title: HIV-Related Stigma, Shame, and Avoidant Coping: Risk Factors for Internalizing Symptoms Among Youth Living with HIV?
abstract: Youth living with HIV (YLH) are at elevated risk of internalizing symptoms, although there is substantial individual variability in adjustment. We examined perceived HIV-related stigma, shame-proneness, and avoidant coping as risk factors of internalizing symptoms among YLH. Participants (N = 88; ages 12-24) completed self-report measures of these potential risk factors and three domains of internalizing symptoms (depressive, anxiety, and PTSD) during a regularly scheduled HIV clinic visit. Hierarchical regressions were conducted for each internalizing symptoms domain, examining the effects of age, gender, and maternal education (step 1), HIV-related stigma (step 2), shame- and guilt-proneness (step 3), and avoidant coping (step 4). HIV-related stigma, shame-proneness, and avoidant coping were each correlated with greater depressive, anxiety, and PTSD symptoms. Specificity was observed in that shame-proneness, but not guilt-proneness, was associated with greater internalizing symptoms. In multivariable analyses, HIV-related stigma and shame-proneness were each related to greater depressive and PTSD symptoms. Controlling for the effects of HIV-related stigma and shame-proneness, avoidant coping was associated with PTSD symptoms. The current findings highlight the potential importance of HIV-related stigma, shame, and avoidant coping on the adjustment of YLH, as interventions addressing these risk factors could lead to decreased internalizing symptoms among YLH.
authors.affiliation: Department of Psychiatry, GLAD Program, Drexel University, 4700 Wissahickon Avenue, Philadelphia, PA, 19144, USA. david.bennett@drexelmed.edu.
authors.forename: David S
authors.initials: DS
authors.lastname: Bennett
authors.affiliation: Psychology Department, Immaculata University, Immaculata, PA, USA.
authors.forename: Jill
authors.initials: J
authors.lastname: Hersh
authors.affiliation: Center for Family Intervention Science, Drexel University, Philadelphia, PA, USA.
authors.forename: Joanna
authors.initials: J
authors.lastname: Herres
authors.affiliation: Government Affairs, Gilead Sciences Inc., Philadelphia, PA, USA.
authors.forename: Jill
authors.initials: J
authors.lastname: Foster
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D001007:Anxiety / Q000523:psychology*; D002648:Child; D003674:Defense Mechanisms; D003863:Depression / Q000523:psychology*; D005260:Female; D006167:Guilt; D015658:HIV Infections / Q000523:psychology*; D006801:Humans; D008297:Male; D012307:Risk Factors; D057566:Self Report; D012752:Shame; D057545:Social Stigma; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology*; D055815:Young Adult
keywords: Avoidant coping; HIV/AIDS; Internalizing symptoms; Shame; Stigma