The Influence of HIV Stigma on Adherence to Antiretroviral Therapy in HIV Positive Gay Men Age 50 and Olde

This secondary data analysis examined the influence of HIV stigma on antiretroviral therapy (ART) adherence in 180 HIV infected gay men age 50 and older. Adherence to ART is necessary to maintain individual health and to prevent the spread of the virus to others. The effects of HIV stigma contribute to suboptimal adherence, which leads to negative health outcomes and greater infectiousness. As a direct result of ART, those infected with the virus are living into old age. Gay men over 50 comprise the largest single group with HIV/AIDS in this country and, consequently, have the highest potential for forward viral transmission. There have been few studies of the influence of HIV stigma on ART adherence, and almost no research in this area devoted to older gay men. In addition to a direct effect, this study hypothesized that depression and substance use would act as mediators. Confirmatory factor analysis revealed that depression, but not substance use, partially mediated the relationship between HIV stigma and ART adherence. While not a mediator, substance use was significantly related to adherence. Overall, this study supported a significant relationship between HIV stigma and adherence to ART. The findings bring into focus the need to include HIV stigma in the design of interventions intended to reduce stigma. The direct relationship between HIV stigma and ART adherence supported in this study suggests the need for research into other distal psychosocial factors that may influence adherence to ART.