title: Brief Report: Interpersonal and Intrapersonal Factors as Parallel Independent Mediators in the Association Between Internalized HIV Stigma and ART Adherence.
abstract: People living with HIV (PLWH) need to adhere to antiretroviral therapy (ART) to achieve optimal health. One reason for ART nonadherence is HIV-related stigma.
  
  
  
  We aimed to examine whether HIV treatment self-efficacy (an intrapersonal mechanism) mediates the stigma-adherence association. We also examined whether self-efficacy and the concern about being seen while taking HIV medication (an interpersonal mechanism) are parallel mediators independent of each other.
  
  
  
  A total of 180 people living with HIV self-reported internalized HIV stigma, ART adherence, HIV treatment self-efficacy, and concerns about being seen while taking HIV medication. We calculated bias-corrected 95% confidence intervals for indirect effects using bootstrapping to conduct mediation analyses.
  
  
  
  Adherence self-efficacy mediated the relationship between internalized stigma and ART adherence. Additionally, self-efficacy and concern about being seen while taking HIV medication uniquely mediated and explained almost all the stigma-adherence association in independent paths (parallel mediation).
  
  
  
  These results can inform intervention strategies to promote ART adherence.
authors.affiliation: Departments of *Psychology;†Medicine, University of Alabama at Birmingham, Birmingham, AL; and‡Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, AL.
authors.forename: Victoria C
authors.initials: VC
authors.lastname: Seghatol-Eslami
authors.forename: Heather E
authors.initials: HE
authors.lastname: Dark
authors.forename: James L
authors.initials: JL
authors.lastname: Raper
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Mugavero
authors.forename: Janet M
authors.initials: JM
authors.lastname: Turan
authors.forename: Bulent
authors.initials: B
authors.lastname: Turan
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000008:administration & dosage*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology*; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D057545:Social Stigma
chemical_list: D044966:Anti-Retroviral Agents