The critical role of internalized HIV-related stigma in the daily negative affective experiences of HIV-positive gay and bisexual men

TY - JOUR

T1 - The critical role of internalized HIV-related stigma in the daily negative affective experiences of HIV-positive gay and bisexual men

AU - Rendina, H. Jonathon

AU - Millar, Brett M.

AU - Parsons, Jeffrey T.

N1 - Publisher Copyright: © 2017 Elsevier B.V.

PY - 2018/2

Y1 - 2018/2

N2 - Background Research suggests that HIV stigma exerts a detrimental impact on the mental health of HIV-positive gay and bisexual men (GBM). We sought to better understand these processes by examining two forms of HIV stigma (i.e., anticipated and internalized) at two levels (i.e., individual and situational) in association with daily negative affective experiences. Methods We conducted a 21-day twice-daily ecological momentary assessment study of 51 HIV-positive GBM. Twice-daily stigma measures were disaggregated into individual-level averages and situational fluctuations, and we utilized multilevel models to examine both concurrent and time-lagged effects of HIV stigma on anxious affect, depressed affect, anger, fatigue, and emotion dysregulation. Results Situational experiences of internalized HIV stigma were associated with increased levels of anxious and depressed affect, anger, and emotion dysregulation in both concurrent and time-lagged analyses. Situational experiences of anticipated HIV stigma were only associated with anger and only within concurrent analyses. Individual-level internalized HIV stigma was associated with anxious affect and emotion dysregulation in both concurrent and time-lagged models, and with depressed affect and fatigue in time-lagged models. Limitations The small and high-risk sample limits generalizability and results should be replicated in larger and more diverse samples. Conclusions These findings suggest that, independent of the effects of individual-level stigma, situational experiences of internalized HIV stigma are associated with increases in event-level negative affective experiences. A combination of individually-delivered and mobile interventions may be successful at reducing the impact of internalized HIV stigma on negative affect and emotion dysregulation.

AB - Background Research suggests that HIV stigma exerts a detrimental impact on the mental health of HIV-positive gay and bisexual men (GBM). We sought to better understand these processes by examining two forms of HIV stigma (i.e., anticipated and internalized) at two levels (i.e., individual and situational) in association with daily negative affective experiences. Methods We conducted a 21-day twice-daily ecological momentary assessment study of 51 HIV-positive GBM. Twice-daily stigma measures were disaggregated into individual-level averages and situational fluctuations, and we utilized multilevel models to examine both concurrent and time-lagged effects of HIV stigma on anxious affect, depressed affect, anger, fatigue, and emotion dysregulation. Results Situational experiences of internalized HIV stigma were associated with increased levels of anxious and depressed affect, anger, and emotion dysregulation in both concurrent and time-lagged analyses. Situational experiences of anticipated HIV stigma were only associated with anger and only within concurrent analyses. Individual-level internalized HIV stigma was associated with anxious affect and emotion dysregulation in both concurrent and time-lagged models, and with depressed affect and fatigue in time-lagged models. Limitations The small and high-risk sample limits generalizability and results should be replicated in larger and more diverse samples. Conclusions These findings suggest that, independent of the effects of individual-level stigma, situational experiences of internalized HIV stigma are associated with increases in event-level negative affective experiences. A combination of individually-delivered and mobile interventions may be successful at reducing the impact of internalized HIV stigma on negative affect and emotion dysregulation.

KW - Daily diary

KW - Ecological momentary assessment

KW - Gay and bisexual men

KW - HIV stigma

KW - Internalized stigma

KW - Negative affect

UR - https://www.scopus.com/pages/publications/85033385078

UR - https://www.scopus.com/pages/publications/85033385078#tab=citedBy

U2 - 10.1016/j.jad.2017.11.005

DO - 10.1016/j.jad.2017.11.005

M3 - Article

C2 - 29128785

SN - 0165-0327

VL - 227

SP - 289

EP - 297

JO - Journal of Affective Disorders

JF - Journal of Affective Disorders

ER -