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

Background: 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.
Objectives: 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.
Method: 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.
Results: After selection, 64 articles were accepted for further analysis (N = 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.
Conclusions: 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.

背景：2021年6月，距首例艾滋病病毒（HIV）感染病例被发现已过去40年。然而，艾滋病病毒感染者（People Living with HIV, PLWH）仍承受着严重的与HIV相关的痛苦与创伤，如今这类困扰大多与持续存在的针对PLWH的污名化现象密切相关。
研究目标：本项系统综述与元分析旨在探讨HIV/艾滋病（AIDS）污名与PLWH心理健康福祉之间的关联，并分析该关联是否会根据社会人口学特征、临床特征、研究发表年份以及污名测量工具的不同而产生差异。
研究方法：本研究在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。
研究结果：经筛选后，最终纳入64篇文献进行后续分析，累计纳入25294名研究对象。随机效应合并效应量分析显示，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）。研究对象的年龄对该关联存在调节作用：老年PLWH群体中二者的关联强度更强。其余社会人口学与临床变量、研究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。
研究结论：本次元分析与系统综述不仅验证了污名与福祉之间存在负相关关系的预期假设，还发现不同研究间存在显著异质性，这提示研究背景在其中发挥了重要作用。该研究结果呼吁学界构建更完善的理论与分析模型，以明确保护性与易感性因素，从而在临床实践与干预工作中有效应对相关问题。
本项元分析探讨了HIV/AIDS污名与艾滋病病毒感染者的福祉之间的关联。
本项元分析探讨了HIV/AIDS污名与艾滋病病毒感染者的福祉之间的关联。