ArticleJournal of the International AIDS Society2018
Internalized HIV stigma, ART initiation and HIV-1 RNA suppression in South Africa: exploring avoidant coping as a longitudinal mediator.
Article in Journal of the International AIDS Society, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 56 papers, 2 of them syntheses that pooled it.
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Who cites it
56 citing papers in PubMed, 2 syntheses or guidelines pooled it, 81 citations in OpenAlex.
- The Social, Behavioral, and Ethical Modalities of COVID-19 on HIV Care in South Africa: A Systematic Review.International journal of environmental research and public health · 2022Pooled it
- Interventions to improve antiretroviral adherence in HIV-infected pregnant women: A systematic review and meta-analysis.Frontiers in public health · 2022Pooled it
- The Factorial Structure, Reliability, and Validity of a Coping Measure Among Women with HIV and Sexual Trauma in Cape Town, South Africa.AIDS and behavior · 2026Trial
- Prevalence and correlates of internalized stigma among adults with HIV and major depressive disorder in rural Malawi.AIDS care · 2023Trial
- The Treatment Ambassador Program: A Highly Acceptable and Feasible Community-Based Peer Intervention for South Africans Living with HIV Who Delay or Discontinue Antiretroviral Therapy.AIDS and behavior · 2021Trial
- Predictors of receiving a diagnosis, referral and treatment of depression in people on antiretroviral therapy in South African primary care: a secondary analysis of data from a randomised trial.Tropical medicine & international health : TM & IH · 2020Trial
- Longitudinal Correlates of Internalized HIV Stigma Among Ugandan PLWH.AIDS and behavior · 2026Article
- Stigma in People Living with HIV/AIDS in Brazil: Implications for Treatment Adherence.AIDS and behavior · 2026Article
- Maladaptive Coping Strategies Mediate the Relationship Between Depression and Anxiety and Moderate-to-Heavy Alcohol Use in Young South Africans with HIV.AIDS and behavior · 2026Article
- Exploring the influence of age, gender, stigma, and years living with HIV on mental health outcomes.HIV medicine · 2025Article
- Why Are They Leaving? Factors Associated With Attrition After Testing Among Young South Africans Recently Diagnosed With HIV: An Observational Study.The Journal of adolescent health : official publication of the Society for Adolescent Medicine · 2025Observational
- "We don't care because we are not sick": understanding youths perceptions of hypertension in urban South Africa.BMC public health · 2025Article
- Article
- Predictors of depression, anxiety, and overall psychological distress in people living with HIV/AIDS: analyses from the Stigma Index Brazil 2.0.Cadernos de saude publica · 2025Article
- Do community-level factors play a role in HIV self-testing uptake, linkage to services and HIV-related outcomes? A mixed methods study of community-led HIV self-testing in rural Zimbabwe.PLOS global public health · 2025Article
- A Risk Prediction Model to Identify People Living with HIV Who are High-risk for Disengagement from Care after HIV Diagnosis in South Africa.AIDS and behavior · 2024Article
- HIV Stigma, Health, and Violence: A Longitudinal Study among Adolescent Boys with HIV in Soweto, South Africa.AIDS and behavior · 2024Article
- Effective Messages to Reduce Stigma among People Newly Diagnosed with HIV during Rapid ART Initiation.International journal of environmental research and public health · 2024Article
- Association Between Clinical Encounter Frequency and HIV-Related Stigma Among Newly-Diagnosed People Living with HIV in Rwanda.AIDS and behavior · 2024Article
- "Emotional stress is more detrimental than the virus itself": A qualitative study to understand HIV testing and pre-exposure prophylaxis (PrEP) use among internal migrant men in South Africa.Journal of the International AIDS Society · 2024Article
Corrections and comments
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Authors and funding
12 authors at 8 institutions in 2 countries.
Funding
Abstract
introductionCross-sectional evidence suggests that internalized HIV stigma is associated with lower likelihoods of antiretroviral therapy (ART) initiation and HIV-1 RNA suppression among people living with HIV (PLWH). This study examined these associations with longitudinal data spanning the first nine months following HIV diagnosis and explored whether avoidant coping mediates these associations.
methodsLongitudinal data were collected from 398 South African PLWH recruited from testing centres in 2014 to 2015. Self-report data, including internalized stigma and avoidant coping (denying and distracting oneself from stressors), were collected one week and three months following HIV diagnosis. ART initiation at six months and HIV-1 RNA at nine months were extracted from the South Africa National Health Laboratory Service database. Two path analyses were estimated, one testing associations between internalized stigma, avoidant coping and ART initiation, and the other testing associations between internalized stigma, avoidant coping and HIV-1 RNA suppression.
resultsParticipants were 36 years old, on average, and 63% identified as female, 18% as Zulu and 65% as Xhosa. The two path models fit the data well (ART initiation outcome: X
conclusionsInternalized stigma experienced soon after HIV diagnosis predicted lower likelihood of ART initiation and HIV-1 RNA suppression over the first year following HIV diagnosis. Avoidant coping played a role in these associations, suggesting that PLWH who internalize stigma engage in greater avoidant coping, which in turn worsens medication- and health-related outcomes. Interventions are needed to address internalized stigma and avoidant coping soon after HIV diagnosis to enhance treatment efforts during the first year after HIV diagnosis.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.