Investigating changes in internalized stigma and avoidant coping among African American adults living with HIV and serious mental illness following a peer-led intervention

Abstract

Background: Individuals living with HIV navigate the health implications of HIV and HIV discrimination. This study aimed to examine changes in internalized stigma and avoidant coping among African American adults living with HIV and serious mental illness (SMI) following a peer-led intervention. Methods: In this quasi-experimental study, 16 patients were recruited using convenience sampling from an HIV clinic in an urban hospital setting in the United States for a community-based participatory research (CBPR) developed peer-led intervention pilot. Participants answered questions about their experiences of HIV-related discrimination, internalized stigma, and cognitive escape coping before and after participating in four 90-minute peer-led weekly group sessions. For data analysis, paired-samples t-test and linear regression with Hayes’ PROCESS Macro in SPSS 27 were used at a 5% significance level. Results: There was a significant indirect effect of HIV-related discrimination on cognitive escape coping through internalized stigma (b = 0.28, 95% CI [0.03, 0.61]). Post-intervention non-significant associations suggest that a CBPR-developed peer-led intervention may buffer against the effects of HIV-related discrimination. Conclusion: Our study provides initial support that community and peer support approaches may buffer against the effects of discrimination on internalized stigma and avoidant coping among African American individuals living with HIV and SMI.