The associations between HIV stigma and mental health symptoms, life satisfaction, and quality of life among Black sexual minority men with HIV

Chenglin Hong; Ayako Miyashita Ochoa; Bianca D M Wilson; Elizabeth S C Wu; Damone Thomas; Ian W Holloway

doi:10.1007/s11136-023-03342-z

The associations between HIV stigma and mental health symptoms, life satisfaction, and quality of life among Black sexual minority men with HIV

Qual Life Res. 2023 Jun;32(6):1693-1702. doi: 10.1007/s11136-023-03342-z. Epub 2023 Jan 17.

Authors

Chenglin Hong¹, Ayako Miyashita Ochoa², Bianca D M Wilson³, Elizabeth S C Wu², Damone Thomas⁴, Ian W Holloway²

Affiliations

¹ Department of Social Welfare, UCLA Luskin School of Public Affairs, University of California Los Angeles, 3250-Public Affairs Building, Los Angeles, CA, 90095-1656, USA. chenglinhong@ucla.edu.
² Department of Social Welfare, UCLA Luskin School of Public Affairs, University of California Los Angeles, 3250-Public Affairs Building, Los Angeles, CA, 90095-1656, USA.
³ The Williams Institute, School of Law, University of California Los Angeles, Los Angeles, CA, USA.
⁴ HEALING With HOPE Corporation, Los Angeles, CA, USA.

Abstract

Purpose: With the advancement of antiretroviral therapy (ART), HIV/AIDS has become a manageable illness, similar to other chronic conditions. This study examined the associations between HIV stigma and patient-reported outcomes including mental health symptoms, life satisfaction, and quality of life among Black sexual minority men with HIV.

Methods: We analyzed baseline data from a randomized comparison trial of a mobile app intervention aimed to address the social work and legal needs of Black sexual minority men with HIV in Los Angeles County. We used validated scales including the Berger HIV stigma scale, the Patient Health Questionnaire-9 & the General Anxiety Disorder-7, the Satisfaction with Life Scale, and the Ladder Scale to assess HIV stigma, depressive symptoms, anxiety, life satisfaction, and quality of life, and we conducted multivariable linear regression to examine their associations.

Results: Participants experienced HIV stigma especially about disclosure concerns (e.g., 81.9% participants indicated "I am very careful who I tell that I have HIV") and public attitudes (52.3% believed "Most people with HIV are rejected when others find out"). In the multivariable models, higher overall stigma scores were associated with higher likelihood of experiencing depression (adjusted b = 0.235, p < 0.001) and anxiety (adjusted b = 0.188, p = 0.002), and lower life satisfaction (adjusted b = - 0.236, p < 0.001) and quality of life (adjusted b = - 0.053, p = 0.013), adjusting for clinical characteristics including ART initiation, viral load suppression, and medication adherence. In addition, being attacked or harassed in the past year were significantly associated with lower life satisfaction and quality of life (adjusted b = - 3.028, p = 0.046; adjusted b = - 1.438, p = 0.002).

Conclusion: Our findings highlight the need for focused HIV stigma reduction interventions to promote the overall well-being of Black sexual minority men with HIV. Strategies to promote the patient-reported outcomes may benefit from trauma-informed approaches.

Keywords: Anxiety; Black sexual minority men; Depression; HIV stigma; Life satisfaction; Quality of life.

MeSH terms

HIV Infections* / drug therapy
HIV Infections* / psychology
Humans
Male
Mental Health
Personal Satisfaction
Quality of Life / psychology
Sexual and Gender Minorities*
Social Stigma

Grants and funding

P2C HD041022/HD/NICHD NIH HHS/United States