{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T04:13:05Z","timestamp":1777954385264,"version":"3.51.4"},"reference-count":57,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T00:00:00Z","timestamp":1777852800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007602","name":"Programme Grants for Applied Research","doi-asserted-by":"publisher","award":["NIHR202038"],"award-info":[{"award-number":["NIHR202038"]}],"id":[{"id":"10.13039\/501100007602","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Examining the relationship of HIV stigmatisation in different social settings with internalised HIV stigma, loneliness and depression among people with HIV, may help in further understanding HIV stigma and informing approaches and interventions to help to mitigate the impacts. The aim of this paper was to investigate among heterosexual men and women, a devised conceptual model of hypothesized causal connections between socio-demographic, HIV-related and psychosocial factors, measures of HIV stigmatisation, and depressive symptoms, in which feelings of loneliness because of HIV are theorised to mediate the relationship between internalised HIV stigma and depression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods and findings<\/jats:title>\n                    <jats:p>This was investigated using structural equation modelling (SEM) and data from Positive Voices, a national cross-sectional study of people living with HIV in the UK (2022\u22122023). The analysis is based on participants who identified as heterosexual and were cis-gender (N\u2009=\u20091232). The mean age was 52 years; 48.5% were Black African, and 39.0% of white ethnicity. Twenty percent of participants were diagnosed with HIV within the last decade (2014\u22122022). Overall, 51.6% and 35.2% agreed or strongly agreed with the statements \u2018I am ashamed of my HIV status\u2019 and \u2018I have poor self-esteem because of my HIV status\u2019 respectively; 57.9% (n\u2009=\u2009713\/1232) agreed\/strongly agreed with either item and were classified as positive for internalised HIV stigma. For the measure of having felt isolated\/lonely because of HIV, the prevalence of responding with \u2018yes, in the last year\u2019 or \u2018yes, but not in the last year\u2019 was 14.2% and 11.7% respectively. The prevalence of depressive symptoms was 18.6% (PHQ-9 score \u226510). The data were consistent with the devised conceptual model. Of the factors investigated to be directly associated with internalised HIV stigma, the largest Beta coefficient was for the association with HIV stigmatisation in healthcare (Beta\u2009=\u20090.600; p\u2009&lt;\u20090.001). The second largest was for having felt scared to be in public places because of HIV in the last year (Beta\u2009=\u20090.271; p\u2009&lt;\u20090.001), closely followed by HIV stigmatisation from family (Beta\u2009=\u20090.269; p\u2009&lt;\u20090.001). Of the factors investigated to be directly associated with depression, the largest Beta coefficient was for the association with having felt isolated\/lonely because of HIV (Beta\u2009=\u20090.492; p\u2009&lt;\u20090.001). The second largest was for the inverse association with resilience (Beta\u2009=\u2009\u22120.288; p\u2009&lt;\u20090.001), followed closely by financial hardship (Beta\u2009=\u20090.267; p\u2009&lt;\u20090.001), having \u2018told most people in my life that I have HIV\u2019 (Beta\u2009=\u20090.267; p\u2009&lt;\u20090.001), and the inverse association with supportive network (Beta\u2009=\u2009\u22120.202; p\u2009&lt;\u20090.001). The largest Beta coefficient for direct effects was for the association between internalised HIV stigma and having felt isolated\/lonely because of HIV (Beta\u2009=\u20090.842; p\u2009&lt;\u20090.001). Internalised HIV stigma was associated with depression indirectly through having felt isolated\/lonely because of HIV (indirect Beta\u2009=\u20090.415; p\u2009&lt;\u20090.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our findings add to existing literature by implicating a number of key factors that upon intervention may help prevent or attenuate symptoms of depression in people living with HIV, including reducing stigmatisation in healthcare, internalised HIV stigma, and loneliness\/social isolation.<\/jats:p>\n                  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Health"},{"issue":"1","key":"pone.0343610.ref002","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1080\/09540120802032627","article-title":"Measuring AIDS stigmas in people living with HIV\/AIDS: The Internalized AIDS-Related Stigma Scale","volume":"21","author":"SC Kalichman","year":"2009","journal-title":"AIDS Care"},{"issue":"9","key":"pone.0343610.ref003","doi-asserted-by":"crossref","first-page":"1411","DOI":"10.1097\/QAD.0000000000002227","article-title":"Mental health and HIV\/AIDS: The need for an integrated response","volume":"33","author":"RH Remien","year":"2019","journal-title":"AIDS"},{"issue":"1","key":"pone.0343610.ref004","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1016\/S0277-9536(02)00304-0","article-title":"HIV and AIDS-related stigma and discrimination: A conceptual framework and implications for action","volume":"57","author":"R Parker","year":"2003","journal-title":"Soc Sci Med"},{"issue":"2","key":"pone.0343610.ref005","doi-asserted-by":"crossref","DOI":"10.1016\/S2352-3018(19)30343-1","article-title":"Stigma reduction interventions in people living with HIV to improve health-related quality of life","volume":"7","author":"GZ Andersson","year":"2020","journal-title":"Lancet HIV"},{"key":"pone.0343610.ref006","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1146\/annurev-soc-071312-145702","article-title":"The stigma complex","volume":"41","author":"BA Pescosolido","year":"2015","journal-title":"Annu Rev Sociol"},{"issue":"1","key":"pone.0343610.ref007","doi-asserted-by":"crossref","first-page":"10709","DOI":"10.1038\/s41598-023-37948-7","article-title":"HIV\/AIDS stigma accumulation among people living with HIV: A role of general and relative minority status","volume":"13","author":"E Gruszczy\u0144ska","year":"2023","journal-title":"Sci Rep"},{"issue":"3","key":"pone.0343610.ref008","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1080\/13548506.2024.2424998","article-title":"Prevalence of mental health problems in people living with HIV: A systematic review and meta-analysis","volume":"30","author":"F-H Hu","year":"2025","journal-title":"Psychol Health Med"},{"issue":"1","key":"pone.0343610.ref009","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1186\/s13033-022-00527-w","article-title":"HIV related stigma associated with social support, alcohol use disorders, depression, anxiety, and suicidal ideation among people living with HIV: A systematic review and meta-analysis","volume":"16","author":"B Armoon","year":"2022","journal-title":"Int J Ment Health Syst"},{"issue":"7","key":"pone.0343610.ref010","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2016-011453","article-title":"Examining the associations between HIV-related stigma and health outcomes in people living with HIV\/AIDS: A series of meta-analyses","volume":"6","author":"S Rueda","year":"2016","journal-title":"BMJ Open"},{"issue":"2","key":"pone.0343610.ref011","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1007\/s12160-010-9210-8","article-title":"Loneliness matters: A theoretical and empirical review of consequences and mechanisms","volume":"40","author":"LC Hawkley","year":"2010","journal-title":"Ann Behav Med"},{"issue":"4","key":"pone.0343610.ref012","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1097\/QAI.0000000000002355","article-title":"Impact of loneliness on brain health and quality of life among adults living with HIV in Canada","volume":"84","author":"M Harris","year":"2020","journal-title":"J Acquir Immune Defic Syndr"},{"issue":"2","key":"pone.0343610.ref013","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1097\/COH.0000000000000912","article-title":"Loneliness and social isolation in people with HIV","volume":"20","author":"JR Blanco","year":"2025","journal-title":"Curr Opin HIV AIDS"},{"issue":"9","key":"pone.0343610.ref014","doi-asserted-by":"crossref","first-page":"3147","DOI":"10.1007\/s10461-022-03653-1","article-title":"Loneliness mediates the effect of HIV-related stigma on depressive symptoms among older persons living with HIV","volume":"26","author":"M Yoo-Jeong","year":"2022","journal-title":"AIDS Behav"},{"issue":"2","key":"pone.0343610.ref015","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1097\/QAI.0000000000000948","article-title":"Mechanisms for the negative effects of internalized HIV-related stigma on antiretroviral therapy adherence in women: The mediating roles of social isolation and depression","volume":"72","author":"B Turan","year":"2016","journal-title":"J Acquir Immune Defic Syndr"},{"issue":"3","key":"pone.0343610.ref016","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1080\/08870446.2017.1357816","article-title":"Internalised HIV-stigma, loneliness, depressive symptoms and sleep quality in people living with HIV","volume":"33","author":"EM Fekete","year":"2018","journal-title":"Psychol Health"},{"key":"pone.0343610.ref017","article-title":"Methodology for the Positive Voices 2022 Survey of People With HIV Accessing Care in England, Wales, and Scotland: Cross-sectional questionnaire study","volume":"14","author":"J Sewell","year":"2025","journal-title":"JMIR Res Protoc"},{"issue":"7","key":"pone.0343610.ref018","doi-asserted-by":"crossref","first-page":"690","DOI":"10.1093\/aje\/kwz270","article-title":"Characterizing cross-culturally relevant metrics of stigma among men who have sex with men across 8 Sub-Saharan African Countries and the United States","volume":"189","author":"JL Augustinavicius","year":"2020","journal-title":"Am J Epidemiol"},{"issue":"2","key":"pone.0343610.ref019","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1037\/1082-989X.5.2.155","article-title":"On the nature and direction of relationships between constructs and measures","volume":"5","author":"JR Edwards","year":"2000","journal-title":"Psychol Methods"},{"issue":"9","key":"pone.0343610.ref020","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1046\/j.1525-1497.2001.016009606.x","article-title":"The PHQ-9: validity of a brief depression severity measure","volume":"16","author":"K Kroenke","year":"2001","journal-title":"J Gen Intern Med"},{"issue":"7","key":"pone.0343610.ref021","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1097\/00005650-198807000-00006","article-title":"The Duke-UNC Functional Social Support Questionnaire. Measurement of social support in family medicine patients","volume":"26","author":"WE Broadhead","year":"1988","journal-title":"Med Care"},{"key":"pone.0343610.ref022","unstructured":"Wagnild G. The resilience scale user\u2019s guide for the US English version of the Resilience Scale and the 14-item Resilience Scale (RS-14). USA: The Resilience Center, 2009."},{"key":"pone.0343610.ref023","doi-asserted-by":"crossref","DOI":"10.2307\/270723","volume-title":"Asymptotic confidence intervals for indirect effects in structural equation models","author":"ME Sobel","year":"1982"},{"key":"pone.0343610.ref024","volume-title":"Stata Statistical Software: Release 18","author":"LLC StataCorp","year":"2023"},{"key":"pone.0343610.ref025","volume-title":"Mplus User\u2019s Guide","author":"LK Muthen","year":"2010"},{"key":"pone.0343610.ref026","doi-asserted-by":"crossref","DOI":"10.1002\/9781118356258","volume-title":"Structural equation modeling: applications using Mplus","author":"J Wang","year":"2012","edition":"1"},{"issue":"1","key":"pone.0343610.ref027","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/10705519909540118","article-title":"Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives","volume":"6","author":"L Hu","year":"1999","journal-title":"Structural Equation Modeling: A Multidisciplinary Journal"},{"issue":"1","key":"pone.0343610.ref028","doi-asserted-by":"crossref","first-page":"919","DOI":"10.1186\/s12889-018-5861-3","article-title":"Stigma and intersectionality: A systematic review of systematic reviews across HIV\/AIDS, mental illness, and physical disability","volume":"18","author":"F Jackson-Best","year":"2018","journal-title":"BMC Public Health"},{"key":"pone.0343610.ref029","doi-asserted-by":"crossref","first-page":"1356430","DOI":"10.3389\/fpubh.2024.1356430","article-title":"HIV-related stigma and associated factors: A systematic review and meta-analysis","volume":"12","author":"ZG Dessie","year":"2024","journal-title":"Front Public Health"},{"key":"pone.0343610.ref030","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.socscimed.2018.05.001","article-title":"Perceptions of intersectional stigma among diverse women living with HIV in the United States","volume":"208","author":"WS Rice","year":"2018","journal-title":"Soc Sci Med"},{"issue":"10","key":"pone.0343610.ref031","doi-asserted-by":"crossref","first-page":"1424","DOI":"10.1080\/09540121.2024.2343770","article-title":"Beyond HIV shame: The role of self-forgiveness and acceptance in living with HIV","volume":"36","author":"SB Skalski-Bednarz","year":"2024","journal-title":"AIDS Care"},{"issue":"1","key":"pone.0343610.ref032","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1080\/25787489.2022.2113962","article-title":"Higher religiosity and spirituality are associated with ethnic group membership among middle-aged and older adults living with HIV","volume":"23","author":"JD Delgadillo","year":"2022","journal-title":"HIV Res Clin Pract"},{"issue":"1","key":"pone.0343610.ref033","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1111\/1468-5906.00103","article-title":"The perceived benefits of religious and spiritual coping among older adults living with HIV\/AIDS","volume":"41","author":"K Siegel","year":"2002","journal-title":"Scientific Study of Religion"},{"issue":"6","key":"pone.0343610.ref034","doi-asserted-by":"crossref","first-page":"4232","DOI":"10.1007\/s10943-024-02084-7","article-title":"Beyond HIV Shame: Effects of self-forgiveness in improving mental health in HIV-positive individuals in Poland","volume":"63","author":"SB Skalski-Bednarz","year":"2024","journal-title":"J Relig Health"},{"issue":"2","key":"pone.0343610.ref035","doi-asserted-by":"crossref","first-page":"52","DOI":"10.5530\/ijcep.2020.7.2.14","article-title":"Heart rate variability during an internal family systems approach to self-forgiveness","volume":"7","author":"KW Eaton","year":"2020","journal-title":"Int J Clin Exp Physiol"},{"issue":"2","key":"pone.0343610.ref036","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1001\/jama.2022.11086","article-title":"Spirituality in serious illness and health","volume":"328","author":"TA Balboni","year":"2022","journal-title":"JAMA"},{"issue":"1","key":"pone.0343610.ref037","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1080\/10508619.2020.1729570","article-title":"Does spirituality or religion positively affect mental health? Meta-analysis of longitudinal studies","volume":"31","author":"B Garssen","year":"2020","journal-title":"The International Journal for the Psychology of Religion"},{"issue":"1","key":"pone.0343610.ref038","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1080\/10508619.2020.1748932","article-title":"Effects of religious service attendance and religious importance on depression: Examining the meta-analytic evidence","volume":"31","author":"TJ VanderWeele","year":"2020","journal-title":"The International Journal for the Psychology of Religion"},{"issue":"5","key":"pone.0343610.ref039","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1080\/13691058.2015.1091509","article-title":"The role of the Black Church in the lives of young Black men who have sex with men","volume":"18","author":"K Quinn","year":"2016","journal-title":"Cult Health Sex"},{"issue":"2","key":"pone.0343610.ref040","doi-asserted-by":"crossref","first-page":"514","DOI":"10.1007\/s10943-011-9499-z","article-title":"HIV\/AIDS prevention, faith, and spirituality among black\/African American and Latino communities in the United States: Strengthening scientific faith-based efforts to shift the course of the epidemic and reduce HIV-related health disparities","volume":"52","author":"MY Sutton","year":"2013","journal-title":"J Relig Health"},{"issue":"3","key":"pone.0343610.ref041","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1159\/000455253","article-title":"Loneliness in older black adults with human immunodeficiency virus is associated with poorer cognition","volume":"63","author":"SD Han","year":"2017","journal-title":"Gerontology"},{"key":"pone.0343610.ref042","doi-asserted-by":"crossref","first-page":"118109","DOI":"10.1016\/j.socscimed.2025.118109","article-title":"An (un)restricted living: A qualitative exploration of the mental health and well-being of people living with HIV in England","volume":"377","author":"V Papageorgiou","year":"2025","journal-title":"Soc Sci Med"},{"issue":"8","key":"pone.0343610.ref043","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1177\/0020764013513442","article-title":"Loneliness mediates the relationship between internalised stigma and depression among patients with psychotic disorders","volume":"60","author":"P \u015awitaj","year":"2014","journal-title":"Int J Soc Psychiatry"},{"key":"pone.0343610.ref044","doi-asserted-by":"crossref","first-page":"103101","DOI":"10.1016\/j.drugpo.2020.103101","article-title":"Recreational drug use and use of drugs associated with chemsex among HIV-negative and HIV-positive heterosexual men and women attending sexual health and HIV clinics in England","volume":"91","author":"AR Miltz","year":"2021","journal-title":"Int J Drug Policy"},{"issue":"2","key":"pone.0343610.ref045","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1111\/hiv.12398","article-title":"Age, time living with diagnosed HIV infection, and self-rated health","volume":"18","author":"JA McGowan","year":"2017","journal-title":"HIV Med"},{"key":"pone.0343610.ref046","author":"FC Lampe","year":"2019"},{"issue":"1","key":"pone.0343610.ref047","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1007\/s10461-016-1541-4","article-title":"Non-Disclosure of HIV Status and Associations with Psychological Factors, ART Non-Adherence, and Viral Load Non-Suppression Among People Living with HIV in the UK","volume":"21","author":"M Daskalopoulou","year":"2017","journal-title":"AIDS Behav"},{"issue":"5","key":"pone.0343610.ref048","doi-asserted-by":"crossref","first-page":"1688","DOI":"10.1007\/s10461-017-1980-6","article-title":"Resilience and physical and mental well-being in adults with and without HIV","volume":"22","author":"JA McGowan","year":"2018","journal-title":"AIDS Behav"},{"issue":"1","key":"pone.0343610.ref049","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1016\/S2215-0366(20)30383-7","article-title":"The association between loneliness and depressive symptoms among adults aged 50 years and older: A 12-year population-based cohort study","volume":"8","author":"SL Lee","year":"2021","journal-title":"Lancet Psychiatry"},{"issue":"2","key":"pone.0343610.ref050","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1037\/a0017216","article-title":"Perceived social isolation makes me sad: 5-year cross-lagged analyses of loneliness and depressive symptomatology in the Chicago health, aging, and social relations study","volume":"25","author":"JT Cacioppo","year":"2010","journal-title":"Psychol Aging"},{"issue":"2","key":"pone.0343610.ref051","doi-asserted-by":"crossref","first-page":"15579883221087531","DOI":"10.1177\/15579883221087531","article-title":"HIV-related stigma, sexual identity, and depressive symptoms among MSM living with HIV in China: A moderated mediation modeling analysis","volume":"16","author":"T Mi","year":"2022","journal-title":"Am J Mens Health"},{"issue":"2","key":"pone.0343610.ref052","doi-asserted-by":"crossref","DOI":"10.1016\/S2468-2667(23)00312-2","article-title":"Structural stigma and LGBTQ+ health: a narrative review of quantitative studies","volume":"9","author":"ML Hatzenbuehler","year":"2024","journal-title":"Lancet Public Health"},{"issue":"4","key":"pone.0343610.ref053","doi-asserted-by":"crossref","DOI":"10.1002\/jia2.26424","article-title":"Evidence from high-income countries on the effectiveness of psychosocial interventions to improve mental health, wellbeing and quality of life for adults living with HIV: A systematic review and meta-analysis","volume":"28","author":"AR Miltz","year":"2025","journal-title":"J Int AIDS Soc"},{"issue":"9","key":"pone.0343610.ref054","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1089\/apc.2014.0014","article-title":"A randomized controlled trial of the efficacy of a stigma reduction intervention for HIV-infected women in the Deep South","volume":"28","author":"J Barroso","year":"2014","journal-title":"AIDS Patient Care STDS"},{"key":"pone.0343610.ref055","article-title":"Effects of an intervention on internalized HIV-related stigma for individuals newly entering HIV care","author":"I Yigit","year":"2020","journal-title":"AIDS"},{"issue":"3","key":"pone.0343610.ref056","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1097\/QAI.0000000000001673","article-title":"Stigma Reduction Among African American Women With HIV: UNITY Health Study","volume":"78","author":"D Rao","year":"2018","journal-title":"J Acquir Immune Defic Syndr"},{"key":"pone.0343610.ref057","first-page":"101","article-title":"Spiritual care may impact mental health and medication 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