Internalized Stigma Research Articles

"FEEL IT, SHARE YOUR FEELING," AN APPLICATION FOR INDONESIANS FREE FROM STIGMA

One of the factors that affect a person's mental health is the presence of stigma or adverse judgment. People who may often face stigma are those with HIV/AIDS (PLHIVA), COVID-19 survivors, and health workers caring for COVID-19 patients. Stigma is divided into enacted stigma and internalized stigma related to beliefs, behaviors, and actions. Overcoming stigma may be done by increasing knowledge using technology in this digital era. The researcher developed an application named "Feel It, Share Your Feeling" for the community, especially for people living with HIV/AIDS, COVID-19 survivors, and health workers caring for COVID-19 patients who are experiencing stigma. The study used a quasi-experimental method with randomized pretest-posttest designs, involving 60 respondents divided into intervention and control groups. The pre and post-intervention data were measured in both groups using The Multidimensional Measure of Internalized HIV Stigma. The data was analyzed using Wilcoxon Signed-Ranks and Mann-Whitney tests. Over a month, the intervention group showed a reduction in internal stigma, with 73.33% reporting lower stigma levels after using the Feel It, Share Your Feeling application. The Wilcoxon test results showed a computed p-value of 0.005, and the Mann-Whitney test results also indicated a p-value of 0.005. The use of the Feel It, Share Your Feeling application was found to lower internal stigma and provide accessible therapies for people living with HIV/AIDS, COVID-19 survivors, and health workers caring for COVID-19 patients. Keywords: Stigma; covid-19; HIV; nurse; mental health

Internalized Stigma and Its Relationship With Quality of Life and Perceived Health Status in Rosacea and Acne Vulgaris: A Comparative Cross-Sectional Study.

Background Internalized stigma (IS) is the acceptance of unfavorable stereotypes about the disease that society has created and withdrawing from society with feelings of shame and worthlessness. Due to the visibility feature of facial skin diseases such as rosacea and acne vulgaris (AV), it is possible for them to cause IS. Objective We aimed to examine the level of IS in AV and rosacea patients and compare these patient groups as well. Methods Fifty-three AV and 46 rosacea patients aged 18-65 were included in this study. Internalized Stigma Scale (ISS) adapted for AV and rosacea were applied to all the patients. They also responded to the "Dermatology Life Quality Index" (DLQI) questionnaire. The relationship between IS levels and DLQI was investigated, and then acne and rosacea patients were compared with each other. Results Total DLQI, total ISS, and its subscales' scores of all patients were found to be positively correlated with each other. When rosacea and AV patients were compared with each other, there was no difference regarding DLQI and ISS scores. Conclusion AV and rosacea patients experience high IS, and it is significantly related to low quality of life and health status. They also have similar IS levels when compared with each other.

The Relationships among Internalized Stigma, Sense of Coherence, and Personal Recovery of Persons with Schizophrenia Living in the Community.

We investigated (i) the relationships among internalized stigma (IS), sense of coherence (SOC), and the personal recovery (PR) of persons with schizophrenia living in the community, and (ii) how to improve the support for these individuals. A questionnaire survey on IS, SOC, and PR was sent by mail to 270 persons with schizophrenia living in the community who were using psychiatric daycare services, of whom 149 responded and 140 were included in the analysis. We established a hypothetical model in which IS influences PR, and SOC influences IS and PR, and we used structural equation modeling to examine the relationships among these concepts. The goodness of fit was acceptable. Our findings suggest that rather than directly promoting PR, SOC promotes PR by mitigating the impact of IS. It is important for nurses/supporters to support individuals with schizophrenia living in the community so that they have opportunities to reflect on their own experiences through their activities and to share their experiences with peers. Nurses/supporters themselves should also reflect on their own support needs. Our findings suggest that this will lead to a reduction of IS and the improvement of SOC, which will in turn promote personal recovery.

Psycho-social predictors of motivation for treatment in patients with mental disorders: the role of adverse childhood experiences and internalized stigma.

IntroductionMotivation for treatment is an important socio-psychological characteristic of patients, which is subject to the joint influence of various factors, each of which may require specific rehabilitation interventions.ObjectivesTo analyze and evaluate the cumulative influence of adverse childhood experiences (ACE), internal stigma, social characteristics on the intensity of treatment motivation in patients with mental disorders.Methods 102 patients with mental disorders were examined using Adverse Childhood Experience Questionnaire (ACEQ), Russian-language validated Internalized Stigma of Mental Illness (ISMI) scale and Treatment Motivation Assessment Questionnaire (TMAQ).Results As a result of regression analysis (table 1), a model was obtained that predicted an increase in the chances of high patient’s motivation for treatment with an increase in the total score of ACEs (ACEQ total score) and with higher education. The overall severity of internal stigma (ISMI total score) did not show a significant effect on the chances of developing intense motivation in patients. Table 1.Model of logistic regression analysis of educational, ACE total score and ISMI total score with the severity of motivation for treatment.PredictorBSEpExp (B)95% confidence interval for EXP(B)Secondary education1,1200,6990,1093,0650,778-12,074Higher education1,9720,775,0117,1891,574-32,834ISMI total score-0,4350,7730,5740,6470,142-2,946ACEQ total score0,3460,1470,0191,4141,060-1,886After post data analysis (table 2), a cut-off point was established for the ACEQ total score of 4 points, corresponding to an increased chances of high patient’s treatment motivation. Table 2.Results of the test ROC analysis for ACEQ total score and the severity of motivation for treatment.CutpointSensitivity (%)Specificity (%)Youden’s indexAUC364.71%53.57%0.1830.689450%75%0.2500.689538.24%85.71%0.2390.689ConclusionsACEs may likely be a source of posttraumatic growth in adulthood in patients with mental illness specially if their count amounts to 4 or more variants. The role of social and psychological characteristics of patients with mental disorders in the psychology of the treatment process should be considered systemically, rather than discretely.Disclosure of InterestNone Declared

Analysis of Participant Stigma and Associated Costs of a Peer-Led Social Media HIV Intervention.

HIV-related stigma is a primary barrier to seeking HIV care. Online social media interventions utilizing peer-led approaches provide an opportunity to revolutionize HIV health behavior change. Secondary analysis of the UCLA HOPE Study (6 waves) was done to examine the effectiveness of an online peer-led intervention in reducing HIV-related internalized stigma (IS), association between IS and sexual risk behaviors (SRB), and associated costs for changing the likelihood of HIV testing. Among 897 participants, an inverse relationship between IS (Discomfort with people with HIV, Stereotypes, Moral Judgment) and SRB (Number of Sexual Partners, Sexual Encounters) factors was identified over time (p < .05). Engagement in stigma conversations increased participant likelihood to request HIV tests (B = 0.02, Wald = 8.10, p = .004) when made in group versus one-on-one contact. Innovative technology has potential to improve HIV-care efforts through expanded reach to at-risk populations, improved communication maintenance, ease of accessibility, and user anonymity.

The role of negative childhood experiences and internal stigma in the formation of motivation for the treatment of patients with mental disorders

Background: Motivation for treatment is an important component of patients' compliance to treatment of mental disorders, and its formation can be affected by different factors. The aim of the study: To analyze relationship between adverse childhood experiences, internal stigma and the intensity and structure of motivation to pharmaco-psychotherapy in patients with mental disorders. Materials and methods: The study involved 102 patients treated at the V.M. Bekhterev National Medical Research Center for Psychiatry and Neurology, the Kashchenko Hospital, and the City Psychiatric Hospital No. 6. The study used the Adverse Childhood Experience (ACE) questionnaire, the Internalized Stigma of Mental Illness (ISMI) questionnaire, and the Treatment Motivation Assessment Questionnaire (TIMQ). Statistical analysis was performed using the SPSS 26.0 software package. Results: According to the results of multiple regression analysis, patients with higher education determined the improvement of patients' motivation for treatment, increasing the probability of its high intensity by 5.92 times. The presence of each additional type of adverse experience in childhood also 1.4-fold increase the odds of intensive motivation of patients. Among individual variants of negative experience, emotional abuse was associated with a tenfold decrease in odds, while observing violence against a mother or stepmother in childhood was conversely associated with a fifteenfold increase in the odds of forming an intense motivation for treatment. Conclusion: Integrative role of adverse childhood experiences is important, but, unlike the internal stigma of mental disorder, it can be equally associated with both less adaptive motivational patterns during treatment. to both more and less adaptive motivational patterns in patients in the process of their treatment.

Religious Identity Dissonance: Examining the Path of Religious Factors to Depression in Sexual Minority Men in the USA.

Little is known about the religious factors that contribute to religious identity dissonance (ID) for sexual minority men. Our aim wasto model the path of religious factors to depression symptoms through ID and internalized stigma (IS). US sexual minority men (N = 168) participated in a survey about religious factors and mental health. Serial mediation of religious factors through ID and IS to depression symptoms was assessed using Hayes PROCESS macro. Results indicate that two religious factors significantly increase depression through ID and IS. Negative parental religious messages about LGBTQ people play a meaningful role in ID and increasing depression.

Internal stigmatization in patients with chronic migraine and medication overuse headache

ObjectivesInternalized stigma can have profound effects on how individuals with migraines and other primary headache disorders see themselves and their quality of life. We aimed to investigate internalized stigma in patients with chronic migraines and medication overuse headaches.MethodsA total of 57 patients (52 women, 5 men) were included in the study, 26 of these patients were affected by chronic migraine, 31 of them were affected by medication overuse headache and chronic migraine. The Internalized Stigma Scale in Mental Illness (Ristsher’s stigmatization scale) and General Health Questionnaire were applied to all patients.ResultsIn Ristsher’s stigmatization scale, which measures internalization of stigma, internalized stigmatization was more significant in patients with medication overuse headache than in patients with chronic migraine compared to groups (p:0.05). The subtitle of alienation was statistically significant when the groups were compared to all subscales in the form of alienation, confirmation of stereotypes, perceived discrimination, social withdrawal and resistance to stigma (p:0.05).DiscussionAlthough internal stigmatize has been observed in chronic migraine patients, medication overuse headache is also a type of headache with intense stigma. In addition, this internal stigma perhaps plays an active role in the transformation of chronic migraine patients to medication overuse headaches patient.

Stigma and its associations with medication adherence in major depressive disorder

This study sought to evaluate internalized stigma (IS) and perceived stigma (PS), in persons (n = 522) living with major depressive disorder (MDD), with a view to analyzing the association of IS and PS with medication adherence in a cohort of participants with MDD in China. Perceived stigma is the awareness of societal negative views and attitudes towards depression, and IS is applying others’ attitudes to oneself, both measured by the Depression Stigma Scale (DSS). Medication adherence was assessed using the Medication Adherence Rating Scale (MARS). We observed that 76.0 % of participants reported IS and 84.5 % reported PS. Factors associated with increased IS included older age, marital status, disease history, and a higher baseline Patient Health Questionnaire-9 (PHQ-9). Higher education level, family income, and scores on the Connor-Davidson Resilience Scale (CD-RISC) were associated with lower levels of IS. Higher education levels, Childhood Trauma Questionnaire (CTQ) scores, and living with others were also associated with higher PS, while engagement in exercise and higher number of prior episodes were associated with lower PS. IS had a negative association with medication adherence, whereas PS did not significantly associate with adherence. In conclusion, a testable hypothesis is derived from our data that strategies targeting IS amongst persons with MDD may improve overall rates of adherence to antidepressant treatment, a necessary prelude to improving recovery.

Examination of internalized stigma, quality of life, and happiness in patients with schizophrenia

Background Happiness in patients with schizophrenia is a neglected concept that needs to be developed. Determining the relationship between internalized stigma, quality of life, and happiness, which is important for the prognosis of schizophrenia, will reveal why it is necessary to focus on activities that will increase happiness in patients with schizophrenia. Aim This study aimed to compare the levels of internalized stigma, quality of life, and happiness in patients with schizophrenia. Methods A descriptive and correlational research design was used. The research population consisted of patients who applied to the psychiatry outpatient clinic of a hospital in eastern Turkey during the research period and were diagnosed with schizophrenia according to the DSM-5 diagnostic criteria; 87 voluntary patients who agreed to participate in the study constituted the research sample. A personal information form, the Internalized Stigma of Mental Illness Scale (ISMI), the World Health Organization Quality-of-Life Scale (WHOQOL-BREF), and the Subjective Happiness Scale (SHS) were used for data collection. Results According to the patients’ ISMI, WHOQOL-BREF-TR, and SHS scores, patients perceived internalized stigma above the moderate level in all sub-dimensions. In general, their quality of life was moderate (the highest mean score was on the national environment domain and the lowest mean score was on the social domain); the mean SHS score was 13.02 ± 5.53. There was a strong and negative correlation between the mean SHS score and the total ISMI score and a strong and positive correlation between SHS and the physical, mental, social, and national environment domains of WHOQOL-BREF-TR. Conclusions It was determined that the mean internal stigma score of the patients decreased and their mean quality of life score increased as their mean subjective happiness score increased. It is recommended clinical studies be carried out to increase happiness in patients with schizophrenia.

Internalized AIDS-Related Stigma Experiences in West of Iran

Background and Objective: Internalized stigma (IS) is defined as negative stereotypes people hold about themselves and have accepted them. The purpose of this study was to determine IS among HIV/AIDS patients in Kermanshah, Iran. Materials and Methods: This cross-sectional research was conducted on 200 HIV/AIDS patients in the Behavioral Diseases Counseling Center of Kermanshah University of Medical Sciences, Kermanshah, Iran, in 2021. The required data were collected using a questionnaire and holding an interview. The gathered data were analyzed in SPSS-16 software using one-way analysis of variance, independent samples t-test, and bivariate correlation tests. Results: The average overall score of IS was obtained at 5.65 (score range: 0 to 6). The mean internalized stigma score was slightly higher among male patients, single individuals, those with primary education, unemployed patients, and those with poor economic status; however, it was not statistically significant. Conclusions: It can be concluded that IS highly prevalent among HIV/AIDS patients in Kermanshah. Comprehensive interventions among patients are needed to reduce stigma.

Help! I Need Somebody: Help-Seeking Among Workers with Self-Reported Work-Related Mental Disorders.

Worker mental health has emerged as one of the most significant challenges in contemporary workplaces. Knowing what intervention is effective is important to help workers adapt to mental health disorders but connecting workers to helpful resources is just as important and perhaps more of a challenge. With the multiple stakeholders involved, mental health disorders arising in the workplace pose specific challenges to help-seeking. The present study sought to explore the lived experience of workers and the personal and contextual influences on help-seeking among workers with work-related mental health disorders. A qualitative methodology was employed utilizing purposive sampling to conduct semi-structured interviews with individuals (n = 12) from various occupational backgrounds who had experienced a work-related (self-declared) mental health disorder. A Critical Theory approach was used to inform study design and analysis. Interpretative phenomenological analysis and thematic content analysis were combined to analyze the data. Three main themes emerged including: (1) self-preservation through injury concealment and distancing themselves from workplace stressors to minimize/avoid internal and external stigma; (2) fatigue relating to complex help-seeking pathways, accumulation of stressors, eroding the worker's ability to make independent decisions regarding supports; and (3) (mis)trust contributed to resources accessed by participants. Along with internalized stigma, findings point to the important role of social identity and trust and how these are influenced by relationships and organizational contexts. Findings indicate the need to educate workplace parties such as supervisors on mental health and pathways to help, simplifying pathways to service and removing barriers to help seeking including stigmatizing behaviours. Future quantitative research and intervention development directed at workplace mental health should integrate models and frameworks emphasizing relational and organizational dimensions in help-seeking.

The Relationship Between Religious Coping and Internalized Stigma Among Patients With Bipolar Disorder.

Stigmatization is a situation that results from the negative perspective of society towardindividuals with certain mental and physical illnesses and has negative effects. It has been observed that there are not enough studies in the literature investigating the attitudes of individuals with mental illness to cope with lifelong difficulties such as stigmaand especially their religious coping attitudes. However, there are many clinical studies on general psychology and religious coping with varying results. Our aim in this research is to reveal the association between religious coping and internal stigma among bipolar disorder patients. The religious coping scale and the Internalized Stigma in Mental Illness (ISMI) scale were administered to 79 patients with bipolar disorder. The obtained data were analyzed usingIBMSPSSStatistics for Windows, Version 22 (Released 2013; IBM Corp., Armonk, New York, United States). Forty-two (53.1%) patients were female and 37 (46.9%) were male, the mean age was 43.41±12.57, and the mean follow-up period was 11.95±9.15 years.A positive correlation was found between negative religious coping and discrimination experience, alienation, and social withdrawal in bipolar disorder patients. A significant negative correlation was found between discrimination experience, alienation and social withdrawal, and positive religious coping. The correlation of religious coping attitudes with discrimination experience, alienation, and social withdrawal makes us think that religious coping methods may be one of the issues to be considered when dealing with self-stigma in bipolar disorder patients.In addition, the relationship between religious coping and self-stigmatization in mental illnesses can add a new dimension to psychosocial approaches. It would be beneficial for authors interested in religion and social psychology to focus on more extensive research on this subject.

Stamp Out Stigma: a national campaign to decrease stigma and increase behavioral health in fire service

ABSTRACT Firefighters are at risk for behavioral health problems; however, mental health stigma is a barrier to seeking treatment. Although effective treatments exist, many firefighters report that internal stigma prohibits presentation for effective care. This study aimed to decrease stigma about behavioral health in fire service through the development and delivery of a peer-led anti-stigma intervention campaign called Stamp Out Stigma (SOS). SOS consisted of three related phases. During Phase 1 (n = 12), we produced testimonials and piloted the videos with firefighters to determine which were most compelling. During Phase 2 (n = 23), we beta-tested our training curriculum with two departments, resulting in a significant decrease in internalized stigma but not in self-stigma. During Phase 3 (n = 73), we presented the curriculum to two cohorts of firefighters. Participation in the SOS workshop was associated with a significant decrease in firefighters’ self-stigma from pre-, M = 22.7, SD = 6.3, to post-workshop, M = 20.8, SD = 5.5, t(66) = 3.2, p = 0.002. Participation in the SOS workshop was associated with a significant decrease in firefighters’ internalized stigma, M = 2.0, SD = 0.5, to post-workshop, M = 1.8, SD = 0.4, t(66) = 2.8, p = 0.007. The SOS approach to stigma reduction is promising for modifying negative attitudes toward mental health and treatment seeking among professional firefighters.

An effective psychological intervention in reducing internalized stigma and improving recovery outcomes in people with severe mental illness

Internalized stigma reduces chances of clinical and subjective recovery in people with schizophrenia and other severe mental illness. To date, there is not enough evidence about an effective intervention to reduce internalized stigma that promotes clinical and subjective recovery in people with high internalized stigma and severe mental illness. The aim of this study was to evaluate the efficacy of a new psychological intervention named “Coping Internalized Stigma Program” (PAREI). An eight-session structured group-based integrative intervention was designed including psychoeducation, cognitive behavioural therapy, and mutual support. Fifty-four individuals with severe mental illness and a high level of internalized stigma were selected and randomly assigned to the PAREI intervention (n = 29) or to the control group (n = 25). The results of mixed ANOVAs revealed improvements in the PAREI group after treatment in the emotional dimension of internalized stigma, perceived legitimacy of discrimination, recovery expectations, and social functioning as compared to the control group. The results indicate that the PAREI represents a promising intervention tool to reduce internalized stigma, and to improve clinical and subjective recovery markers in people with severe mental illness and high internalized stigma.

!e Psychological Impact of Six Weeks of Lockdown as a Consequence of COVID-19 and the Importance of Social Support: A Cross-Cultural Study Comparing Spanish and Russian Populations

Background. !e COVID-19 pandemic has been an unprecedented social and health emergency worldwide. Cross-cultural research on mental health during this situation is needed to better understand its consequences. Objective. To evaluate the di"erent psychological impacts of the crisis and lockdown situation during the #rst six weeks of COVID emergency measures in samples of the Spanish and Russian populations. Design. A cross-sectional study was conducted through an online survey (NSpain = 1041; NRussia = 743). !e prevalence of loneliness, depression, anxiety, perceived discrimination (PD), internalized stigma (IS), and perceived social support (PSS) was evaluated. Chi-square tests and t-tests were administered. The Enter Method were used to identify the predictors of the mental health impact. Results. Di"erences were found between the Russian and the Spanish populations. While the degrees of anxiety and depression did not di"er signi#cantly, loneliness, the alienation dimension of IS, and PD were more pronounced in the Russian respondents. In Spain, the predictor of less negative impact was PSS from various sources, while in Russia we only found PSS from the family. Conclusion. Although in both countries the impact at the clinical level seemed to be similar, di"erences were found at the psychosocial level. Variables with a strong cultural component may be key to determining the means of alleviating the e"ects of the crisis, with PSS being a fundamental protective factor. More crosssectional studies are needed to understand the impact of the pandemic in depth.

Are causal beliefs associated with stigma? A test of the impact of biogenetic versus psychosocial explanations on stigma and internalized stigma in people experiencing psychosis.

Individuals with psychosis are often subject to external stigma and discrimination and commonly also experience internalized stigma. Attempts to improve attitudes have tended to medicalize the experiences associated with psychosis; however, research increasingly indicates an association between biogenetic attitudes and stigma. This study aims to evaluate this approach by investigating the impact of two different etiological explanations on both internalized and external stigma in people experiencing psychosis. A total of 60 participants who have a diagnosis of schizophrenia or meet criteria for early intervention services for psychosis were randomly allocated to one of two conditions (psychosocial vs. biogenetic). Attitudes were assessed before and after the intervention. Both interventions resulted in a decrease in internalized stigma. Only the psychosocial intervention decreased external stigma. Although further research is necessary, providing education to individuals could be an effective way to reduce internal stigma. Antistigma campaigns should avoid a singular focus on biogenetic explanations of psychosis, and a psychosocial viewpoint may be a suitable alternative.

Investigation of the effect of internalized stigmatization on addiction characteristics and perceived social support in women addicts

Objective: The aim of this study was to determine the relationship between the internalized stigma (IS), addiction characteristics and perceived social support (PSS) characteristics of female inpatient or outpatients undergoing treatment for alcohol and substance use disorder. Methods: This was a cross-sectional, multi-center study. One hundred and five female patients were included according to the criteria of the DSM-5 alcohol or substance use disorder which treated in Istanbul Green Crescents Consultancy Center and four Addiction Centers in Turkey. In this study, an introductory information form, Internalized Stigma in Mental Disorders (ISMI) Scale, Addiction Profile Index (API), Addiction Profile Index-Clinic (API-C) form and Multidimensional Perceived Social Support Scale Re-vised Form (MSPSS) were used. In the evaluation of the data, the number and percentage distributions were made, and the relationship between the variables was examined by analysis of variance and correlation analysis. Results: The mean age of the participants was 30.76. The proportion of currently married was 16.2%, others were single or divorced. 64.7% of the participants stated that they did not work. The economic situation of 78.1% was moderate and low. The relationship between the subscale scores of the ISMI and the MSPSS and API scales were examined. There was a linear relationship showed between alienation, stereotype endorsement and social withdrawal sub-scales of the ISSMD and many features of the API and also depression and anxiety subscales of the API-C. Except for the stigma resistance subscale, a significant positive correlation was found between all subscales of ISMI and MSPSS subscales. Discussion: It is an enormous problem both in Turkey and in the world, stigma has a negative impact on women with addiction was discussed in this study.

"They called me a terrorist": Social and Internalized Stigma in Latino Youth with Type 1 Diabetes.

Diabetes-related stigma (DRS) globally affects patients' lives. Over a third of adolescents with type 1 diabetes (T1D) in Puerto Rico reported concerns of others knowing about their diabetes and about being different. We examined DRS among 65 T1D Latino youth (aged 12-17). During a depression-treatment study screening, they answered open-ended questions about diabetes-related concerns/difficulties and issues bothering them while interacting with peers, family, and healthcare professionals because of T1D. Using content analysis, we classified responses into Social Stigma (SS), Internalized Stigma (IS), and No Stigma. Four SS and IS sub-categories were developed. After coding, inter-rater reliability (Cohen's kappa) ranged from .73 to .1.00 (p≤.001). Forty-four youth (67.69%) reported at least one DRS verbalization, and 25 reported more than one. Both SS and IS were identified in 32 (49.23%) adolescents. Among SS experiences were: "they call me a junkie [because of insulin shots]"; "they call me a terrorist [because of insulin pump]". IS verbalizations included: "I've never wanted to accept that I have T1D, so I don't practice good self-care"; "at times I do not feel the same as others". We found more stigma-related verbalizations among those from urban zones or larger families. DRS was related to increased depressive symptoms and risk of a depressive disorder. Peers were the main source of SS. DRS was common, pervasive, and linked to depression. This study innovatively examines DRS in an exclusively T1D Latino and adolescent sample. Understanding its extent and nature is essential for developing interventions to address DRS.

The Influence of Internalized Stigma on the Efficacy of an HIV Prevention and Relationship Education Program for Young Male Couples

Young MSM are at increased risk for HIV, especially in the context of serious relationships, but there is a lack of couples-based HIV prevention for this population. The 2GETHER intervention-an HIV prevention and relationship education program for young male couples-demonstrated promising effects in a pilot trial. However, there is evidence that internalized stigma (IS) can influence treatment outcomes among MSM. The current study examined the influence of IS on the efficacy of the 2GETHER intervention among 57 young male couples. The intervention led to decreases in percentage of condomless anal sex partners and increases in subjective norms regarding HIV prevention for those with low/average IS, but not high IS. The intervention also led to increases in motivation to get tested with one's partner and decreases in alcohol consumption for those with high IS, but not low/average IS. In contrast, IS did not moderate intervention effects on other motivational constructs, dyadic adjustment, or alcohol problems. In sum, IS influences the extent to which young male couples benefit from HIV prevention and relationship education depending on the outcome. Research is needed to understand how IS influences treatment outcomes.