We adopted an intersectionality framework and examined whether the relationship between internalized HIV stigma and depressive symptoms is moderated by internalized substance use stigma. A total of 85 people living with HIV with a history of substance use in the Bronx, New York, completed a survey. Results revealed evidence of moderation: Participants who internalized HIV stigma experienced greater depressive symptoms only if they also internalized substance use stigma. Researchers should examine stigma associated with multiple socially devalued characteristics to best understand how stigma impacts mental health among people living with HIV. Healthcare providers should address stigma associated with the full range of socially devalued characteristics with which people living with HIV live.
AikenLSWestSG (1991) Multiple Regression: Testing and Interpreting Interactions. Newbury Park, CA: SAGE.
2.
AliRAwwadEBaborT. (2002) The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST): Development, reliability and feasibility. Addiction97(9): 1183–1194.
3.
BergerMT (2004) Workable Sisterhood: The Political Journey of Stigmatized Women with HIV/AIDS. Princeton, NJ: Princeton University Press.
4.
BogartLMWagnerGJGalvanFH. (2010) Longitudinal relationships between antiretroviral treatment adherence and discrimination due to HIV-serostatus, race, and sexual orientation among African–American men with HIV. Annals of Behavioral Medicine40(2): 184–190.
5.
CampbellCNairYMaimaneS. (2007) “Dying twice”: A multi-level model of the roots of AIDS stigma in two South African communities. Journal of Health Psychology12: 403–416.
6.
CantisanoNRimeBMunoz-Sastre (2013) The social sharing of emotions in HIV/AIDS: A comparative study of HIV/AIDS, diabetes, and cancer patients. Journal of Health Psychology18: 1255–1267.
ColeER (2009) Intersectionality and research in psychology. American Psychologist64(3): 170–180.
9.
EarnshawVABogartLMDovidioJF. (2013a) Stigma and racial/ethnic HIV disparities: Moving toward resilience. American Psychologist68(4): 225–236.
10.
EarnshawVASmithLRCopenhaverM (2013b) Drug addiction stigma in the context of methadone maintenance therapy: An investigation into understudied sources of stigma. International Journal of Mental Health and Addiction11(1): 110–122.
11.
EarnshawVASmithLRChaudoirSR. (2013c) HIV stigma mechanisms and well-being among PLWH: A test of the HIV stigma framework. AIDS and Behavior17: 1785–1795.
12.
EdlinBRIrwinKLFaruqueS. (1994) Intersecting epidemics–crack cocaine use and HIV infection among inner-city young adults. The New England Journal of Medicine331(21): 1422–1427.
13.
GalvanFHBingEGFleishmanJA. (2002) The prevalence of alcohol consumption and heavy drinking among people with HIV in the United States: Results from the HIV cost and services utilization study. Journal of Studies on Alcohol and Drugs63(2): 179–186.
14.
GonzalezASolomonSEZyolenskyMJ. (2009) The interaction of mindful-based attention and awareness disengagement coping with HIV/AIDS-related stigma in regard to concurrent anxiety and depressive symptoms among adults with HIV/AIDS. Journal of Health Psychology14: 403–413.
15.
HansenNBHarrisonBFambroS. (2013) The structure of coping among older adults living with HIV/AIDS and depressive symptoms. Journal of Health Psychology18: 198–211.
16.
HayesAFMatthesJ (2009) Computational procedures for probing interactions in OLS and logistic regression: SPSS and SAS implementations. Behavior Research Methods41(3): 924–936.
17.
HumeniukRAliRBaborTF. (2008) Validation of the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). Addiction103(6): 1039–1047.
18.
IrwinMArtinKHOxmanMN (1999) Screening for depression in the older adult: Criterion validity of the 10-item Center for Epidemiological Studies Depression Scale (CES-D). Archives of Internal Medicine159(15): 1701–1704.
19.
LeeRSKochmanASikkemaKJ (2002) Internalized stigma among people living with HIV/AIDS. AIDS and Behavior6(4): 309–319.
20.
LinkBG (1987) Understanding labeling effects in the area of mental disorders: An assessment of the effects of expectations of rejection. American Sociological Review52: 96–112.
21.
LogieCHJamesLTharaoW. (2011) HIV, gender, race, sexual orientation, and sex work: A qualitative study of intersectional stigma experienced by HIV-positive women in Ontario, Canada. PLoS Medicine8(11): e1001124.
22.
LogieCJamesLTharaoW. (2013) Associations between HIV-related stigma, racial discrimination, gender discrimination, and depression among HIV-positive African, Caribbean, and Black women in Ontario, Canada. AIDS Patient Care and STDs27(2): 114–122.
23.
LuomaJBKohlenbergBSHayesSC. (2008) Reducing self-stigma in substance abuse through acceptance and commitment therapy: Model, manual development, and pilot outcomes. Addiction Research and Theory16(2): 149–165.
24.
LuomaJBTwohigMPWaltzT. (2007) An investigation of stigma in individuals receiving treatment for substance abuse. Addictive Behaviors32(7): 1331–1346.
25.
MakWWSPoonCYMPunLYK. (2007) Meta-analysis of stigma and mental health. Social Science & Medicine65(2): 245–261.
26.
PattersonTLSempleSJZiansJK. (2005) Methamphetamine-using HIV-positive men who have sex with men: Correlates of polydrug use. Journal of Urban Health82: i120–i126.
27.
PerezJEChartierMKoopmanC. (2009) Spiritual striving, acceptance coping, and depressive symptoms among adults living with HIV/AIDS. Journal of Health Psychology14: 88–97.
28.
RiggsSAVosvickMStallingsS (2007) Attachment style, stigma and psychological distress among HIV+ adults. Journal of Health Psychology12: 922–936.
29.
SimbayiLCKalichmanSStrebelA. (2007) Internalized stigma, discrimination, and depression among men and women living with HIV/AIDS in Cape Town, South Africa. Social Science & Medicine64(9): 1823–1831.
