HIV is not a Crime

Although scholars have written extensively about the effects of interpersonal HIV stigma on people living with HIV/AIDS (PLWHA), there is a dearth of information about the psychological and behavioral impact of structural HIV stigma. The current study builds on previous work investigating the dual roles of structural and interpersonal minority stressors with a national sample of 234 PLWHA by testing an HIV/AIDS-specific expansion of minority stress theory grounded in the psychological mediation framework. Through bivariate correlations and structural equation modeling, the study examined relations between four sets of variables: (1) distal stigma-related stressors (i.e., HIV criminalization by state, HIV-related discrimination), (2) general psychological processes (i.e., social support, cognitive reappraisal), (3) group-specific processes (i.e., HIV criminalization belief, HIV stigma), and (4) mental/behavioral health outcomes (i.e., psychological distress, health-related quality of life). Results provide mixed support for a dual, mediated model of HIV/AIDS minority stress. Findings indicate mixed support for hypothesized associations. HIV criminalization by state yielded a significant negative direct and significant positive indirect association with psychological distress. HIV-related discrimination yielded direct and indirect associations with both health outcomes. With the exception of cognitive reappraisal, mediators demonstrated support for the psychological mediation framework among PLWHA. Implications are discussed in support of future HIV/AIDS minority stress research, as well as clinical and policy interventions.