Impact of HIV-related stigma on medication adherence among persons living with HIV

This paper reviews recent studies on HIV-related stigma and medication adherence, including: (1) summary of the empirical evidence linking stigma to adherence, (2) discussion of proposed causal mechanisms of the stigma and adherence relationship, (3) examination of studies that have empirically tested causal mechanisms, and (4) methodological critique and directions for future research. Although there is substantial empirical evidence linking stigma to adherence difficulties, few studies provide data on psychosocial mechanisms that may account for this relationship. Two proposed causal mechanisms include (a) concerns about inadvertent disclosure of HIV status and (b) depressive symptoms. Future research should assess the multiple domains of stigma, address the multidimensionality of adherence, and include prospective analyses to test mediating variables.