Pathways to perceived HIV-related stigma among people living with HIV: the role of social support, coping styles, psychosocial symptoms and caregiver stigma

This study investigates the pathways to perceived HIV-related stigma among people living with HIV (PLWH) in China, focusing on the roles of social support, coping styles, psychosocial symptoms, and caregiver stigma. Utilizing a cross-sectional survey of 3,040 participants and 425 caregivers recruited from healthcare settings across Shanghai, Beijing, Guangdong, Guangxi, and Yunnan, we employed Structural Equation Modeling (SEM) to examine the complex interrelationships among these factors. Our results indicate that higher levels of social support and positive coping styles are associated with lower perceived stigma, whereas negative coping styles, psychological symptoms such as negative emotions, and caregiver stigma contribute to higher perceived stigma among PLWH. The influence of interpersonal interactions was notably significant, demonstrating that negative experiences and social withdrawal amplify stigma perceptions. Furthermore, caregiver stigma emerged as a critical factor directly associated with the stigma experienced by PLWH. These findings highlight the necessity of multi-faceted interventions that enhance social support, foster positive coping strategies, and address caregiver stigma to effectively reduce the burden of perceived stigma and improve the wellbeing of PLWH in China.