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Enacted and internalized stigma and quality of life among people with HIV: the role of group identity

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Abstract

Purpose

This study analyzes the mediating role of social identity in the relationship between enacted stigma and internalized stigma and quality of life of people with HIV.

Methods

A total of 557 people with HIV participated in this study. Participants were recruited from hospitals and non-governmental organizations. Questionnaires measuring perceived stigma (Berger’s HIV Stigma Scale), social identity (Cameron’s three factor identity scale), and quality of life (Ruiz and Baca’s Quality of Life Questionnaire) were administered. The instruments were adapted for use with the Spanish population. Structural equation modeling (SEM) was used to test the mediation model, and multigroup SEM was conducted to evaluate its invariance.

Results

Both enacted stigma and internalized stigma had a negative influence on the quality of life of people with HIV, but this influence occurred in different ways. Enacted stigma had a direct negative influence on quality of life. No dimension of group identity protected people with HIV from its negative influence. However, the negative influence of internalized stigma was totally mediated by some dimensions of group identification, mainly through in-group affect.

Conclusions

Group identification not only did not protect people with HIV from the negative effects of stigmatization, but it may even be detrimental in the case of internalized stigma. This suggests that in highly stigmatized groups, the salience of identity is negative and worsens the members’ opinion of their own group. This argues for different kinds of intervention to improve the quality of life of people with HIV.

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Acknowledgments

Work on this paper was supported by a Spanish Science and Innovation Ministry Grant (Number PSI2008-02966). This study was supported by Fundacion para la Investigación y la Prevención del Sida en España (FIPSE: 24637/07).

Conflict of interest

None to be declared.

Author information

Authors and Affiliations

  1. Department of Social and Organizational Psychology, Universidad Nacional de Educación a Distancia (UNED), Madrid, Spain

    Maria J. Fuster-Ruizdeapodaca & Fernando Molero

  2. Department of Methodology of Behavioral and Health Sciences, Universidad Nacional de Educación a Distancia (UNED), Madrid, Spain

    Francisco Pablo Holgado

  3. Department of Social Psychology and Methodology of Behavioral Sciences, Universidad del País Vasco, San Sebastián, Spain

    Sonia Mayordomo

Authors
  1. Maria J. Fuster-Ruizdeapodaca
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  2. Fernando Molero
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  3. Francisco Pablo Holgado
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  4. Sonia Mayordomo
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Corresponding author

Correspondence to Fernando Molero.

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Fuster-Ruizdeapodaca, M.J., Molero, F., Holgado, F.P. et al. Enacted and internalized stigma and quality of life among people with HIV: the role of group identity. Qual Life Res 23, 1967–1975 (2014). https://doi.org/10.1007/s11136-014-0653-4

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