ArticleJournal of acquired immune deficiency syndromes (1999)2017
Association Between Internalized HIV-Related Stigma and HIV Care Visit Adherence.
Article in Journal of acquired immune deficiency syndromes (1999), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 84 papers, 4 of them syntheses that pooled it.
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Who cites it
84 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Impact of Mass Media on HIV/AIDS Stigma Reduction: A Systematic Review and Meta-analysis.AIDS and behavior · 2023Pooled it
- A systematic review of the effects of intimate partner violence on HIV-positive pregnant women in sub-Saharan Africa.BMC public health · 2022Pooled it
- Psychometric Properties of the Berger HIV Stigma Scale: A Systematic Review.International journal of environmental research and public health · 2021Pooled it
- Guideline
- Disclosure Events and Psychosocial Well-Being Among Young South African Adults Living with HIV.International journal of behavioral medicine · 2025Trial
- Prevalence and correlates of internalized stigma among adults with HIV and major depressive disorder in rural Malawi.AIDS care · 2023Trial
- Impact of Community Support Workers in Rural Ethiopia on Emotional and Psychosocial Health of Persons Living with HIV: Results of a Three-Year Randomized Community Trial.AIDS and behavior · 2023Trial
- Effects of an intervention on internalized HIV-related stigma for individuals newly entering HIV care.AIDS (London, England) · 2020Trial
- Factors affecting linkage to HIV care and ART initiation following referral for ART by a mobile health clinic in South Africa: evidence from a multimethod study.Journal of behavioral medicine · 2019Trial
- Beyond knowledge deficits: social visibility, family dynamics, and delayed initiation among people living with HIV in Southwestern China-a descriptive phenomenological study.BMC public health · 2026Article
- Factors Associated with High Internalized Stigma Among People Living with HIV in Selected Provinces in Vietnam.AIDS and behavior · 2026Article
- HIV Stigma Reduction Interventions in People Living with HIV in the United States: A Systematic Review.AIDS and behavior · 2026Article
- Exploring barriers to and experiences of palliative and end-of-life care for people living with HIV: a cross-sectional survey.BMJ open · 2026Article
- Development and Validation of an Updated Internalized HIV Stigma Scale Among People Living with HIV.AIDS and behavior · 2026Article
- Stigma in People Living with HIV/AIDS in Brazil: Implications for Treatment Adherence.AIDS and behavior · 2026Article
- The burden of HIV-related stigma on clinical and quality of life outcomes: results from a systematic literature review.Health psychology and behavioral medicine · 2026Review
- Subjective social status in relation to the associations between internalized stigmas and missed HIV appointments among MSM who use substances.SSM. Mental health · 2025Article
- Exploring differences in HIV stigma and treatment interruptions between young and older adults in Zimbabwe.BMC public health · 2025Article
- Exploring the influence of age, gender, stigma, and years living with HIV on mental health outcomes.HIV medicine · 2025Article
- Article
24 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
backgroundInternalized HIV-related stigma acts as a barrier to antiretroviral therapy (ART) adherence, but its effects on other HIV care continuum outcomes are unclear.
methodsAmong 196 HIV clinic patients in Birmingham, AL, we assessed internalized HIV-related stigma and depressive symptom severity using validated multi-item scales and assessed ART adherence using a validated single-item measure. HIV visit adherence (attended out of total scheduled visits) was calculated using data from clinic records. Using covariate-adjusted regression analysis, we investigated the association between internalized stigma and visit adherence. Using path analytic methods with bootstrapping, we tested the mediating role of depressive symptoms in the association between internalized stigma and visit adherence and the mediating role of visit adherence in the association between internalized stigma and ART adherence.
resultsHigher internalized stigma was associated with lower visit adherence (B = -0.04, P = 0.04). Black (versus white) race and depressive symptoms were other significant predictors within this model. Mediation analysis yielded no indirect effect through depression in the association between internalized stigma and visit adherence (B = -0.18, SE = 0.11, 95% confidence interval: -0.44 to -0.02) in the whole sample. Supplemental mediated moderation analyses revealed gender-specific effects. Additionally, the effect of internalized stigma on suboptimal ART adherence was mediated by lower visit adherence (B = -0.18, SE = 0.11, 95% confidence interval: -0.44 to -0.02).
conclusionsResults highlight the importance of internalized HIV stigma to multiple and sequential HIV care continuum outcomes. Also, findings suggest multiple intervention targets, including addressing internalized stigma directly, reducing depressive symptoms, and promoting consistent engagement in care.
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