Prospective Associations Between HIV-Related Stigma, Transmission Risk Behaviors, and Adverse Mental Health Outcomes in Men Who Have Sex with Men

Abstract

The vast majority of research on HIV-related stigma has been cross sectional, and few studies have examined whether experiencing stigma is associated with sexual risk behaviors. The purpose of this study is to examine the prospective relationships between experiencing HIV-related stigma and symptoms of anxiety and depression, as well as sexual transmission risk behavior. The sample included HIV-infected men who have sex with men (n = 314) who participated in a secondary HIV-prevention study at their primary care site. Participants were assessed at baseline, and then completed follow-up assessments at 3, 6, 9, and 12months. Experiencing HIV-related stigma was prospectively associated with symptoms of depression (β = 0.16, p < .001), panic (β = 0.11, p = .01), and generalized anxiety (β = 0.05, p = .05). In addition, perceiving HIV-related stigma was prospectively associated with transmission risk behaviors, including unprotected receptive or insertive anal intercourse with HIV-seronegative or status unknown partners (β = 0.06, p = .047). Experiencing HIV-related stigma may increase risk for sexual transmission risk behavior and mental health problems.