Analysis of the Mediation Effects of Adverse Mental Health Outcomes in HIV-Infected Women of Childbearing Age from Multiple Perspectives Including Discrimination Perception

Figures & data

Table 1 Basic Characteristics of the Survey Respondents

Variable	Frequency	Percentage (%)
Basic feature
Age (years)
<25	29	5.2
25–35	179	32.4
≥35	345	62.4
Domicile
Countryside	231	41.8
City	322	58.2
Educational status
High school and below	506	91.5
Junior college	33	6
Bachelor’s degree or above	14	2.5
Marital status
Unmarried	41	7.4
Married	313	56.6
Divorced	135	24.4
Widowed	64	11.6
Occupation
Employed	186	33.6
Student	4	0.7
Unemployed	363	65.6
Monthly income
<1000 yuan (about 138.4 dollar)	247	44.7
1000–3000 yuan((about 138.4–415.2 dollar))	241	43.6
3000–5000 yuan (about 415.2–692 dollar)	57	10.3
≥5000 yuan (about 692 dollar)	8	1.4
Medical insurance type
Employee medical insurance	108	19.5
Resident medical insurance	397	71.8
Commercial insurance	5	0.9
Other	16	2.9
Without cover	27	4.9
HIV infection status
Route of infection
Sex with the opposite sex	362	65.5
Homosexual behavior	29	5.2
Paid blood donation	2	0.4
Blood transfusion or blood products	8	1.4
Take drugs	25	4.5
Not clear/other	127	22.9
Infection time
<12 years	13	2.4
≥12 years	540	97.6
Condom usage (last 6 months)
In marriage sex
Every time	146	63.76
Often	38	16.59
Occasionally	20	8.73
Never	25	10.92
Having heterosexual sex outside marriage
Every time	37	74
Often	6	12
Occasionally	3	6
Never	4	8

Abbreviation: HIV, Human Immunodeficiency Virus.

Table 2 Discrimination Perception, Depression, Social Capital, and Adverse Mental Health Outcomes Among the Participants

Variable	Mean/n	SD/%
Discrimination (mean and SD)
Total discrimination perception	27.18	8.89
Actual discrimination	6.57	2.56
Worry about public	7.31	2.34
Public attitude	6.56	2.52
Negative self-impressions	6.74	2.55
Anxious
SAS-20 (mean and SD)	81.25	50.11
Anxiety symptoms
No (n, %)	305	55.15
Yes (n, %)	248	44.85
Depression (mean and SD)	17.80	7.02
Social capital (mean and SD)
Total of social capital	20.24	6.95
Family support	1.24	0.42
Social support	1.20	0.40
Life attitude	1.29	0.45
Poor mental health outcomes (mean and SD)
No	489	88.40
Yes	64	11.60

Abbreviation: SD, Standard deviation; SAS, Self-Rating Anxiety Scale.

Table 3 Correlation Analysis of Perceived Discrimination, Depression, Social Capital, Psychological Resilience, and Adverse Outcomes of Mental Health

Variable	1	2	3	4	5	6	7	8	9	10	11	12	13	14	15	16
1. Actual discrimination
2. Worry about public	0.718**	1
3. Public attitude	0.698**	0.761**	1
4. Negative self-impressions	0.642**	0.695**	0.840**	1
5. Total discrimination perception	0.859**	0.886**	0.926**	0.893**	1
6. Depression	0.116**	0.157**	0.145**	0.211**	0.176**	1
7. Bear hardships and stand hard work	0.038	0.174**	0.068	0.058	0.093*	0.169**	1
8. Continuous work	0.104*	0.173**	0.093*	0.068	0.121**	0.106*	0.731**	1
9. Firm	0.062	0.191**	0.103*	0.064	0.116**	0.209**	0.691**	0.688**	1
10. See hope	0.101*	0.212**	0.134**	0.081	0.146**	0.209**	0.643**	0.666**	0.836**	1
11. Total psychological resilience	0.076	0.234**	0.131**	0.08	0.144**	0.184**	0.802**	0.790**	0.889**	0.885**	1
12. Family support	0	0.048	0.006	−0.012	0.011	−0.103*	0.296**	0.272**	0.298**	0.247**	0.310**	1
13. Social support	−0.027	0.014	0.023	−0.013	−0.001	−0.091*	0.326**	0.302**	0.338**	0.280**	0.353**	0.617**	1
14. Life attitude	−0.088*	−0.032	−0.069	−0.087*	−0.078	0.334**	0.244**	0.240**	0.224**	0.219**	0.251**	0.098*	0.118**	1
15. Total social capital	0.025	0.159**	0.074	0.023	0.077	−0.076	0.474**	0.465**	0.507**	0.459**	0.536**	0.621**	0.667**	0.142**	1
16. Poor mental health outcomes	0.012	0.082	0.057	0.170**	0.090*	0.243**	−0.014	−0.05	−0.016	−0.022	−0.002	0.107*	−0.111**	−0.006	−0.093*	1

Notes: **P <0.01, *P <0.05.

Figure 1 Path analysis graph of discrimination, social capital, psychological resilience.

Table 4 Pathway Coefficients for the Pathway Model

Route			Non-Standard Coefficient	Standard Coefficient	S.E.	C.R.	P
Psychological resilience	←	Discrimination perception	0.068	0.140	0.022	3.035	0.002
Social capital	←	Discrimination perception	0.000	−0.011	0.001	0.229	0.819
Depression	←	Social capital	−2.854	−0.230	1.255	−2.273	0.023
Depression	←	Psychological resilience	0.092	0.126	0.032	2.851	0.004
Depression	←	Discrimination perception	0.081	0.226	0.016	4.995	<0.001
Poor mental health outcomes	←	Psychological resilience	−0.005	−0.050	0.005	−1.035	0.301
Poor mental health outcomes	←	Depression	−0.144	−0.008	0.020	−7.207	<0.001
Actual discrimination	←	Discrimination perception	1.000	0.761
Worry about Public	←	Discrimination Perception	0.988	0.821	0.048	20.441	<0.001
Public attitude	←	Discrimination perception	1.215	0.937	0.051	23.609	<0.001
Negative self-impressions	←	Discrimination perception	1.153	0.880	0.052	22.213	<0.001
Bear hardships and stand hard work	←	Discrimination perception	1.000	0.769
Continuous work	←	Discrimination perception	0.989	0.775	0.052	19.155	<0.001
Firm	←	Discrimination perception	1.176	0.920	0.051	23.267	<0.001
See hope	←	Discrimination perception	1.115	0.888	0.049	22.521	<0.001
Fear	←	Depression	1.000	0.742
Work difficult	←	Depression	1.105	0.890	0.051	21.672	<0.001
Be down in spirits	←	Depression	1.133	0.911	0.051	22.233	<0.001
Upset	←	Depression	1.126	0.908	0.051	22.154	<0.001
Life attitude	←	Social capital	1.000	0.123
Social support	←	Social capital	5.981	0.835	2.430	2.461	0.014
Family support	←	Social capital	5.616	0.740	2.220	2.529	0.011
Poor mental health outcomes	←	Poor mental health outcomes	1.000	0.310
Sleep is not good	←	Poor mental health outcomes	−6.103	−0.665	0.862	−7.076	<0.001
Psychological resilience	←	Visual perception	0.068	0.140	0.022	3.035	0.002

Table 5 Model-Fitting Exponents

	Index	Chi-Square/df	GFI	RMSEA	IFI	TLI	CFI	NFI
Standard	Acceptability	<5	>0.7	>0.1	>0.7	>0.7	>0.7	>0.7
	Excellent	<3	>0.9		>0.9	>0.9	>0.9	>0.9
Actual value		3.25	0.921	0.084	0.927	0.910	0.926	0.909