ArticleFrontiers in public health2026
Stigma and anxiety/depression among Chinese older people living with HIV/AIDS: a moderated mediation model of coping strategies and quality of life.
Article in Frontiers in public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Older people living with HIV/AIDS (PLWHA) are increasingly susceptible to depression and anxiety, with HIV-related stigma being a significant contributing factor. However, the mechanisms underlying this association remain poorly understood in this specific population. This study investigates whether coping strategies mediate, and multidimensional quality of life (QOL) moderates, the relationship between stigma and mental health outcomes (depression and anxiety) among older PLWHA. Methods: A cross-sectional study was conducted involving 254 PLWHA aged ≥50 years. Data were collected through face-to-face interviews, encompassing socio-demographics, HIV-related factors, stigma, QOL (total and dimensional scores), coping strategies (confrontation, avoidance, resignation), and mental health assessed using the PHQ-9 (for depression) and GAD-7 (for anxiety). Mediation and moderated mediation analyses were performed using the PROCESS macro, with coping strategies as mediators and QOL dimensions as moderators. Results: The positive rate for depressive symptoms (PHQ-9≥10) was 50.4%, and that for anxiety symptoms (GAD-7≥10) was 29.9%. Higher levels of stigma and greater reliance on resignation coping were found to predict more severe symptoms of depression and anxiety. Resignation coping partially mediated the effect of stigma on both anxiety and depression. Furthermore, QOL, particularly its psychosocial and spiritual dimensions, moderated the direct pathway from stigma to anxiety/depression. Conclusion: HIV-related stigma exacerbates depression and anxiety among older PLWHA, partly via resignation coping, while higher QOL, particularly in psychosocial and spiritual domains, buffers the adverse effects of stigma. Interventions targeting passive coping styles and improving psychosocial and spiritual wellbeing may help mitigate the mental health burden of stigma in this population.
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