A Mixed Methods Approach to Exploring Social Support and Resilience in Coping with Stigma and Psychological Distress among HIV-Positive Adults

Since its emergence in the U.S., HIV has been a stigmatized illness. People living with HIV (PLH) are a minority and prone to psychological distress and poor mental health outcomes due to HIV-related stigma. PLH who identify with another minority group in addition to being HIV-positive (e.g., gay, African-American) experience multiple forms of oppression or layered stigma. Affirmative social support and resilience are negatively associated with HIV-stigma and are important coping resources for PLH. We used an explanatory sequential mixed methods design study involving a quantitative survey phase and a qualitative interview phase. We explored whether social support and resilience (Positive Psychological Resources) mediate or moderate the relationship between HIV Stigma and Psychological Distress among HIV-positive adults using partial least squares (PLS) path modeling and multiple regressions. Via PLS, we found Positive Psychological Resources partially mediated the relationship between HIV Stigma and Psychological Distress: the path between HIV Stigma and Psychological distress reduced (from t = 5.49, p = .000 to t = 2.39, p = .000) but remained statistically significant. Similarly, via regression, the Sobel test was significant (Sobel = .26, SE = .07, z = 3.63, p = .000). However, moderation was not found (HIV Stigma x Positive Psychological Resources β = .05, t = .66, p = .508). Overall, our quantitative survey and qualitative interview data were consistent. We anticipate that our findings will inform strengths-based therapeutic interventions to mitigate stress and stigma among PLH