Devaluing Stigma in the Context of Forgiveness, Coping and Adaptation: a Structural Regression Model of Reappraisal

The 2010 National HIV/AIDS Strategy outlined three important goals for managing the current HIV pandemic in the U.S.: (1) reduce the number of people who become infected with HIV; (2) improve access to health care and health-related outcomes for people living with HIV/AIDS (PLH/A); and (3) reduce HIV-related health disparities. Each of these goals tacitly depends upon reducing HIV-related stigma, and this study examined how HIV+ individuals evaluate coping efforts to overcome stigma’s impact on quality of life (QOL). a structural regression model was developed to instantiate the reappraisal process described by Lazarus and Folkman’s transactional theory of stress and coping, and this model indicated that maladaptive coping fully mediated the relationship between dispositional forgiveness and perceived stigma, which supports the prediction that coping efficacy is related to stress reduction. Additionally, maladaptive coping fully mediated the relationship between dispositional forgiveness and QOL, supporting the contention that forgiveness is a critical aspect to the evaluative process that influences how PLH/A cope with stigma. Lastly, the model showed that when PLH/A engaged in maladaptive coping to mitigate stress-related stigma, these individuals experienced increased stigmatization and reported significantly lower levels of health-related QOL. in contrast, PLH/A that reported higher levels of dispositional forgiveness were significantly less likely to use maladaptive coping to overcome stigma. Therefore, dispositional forgiveness works through coping to alter perceptions regarding stigmatization, while indirectly influencing attitudes related to health distress, mental health, and cognitive and social functioning. the theoretical and clinical implications of these findings are discussed