The Role of HIV Stigma in ART Adherence and Quality of Life Among Rural Women Living with HIV in India

Abstract

HIV stigma continues to be a barrier to physical and mental health among people living with HIV globally, especially in vulnerable populations. We examined how stigma is associated with health outcomes and quality of life among rural women living with HIV in South India (N = 600). Interviewer-administered measures assessed multiple dimensions of stigma, as well as loneliness, social support, ART adherence, time since diagnosis, and quality of life. Internalized stigma and a lack of social support were associated with a lower quality of life, while the association between internalized stigma and adherence was mediated by the use of stigma-avoidant coping strategies, suggesting that keeping one's diagnosis a secret may make it more difficult to take one's medications. These findings suggest that these women constitute a vulnerable population who need additional services to optimize their health and who might benefit from peer support interventions and stigma-reduction programs for family and community members.

Keywords: Adherence; HIV stigma; India; Quality of life; Rural women.

Conflict of interest statement

Conflict of interest: the authors declare that they have no conflict of interests

Figures

Figure 1:

Mediation of association between internalized stigma and adherence by stigma-avoidant coping.