{
  "abstract": "Objectives Overtly experienced HIV-related stigma is associated with depressive symptoms for people living with HIV (PLWH). Research suggests that an important mediating mechanism in this association is internalised stigma, where PLWH accept negative societal views about HIV, apply them to themselves and develop a negative view of themselves. Microaggressions are subtle and indirect discriminatory behaviours and, like overtly experienced stigma, may also contribute to depressive symptoms. We tested this hypothesis and examined the mediating roles of internalised stigma and maladaptive ways of coping with shame in the association between microaggressions and depressive symptoms among PLWH in Türkiye.Methods This study examines the serial mediating roles of internalised HIV stigma and shame-related coping strategies (ie, withdrawal and self-attack) in the association between HIV-related microaggressions and depressive symptoms among PLWH. PLWH in Izmir, Türkiye (N=308) completed validated scales measuring experiences of microaggressions, internalised HIV stigma, coping strategies related to shame and depression symptoms.Results Structural equation modelling results suggest that internalised HIV stigma significantly mediates the relationship between HIV-related microaggressions and depression symptoms. Furthermore, serial mediation analysis suggests that withdrawal and self-attack strategies of coping with shame mediate the association between internalised HIV stigma and depressive symptoms. Thus, internalised HIV stigma and shame-related coping strategies may partially stem from experiencing HIV-related microaggressions and may negatively affect the mental health of PLWH.Conclusions Findings highlight the importance of assessing subtle forms of discrimination (ie, microaggressions) given their negative impact on the self-concept of PLWH. In addition to addressing negative attitudes and behaviours against PLWH in society, interventions that help PLWH cope with shame-related experiences might improve their mental health.",
  "authors": [
    {
      "affiliations": [
        "Department of Psychology, Faculty of Economics, Administrative and Social Sciences, Bahçeşehir University, Istanbul, Turkey",
        "Department of Psychology, College of Social Sciences and Humanities, Koç University, Istanbul, Turkey"
      ],
      "name": "Aliye Canan Taşlıoğlu Sayıner"
    },
    {
      "affiliations": [
        "Department of Psychology, College of Social Sciences and Humanities, Koç University, Istanbul, Turkey"
      ],
      "name": "Bulent Turan"
    },
    {
      "affiliations": [
        "Department of Infectious Diseases and Clinical Microbiology, Dokuz Eylül University, Izmir, Turkey"
      ],
      "name": "Arzu Nazlı"
    },
    {
      "affiliations": [
        "Department of Psychology, College of Social Sciences and Humanities, Koç University, Istanbul, Turkey"
      ],
      "name": "Deniz Özer"
    },
    {
      "affiliations": [
        "Department of Psychology, College of Social Sciences and Humanities, Koç University, Istanbul, Turkey",
        "Department of Psychology, Faculty of Humanities and Social Sciences, Istinye University, Istanbul, Turkey"
      ],
      "name": "Hamed Abdollahpour Ranjbar"
    },
    {
      "affiliations": [
        "Department of Infectious Diseases and Clinical Microbiology, Izmir Katip Celebi University, Izmir, Turkey"
      ],
      "name": "Salih Atakan Nemli"
    },
    {
      "affiliations": [
        "Department of Infectious Diseases and Clinical Microbiology, Dokuz Eylül University, Izmir, Turkey"
      ],
      "name": "Ahmad Nejat Ghaffari"
    },
    {
      "affiliations": [
        "Department of Infectious Diseases and Clinical Microbiology, Ege University, Izmir, Turkey"
      ],
      "name": "Merve Mert Vahabi"
    },
    {
      "affiliations": [
        "Department of Infectious Diseases, Izmir Atatürk Training and Research Hospital, Izmir, Turkey"
      ],
      "name": "Nur Miray Ayhan"
    },
    {
      "affiliations": [
        "Department of Infectious Diseases and Clinical Microbiology, Ege University, Izmir, Turkey"
      ],
      "name": "Deniz Gokengin"
    },
    {
      "affiliations": [
        "Department of Community Health Sciences, School of Public Health, SUNY Downstate Health Sciences University, Brooklyn, New York, USA"
      ],
      "name": "Andrea Norcini Pala"
    }
  ],
  "title": "HIV-related microaggressions and depressive symptoms among people living with HIV: the mediating roles of internalised stigma and coping with shame",
  "uid": "bc41fcef-1954-571b-8cb1-6a6d3ebf14f8"
}