johnson, Mallory O, Weiser, Sheri D, and Turan, Janet M
- Subjects
Epidemiology ,Public Health ,Health Sciences ,HIV/AIDS ,Brain Disorders ,Prevention ,Behavioral and Social Science ,Social Determinants of Health ,Infectious Diseases ,Mental Illness ,Sexually Transmitted Infections ,Mental Health ,Clinical Research ,Good Health and Well Being ,Adult ,Aged ,Anti-HIV Agents ,Anti-Retroviral Agents ,Depression ,Female ,HIV Infections ,Humans ,Male ,Medication Adherence ,Middle Aged ,Social Stigma ,Virus Internalization ,Young Adult ,negative evaluation ,attachment ,resilience ,HIV ,stigma ,adherence ,Clinical Sciences ,Public Health and Health Services ,Virology ,Clinical sciences ,Public health - Abstract
BackgroundOne mechanism through which social stigma of HIV affects health outcomes for people living with HIV (PLWH) is through internalization of stigma. However, this transformation of social stigma in the community into internalized stigma may not be of the same magnitude for all PLWH. We examined the moderating effects of 3 personality traits-fear of negative social evaluation, attachment-related anxiety, and dispositional resilience-in transforming perceived stigma in the community into internalized stigma. Furthermore, we investigated downstream effects of these moderated associations on depressive symptoms and antiretroviral treatment (ART) adherence.Setting/methodsIn study 1, data from 203 PLWH in the Southeast United States were analyzed controlling for age, sex, education, race, and time on ART. In study 2, data from 453 women in a multisite study were analyzed controlling for age, education, race, time on ART, and substance use.ResultsIn both studies, fear of negative evaluation and attachment-related anxiety moderated the effect of perceived HIV stigma in the community on internalized HIV stigma: People higher on those moderating variables had stronger associations between perceived stigma in the community and internalized stigma. In study 2, resilience was assessed and also moderated the effect of perceived HIV stigma in the community on internalized stigma. In moderated mediation models, fear of negative evaluation, attachment-related anxiety, and resilience moderated the indirect effect of perceived HIV stigma in the community on ART adherence and depression through internalized stigma.ConclusionsInterventions to assuage internalization of HIV stigma should focus on bolstering attachment-related security, social competence, and resilience.
- Published
- 2019