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. 2014 Jun;18(6):1054-62.
doi: 10.1007/s10461-013-0649-z.

Vicious circle of perceived stigma, enacted stigma and depressive symptoms among children affected by HIV/AIDS in China

Peilian Chi  1 , Xiaoming Li, Junfeng Zhao, Guoxiang Zhao
Affiliations

Vicious circle of perceived stigma, enacted stigma and depressive symptoms among children affected by HIV/AIDS in China

Peilian Chi et al. AIDS Behav. 2014 Jun.

Abstract

Previous research has found a deleterious impact of stigma on the mental health of children affected by HIV/AIDS. Little is known about the longitudinal relationship of stigma and children's mental health. This study explores the longitudinal reciprocal effects of depressive symptoms and stigma, specifically enacted stigma and perceived stigma, among children affected by HIV/AIDS aged 6-12. Longitudinal data were collected from 272 children orphaned by AIDS and 249 children of HIV-positive parents in rural China. Cross-lagged panel analysis was conducted in the study. Results showed that the autoregressive effects were stable for depressive symptoms, perceived stigma and enacted stigma suggesting the substantially stable individual differences over time. The cross-lagged effects indicated a vicious circle among the three variables in an order of enacted stigma → depressive symptom → perceived stigma → enacted stigma. The possibility of employing equal constraints on cross-lagged paths suggested that the cross-lagged effects were repeatable over time. The dynamic interplay of enacted stigma, perceived stigma and depressive symptoms suggests the need of a multilevel intervention in stigma reduction programming to promote mental health of children affected by HIV/AIDS.

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Figures

Figure 1
Figure 1
The hypothesized conceptual model
Figure 2
Figure 2
Basic model with standardized path estimates (Model 1) * p < .05, *** p < .001.
Figure 3
Figure 3
Final model (model 8) with crossed lagged effects. Note.** p < .01, *** p < .001. The cross-lagged paths were constrained to be equal across waves. The within-waves correlated residuals were constrained to be equal across waves of depressive symptoms and perceived stigma, and of perceived stigma and enacted stigma
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