Perceived discrimination and mental health symptoms among persons living with HIV in China: the mediating role of social isolation and loneliness

ABSTRACT

Perceived discrimination is significantly associated with mental health symptoms among persons living with HIV (PLWH). However, little is known about the factors mediating this relationship. We aimed to examine the mediating role of social isolation and loneliness in the association between perceived discrimination and mental health symptoms among PLWH. A multicenter (Shanghai, Kunming, Nanning, Hengyang, and Changning in China) cross-sectional study was conducted in 2017. Data from 883 PLWH were used for statistical analysis. Perceived discrimination, mental health symptoms, loneliness and social isolation were assessed through self-report questionnaires. Structural equation modeling (SEM) showed a satisfactory model fit (CMIN/DF = 2.676, GFI = 0.998, CFI = 0.997, NFI = 0.995, TLI = 0.985, RMSEA = 0.044 [0.000, 0.090]) and a significant total indirect effect (β = 0.058, SE = 0.009, Z = 6.444, p < 0.01). Both loneliness (β = 0.042, SE = 0.008, Z = −5.250, p < 0.01) and social isolation (β = 0.016, SE = 0.004, Z = −4.000, p < 0.01) were determined to be significant mediators of the association between perceived discrimination and mental health symptoms. Interventions that combat loneliness and social isolation may help ameliorate the adverse consequences of perceived discrimination on mental health.

KEYWORDS:

• HIV/AIDS
• perceived discrimination
• anxiety
• depression
• loneliness
• social isolation

Acknowledgements

The authors would like to acknowledge all the staff who helped them complete this project: Lin Zhang and Hongzhou Lu from Shanghai Public Health Center Affiliated with Fudan University; Qingfen Liu from Yunnan Infectious Disease Special Hospital; Caiyun Wei from Nanning No.4 People’s Hospital; Lian Yang from Hengyang No.3 People’s Hospital; Dongning Zhao from the Changning Centers for Disease Control; and Yuquan Luan and Yanfen Fu from the School of Nursing, Dali University.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study was funded by the National Natural Science Foundation of China [grant number 71673057]; and the China Scholarship Council [grant number 201906100135].