title: Depressive Symptoms Mediate the Effect of HIV-Related Stigmatization on Medication Adherence Among HIV-Infected Men Who Have Sex with Men.
abstract: This study tested the hypothesis that depressive symptoms would mediate the association of HIV-related stigma to medication adherence. We recruited HIV-infected men who have sex with men (MSM; N = 66; 66 % White, 23 % African-American) from an outpatient infectious disease clinic, and asked them to complete self-report measures. Mediational analyses showed that depressive symptoms fully mediated the association between HIV-related stigma and adherence. That is, stigma-related experiences were positively associated with depressive symptoms and negatively associated with adherence, and, in the final model, depressive symptoms remained a significant correlate of adherence while stigma did not. A test of the indirect effect of stigma on adherence through depressive symptoms was also significant (unstandardized b = -0.19; bootstrap 95 % CI -0.45 to -0.01). These results highlight the importance of treating depressive symptoms in interventions aiming to improve medication adherence among HIV-infected MSM.
authors.affiliation: Department of Psychology, Syracuse University, 430 Huntington Hall, Syracuse, NY, 13244-2340, USA, ldmitzel@syr.edu.
authors.forename: Luke D
authors.initials: LD
authors.lastname: Mitzel
authors.forename: Peter A
authors.initials: PA
authors.lastname: Vanable
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Brown
authors.forename: Rebecca A
authors.initials: RA
authors.lastname: Bostwick
authors.forename: Shannon M
authors.initials: SM
authors.lastname: Sweeney
authors.forename: Michael P
authors.initials: MP
authors.lastname: Carey
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D003863:Depression / Q000150:complications* / Q000453:epidemiology / Q000523:psychology; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D018451:Homosexuality, Male / Q000523:psychology*; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D008954:Models, Biological; D057545:Social Stigma; D012944:Social Support; D012959:Socioeconomic Factors; D013240:Stereotyping; D014481:United States / Q000453:epidemiology; D016903:Drug Monitoring
chemical_list: D044966:Anti-Retroviral Agents