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


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 - 1 Jun 2021


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


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