HIV-related stigma and optimism as predictors of anxiety and depression among HIV-positive men who have sex with men in the United Kingdom and Ireland

Abstract

This study investigated the associations between forms of HIV-related optimism, HIV-related stigma, and anxiety and depression among HIV-positive men who have sex with men (MSM) in the United Kingdom and Ireland. HIV health optimism (HHO) and HIV transmission optimism (HTO) were hypothesised to be protective factors for anxiety and depression, while the components of HIV-related stigma (enacted stigma, disclosure concerns, concern with public attitudes, and internalised stigma) were hypothesised to be risk factors. Data were collected from 278 HIV-positive MSM using an online questionnaire. The prevalence of psychological distress was high, with close to half (48.9%) of all participants reporting symptoms of anxiety, and more than half (57.9%) reporting symptoms of depression. Multiple linear regressions revealed that both anxiety and depression were positively predicted by internalised stigma and enacted stigma, and negatively predicted by HHO. For both anxiety and depression, internalised stigma was the strongest and most significant predictor. The results highlight the continued psychological burden associated with HIV infection among MSM, even as community support services are being defunded across the United Kingdom and Ireland. The results point to the need for clinicians and policy makers to implement stigma reduction interventions among this population.

The Mediating Role of Internalized Stigma and Shame on the Relationship between COVID-19 Related Discrimination and Mental Health Outcomes among Back-to-School Students in Wuhan

“…Meanwhile, our findings suggested that shame could directly influence the internalized stigma, thus, affecting negative mental health outcomes through their chain mediating path. This was in line with previous studies linking shame and internalized stigma to increased risks for negative mental health outcomes [20,[50][51][52][53][54][55][56][57][58] in the context of HIV, obesity, schizophrenia, and marginalized groups. Multiple mediating analyses further revealed the underlying mechanisms and explained why discrimination could increase negative mental health outcomes.…”

Predictors of anxiety and depression among newly diagnosed people living with HIV: A longitudinal study

“…Social stigma is another variable central to HIV infection, an important stressor that is closely related to anxiety and depression, as a recent meta-analysis found (Rueda, Gibson, Rourke et al, 2012). Although there are various dimensions of HIV stigma (e.g., enacted, anticipated, and internalized; Earnshaw & Chaudoir, 2009), it is internalized stigma, defined as the devaluation and discrediting of oneself based on one's HIV status (Earnshaw, Bogart, Dovidio & Williams, 2013), the one which has been claimed to have the most severe consequences in terms of quality of life and mental and physical health (Murphy, Garrido-Hernansaiz, Mulcahy & Hevey, 2018;Phillips, Moneyham & Tavakoli, 2011;Singh, Kumar, Mukhopadhyay & Singh, 2014). Internalization of HIV stigma, as mentioned before, depends on how resilient the person is (Brouard & Wills, 2006) and internalized stigma has indeed been consistently related to higher anxiety and depressive symptoms and lower quality of life in different populations (Heywood & Lyons, 2016;Murphy et al, 2018;Willie et al, 2016), including PLWH in Spain (Fuster-Ruizdeapodaca, Molero, Holgado & Mayordomo, 2014;Hernansaiz-Garrido & Alonso-Tapia, 2017).…”

Psychometric Properties and Factor Structure of the Chinese Version of the Hospital Anxiety and Depression Scale in People Living With HIV

“…Systematic reviews suggested that the prevalence of depression and anxiety in women is greater than that in men (2, 3). Men who have sex with men (MSM) have a relatively higher tendency toward negative perceptions of HIV/AIDS both cognitively and emotionally (32) and demonstrate a higher prevalence of anxiety and depression when compared to other patients (33). As the prevalence is considerably higher in those special subgroups, there is a need to test if the HADS is an invariant measurement for patients of different genders or course of infection.…”