The relationship between social support and experienced and internalized HIV-related stigma among people living with HIV in the Deep South.

Abstract

The Deep South has experienced disproportionately high HIV diagnosis and death rates compared to other U.S. regions. Stigma experiences and perceptions are particularly high among individuals living with HIV in the Deep South and are consistently associated with negative health outcomes including poorer medication adherence. This study included a survey of 201 individuals living with HIV in the Deep South and examined the relationship between social support and internalized stigma with a focus on individuals who had recent experiences of verbal HIV stigma related to HIV. Study participants were recruited from HIV medical care clinics and community-based organizations. Over one-third of study participants reported experiencing verbal stigma related to HIV in the last 3 months such as being "insulted" because of their HIV status (25%). Internalized stigma, as measured by the HIV Stigma Scale, was also prevalent among study participants. Multivariate analyses identified that higher internalized stigma was predicted by recent verbal stigma experiences and social support was found to be a statistically significant modifier of the relationship of recent verbal stigma experiences and internalized stigma ( p < .01). These findings emphasize the critical need for effective interventions that build and enhance social support and address internalized HIV-related stigma among individuals living with HIV in the U.S. Deep South.

Role of Self-Stigma in Pathways from HIV-Related Stigma to Quality of Life Among People Living with HIV

“…Disentangling how various forms of stigma work to impact quality-of-life outcomes across psychological, social, and health dimensions, and whether social support can buffer against the internalization of public stigma is not only theoretically important, it is important for the design of effective interventions that reduce stigma and improve quality of life in PLHIV. 5 , 36 …”

Public health noncompliance: Targets with COVID-19 are stigmatized when they fail to follow public health protocols.

“…Previous research has demonstrated that social support is extremely important in deterring the negative consequences for people who face disease stigma (e.g., Reif et al, 2021). People who contract COVID-19 because they failed to follow public health protocol might experience reduced instrumental, emotional, and social support from people in their immediate circle (e.g., Johnson et al, 2019).…”

A Review of the State of the Science of HIV and Stigma: Context, Conceptualization, Measurement, Interventions, Gaps, and Future Priorities

“…During the past two decades, numerous reviews (systematic reviews, scoping reviews, literature reviews) have examined HIV stigma reduction interventions (Brown et al, 2003;Dunbar et al, 2020;Ingram et al, 2019;Kane et al, 2019;Kemp et al, 2019;Ma et al, 2019;Mahajan et al, 2008;Mak et al, 2017;Pantelic et al, 2019;Rao et al, 2019;Reif et al, (Reif et al, 2015). From an ecological perspective, these interventions can be organized as (a) individual level only, (b) at the individual and relational level, (c) at the individual and structural level, and (d) at the structural level only (Pantelic et al, 2019).…”

“…First, HIV-related stigma intervention research needs to use a longitudinal design (Brown et al, 2003;Kane et al, 2019;Reif et al, 2015). Without a longitudinal design, the ability to identify the efficacy of an HIV-related stigma intervention on distal care continuum outcomes (adherence, engagement in care) is limited.…”

“…Second, it is critical that future HIV-related stigma research uses experimental designs (randomized clinical trial), or at least a control group of some fashion, in order to determine the efficacy or effectiveness of the intervention (Paudel & Baral, 2015;Rao et al, 2019;Reif et al, 2015). Third, future HIV-related stigma research needs to be sufficiently powered.…”