Current challenges in caring for injection drug users with human immunodeficiency virus infection in Pakistan

The stigmatized status of injecting illicit drugs use and human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome in Pakistan, enlists HIV positive injection drug users (IDUs) at preeminent risk for poor mental health. This study aims to investigate the potential link between enacted HIV stigma, community attachment, and mental health problems in HIV-positive IDUs, along with mediating role of community attachment and moderating role of drug type. Correlation analysis revealed that enacted HIV stigma and community attachment were significantly negatively associated with mental health. Mediation analysis indicated that enacted HIV stigma influences mental health indirectly by shaping individuals' level of attachment to the community of IDUs. Moderation analysis revealed that synthetic illicit drugs significantly moderated the association between enacted HIV stigma and mental health. The findings highlight the need for targeted interventions addressing enacted HIV stigma among IDUs to effectively improve their mental health outcomes.