HIV-related stigma and self-disclosure among older people living with HIV: chain mediating roles of perceived social support and acceptance of illness

Self-disclosure represents a pivotal challenge for older people living with HIV (PLWH) in China, who are frequently impacted by HIV-related stigma. As such, the current study aims to explore the relationship between HIV-related stigma and self-disclosure, and specifically examine the chain-mediating roles of perceived social support and acceptance of illness. A cross-sectional study was conducted among 282 older PLWH, recruited from Wuxi, China. AMOS 24.0 was used for model drawing and mediation path testing, and SPSS 26.0 was used for data analysis. Structural equation modeling (SEM) showed a satisfactory model fit (CMIN/DF = 1.744, CFI = 0.966, GFI = 0.906, AGFI = 0.853, IFI = 0.972, RMSEA = 0.051). We found that the mediated effect values of perceived social support and acceptance of illness were - 0.128 and - 0.055, respectively, while their chain mediated effect value was - 0.015. It suggests that interventions enhancing perceived social support and acceptance of illness may mitigate the negative impact of HIV-related stigma on self-disclosure behavior.