The role of knowing someone living with HIV/AIDS and HIV disclosure in the HIV stigma framework: a Bayesian mediation analysis

The current study evaluated the role of knowing someone living with HIV/AIDS and disclosure of one's HIV-positive status in the HIV Stigma Framework using a Bayesian mediation analysis. We used data on 387 people living with HIV/AIDS (PLWHA) and 6074 HIV uninfected Italian participants. Knowing someone living with HIV/AIDS was negatively related to stigmatizing attitudes among HIV uninfected participants and internalized stigma among PLWHA. Internalized stigma mediated the relationship between personal knowledge of someone living with HIV/AIDS and disclosure of one's HIV-positive status. In turn, disclosure of one's HIV-positive status mediated the relationship between internalized stigma and engagement in HIV care. Undetectable viral load was predicted by internalized stigma but not by disclosure of one's HIV-positive status and enacted stigma. Among uninfected participants, stigmatizing attitudes mediated the relationship between knowledge of someone living with HIV/AIDS and HIV testing. In addition, an interaction between knowledge of someone living with HIV/AIDS and HIV testing was found such that stigmatizing attitudes did not predict HIV testing among participants who do not have a personal knowledge of someone living with HIV/AIDS.