Experiences of HIV stigma: the role of visible symptoms, HIV centrality and community attachment for people living with HIV

Loren Brener, Denton Callander, Sean Slavin, John de Wit

Research output: Contribution to journalArticleAcademicpeer-review


For many people living with HIV (PLHIV), disclosure or concealment of their HIV status may be under their personal control; however, for PLHIV with visible symptoms of their illness, disclosure may no longer be a choice. Previous research suggests that those with visible HIV symptoms have poorer mental and physical health than those without visible HIV symptoms. This study aimed to extend these findings and assess the role of perceived centrality of HIV in the lives of PLHIV as well as the role of attachment to an HIV-positive community in understanding the negative effects on health and well-being for PLHIV with visible HIV symptoms. Participants were 697 PLHIV who completed an online survey that assessed symptom visibility, HIV-status disclosure, perceived stigma, health and well-being, how central HIV was to identity and HIV community attachment. Results indicate that those with visible symptoms experienced more HIV-related stigma and had poorer outcomes on a range of psychological and mental health measures than those who were able to conceal their stigma. These effects remained after controlling for length of time since diagnosis, time on HIV treatment, perceived health satisfaction and age. PLHIV with visible symptoms also reported that HIV was more central to their identity and reported greater attachment to an HIV-positive community. Furthermore, findings suggest that while HIV centrality appears to increase the negative effects of having visible symptoms associated with HIV, greater community attachment seems to ameliorate these effects. This suggests the need for a nuanced understanding of the implications of visible HIV symptoms for PLHIV. The study also highlights the potential benefits of HIV-positive community attachment in buffering PLHIV from the negative effect of visible HIV symptoms on their health and well-being.

Original languageEnglish
Pages (from-to)1166-73
Number of pages8
JournalAIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
Issue number9
Publication statusPublished - 2013
Externally publishedYes


  • Adolescent
  • Adult
  • Aged
  • Attitude to Health
  • Emotions
  • Female
  • HIV Infections
  • Humans
  • Male
  • Middle Aged
  • Quality of Life
  • Self Report
  • Social Discrimination
  • Social Stigma
  • Social Support
  • Young Adult
  • Journal Article
  • Research Support, Non-U.S. Gov't


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