HIV Stigma Among Substance Abusing People Living with HIV/AIDS: Implications for HIV Treatment
Open accessAbstract
HIV-related stigma has a major impact on quality of life and health among people living with HIV and AIDS (PLWHA). This study examines demographic, mental health, behavioral, contextual, and HIV care-related correlates of HIV stigma among 503 substance abusing PLWHA. Stigma was measured with the HIV Internalized Stigma Measure which has four subscales: stereotypes about HIV, self-acceptance, disclosure concerns, and social relationships. Severe substance dependence (55.3%) and depression (54.7%) were associated with higher HIV stigma across all domains. 49.9% of the sample reported antiretroviral (ARV) medication diversion (the unlawful sale and trading of ARV medications); diverters endorsed significantly higher stigma related to disclosure. 54.1% of the sample reported ≥95% ARV adherence; these individuals reported significantly lower stigma for self-acceptance, disclosure, and social relationships. Multivariate linear regression showed that depression and social support demonstrated significant main effects across stigma domains. Findings suggest that interventions to decrease HIV related stigma may be an important component of initiatives to increase engagement in HIV care.
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HIV-related stigma exacerbates mental health problems among people living with HIV.
“PLWH also experience HIV-related stigma which exacerbates mental health problems (Levi-Minzi & Surratt, 2014) and can compromise health behaviours such as adherence to life-saving antiretroviral therapy (ART) (Remien et al., 2019; Uthman et al., 2014).”
From Resilience resources for mental health among people living with HIV: a mixed-method systematic review (2024) · cites this paper as Levi-Minzi & Surratt, 2014
The Introduction links HIV-related stigma to increased mental distress, including depression and anxiety, and says concealment of HIV status can lead to depression. But the paper’s own findings, reported in the Discussion, show an association between depression and higher stigma; they do not establish that stigma exacerbates mental health problems. (LLM, conf=0.85)
Experimental — accuracy not yet measuredPeople living with HIV experience HIV-related stigma.
“PLWH also experience HIV-related stigma which exacerbates mental health problems (Levi-Minzi & Surratt, 2014) and can compromise health behaviours such as adherence to life-saving antiretroviral therapy (ART) (Remien et al., 2019; Uthman et al., 2014).”
From Resilience resources for mental health among people living with HIV: a mixed-method systematic review (2024) · cites this paper as Levi-Minzi & Surratt, 2014
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- Authors
- Levi-Minzi, M. A., & Surratt, H. L.
- Affiliations
- Center for Applied Research on Substance Use and Health Disparities, Nova Southeastern University, Miami, Florida.
- Nova Southeastern University (US)
- ORCID
- Surratt, Hilary L.
- Venue
- AIDS Patient Care and STDs
- Publisher
- SAGE Publications
- Published
- 2014-08
- Volume
- 28
- Issue
- 8
- Pages
- 442-451
- ISSN
- 1087-2914 (ISSN-L)
- 1557-7449
- PMC
- PMC4117265
- OpenAlex
- W2324487731
- Cited by
- 80
- References
- 39
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 13 · 2023: 4 · 2022: 10 · 2021: 8 · 2020: 5 · 2019: 8 · 2018: 5 · 2017: 5 · 2016: 6 · 2015: 6 · 2014: 1
- FWCI
- 4.22
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- AIDS Patient Care and STDs (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- NSUWorks (Nova Southeastern University) (submittedVersion)
- Funders
- National Institute on Drug Abuse (R01DA023157)
- Topics
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- HIV stigma, people living with HIV, substance use disorders, depression, HIV status disclosure, antiretroviral therapy adherence, social support, HIV care engagement
- MeSH terms
- Assessment of Medication Adherence, Adult, Aged, Cross-Sectional Studies, Depressive Disorder, Female, Florida, Humans, Male, Middle Aged, Quality of Life, Surveys and Questionnaires, Regression Analysis, Severity of Illness Index, Social Support, Socioeconomic Factors, Stereotyping, HIV Infections, Multivariate Analysis, Drug Monitoring, Substance-Related Disorders, Anti-Retroviral Agents, Medication Adherence, Social Stigma
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