Photo Credit: Davizro

Internalized HIV stigma has an indirect impact on viral non-suppression through several factors, according to findings published in AIDS. Timothy Crawford, PhD, MPH, and colleagues assessed the influence of internalized HIV stigma on viral non-suppression via depressive symptoms, alcohol and illicit drug use, and medication adherence, as well as whether social support could moderate these factors. The study, which included 9,574 participants (81.1% men; 41.4% Black), showed an overall indirect effect that was significant (beta=0.048; 95% CI, 0.019-0.098), indicating that internalized HIV stigma’s impact on viral non-suppression was mediated by depressive symptoms, illicit drug use, and medication adherence. An interaction was seen for alcohol use between internalized HIV stigma and social support, but there was no mediation. “Social support may buffer the impact [of internalized HIV stigma], but more research is needed,” Dr. Crawford and colleagues wrote. “Understanding the pathways through which internalized stigma impacts viral suppression is key to improving the health of people with HIV.”