Brief Report: Interpersonal and Intrapersonal Factors as Parallel Independent Mediators in the Association between Internalized HIV Stigma and ART Adherence

Academic Article


  • Introduction: 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. Objectives: 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. Methods: 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. Results: 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). Conclusion: These results can inform intervention strategies to promote ART adherence.
  • Digital Object Identifier (doi)

    Author List

  • Seghatol-Eslami VC; Dark HE; Raper JL; Mugavero MJ; Turan JM; Turan B
  • Start Page

  • e18
  • End Page

  • e22
  • Volume

  • 74
  • Issue

  • 1