‍Let's talk stigma: Join us on this journey as we explore HIV stigma written with people living with HIV for people living with HIV and their communities.

W‍hat is the cost of scientific knowledge? Gathering data often involves picking apart the lives of people and their communities. When we delve into data, we are tapping into the personal journeys of countless individuals – their hope, struggles, triumphs, tragedy. It is our obligation to ensure that these stories reverberate beyond the confines of research papers and that the insights gleaned are returned to the communities from where they came.

This third of four blogs examines the significant impact of HIV stigma and various health determinants on the mental health of people living with HIV, highlighting the need for comprehensive support and policy efforts to address these intertwined challenges.

The Hidden Struggle: How Stigma Impacts Mental Health

Stigma remains one of the biggest burdens that people living with HIV must manage. We've been exploring its effects in this series of blogs. In our first two blog posts, we talked about how enacted HIV stigma can worsen health by increasing levels of internalized stigma and depression as well as anticipated stigma. However, not everyone has the same life experiences, and these different experiences may change the way people are affected by stigma.

The Role of Determinants of Health

Determinants of health are factors in a person’s life and environment that they usually can’t control but can greatly affect their health and wellbeing. These factors may include gender and race, income and social status, education, housing, and physical environment among others.

Interactions Between Stigma and Health Determinants

The experience of stigma has become generally recognized as a determinant of health because it can seriously impact health and act as a major barrier to well-being. Evidence shows that it is a key reason for health inequalities among different populations.

While we know stigma and various determinants of health affect a person’s life, there isn’t much research around how they interact with each other and affect people’s mental health. The team at Reach Nexus wanted to understand this better using data from the People Living with HIV Stigma Index in Ontario.

The Stigma Index is a survey tool that gathers information on various determinants of health and includes validated measures for stigma and mental health.

Key Findings: Determinants and Mental health

‍The study looked at how selected determinants of health may change the relationship between stigma and mental health. These determinants of health impact all of our lives so we need to understand their role and how they influence a person’s experience of stigma.

The study showed that certain determinants of health and stigma affected the mental health of people with HIV. For instance, people living in rural areas or who lacked basic needs like food, clothing or shelter in the last 12 months had worse mental health.

On the other hand, people living in urban areas or who had their basic needs met had better mental health but only if they didn’t face a lot of HIV stigma. If people who had their basic needs met or lived in urban areas experienced high levels of stigma, their mental health was also poor.    

Supporting Mental Health for People with HIV

This sheds some light on how people living with HIV need to be supported to improve their mental health. If people don't have basic needs like food and shelter, or if they live in rural areas with inadequate services, their mental health can suffer.

Similarly, if people are experiencing a lot of HIV stigma, this also harms mental health. To help people living with HIV maintain good mental health it’s crucial to both reduce stigma and ensure they have access to the support and services they need.

‍

‍

‍

The Bigger Picture: Policy and Support

While it is well known that determinants of health really impact your mental health, there is not enough research or programming that addresses these issues. Governments and policy makers need to step up and put more effort and resources into tackling these big social and structural challenges that make life hard for many people.

When we’re thinking about ways to help people with their mental health, we need to look at the bigger picture and use approaches that address both stigma and other determinants of health. Just reducing stigma isn’t enough if we don’t consider the other challenges people might be facing.

We’ve seen that when people living with HIV get good support with things like access to basic needs and services and face less stigma, their mental health can flourish.

‍We would like to acknowledge the peer researchers who worked on this study and a special thank you to Michael Murphy, Anthony B, and Lynne Cioppa for contributing to the writing of this blog and lending their lived expertise – without them, this work would not have been possible. We would also like to thank the study participants for sharing their stories and allowing us to document their personal experiences with HIV stigma.

‍

‍‍If you or anyone you know need support with their mental health, help is available:

·      Mental Health Support: Government of Canada Provincial andTerritorial Resources – click here

·      Canadian Mental Health Association – click here

·      CATIE: Mental and Emotional Health –  click here