Stigma and Spiritual Well-being among People Living with HIV/AIDS in Southern Appalachia

Issues Ment Health Nurs. 2018 Jun;39(6):482-489. doi: 10.1080/01612840.2017.1423426. Epub 2018 Feb 15.


The Appalachian South is disproportionately affected by HIV/AIDS. Partly due to the negative connotation that this disease carries in religiously conservative areas, HIV-related stigma remains a critical barrier to HIV care in the South. However, spirituality is a well-documented, effective coping mechanism among persons living with HIV/AIDS (PLWH). The purpose of this study was to examine the relationship between HIV-related stigma and spiritual well-being among a sample of PLWH (n = 216) in Appalachian counties of Tennessee and Alabama using the HIV Stigma Scale and the Spiritual Well-being Scale. Overall, disclosure of HIV status was the most highly reported stigma concern. Women reported higher levels of stigma and religious well-being than men. While existential well-being was negatively correlated with stigma, no significant overall correlation was found between religious well-being and stigma. Our findings reveal the importance of defining theology and differentiating between cultural religious conditioning and internalized beliefs.

MeSH terms

  • Adaptation, Psychological
  • Adolescent
  • Adult
  • Aged
  • Alabama
  • Appalachian Region
  • Female
  • HIV Infections / psychology*
  • Humans
  • Male
  • Middle Aged
  • Social Stigma*
  • Spirituality*
  • Tennessee
  • Young Adult