HIV is a potentially fatal virus that affects over 1,148,200 people in the United States. Due to the minority status that comes with living with HIV, PLH (people living with HIV) often encounter various aspects of stigma due to HIV, which contributes to suppressed overall psychological quality of life (PQOL).While the relationship between stigma and PQOL in PLH is well documented, little research examines mediators of this relationship. We hypothesized that spirituality (as measured by sense of peace, forgiveness of self and perceived fulfillment of life's goal) mediates the relationship between stigma and PQOL (as measured by depression, mental health and stress). We used an explanatory sequential mixed methods design which utilizes two distinct phases of the research process: quantitative (QUANT) analysis followed by qualitative (QUAL) analysis. Results of the QUANT phase suggest spirituality is a partial mediator in the relationship between stigma and PQOL in PLH. In the QUAL phase, we interviewed 15 PLH to elaborate on the relationships between the three constructs. We found PLH endorsed personalized stigma most frequently. Similarly, our results also indicate PLH experience stress, depression and anxiety as a result of their HIV status. Lastly, participant's interviewed most commonly described their spiritual beliefs as relating to religion or God, which is in contrast to how spirituality was conceptualized in the quantitative portion of our study. In all, QUAL results confirmed QUANT findings, with the one main difference between how spirituality was conceptualized between the QUANT and QUAL qualitative portions of our study. Results highlight the importance of clinicians inquiring about PLH's PQOL, experiences of stigma and spiritual beliefs.

Diss. (sammanfattning) Uppsala : Univ., 2001. / Härtill 5 uppsatser.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2005. / Härtill 4 uppsatser.

Diss. (sammanfattning) Linköping : Univ., 2003. / Härtill 4 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst., 2005. / Härtill 4 uppsatser.

Diss. (sammanfattning) Umeå : Univ., 2007. / Härtill 4 uppsatser.

Thesis (Ph.D.). / Written for the Dept. of Epidemiology, Biostatistics and Occupational Health. Title from title page of PDF (viewed 2009/06/10). Includes bibliographical references.

Diss. (sammanfattning) Stockholm : Karol. inst., 2003. / Härtill 4 uppsatser.

Although the negative impact of HIV stigma is well documented, a gap exists in exploration of constructs that mediate the relationship between HIV stigma and psychological QOL (PQOL). Self-esteem is often conceptualized as a protective factor. We used PLS-SEM to explore the relationships between HIV stigma, PQOL and self-esteem, where PQOL and self-esteem are latent constructs represented by direct observations. Our hypotheses were supported - stigma is negatively related to self-esteem (as measured by self-blame, forgiveness of self, acceptance without judgment and self-esteem), self-esteem is positively related to PQOL (as measured by depression, mental health, QOL and perceived stress) and when the two aforementioned relationships are controlled for, a previously significant relation between stigma and PQOL changes its value significantly. These findings have implications for interventions designed to mitigate the negative psychosocial effects of stigma in PLH.

Sexual minorities experience higher levels of stress than heterosexuals, which in turn affects coping and psychological quality of life (PQOL). Although many sexual minorities remain mentally healthy, a higher prevalence of mental disorders among members of the lesbian, gay and bisexual (LGB) communities exists; thus, LGB PQOL becomes an important area to examine. Several key factors are related to PQOL: shame due to heterosexism, self-esteem and perceived stress. Using minority stress model, I hypothesized that shame due to heterosexism and perceived stress are negatively correlated with PQOL, while self-esteem is positively correlated with PQOL. I hypothesized that collectively shame due to heterosexism, self-esteem and perceived stress account for a significant proportion of the variance in PQOL, that self-esteem moderates the relationship between perceived stress and PQOL and that age moderates the relationship between shame due to heterosexism and PQOL. I calculated Pearson product-moment correlation coefficient and found shame due to heterosexism was negatively correlated with PQOL (r(146) = -.21, p = .009), perceived stress was negatively correlated with PQOL (r (146) = -.69, p < .001) and self-esteem was positively correlated with PQOL (r(146) = .72, p < .001). I conducted a regression analysis and found our model accounted for 59% of the variance in PQOL (adj. R2 = .59, F(3, 144) = 68.88, p < .001). Self-esteem did moderate the relationship between perceived stress and PQOL (p = .029), but age did not moderate the relationship between shame due to heterosexism and PQOL. Results suggest perceived stress and self-esteem play key roles in sexual minorities’ PQOL. Implications are discussed.