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A structural equation model of perceived and internalized stigma, depression, and suicidal status among people living with HIV/AIDS

BACKGROUND: Previous studies have shown positive association between HIV-related stigma and depression, suicidal ideation, and suicidal attempt among people living with HIV/AIDS (PLWH). But few studies have examined the mechanisms among HIV-related stigma, depression, and suicidal status (suicidal i...

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Autores principales: Zeng, Chengbo, Li, Linghua, Hong, Yan Alicia, Zhang, Hanxi, Babbitt, Andrew Walker, Liu, Cong, Li, Lixia, Qiao, Jiaying, Guo, Yan, Cai, Weiping
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5769512/
https://www.ncbi.nlm.nih.gov/pubmed/29334959
http://dx.doi.org/10.1186/s12889-018-5053-1
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author Zeng, Chengbo
Li, Linghua
Hong, Yan Alicia
Zhang, Hanxi
Babbitt, Andrew Walker
Liu, Cong
Li, Lixia
Qiao, Jiaying
Guo, Yan
Cai, Weiping
author_facet Zeng, Chengbo
Li, Linghua
Hong, Yan Alicia
Zhang, Hanxi
Babbitt, Andrew Walker
Liu, Cong
Li, Lixia
Qiao, Jiaying
Guo, Yan
Cai, Weiping
author_sort Zeng, Chengbo
collection PubMed
description BACKGROUND: Previous studies have shown positive association between HIV-related stigma and depression, suicidal ideation, and suicidal attempt among people living with HIV/AIDS (PLWH). But few studies have examined the mechanisms among HIV-related stigma, depression, and suicidal status (suicidal ideation and/or suicidal attempt) in PLWH. The current study examined the relationships among perceived and internalized stigma (PIS), depression, and suicidal status among PLWH in Guangzhou, China using structural equation modeling. METHODS: Cross-sectional study by convenience sampling was conducted and 411 PLWH were recruited from the Number Eight People’s Hospital from March to June, 2013 in Guangzhou, China. Participants were interviewed on their PIS, depressive symptoms, suicidal status, and socio-demographic characteristics. PLWH who had had suicidal ideation and suicidal attempts since HIV diagnosis were considered to be suicidal. Structural equation model was performed to examine the direct and indirect associations of PIS and suicidal status. Indicators to evaluate goodness of fit of the structural equation model included Chi-square Statistic, Comparative Fit Index (CFI), Root Mean Square Error of Approximation (RMSEA), Standardized Root Mean Square Residual (SRMR), and Weighted Root Mean Square Residual (WRMR). RESULTS: More than one-third (38.4%) of the PLWH had depressive symptoms and 32.4% reported suicidal ideation and/or attempt since HIV diagnosis. The global model showed good model fit (Chi-square value = 34.42, CFI = 0.98, RMSEA = 0.03, WRMR = 0.73). Structural equation model revealed that direct pathway of PIS on suicidal status was significant (standardized pathway coefficient = 0.21), and indirect pathway of PIS on suicidal status via depression was also significant (standardized pathway coefficient = 0.24). There was a partial mediating effect of depression in the association between PIS and suicidal status. CONCLUSIONS: Our findings suggest that PIS is associated with increased depression and the likelihood of suicidal status. Depression is in turn positively associated with suicidal status and plays a mediating role between PIS and suicidal status. Therefore, to reduce suicidal ideation and attempt in PLWH, targeted interventions to reduce PIS and improve mental health status of PLWH are warranted.
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spelling pubmed-57695122018-01-25 A structural equation model of perceived and internalized stigma, depression, and suicidal status among people living with HIV/AIDS Zeng, Chengbo Li, Linghua Hong, Yan Alicia Zhang, Hanxi Babbitt, Andrew Walker Liu, Cong Li, Lixia Qiao, Jiaying Guo, Yan Cai, Weiping BMC Public Health Research Article BACKGROUND: Previous studies have shown positive association between HIV-related stigma and depression, suicidal ideation, and suicidal attempt among people living with HIV/AIDS (PLWH). But few studies have examined the mechanisms among HIV-related stigma, depression, and suicidal status (suicidal ideation and/or suicidal attempt) in PLWH. The current study examined the relationships among perceived and internalized stigma (PIS), depression, and suicidal status among PLWH in Guangzhou, China using structural equation modeling. METHODS: Cross-sectional study by convenience sampling was conducted and 411 PLWH were recruited from the Number Eight People’s Hospital from March to June, 2013 in Guangzhou, China. Participants were interviewed on their PIS, depressive symptoms, suicidal status, and socio-demographic characteristics. PLWH who had had suicidal ideation and suicidal attempts since HIV diagnosis were considered to be suicidal. Structural equation model was performed to examine the direct and indirect associations of PIS and suicidal status. Indicators to evaluate goodness of fit of the structural equation model included Chi-square Statistic, Comparative Fit Index (CFI), Root Mean Square Error of Approximation (RMSEA), Standardized Root Mean Square Residual (SRMR), and Weighted Root Mean Square Residual (WRMR). RESULTS: More than one-third (38.4%) of the PLWH had depressive symptoms and 32.4% reported suicidal ideation and/or attempt since HIV diagnosis. The global model showed good model fit (Chi-square value = 34.42, CFI = 0.98, RMSEA = 0.03, WRMR = 0.73). Structural equation model revealed that direct pathway of PIS on suicidal status was significant (standardized pathway coefficient = 0.21), and indirect pathway of PIS on suicidal status via depression was also significant (standardized pathway coefficient = 0.24). There was a partial mediating effect of depression in the association between PIS and suicidal status. CONCLUSIONS: Our findings suggest that PIS is associated with increased depression and the likelihood of suicidal status. Depression is in turn positively associated with suicidal status and plays a mediating role between PIS and suicidal status. Therefore, to reduce suicidal ideation and attempt in PLWH, targeted interventions to reduce PIS and improve mental health status of PLWH are warranted. BioMed Central 2018-01-15 /pmc/articles/PMC5769512/ /pubmed/29334959 http://dx.doi.org/10.1186/s12889-018-5053-1 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Zeng, Chengbo
Li, Linghua
Hong, Yan Alicia
Zhang, Hanxi
Babbitt, Andrew Walker
Liu, Cong
Li, Lixia
Qiao, Jiaying
Guo, Yan
Cai, Weiping
A structural equation model of perceived and internalized stigma, depression, and suicidal status among people living with HIV/AIDS
title A structural equation model of perceived and internalized stigma, depression, and suicidal status among people living with HIV/AIDS
title_full A structural equation model of perceived and internalized stigma, depression, and suicidal status among people living with HIV/AIDS
title_fullStr A structural equation model of perceived and internalized stigma, depression, and suicidal status among people living with HIV/AIDS
title_full_unstemmed A structural equation model of perceived and internalized stigma, depression, and suicidal status among people living with HIV/AIDS
title_short A structural equation model of perceived and internalized stigma, depression, and suicidal status among people living with HIV/AIDS
title_sort structural equation model of perceived and internalized stigma, depression, and suicidal status among people living with hiv/aids
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5769512/
https://www.ncbi.nlm.nih.gov/pubmed/29334959
http://dx.doi.org/10.1186/s12889-018-5053-1
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