Role of Self-Stigma in Pathways from HIV-Related Stigma to Quality of Life among People Living with HIV

Yvonne L. Van Der Kooij*, Alžběta Kupková, Chantal Den Daas, Guido E.L. Van Den Berk, Marie Jose T. Kleene, Hannah S.E. Jansen, Loek J.M. Elsenburg, Leo G. Schenk, Peter Verboon, Kees Brinkman, Arjan E.R. Bos, Sarah E. Stutterheim

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

24 Citations (Scopus)
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This study examined the relationships between perceived public stigma, experienced stigma, and quality of life in people living with HIV (PLHIV), and whether self-stigma mediates these relationships. Cross-sectional data were analyzed from 1704 PLHIV in care at OLVG hospital in the Netherlands. We measured different types of stigma (perceived public stigma, experienced stigma, and self-stigma), and various quality-of-life outcomes (disclosure concerns, depression, anxiety, sexual problems, sleeping difficulties, self-esteem, general health, and social support). Structural equation modeling was used to test the paths from different types of stigma to quality-of-life outcomes. All direct effects of self-stigma on quality-of-life outcomes were significant. The final mediation model showed that the effects of both perceived public and experienced stigma on quality-of-life outcomes were mediated by self-stigma. These findings highlight the importance of addressing self-stigma in PLHIV, and call for (psychosocial) interventions that reduce the harmful effects of HIV-related stigma.

Original languageEnglish
Pages (from-to)231-238
Number of pages8
JournalAIDS Patient Care and STDs
Issue number6
Publication statusPublished - 4 Jun 2021

Bibliographical note

Funding Information:
This study was supported by Viiv Healthcare, Gilead, and Aidsfonds (research Grant Number AF-P.42601). The funders had no role in decisions regarding the study design, data analysis, or publication.
We extend our gratitude to all PLHIV who completed the survey. We further thank the HIV specialist nurses and doctors at OLVG hospital for their effort in recruiting patients to complete the surveys.


  • health outcomes
  • HIV-related stigma
  • internalized
  • quality of life
  • self-stigma


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