Loneliness Mediates the Effect of HIV-related Stigma on Depressive Symptoms among Older Persons Living with HIV.

Studies have shown associations among stigma, loneliness, and depressive symptoms in older persons living with HIV (PWH) but research assessing the mediating pathway among these variables is sparse. Building on this prior work, the aim of this study was to test the mediating effects of loneliness. A sample of 146 older PWH (≥50 years old) from an outpatient HIV clinic in Atlanta, GA, completed a cross-sectional survey. Mediation analysis, guided by Baron and Kenny's criteria, was conducted using Stata v14.2 to assess the direct and indirect effects of loneliness on the association between stigma and depressive symptoms while controlling for covariates (sex; income; self-rated health; past unstable housing). Loneliness mediated the association between stigma and depressive symptoms. Stigma predicted higher loneliness, which in turn predicted more depressive symptoms. Findings suggest that addressing depressive symptoms in older PWH may require multifaceted interventions targeting psychosocial and interpersonal factors including stigma and loneliness.