7 - (IOP 21) The Indirect Effect of HIV Stigma on Mental Health Symptoms and Alcohol Use Through Insomnia Symptom Severity

Young people with HIV (YPWH) experience unique stressors related to their health, such as HIV stigma. HIV stigma is associated with poor sleep health, mental health symptoms, and alcohol use, which can be problematic for HIV care management. Poor sleep health is associated with mental health symptoms and alcohol use among PWH. Among YPWH, the effect of poor sleep health on the relationships between HIV stigma and mental health and alcohol use has not been examined. The current analyses examined these relationships with the expectation that HIV stigma would be related to insomnia symptom severity (ISS), mental health symptoms, and alcohol use. Lastly, an indirect effect between HIV stigma and mental health symptoms and alcohol use through ISS was hypothesized.
As part of a larger NIAAA-funded Program Project (P01 AA029547), 105 YPWH residing in Florida who met eligibility criteria for the current study were recruited and enrolled. A subset of participants (n=67) completed all measures used in the current analyses. All study variables were assessed via REDCap using validated assessment measures (i.e., Berger HIV Stigma Scale, Sleep Condition Indicator, DSM-5 Level 1 Screener, Alcohol, Smoking, and Substance Involvement Screening Test).
The results indicated that all study variables had bivariate associations in the expected directions. The indirect effects model was tested and supported. HIV stigma was related to ISS (z=-3.660, p =0.000) and ISS was related to mental health symptoms (z=-5.269, p=0.000) and alcohol use (z=-2.265, p=0.023). The indirect effects through ISS on mental health symptoms (z=3.006, p=0.003) and alcohol use (z=1.926, p=0.054) were significant, whereas the direct effects between HIV stigma and the two outcomes were not significant.
The results highlight the association that stressors, such as HIV stigma, have with sleep health and the intermediary effects that sleep health may have on mental health and substance use. In line with previous research, when stress contributes to poor sleep health, there is increased risk for poorer mental health outcomes and alcohol use may increase as a compensatory behavior, a general method of coping, or due to impacts on inhibitory control. Limitations and future directions will be discussed.