The mediating role of individual resilience resources in stigma–health relationship among people living with HIV in Guangxi, China

Abstract

Despite the vigorous global efforts to reduce stigma, HIV-related stigma continues to undermine the health status of people living with HIV (PLHIV). Internalized HIV stigma may cause stress adversely affecting the health of PLHIV. Resilience is the process of an effective coping and positive adaption in the face of adversities. To date, limited data are available on the mediating role of resilience in the relationship of internalized HIV stigma and health status among PLHIV in China. A cross-sectional survey was conducted among 2987 PLHIV in Guangxi Autonomous Region (Guangxi) in China. A mediation analysis was employed and Sobel test was used to test the mediation effect of individual resilience. Of the 2987 PLHIV, 62.8% were men. The mean age of the sample was 42.5 years (SD = 12.8). Over 57.7% of PLHIV reported their overall health status being poor. About 72% of PLHIV reported experiencing internalized HIV stigma. Internalized HIV stigma had a negative direct effect on self-rated health status (p < .001). Individual resilience resources mediated the relationship between internalized HIV stigma and self-rated health status (p < .001). Sobel test confirmed the mediation effect of resilience (z = −8.359, SE = 0.003, p < .001). Resilience as a protective factor might buffer the effect of internalized HIV stigma on health status. Multilevel interventions are needed to foster resilience of PLHIV in order to mitigate the negative impact of HIV stigma and to improve the overall health status of PLHIV.

Keywords:

• stigma
• resilience
• health status
• HIV infection
• PLHIV
• China

Acknowledgements

The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or NSFC. The authors thank local team members at Guangxi CDC for their efforts in instrument development and data collection. The authors also thank Ms. Joanne Zwemer for assistant in manuscript preparation.

Disclosure statement

No potential conflict of interest was reported by the authors.

Funding

The study is supported by National Institutes of Health (NIH) research grants R01HD074221 and R01AA018090 and National Natural Science Foundation of China (NSFC) [grant number 71203098].