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van der Kooij YL, Kupková A, den Daas C, van den Berk GE, Kleene MJT, Jansen HS, Elsenburg LJ, Schenk LG, Verboon P, Brinkman K, Bos AE, Stutterheim SE. Role of Self-Stigma in Pathways from HIV-Related Stigma to Quality of Life Among People Living with HIV. AIDS Patient Care STDS 2021; 35:231-238. [PMID: 34097466 PMCID: PMC8215416 DOI: 10.1089/apc.2020.0236] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
This study examined the relationships between perceived public stigma, experienced stigma, and quality of life in people living with HIV (PLHIV), and whether self-stigma mediates these relationships. Cross-sectional data were analyzed from 1704 PLHIV in care at OLVG hospital in the Netherlands. We measured different types of stigma (perceived public stigma, experienced stigma, and self-stigma), and various quality-of-life outcomes (disclosure concerns, depression, anxiety, sexual problems, sleeping difficulties, self-esteem, general health, and social support). Structural equation modeling was used to test the paths from different types of stigma to quality-of-life outcomes. All direct effects of self-stigma on quality-of-life outcomes were significant. The final mediation model showed that the effects of both perceived public and experienced stigma on quality-of-life outcomes were mediated by self-stigma. These findings highlight the importance of addressing self-stigma in PLHIV, and call for (psychosocial) interventions that reduce the harmful effects of HIV-related stigma.
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Affiliation(s)
| | - Alžběta Kupková
- Department of Work and Social Psychology, Maastricht University, Maastricht, the Netherlands
| | - Chantal den Daas
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
- Health Psychology Group, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, Scotland
| | | | | | | | | | - Leo G. Schenk
- Hello Gorgeous Foundation, Amsterdam, the Netherlands
| | - Peter Verboon
- Faculty of Psychology, Open University, Heerlen, the Netherlands
| | - Kees Brinkman
- Internal Medicine, OLVG Hospital, Amsterdam, the Netherlands
| | - Arjan E.R. Bos
- Faculty of Psychology, Open University, Heerlen, the Netherlands
| | - Sarah E. Stutterheim
- Department of Work and Social Psychology, Maastricht University, Maastricht, the Netherlands
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