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The mediation effect of resilience on the relationship between stigma and mental health problems among HIV-infected adults in Southwest China

Shaobing Su1, Xiaoming Li1, Liying Zhang1, Shan Qiao1, Juxian Pan2, Weigui Guo2, Yuejiao Zhou3, Peiying Zuo4

1 Department of Pediatrics Prevention Research Center, School of Medicine, Wayne State University, Detroit, MI 48201, USA.2 Beihai Center for Disease Prevention and Control (CDC), Guangxi, China.3 Guangxi Center for Disease Prevention and Control (CDC), Guangxi, China.4 Institute of Developmental Psychology, Beijing Normal University, Beijing, China.

Abstract no.WEPDD01

Presenter: Peiying Zuo

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Background

• Destructive impact of stigma on the mental health of HIV-infected adults

• Limited study has explored the protective effect of resilience on mental health among HIV-infected adults.

• The purpose of the current study is to examine the associations among stigma, resilience, and mental health among HIV-infected adults in China.

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Methods• SampleA total of 3002 HIV-infected adults from 12 cities/counties in Guangxi, China participated

in the survey.

After removing 15 uncompleted questionnaires, we finally obtained data from 2,987

participants for the current study.

• MeasurementsDemographics

HIV-related characteristics: Duration of infection, CD4 cell count.

Stigma: Internalized stigma, Perceived stigma

Resilience

Mental health problems: Depressive symptoms, Anxiety

• Data AnalysisLinear regressions were applied to examine the prediction models of depressive symptoms and

anxiety on demographics, HIV related characteristics, and independent variables (resilience and

stigma).

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Results

Demographics Value

Age 42.46±12.83Gender

Female 1111(37.2%)

Male 1876(62.8%)

Education (year) 6.97±3.30CD 4≤250 1035(36.2%)251-499 1261(44.1%)≥500 565(19.7%)

Duration of HIV infection (month) 38.72±28.65Income (month)

<2000 2442(82.6%)

2000~3999 418(14.1%)

≥4000 98(3.3%)

Table 1 Demographic Characteristics

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Results

Depressive symptoms Anxiety

Demographics Model 1 Model 2 Model 3 Model 1 Model 2 Model 3Age

-0.05* -.051* -.069 -0.07*** -0.07*** -0.09***

Educational level -0.04 -0.04* 0.03 -0.05* -0.05** 0.00Gender 0.06** .054** 0.06 0.04* 0.04 0.04*

Income-0.11*** -0.11*** -0.04 -0.11*** -0.10*** -0.05**

HIV related characteristics

           

CD 4   -0.06** -.054   -0.05* -0.04*Duration of HIV infection

  0.03 0.03   0.04 0.04*

Independent variables

           

Stigma      0.37***      0.27***

R2 0.02 0.02 0.15 0.02 0.02 0.09

Table 2 Linear Regression Analysis of Mental Health Problems on Stigma

StigmaDepressive

symptoms/AnxietyMediation test-Path A:

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Results

Table 3 Linear Regression Analysis of Resilience on Stigma

Resilience Depressive symptoms

Anxiety

DemographicsAge -0.06 -0.05** -0.07***Educational level 0.12** 0.04* 0.01Gender 0.03 0.05** 0.04*Income 0.13*** -0.04** -0.05**HIV related characteristics      

CD 4 -0.01 -0.06** -0.04*Duration of HIV infection 0.01 0.02 0.03Independent variables      

Resilience -0.39*** -0.34***Stigma -0.23*** 0.28*** 0.19***R2 10.2 0.30 0.20

Stigma ResilienceMediation test- Path B:

Stigma

ResilienceMediation test- Path C: Depressive

symptoms/Anxiety

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Conclusion• Stigma has negative effects on the mental

health of HIV-infected adults. • Resilience can not only protect HIV

infected patients from suffering mental health difficulties, but also buffer the negative impact of stigma on HIV-infected patients' mental health.

• Resilience-based intervention would be helpful for HIV-infected patients to effectively cope with stresses and improve mental health status.

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Thank you for your attention!Contacts: Xiaoming Li xiaoli@med.wayne.eduShaobing Su ssu@med.wayne.edu