Examining HIV Stigma, Depression, Stress, and Recent Stimulant Use in a Sample of Sexual Minority Men Living with HIV: An Application of the Stigma and Substance Use Process Model

Meyers-Pantele, Stephanie A.; Lammert, Sara; Rendina, H. Jonathon; Shalhav, Ore; Talan, Ali; Smith, Laramie R.; Pitpitan, Eileen V.; Horvath, Keith J.

doi:10.1007/s10461-021-03517-0

Cited by 13 publications

(4 citation statements)

References 47 publications

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“…PLWHIV who use stimulants face an intersectionality of stigmas in which socioeconomic status may affect social interactions and, may mediate the loss of social status (Do et al, 2021 ; Lim et al, 2013 ). Consequently, the high socioeconomic status of this sample could explain the low expected, experienced, and internalized stigma reported in this study, as described in other samples across settings (Meyers-Pantele et al, 2022 ; Turan et al, 2017a , 2017b ). Internalized stigma may act as an additional barrier in the dissemination of serological status to close people because this mechanism encourages self-exclusion from interpersonal relationships, distorts the perception of social support, and increases attachment-related anxiety (Turan et al, 2019 ; USAID, 2006 ).…”

Section: Discussionsupporting

confidence: 61%

HIV-Related Stigma and Treatment Adherence Among Gay, Bisexual, and Other Men Who Have Sex with Men Who Use Crystal Meth in the Metropolitan Area of Mexico City

Jiménez-Rivagorza,

Orozco,

Medina-Mora

et al. 2024

Arch Sex Behav

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Internationally, HIV-related stigma and crystal methamphetamine (meth) use have been described as barriers to treatment adherence among gay, bisexual, and other men who have sex with men (gbMSM). Crystal meth use has been increasing among gbMSM in the Metropolitan Area of Mexico City (MAMC). Therefore, this study aimed to determine the association between HIV-related stigma and HIV treatment adherence among gbMSM who use crystal meth in the MAMC. This study was undertaken as part of an exploratory study of crystal meth use in the MAMC. The data were collected from September to December 2021 through an encrypted online survey. Participants (n = 89) were gbMSM adults living with HIV who reported crystal meth use in the past month that were recruited through an online snowball sampling. The online survey included questions about HIV treatment adherence, sexual behaviors, the Alcohol, Smoking, and Substance Involved Screening Test, and the HIV-Related Stigma Mechanisms Scale. Logistic regression analyses assessed the association between HIV-related stigma and HIV treatment adherence. The multivariate logistic regression model showed that, controlling for health insurance [adjusted odds ratio (AOR) = 0.13; 95% confidence intervals (CI) = 0.02–0.59] and educational level (AOR = 0.16; 95% CI = 0.02–0.88), non-adherence to HIV treatment was independently associated with higher HIV-related stigma (AOR = 1.06; 95% CI = 1.01–1.12). Public health policies must include HIV-related stigma and substance use in treating gbMSM with HIV.

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Section: Discussionsupporting

confidence: 61%

HIV-Related Stigma and Treatment Adherence Among Gay, Bisexual, and Other Men Who Have Sex with Men Who Use Crystal Meth in the Metropolitan Area of Mexico City

Jiménez-Rivagorza,

Orozco,

Medina-Mora

et al. 2024

Arch Sex Behav

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“…Several research studies have indicated a link between internalized stigma and depression in PLHIV. The phenomenon was consistently found in general adults living with HIV [16,22,23,26,38], women living with HIV [21], older adults living with HIV (aged ≥ 50 years old) [24], and MSM [25]. However, these studies only examined overall internalized HIV stigma.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies from Asia, Africa, Australia, the Caribbean, and the United States have shown a correlation between internalized stigma and depression among PLHIV [16,[21][22][23][24][25][26][27][28][29][30]. From a cognitive theory perspective, depression is defined by people's dysfunctional negative beliefs about themselves, their life experience, their future, and the world in general [31], while internalized stigma entails accepting society's negative attitudes and feelings regarding PLHIV and applying them to oneself [32].…”

Section: Introductionmentioning

confidence: 99%

Association between Internalized Stigma and Depression among People Living with HIV in Thailand

Thapinta

Srithanaviboonchai

Uthis

et al. 2022

IJERPH

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Internalized stigma and depression are among the most common mental health problems in people living with HIV (PLHIV). This study aimed to examine the association between depression and overall internalized stigma, as well as different aspects of internalized stigma in PLHIV. The study included 400 PLHIV receiving care in Bangkok and Chiang Mai, Thailand. Data were analyzed using descriptive statistics, Mann-Whitney U test, and Spearman correlation coefficients. The results indicated the PLHIV with mild depression had lower median scores for the social relationship internalized stigma subscale than PLHIV with major depressive disorder (p = 0.009). Total HIV internalized stigma scores were significantly correlated with PHQ-9 scores in the mild depression group (r = 0.327, p = 0.004). Depression and internalized stigma were prevalent and associated, especially in the area of social relationships. Health personnel should be aware of possible depression in PLHIV who have internalized stigma. Intervention to promote understanding and social support for PLHIV is warranted.

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“…Qualitative research has documented the various distressing emotions that arise in the face of HIV stigma and how those emotions affect HIV care and treatment, including ART adherence (Robinson et al, 2023). Likewise, quantitative findings have linked HIV stigma to multiple mental health concerns, like depression and anxiety, which also affect ART adherence (Felker‐Kantor et al, 2019; Hatzenbuehler et al, 2011; Hernandez et al, 2018; Logie & Gadalla, 2009; Meyers‐Pantele et al, 2022; Sayles et al, 2009).…”

Section: Introductionmentioning

confidence: 99%

Emotion regulation as a potential moderator of the association between HIV stigma and nonadherence to antiretroviral therapy among youth living with HIV

Wiginton,

Amico,

Hightow‐Weidman

et al. 2024

Journal of Adolescence

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IntroductionHuman immunodeficiency virus (HIV)‐related stigma affects adherence to antiretroviral therapy (ART) for youth living with HIV. Emotion regulation strategies such as cognitive reappraisal (reinterpreting adversity to mitigate emotional impact) and expressive suppression (inhibiting emotion‐expressive behavior activated by adversity) may moderate the HIV stigma‐ART adherence relationship in this group.MethodsUsing baseline data from 208 youth living with HIV aged 15–24 years enrolled in an mHealth ART‐adherence intervention, we performed modified Poisson regressions with robust variance between HIV stigma (internalized, anticipated, enacted) and ART nonadherence. We tested for multiplicative interaction via product terms between HIV stigma and emotion regulation scores, and additive interaction via relative excess risk due to interaction and attributable proportion using dichotomous HIV stigma and emotion regulation variables.ResultsMean age was 21 years; ≥50% of participants were cisgender male, non‐Hispanic Black, and gay‐identifying; 18% reported ART nonadherence. Confounder‐adjusted regressions showed positive associations between each HIV stigma variable and ART nonadherence. Internalized HIV stigma and cognitive reappraisal negatively, multiplicatively interacted (as internalized HIV stigma increased, ART nonadherence increased for those with low cognitive reappraisal). High internalized HIV stigma positively, additively interacted with low cognitive reappraisal and low expressive suppression (when high internalized HIV stigma and low levels of either emotion regulation strategy were present, ART nonadherence increased dramatically).ConclusionCognitive reappraisal and expressive suppression may protect against internalized HIV stigma's harmful association with ART nonadherence. These modifiable emotion regulation strategies may be targeted to potentially buffer the effects of internalized HIV stigma and support ART adherence for youth living with HIV.

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Examining HIV Stigma, Depression, Stress, and Recent Stimulant Use in a Sample of Sexual Minority Men Living with HIV: An Application of the Stigma and Substance Use Process Model

Cited by 13 publications

References 47 publications

HIV-Related Stigma and Treatment Adherence Among Gay, Bisexual, and Other Men Who Have Sex with Men Who Use Crystal Meth in the Metropolitan Area of Mexico City

HIV-Related Stigma and Treatment Adherence Among Gay, Bisexual, and Other Men Who Have Sex with Men Who Use Crystal Meth in the Metropolitan Area of Mexico City

Association between Internalized Stigma and Depression among People Living with HIV in Thailand

Emotion regulation as a potential moderator of the association between HIV stigma and nonadherence to antiretroviral therapy among youth living with HIV

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