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- Title
Psychological Distress Mediates the Relationship Between HIV-Related Stigma and Prescription Opioid Misuse Among Chinese People Living with HIV.
- Authors
Tam, Cheuk Chi; Harrison, Sayward E.; Benotsch, Eric G.; Litwin, Alain H.; Zhou, Yuejiao; Shen, Zhiyong; Li, Xiaoming
- Abstract
Prescription opioid misuse (POM) among people living with HIV (PLWH) is a serious concern due to risks related to dependence and overdose, and PLWH may be at higher risk for POM due to psychosocial stressors including psychological distress. However, scant POM research has examined the role of HIV-related stigma (e.g., internalized stigma, enacted stigma) in POM among PLWH. Guided by minority stress theory, this study examined a hypothesized serial mediation among enacted stigma, internalized stigma, psychological distress, and POM within a sample of Chinese PLWH with pain symptoms enrolled in a wave (between November 2017 and February 2018) of a longitudinal cohort study in Guangxi (n = 116). Models were tested individually for six enacted stigma experiences, controlling for key demographic and health-related variables (e.g., CD4 + count). Results showed HIV-related workplace discrimination was the most common stigma experience (12%,) and 10.3% of PLWH reported POM. Indirect effect analyses showed that internalized stigma was indirectly associated with POM through psychological distress. Internalized stigma and psychological distress mediated the association between workplace discrimination and POM. Family discrimination, gossip, and healthcare discrimination were directly associated with POM. This study suggests that Chinese PLWH may engage in POM to cope with psychological distress that is rooted in HIV-related stigma and highlights the important context of workplace discrimination for PLWH. Implications for interventions to reduce POM among PLWH are discussed.
- Subjects
CHINA; SUBSTANCE abuse risk factors; PSYCHOLOGICAL distress; RESEARCH funding; WORK environment; HIV infections; PSYCHOLOGY of HIV-positive persons; LONGITUDINAL method; PAIN; OPIOID analgesics; EMPLOYMENT discrimination; HEALTH equity; SOCIAL stigma
- Publication
AIDS & Behavior, 2024, Vol 28, Issue 5, p1673
- ISSN
1090-7165
- Publication type
Article
- DOI
10.1007/s10461-024-04288-0