HIV/AIDS stigma and psychological well-being after 40 years of HIV/AIDS: a systematic review and meta-analysis

<b>Background</b>: In June 2021, 40 years have passed since the first cases of HIV infection were detected. Nonetheless, people living with HIV (PLWH) still suffer from intense HIV-related distress and trauma, which is nowadays mostly linked to the still-existing stigmatization of PLWH. <b>Objectives</b>: The aim of this systematic review and meta-analysis was to examine the association between HIV/AIDS stigma and psychological well-being among PLWH. We also explored whether this association varies as a function of sociodemographic and clinical characteristics as well as study publication year and stigma measurement. <b>Method</b>: A structured literature search was performed on Web of Science, Scopus, PsyARTICLES, MedLine, ProQuest, and Google Scholar databases. The inclusion criteria were quantitative, peer-reviewed articles published in English between 1996 and 2020. <b>Results</b>: After selection, 64 articles were accepted for further analysis (<i>N</i> = 25,294 participants). The random-effects pooled estimate revealed an overall negative and medium-strength association between stigma and well-being (r = −.31, 95% CI [−.35; −.26]). The participants’ age modified this effect with a stronger association for older PLWH. Other sociodemographic and clinical variables as well as publication year and stigma measurement did not explain the variation in association between stigma and well-being across studies. <b>Conclusions</b>: The present meta-analysis and systematic review not only showed an expected negative relationship between stigma and well-being but also revealed a substantial heterogeneity between studies that suggests a strong role of context of a given study. This finding calls for more advanced theoretical and analytical models to identify protective and vulnerability factors to effectively address them in clinical practice and interventions. In this meta-analysis, the relationship between HIV/AIDS stigma and well-being of people living with HIV was investigated. In this meta-analysis, the relationship between HIV/AIDS stigma and well-being of people living with HIV was investigated.

<b>背景</b>：2021年6月，首例艾滋病病毒（HIV）感染病例被发现已过去40周年。尽管如此，艾滋病病毒感染者（People Living with HIV, PLWH）仍承受着强烈的与HIV相关的痛苦与创伤，而这一现状如今大多与持续存在的针对PLWH的污名化现象密切相关。<b>研究目的</b>：本项系统综述与元分析旨在探讨艾滋病病毒感染者所面临的HIV/AIDS污名与其心理健康福祉之间的关联。同时，本研究还探究了该关联是否会因社会人口学特征、临床特征，以及研究发表年份与污名测量工具的不同而产生差异。<b>研究方法</b>：研究团队在Web of Science、Scopus、PsyARTICLES、MedLine、ProQuest及Google Scholar数据库中开展了结构化文献检索。纳入标准为1996年至2020年间发表的英文同行评议定量研究论文。<b>研究结果</b>：经筛选后，共有64篇文献纳入后续分析（样本量<i>N</i> = 25,294名参与者）。随机效应合并分析结果显示，污名与福祉之间总体呈中等强度的负相关关系（r = −0.31，95%置信区间[CI: −0.35, −0.26]）。参与者的年龄对该关联存在调节作用，老年感染者的关联强度更强。其余社会人口学与临床变量、发表年份以及污名测量工具均无法解释不同研究间关联强度的异质性。<b>研究结论</b>：本项元分析与系统综述不仅证实了污名与福祉之间预期存在的负相关关系，还揭示了不同研究间存在显著异质性，这表明特定研究的情境因素发挥着重要作用。该研究结果呼吁构建更完善的理论与分析模型，以识别保护性与易感性因素，从而在临床实践与干预措施中有效应对这些因素。本项元分析探讨了艾滋病病毒感染者所面临的HIV/AIDS污名与其心理健康福祉之间的关联。本项元分析探讨了艾滋病病毒感染者所面临的HIV/AIDS污名与其心理健康福祉之间的关联。