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The role of knowing someone living with HIV/AIDS and HIV disclosure in the HIV stigma framework: a Bayesian mediation analysis

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Abstract

The current study evaluated the role of knowing someone living with HIV/AIDS and disclosure of one’s HIV-positive status in the HIV Stigma Framework using a Bayesian mediation analysis. We used data on 387 people living with HIV/AIDS (PLWHA) and 6074 HIV uninfected Italian participants. Knowing someone living with HIV/AIDS was negatively related to stigmatizing attitudes among HIV uninfected participants and internalized stigma among PLWHA. Internalized stigma mediated the relationship between personal knowledge of someone living with HIV/AIDS and disclosure of one’s HIV-positive status. In turn, disclosure of one’s HIV-positive status mediated the relationship between internalized stigma and engagement in HIV care. Undetectable viral load was predicted by internalized stigma but not by disclosure of one’s HIV-positive status and enacted stigma. Among uninfected participants, stigmatizing attitudes mediated the relationship between knowledge of someone living with HIV/AIDS and HIV testing. In addition, an interaction between knowledge of someone living with HIV/AIDS and HIV testing was found such that stigmatizing attitudes did not predict HIV testing among participants who do not have a personal knowledge of someone living with HIV/AIDS.

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Acknowledgments

This research was supported by a grant from the Italian League for the Fight against AIDS (LILA) to the Department of Psychology of the University of Bologna.

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Authors and Affiliations

  1. Dipartimento di Psicologia, Università di Bologna, Viale Europa 115, 47521, Cesena, FC, Italy

    Gabriele Prati, Bruna Zani & Luca Pietrantoni

  2. Italian League for the Fight Against AIDS (Italy), Via Varesina, 1, 22100, Como, Italy

    Diego Scudiero, Patrizia Perone, Lella Cosmaro, Alessandra Cerioli & Massimo Oldrini

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  1. Gabriele Prati
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  2. Bruna Zani
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  4. Diego Scudiero
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  7. Alessandra Cerioli
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Corresponding author

Correspondence to Gabriele Prati.

Appendix: HIV Stigma Mechanism Measure

Appendix: HIV Stigma Mechanism Measure

Internalized stigma (partly derived from previous instruments; e.g., Sayles et al. 2008; Visser et al. 2008)

  • I feel ashamed to tell other people that I have HIV

  • It is important for a person to keep HIV a secret from co-workers

  • I am comfortable telling everyone I know that I have HIV

  • I am concerned if I go to the HIV clinic because someone I know might see me

  • I am concerned that if I am sick people I know will find out about my HIV

  • I am concerned if I go to an AIDS organization because someone I know might see me

  • I am concerned if people will find out I have HIV by looking at my medical paperwork

  • I feel ashamed that I have HIV

  • Being HIV positive changed what I believe is important in life (reverse)

  • I learnt something through having HIV (reverse)

  • I grew as a person through having HIV (reverse)

Stigmatizing attitudes (derived from a personal stigma for community members scale, see Visser et al. 2008)

  • It is not safe for a person with HIV to look after somebody else’s children

  • I feel afraid to be around people with HIV

  • People with HIV deserve as much respect as anyone else (reverse)

  • I would not drink from a tap if a person with HIV had just drunk from it

  • If you have HIV you must have done something wrong to deserve it

  • I feel uncomfortable around people with HIV

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Prati, G., Zani, B., Pietrantoni, L. et al. The role of knowing someone living with HIV/AIDS and HIV disclosure in the HIV stigma framework: a Bayesian mediation analysis. Qual Quant 50, 637–651 (2016). https://doi.org/10.1007/s11135-015-0168-2

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