HIV Stigma, Depressive Symptoms, and Substance Use

Area of Science:

• Psychiatry
• Public Health
• Infectious Diseases

Background:

• Substance use negatively impacts HIV treatment adherence and secondary prevention.
• Understanding predictors of substance use is crucial for people living with HIV (PLWH).
• Stigma (internalized and enacted) and depression are potential factors influencing substance use in PLWH.

Purpose of the Study:

• To investigate the association between internalized and enacted HIV stigma and substance use indicators among PLWH.
• To examine the mediating role of depressive symptoms in the relationship between stigma and substance use.
• To assess three substance use indicators: number of substances used, number of substances used at moderate to high risk, and frequency of substance use before sex.

Main Methods:

• Cross-sectional study with 358 PLWH (aged 18-35) in Georgia, USA.
• Data collection included self-report measures of internalized/enacted stigma, depressive symptoms, and substance use severity, supplemented by urinalysis.
• Daily text messaging tracked substance use before sex over 28 days; path analysis was used for data analysis.

Main Results:

• Internalized and enacted stigma were significantly associated with higher depressive symptoms.
• Depressive symptoms were significantly associated with all three substance use indicators.
• Depressive symptoms partially mediated the relationship between stigma and substance use, indicating an indirect effect.

Conclusions:

• Depressive symptoms play a significant mediating role in the link between HIV-related stigma and substance use among young PLWH.
• Interventions targeting both stigma reduction and management of depressive symptoms are recommended to decrease substance use.
• These interventions are vital for improving HIV treatment outcomes and secondary prevention efforts.