Amsterdam 2015
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| Abstract #2297 - The Enigma of Stigma | ||||
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Session: 35.3: The Enigma of Stigma (Symposium) on Thursday @ 14.30-16.00 in C104 Chaired by Danuta Kasprzyk, Jeffrey Fisher Authors: Presenting Author: Prof. Yan Guo - Sun Yat-sen University, School of Public Health, China |
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| Additional Authors: | ||||
| Aim: It is well recognized that HIV-related stigma has profound negative effect on the mental health of people living with HIV/AIDS (PLWHA). Studies also show that individuals’ social support and self-efficacy are associated with their mental health. However, few studies have explored the interrelationships of these factors among PLWHA simultaneously. This study aims to examine the mechanism through which HIV-related stigma is associated with poor mental health of PLWHA. We hypothesize that 1) HIV-related stigma has direct and indirect effects on the mental health of PLWHA 2) social support and self-efficacy mediate the effect of HIV-related stigma on the mental health of PLWHA and 3) there is an association between social support and self-efficacy. | ||||
| Method / Issue: We conducted a cross-sectional survey through convenience sampling among 412 PLWHA between March and June, 2013 in Guangzhou, China. HIV-related stigma was assessed by 14 items ed from perceived and enacted stigma scales (a=0.93). Mental health was measured by the 20-item Centers for Epidemiological Studies Depression scale (CES-D, a=0.83) the higher the score, the more depressive the individual was. Social support was measured by three parts: 1) general social support assessed by 19-item from the Chinese version of the Medical Outcomes Study-Social Support Survey (MOS-SSS-C) 2) medication-related support assessed by 8 items and 3) emotion-related support assessed by 25 items. The estimates of reliability of these scales were 0.97, 0.92 and 0.89, respectively. Self-efficacy was measured by 10-item self-efficacy scale. Structural equation modeling (SEM) was used to examine the interrelationships among these constructs. | ||||
| Results / Comments: The average age of the PLWHA was 38.3 (±8.78) years over two thirds (69.7%) were male. The SEM model showed that HIV-related stigma had both direct effect (standard coefficient, ß =0.44, p<0.001) and indirect effect on depression through HIV-related support and self-efficacy. HIV-related support and self-efficacy both had direct effects in reducing depression (standard coefficient, ß =-0.20, p=0.008 ß =-0.38, p<0.001, respectively). HIV-related support also had a positive direct effect on self-efficacy (standard coefficient, ß =0.27, p<0.001) the higher level of the support, the higher level of self-efficacy. The overall model yielded a satisfactory fit (Chi-square=7.243, p=0.065 NFI=0.988 CFI=0.993, TLI=0.964, RMSEA=0.059). | ||||
| Discussion: In sum, we found a significant combined direct and indirect effect of HIV-related stigma on depression among PLWHA, and HIV-related support and self-efficacy mediated the association between HIV-related stigma and depression. Health interventions to improve mental health of PLWHA need to reduce HIV-related stigma, as well as enhance HIV-related support and self-efficacy of PLWHA. | ||||
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