1. www.aids2014.org The mediation effect of resilience on the relationship between stigma and mental health problems among HIV-infected adults in Southwest China Shaobing Su 1, Xiaoming Li 1, Liying Zhang 1, Shan Qiao 1, Juxian Pan 2, Weigui Guo 2, Yuejiao Zhou 3, Peiying Zuo 4 1 Department of Pediatrics Prevention Research Center, School of Medicine, Wayne State University, Detroit, MI 48201, USA. 2 Beihai Center for Disease Prevention and Control (CDC), Guangxi, China. 3 Guangxi Center for Disease Prevention and Control (CDC), Guangxi, China. 4 Institute of Developmental Psychology, Beijing Normal University, Beijing, China. Abstract no.WEPDD01 Presenter: Peiying Zuo

2. www.aids2014.org Background Destructive impact of stigma on the mental health of HIV-infected adults Limited study has explored the protective effect of resilience on mental health among HIV- infected adults. The purpose of the current study is to examine the associations among stigma, resilience, and mental health among HIV- infected adults in China.

3. www.aids2014.org Methods Sample A total of 3002 HIV-infected adults from 12 cities/counties in Guangxi, China participated in the survey. After removing 15 uncompleted questionnaires, we finally obtained data from 2,987 participants for the current study. Measurements Demographics HIV-related characteristics: Duration of infection, CD4 cell count. Stigma: Internalized stigma, Perceived stigma Resilience Mental health problems: Depressive symptoms, Anxiety Data Analysis Linear regressions were applied to examine the prediction models of depressive symptoms and anxiety on demographics, HIV related characteristics, and independent variables (resilience and stigma).

4. www.aids2014.org Results DemographicsValue Age 42.46±12.83 Gender Female 1111(37.2%) Male 1876(62.8%) Education (year) 6.97±3.30 CD 4 ≤2501035(36.2%) 251-4991261(44.1%) ≥500565(19.7%) Duration of HIV infection (month) 38.72±28.65 Income (month) <2000 2442(82.6%) 2000~3999 418(14.1%) ≥4000 98(3.3%) Table 1 Demographic Characteristics

5. www.aids2014.org Results Depressive symptomsAnxiety Demographics Model 1Model 2Model 3Model 1Model 2Model 3 Age -0.05*-.051*-.069-0.07*** -0.09*** Educational level -0.04-0.04*0.03-0.05*-0.05**0.00 Gender 0.06**.054**0.060.04*0.040.04* Income -0.11*** -0.04-0.11***-0.10***-0.05** HIV related characteristics CD 4 -0.06**-.054 -0.05*-0.04* Duration of HIV infection 0.03 0.040.04* Independent variables Stigma 0.37*** 0.27*** R2R2 0.02 0.15 0.02 0.09 Table 2 Linear Regression Analysis of Mental Health Problems on Stigma Stigma Depressive symptoms/Anxiety Mediation test -Path A:

6. www.aids2014.org Results Table 3 Linear Regression Analysis of Resilience on Stigma ResilienceDepressive symptoms Anxiety Demographics Age -0.06-0.05**-0.07*** Educational level 0.12**0.04*0.01 Gender 0.030.05**0.04* Income 0.13***-0.04**-0.05** HIV related characteristics CD 4 -0.01-0.06**-0.04* Duration of HIV infection 0.010.020.03 Independent variables Resilience -0.39***-0.34*** Stigma -0.23***0.28***0.19*** R2R2 10.20.30 0.20 Stigma Resilience Mediation test - Path B: Stigma Resilience Mediation test - Path C: Depressive symptoms/Anxiety

7. www.aids2014.org Conclusion Stigma has negative effects on the mental health of HIV-infected adults. Resilience can not only protect HIV infected patients from suffering mental health difficulties, but also buffer the negative impact of stigma on HIV-infected patients' mental health. Resilience-based intervention would be helpful for HIV-infected patients to effectively cope with stresses and improve mental health status.

8. www.aids2014.org Thank you for your attention! Contacts: Xiaoming Li xiaoli@med.wayne.edu Shaobing Su ssu@med.wayne.edu