# Perceived stigma and the role of BMI on perceived HIV-related stigma among people living with HIV/AIDS in Southeast Ethiopia

## TL;DR

This study in Ethiopia found that underweight HIV patients and those with poor social support experience higher HIV-related stigma, with depression playing a mediating role.

## Contribution

The study identifies BMI and depression as key factors in HIV-related stigma and reveals a chain mediation effect involving depression.

## Key findings

- 68% of participants experienced perceived HIV-related stigma.
- Underweight (BMI <18.5) and poor social support significantly increased perceived stigma.
- Depression indirectly predicted perceived HIV-related stigma through a chain mediation effect.

## Abstract

People living with HIV/AIDS are at an increased risk of perceived HIV-related stigma. The effectiveness of social support for perceived HIV-related stigma is hampered by high depression. Although there is evidence that being underweight is associated with perceived HIV-related stigma, the mechanism is not well known. This study aimed to assess perceived HIV-related and the role of body mass index (BMI) on perceived HIV-related stigma in Southeast Ethiopia.

A hospital-based cross-sectional study design was conducted among 547 randomly selected HIV/AIDS patients in Southeast Ethiopia. Perceived HIV-related stigma was assessed using a 10-item perceived HIV stigma scale assessment tool. Descriptive statistics were computed, and the data were analyzed by logistic regression, correlation, and mediation model.

The magnitude of perceived HIV-related stigma was found to be 68% [95% CI: (64.1%, 71.9%)] among participants. Patients with low social support [AOR=1.5, 95% CI: (1.05, 2.40)], a body mass index (BMI) of <18.5 kg/m2 (kilogram per meter squared) [(AOR = 5, 95% CI: (2.30, 11.0)], and non-adherence to highly active antiretroviral therapy (HAART) [(AOR: 5, 95% CI: (1.03, 3.05)] were significantly associated with perceived HIV-related stigma. In mediation, the results indicated that the total mediation effect (B = -0.62, 95% CI [-0.828, 0.404]), direct effect (B = -0.30, 95% CI [-0.554, -0.046]), and depression played a chain mediating role (indirect effect) (B = -0.41, 95% CI [-0.557, -0.261]) were significant.

The prevalence of perceived HIV-related stigma was found high. Patients with poor social support and non-adherent to HAART were more likely to suffer from HIV-related perceived stigma. Our findings suggest that there is a relationship between body mass index and perceived HIV-related stigma, while depression can indirectly predict perceived HIV-related stigma.