HIV-Specific Unsupportive Social Interactions, Health, and Ethnicity in Men Living With HIV

Individuals living with HIV experience higher rates of stigmatizing social interactions that may negatively impact psychological and physical health. We examined depressive symptoms as a mediator of the relationship between HIV-specific unsupportive social interactions (USIs) and health behaviors in 87 Black and White men living with HIV (MLWH). We also examined ethnicity as a moderator of this model. Depressive symptoms were an indirect mechanism through which HIV-specific USIs explained poorer health behaviors. The indirect effects between disconnecting USI, more depressive symptoms, and poorer health behaviors were significant for Black men but not for White men. Depressive symptoms may be one pathway through which USI are associated with physical health, and disconnecting USI may be particularly detrimental for Black MLWH

Internalised HIV-Stigma, Loneliness, Depressive Symptoms and Sleep Quality in People Living With HIV

Objective: People living with HIV (PLWH) commonly report sleep disturbances which are associated with long-term health consequences, including disease progression. PLWH also experience internalised stigma as a result of their HIV status, which can be associated with increased loneliness and depression. Little attention focuses on the impact of these factors on sleep. Therefore, we examined whether internalised HIV-stigma was indirectly related to poorer sleep quality through higher levels of loneliness and depressive symptoms. Design: 181 PLWH from across the United States completed an online survey. Main Study Measures: Internalised HIV-stigma was assessed using the HIV-Stigma Scale, loneliness was assessed using the UCLA-Loneliness Scale-Short Form, depressive symptoms were assessed with the Center for Epidemiologic Studies–Depression Index, and Sleep Quality was assessed using the Pittsburgh Sleep Quality Index. Results: Internalised HIV-stigma was indirectly associated with poorer global sleep quality and daytime sleep dysfunction through both loneliness and depressive symptoms. Conclusions: PLWH who experience HIV-related stigma may experience greater feelings of loneliness, which are related to increased depressive symptoms and poorer sleep quality. Interventions focused on improving sleep in PLWH should focus on multiple factors that influence sleep, including psychosocial factors such as stigma, social isolation and depressive symptoms

Self-Compassion in PLWH: Less Internalized Shame and Negative Psychosocial Outcomes

People living with HIV (PLWH) may experience internalized shame, which has been associated with negative psychosocial outcomes. Some of these psychosocial outcomes also are linked with worsening disease. Self-compassion, however, is the antithesis of internalizing shame, with elements of self-compassion (self-kindness, mindfulness, common humanity) at odds with indicators of internalized shame (negative beliefs about the self, desire to withdraw or avoid emotion, feelings of isolation). Therefore, we examined whether self-compassion among PLWH was associated with lower levels of internalized shame and, in turn, better psychosocial outcomes. We examined these relations using cross-sectional data collected from 181 PLWH living in the US via their participation in an online survey. Results revealed initial support for lower levels of internalized shame as potential mechanism that may explain how self-compassion comes to be associated with better outcomes among PLWH. Given self-compassion can be induced through intervention, we discuss how future research and clinical work with PLWH might address shame and improve outcomes

HIV-Related Stigma, Loneliness, and Sleep Quality in Men and Women Living With HIV

We examined the links between HIV-stigma, loneliness and sleep quality in 181 people living with HIV (PLWH) who completed an online self-report questionnaire. Results suggested that the indirect effect of stigma on poorer sleep through increased loneliness was significant. Researchers will address implications for research on stigma and health

Gender Differences in Disclosure Concerns and HIV-Related Quality of Life

HIV-related disclosure concerns are associated with higher rates of concealment and poorer well-being, including poorer health related HIV quality of life (HIV-QOL). Little research, however, has examined whether gender differences exist in the links between HIV disclosure concerns and HIV-QOL. We expected that disclosure concerns and gender would be associated with HIV-QOL, such that the relationship between disclosure concerns and poorer HIV-QOL to be stronger in women living with HIV (WLWH) than in men living with HIV (MLWH). One hundred and forty MLWH (n = 102) and WLWH (n = 38) completed an online questionnaire consisting of measures regarding their demographics, disclosure concerns (HIV-stigma scale), and HIV-QOL (HIV-AIDS-Targeted Quality of Life Instrument). Results suggested that more disclosure concerns were associated with poorer HIV-QOL, but in general, men and women did not differ in their levels of HIV-QOL. As expected, interactions emerged between gender and disclosure concerns such that disclosure concerns were associated with increased health worries and poorer sexual functioning for WLWH but not for MLWH. Interventions should acknowledge the differing needs and experiences of WLWH in order to improve HIV-QOL and increase longevity

Ethnic Differences in Spirituality, Shame, and Stigma in People Living With HIV

We hypothesized that the links between spirituality and lower HIV-related stigma would be accounted for by lower levels of shame, and that this mediation model would be moderated by ethnicity in 106 people living with HIV (PLWH). Moderated mediation analyses revealed that higher spirituality was associated with reduced levels of shame, which in turn was associated with lower levels of HIV-related stigma. The indirect effect of spirituality on lower stigma through reduced shame was significant for White but not for Non-White PLWH. It is possible that other mechanisms exist to explain how spirituality operates on stigma for minorities living with HIV

Ethnic Differences in the Links Between Benefit Finding and Psychological Adjustment in People Living With HIV

Experiencing growth after the diagnosis of a life threatening illness is commonly reported among people living with HIV (PLWH). The links between benefit finding and better adjustment in PLWH have been identified, but it is less clear whether these links vary by ethnicity. Minority stress theory suggests that individuals from minority populations may have unique stress experiences, which can have negative health implications but may also provide opportunity for growth. We hypothesized that the association between benefit finding and psychological adjustment would be stronger for Black (n = 80) than White (n = 87) PLWH. Contrary to predictions, the relationship between benefit finding and better adjustment was significant for White but not Black PLWH. Post-hoc analyses suggested that sexual orientation played role in this relationship. The relationship between benefit finding and psychological adjustment may be complex for Black PLWH, or they may achieve adjustment using other resources

Ethnic identity and perceived stress in HIV+ minority women: the role of coping self-efficacy and social support

Ethnic minority women living with HIV (WLWH) face multiple stigmas that can contribute to overwhelming levels of stress, which could hamper their ability to manage their chronic disease. Little is known about whether having a greater sense of ethnic identity might insulate WLWH from stress. It is also possible that certain cognitive and interpersonal factors (i.e., coping self-efficacy and perceived social support) may act as mediators of this relationship. We hypothesized that WLWH with a greater sense of ethnic identity would report less stress because they access these cognitive and interpersonal resources to better manage stressors. The present study (1) related ethnic identity to perceived stress and (2) examined coping self-efficacy and social support as co-mediators of this relationship in a sample of low-income minority WLWH. Ninety-two minority women (89% African American) completed self-report psychosocial measures including the Multigroup Ethnic Identity Measure (MEIM), Perceived Stress Scale (PSS), Cognitive Coping Self-efficacy Scale (CCSE), and Social Provision Scale (SPS). Greater ethnic identity was associated with less perceived stress, and this relationship was mediated by greater levels of both coping self-efficacy and social support. WLWH who identify more with their ethnic group may experience less stress via their access to more cognitive and interpersonal resources

Unsupportive Social Interactions, Shame, and Psychological Well-Being in People With HIV

We hypothesized that unsupportive social interactions (USI) would be associated with poorer psychological wellbeing in people living with HIV (PLWH), and that this relationship would be explained by increased levels of shame. 106 PLWH completed an online questionnaire including measures of HIV-specific USI, shame, depression, negative affect, and perceived stress. Results suggest that insensitive interactions were related to higher levels of depression, negative affect, and perceived stress through higher levels of shame. Internalized feelings of shame may partially explain the relationship between insensitive interactions and psychological well-being