title: Stigma, disclosure, coping, and medication adherence among people living with HIV/AIDS in Northern Tanzania.
abstract: This study examines a proposed theoretical model examining the interrelationships between stigma, disclosure, coping, and medication adherence among 158 HIV-infected patients on antiretroviral therapy (ART) in northern Tanzania. Perceived and self-stigma, voluntary and involuntary disclosure, positive and negative coping, and demographics were assessed by trained interviewers, and self-reported adherence was collected during 5 months follow-up. Data were examined using correlation and regression analyses. The analyses showed that perceived stigma is primarily related to involuntary disclosure, whereas self-stigma is related to voluntary disclosure. Religious coping positively relates to acceptance, whereas perceived stigma explains higher levels of denial of HIV status. Lastly, adherence was negatively affected by alcohol use, self-stigma, and denial. We conclude that adherence is predominantly predicted by negative rather than positive coping mechanisms. Therefore, substituting maladaptive coping mechanisms like denial and alcohol use with a more adaptive coping style may be an important strategy to improve long-term ART adherence and well-being of patients. Moreover, this study showed that it is useful to examine both involuntary and voluntary disclosure when studying its relation with stigma.
authors: 1 Kilimanjaro Clinical Research Institute/Kilimanjaro Christian Medical Center ; Moshi, Tanzania .
authors: Ramsey A
authors: RA
authors: Lyimo
authors: Sarah E
authors: SE
authors: Stutterheim
authors: Harm J
authors: HJ
authors: Hospers
authors: Teuntje
authors: T
authors: de Glee
authors: Andre
authors: A
authors: van der Ven
authors: Marijn
authors: M
authors: de Bruin
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D030881:Disclosure; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy* / Q000523:psychology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D011287:Prejudice; D011446:Prospective Studies; D012044:Regression Analysis; D012424:Rural Population; D057566:Self Report; D012934:Social Isolation / Q000523:psychology; D057545:Social Stigma; D012959:Socioeconomic Factors; D013240:Stereotyping; D011795:Surveys and Questionnaires; D013636:Tanzania; D055815:Young Adult
chemical_list: D044966:Anti-Retroviral Agents