HIV-related stigma and symptoms of post-traumatic stress disorder and depression in HIV-infected individuals: does social support play a mediating or moderating role?

Abstract

HIV stigma plays a major role in the etiology of psychological distress among persons living with HIV, but may be ameliorated by social support. This cross-sectional study examined whether social support mediates or moderates the relationship between HIV stigma and psychological symptoms. We recruited a convenience sample of 210 individuals living with HIV in three peri-urban communities in the Western Cape, South Africa. People living with HIV and AIDS (PLWHA) completed self-report questionnaires that assessed HIV-related stigma, social support, post-traumatic stress disorder (PTSD) and depression. Product-term regression analyses showed that social support played a mediating role in the relationship between HIV-related stigma and symptoms of PTSD (not depression). Social support did not, however, moderate the relationship between HIV-related stigma and PTSD or depression. The results indicate that perceived HIV-related stigma may decrease PLWHA's perceived level of social support, which in turn may increase PTSD symptoms. Moreover, these findings suggest that despite the protective role of social support, there are other factors that affect the relationship between HIV-related stigma and mental health that hinder the buffering role of social support in this relationship. These findings may have implications for designing and implementing interventions that increase perceived social support and decrease perceived HIV-related stigma, which in turn may decrease symptoms of PTSD among PLWHA.

Keywords:

• HIV stigma
• post-traumatic stress disorder
• depression
• mediation and moderation
• social support

Acknowledgement

The financial assistance from the South African Research Chair Initiative, National Research Foundation (NRF) [grant number – 64811], is hereby acknowledged. Opinions expressed or conclusions arrived at in this work are those of the author and should not necessarily be regarded as those of the National Research Foundation (NRF). S. Seedat is supported by the South African Research Chairs Initiative, National Research Foundation (NRF) and the Medical research Council Unit on Anxiety and Stress Disorders.