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The Effect of Social Stigma on Suicidal Ideation of Male HIV Infected People: Focusing on the Mediating Effect of Hope and Depression

II Ok Kim1, Sun Hwa Shin2
Korean Journal of Adult Nursing 2014;26(5):563-572.
Published online: October 31, 2014

1Department of Nursing, Sahmyook University, Seoul

2Graduate School of Division of Nursing Science, Ewha Womans University, Seoul, Korea

Corresponding author: Shin, Sun Hwa Graduate School of Division of Nursing Science, Ewha Womans University, 275-33 Junghwa 1-dong, Jungnang-gu, Seoul 131-875, Korea. Tel: +82-2-3399-1593, Fax: +82-2-3399-1594, E-mail: ffssh@hanmail.net
• Received: May 15, 2014   • Accepted: October 2, 2014

Copyright © 2014 Korean Society of Adult Nursing

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Purpose
    The purpose of this study was to identify the mediating effect of hope and depression applied on the influence of social stigma on suicidal ideation of 108 HIV infected males.
  • Methods
    This study was a descriptive, cross-sectional design that used a survey approach. Data collection was one-on-one interviews by a counseling nurse from July 2012 to January 2013. The survey included questions about social stigma, hope, depression, and suicidal ideation.
  • Results
    Fitness of the hypothetical model was appropriate (x2/df=1.97, TLI=.97, CFI=.98, RMSEA=.07, SRMR=.04). Social stigma had no direct effect on suicidal ideation but had a significant indirect effect on suicidal ideation via hope and depression. Hope had a mediating effect the relationship between stigma and depression but no direct effect on the relationship between stigma and suicidal ideation. Hope had an indirect effect on suicidal ideation via depression. Stigma and hope accounted for 41% of depression was where as suicidal ideation was explained 56.3% by depression, hope, and stigma.
  • Conclusion
    In order to reduce depression and suicidal ideation of HIV infected people, stigma improving strategies are required. And hope intervention for HIV infected people may decrease their suicidal ideation and depression.
  • Key Words: HIV; Social stigma; Hope; Depression; Suicidal ideation
Figure 1.
Path diagram for the research model.
kjan-26-563f1.jpg
Table 1.
Descriptive Statistics of the Observed Variables (N=180)
Variables Range M±SD Skewness Kurtosis Tolerance VIF
Social stigma 15~75 50.98±10.48 -.21 -.34 .85 1.18
Hope 8~32 21.61±4.91 -.08 -.24    
  Agency thinking 4~16 11.62±2.79 -.20 -.44 .44 2.28
  Pathways thinking 4~16 9.99±2.50 .09 .03 .39 1.53
Depression 0~60 18.55±13.87 .65 -.44    
  Depressed affect 0~27 8.25±7.07 .72 -.40 .16 6.16
  Interpersonal problems 0~15 4.11±3.77 .86 -.18 .16 6.08
  Positive affect 0~9 3.37±2.67 .34 -.86 .81 1.24
  Somatic complaints 0~9 2.82±2.46 .74 -.30 .34 2.92
Suicidal ideation 0~180 38.68±4.05 1.06 .33    
Table 2.
Correlations among Social Stigma, Hope, Depression, and Suicidal Ideation (N=180)
Variables Social stigma Hope Y1 Y2 Depression Y3 Y4 Y5 Y6
r (p) r (p) r (p) r (p) r (p) r (p) r (p) r (p) r (p)
Hope -.22                
  (.003)                
Y1 -.17 .94              
  (.026) (＜.001)              
Y2 -.25 .92 .72            
  (＜.001) (＜.001) (＜.001)            
Depression .34 -.56 -.47 -.57          
  (＜.001) (＜.001) (＜.001) (＜.001)          
Y3 .36 -.51 -.41 -.54 .96        
  (＜.001) (＜.001) (＜.001) (＜.001) (＜.001)        
Y4 .32 -.53 -.47 -.52 .94 .90      
  (＜.001) (＜.001) (＜.001) (＜.001) (＜.001) (＜.001)      
Y5 .20 -.36 -.35 -.32 .54 .36 .39    
  (＜.001) (＜.001) (＜.001) (＜.001) (＜.001) (＜.001) (＜.001)    
Y6 .21 -.47 -.39 -.50 .85 .78 .78 .33  
  (.004) (＜.001) (＜.001) (＜.001) (＜.001) (＜.001) (＜.001) (＜.001)  
Suicidal ideation .29 -.37 -.33 -.35 .70 .71 .70 .26 .56
  (＜.001) (＜.001) (＜.001) (＜.001) (＜.001) (＜.001) (＜.001) (＜.001) (＜.001)

Y1=Agency thinking; Y2=Pathways thinking; Y3=Depressed affect; Y4=Interpersonal problems; Y5=Positive affect; Y6=Somatic complaints.

Table 3.
Goodness of Fit on Research Model (N=180)
Model x2 df p x2/df TLI CFI RMSEA (90% CI) SRMR
Research model 31.57 16 .011 1.97 .97 .98 .07 (.03~.11) .04

TLI=Tucker-Lewis Index; CFI=Comparative Fit Index; RMSEA=root mean squared error of approximation; SRMR=standardized root mean-squared

Table 4.
Path Coefficient and Direct ․ Indirect Effect of Modification Model (N=180)
Dependent Independent Path coefficient Effect (standardized) SMC
b p Direct (p) Indire ct (p) Total (p)
Hope Social stigma -0.06 .001 -.28 (.002) -.28 (.002) .077
Depression Social stigma 0.15 .001 .22 (.006) .15 (. .002) .37 (.002) .407
  Hope -1.71 ＜.001 -.54 (.005) -.54 (.005)  
Suicidal Social stigma 0.20 .420 .05 (.391) .27 (. .002) .32 (.002) .563
ideation Hope 1.94 .153 .10 (.111) -.42 (. .003) -.32 (.002)  
  Depression 4.70 ＜.001 .79 (.002) .79 (.002)  

SMC=squared multiple correlations.

  • Bae B. R.. 2007. Structural equation modeling with AMOS 7-Principles and practice. p. 186–-195. 278-281.Chungram: Seoul.
  • Bernays S., Rhodes T., Barnett T.. 2007;Hope: A new way to look at the HIV epidemic. Aids. 21(Suppl 5):S5–-11. http://dx.doi.org/10.1097/01.aids.0000298097.64237.4b.
  • Carrico A. W., Johnson M. O., Morin S. F., Remien R. H., Char-lebois E. D., Steward W. T., et al. 2007;Correlates of suicidal ideation among HIV-positive persons. AIDS. 21(9):1199–-1203.
  • Choi L. S.. 1996;Family views about social stigma of mental illness patients. The Korean Journal of Clinical Psychology. 15(1):69–-89.
  • Choi Y. H., Lee H. K., Lee D. G.. 2008;Validation of the Korean version of Snyder's Dispositional Hope Scale. The Korean Journal of Social and Personality Psychology. 22(2):1–-16.
  • Chon K. K., Kwon K. D., Kim S. K.. 1999;An attempt to revise the Korean adaptation of the CES-D: I. Journal of Social Science Research. 6(1):429–-451.
  • Cooperman N. A., Simoni J. M.. 2005;Suicidal ideation and attempted suicide among women living with HIV/AIDS. Journal of Behavioral Medicine. 28(2):149–-156.
  • Ding L., Velicer W., Harlow L.. 1995;Effect of estimation methods, number of indicators per factor and improper solutions on structural equation modeling fit indices. Structural Equation Modeling. 2:119–-143.
  • Green G.. 1995;Attitudes towards people with HIV: Are they as stigmatizing as people with HIV perceive them to be? Social Science and Medicine. 41(4):557–-568.
  • Han K. S., Park Y. H., Im H. S., Ju G. Y., Bae M. H., Kang H. C.. 2010;Hope, depression and suicidal ideation in chronic mental illness patients. Journal of Korean Academic Psychiatric Mental Health Nursing. 19(2):205–-211.
  • Harris G. E., Larsen D.. 2008;Understanding hope in the face of an HIV diagnosis and high-risk behaviors. Journal of Health Psychology. 13(3):401–-415. http://dx.doi.org/10.1177/1359105307088143.
  • Kim S. Y., Lee J. S., Park S. K., Kim Y. I.. 2008;Knowledge and attitudes towards AIDS in a general population. Journal of Korean Society for Health Education and Promotion. 25(4):13–-28.
  • Korean Centers for Disease Control and Prevention. 2013;2013 HIV/AIDS care guidelines Ministry of Health and Welfare: Seoul. Available from:.http://www.cdc.go.kr/CDC/notice/CdcKrTogether0302.jsp?menuIds=HOME001-MNU0004-MNU0085-MNU0088&cid=21276.
  • Kwon S. M., Kim S. Y., Lee J. S., Ko U. Y.. 2001;Brief report: Mental health status and related factors of HIV-infected Korean males. The Korean Journal of Clinical Psychology. 20(1):219–-228.
  • Kwon Y. Y.. 2009;Suicidal ideation of people living with HIV/AIDS and its determinants Unpublished doctor's thesis, Chungnam National University, Daejeon, Korea..
  • Lee S. H.. 1999;Quality of life in persons with HIV/AIDS Unpublished master's thesis, Ewha Womans University, Seoul..
  • Lee S. H., Kho K. B., Kim J. M., Hong S. K., Choi T. K., Lee E. H., et al. 2006;Psychosocial factors associated with biological markers in Korean patients with Human Immunodeficiency Virus Infection. Journal of Korean Neuropsychiatric Association. 45(1):34–-41.
  • Lichtenstein B., Laska M. K., Clair J. M.. 2002;Chronic sorrow in the HIV-positive patient: Issues of race, gender, and social support. AIDS patient care and Standards. 16(1):27–-38.
  • Lim S. A., Kim I. O.. 2013;HIV-infected people, depression, social support, quality of life. The Korean Journal of Health Psychology. 18(2):363–-381.
  • Park H. O., Yook S. P.. 2013;The effect of spousal bereavement stress on depression and suicidal ideation in the elderly according to marital intimacy- A moderated mediation model. The Korean Journal of Counseling and Psychotherapy. 25(4):933–-951.
  • Park H. S.. 2008;The moderating effect of social supports and hope on the relationship of career barrier and carrier aspirations in Jeju island high school students. Journal of Adolescent Welfare. 10(4):129–-151.
  • Park J. Y., Lim Y. O., Yoon H. S.. 2010;Suicidal impulse caused by stress in Korea: Focusing on mediational effects of existent spirituality, family support, and depression. Korean Journal of Social Welfare Studies. 41(4):81–-105.
  • Shin M. S.. 1992;An empirical study of the mechanism of suicide: Validation of the scale for escape from the self Unpublished doctor's thesis, Yeonsei University, Seoul..
  • Sohn A. R., Moon J. S., Park J. E., Chun S. S., Ko S. D.. 2007;HIV/AIDS knowledge and discriminatory attitudes and identifying factors which impact the discriminatory attitudes towards persons with HIV/AIDS among adolescents in Korea. Korean Association of Health and Medical Sociology. 21:25–-49.
  • Suh K. H., Yang S. A.. 2012;Relationship between obsessive beliefs, experiential avoidance, AIDS-related knowledge/ attitude, and AIDS phobia among nurses. The Korean Journal of Health Psychology. 17(3):731–-746.
  • Sung M. H.. 2008;Knowledge, attitudes and perceived vulnerability to AIDS of medical and nursing students. Journal of Korean Academy of Fundamentals of Nursing. 15(2):221–-228.
  • Van Brakal W. H.. 2006;Measuring health-related stigma- A literature review. Psychology Health & Medicine. 11(3):307–-334.
  • Wang B., Li X., Barnett D., Zhao G., Zhao J., Stanton B.. 2012;Risk and protective factors for depression symptoms among children affected by HIV/AIDS in rural China: A structural equation modeling analysis. Social Science & Medicine. 74(9):1435–-1443. http://dx.doi.org/10.1016/j.socscimed.2012.01.007.
  • Yang J. H.. 2008;The lived experiences of illness among people living with HIV. Journal of Qualitative Research. 9(2):111–-119.
  • Yoon S. H., Kim S. S.. 2012;Influence of depression, hope, and social support on suicidal ideation in renal dialysis patients. Korean Journal of Adult Nursing. 24(3):209–-218. http://dx.doi.org/10.7475/kjan.2012.24.3.209.

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    Citations

    Citations to this article as recorded by  
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    The Effect of Social Stigma on Suicidal Ideation of Male HIV Infected People: Focusing on the Mediating Effect of Hope and Depression
    Korean J Adult Nurs. 2014;26(5):563-572.   Published online October 31, 2014
    DOI: https://doi.org/10.7475/kjan.2014.26.5.563
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    The Effect of Social Stigma on Suicidal Ideation of Male HIV Infected People: Focusing on the Mediating Effect of Hope and Depression
    Korean J Adult Nurs. 2014;26(5):563-572.   Published online October 31, 2014
    DOI: https://doi.org/10.7475/kjan.2014.26.5.563
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    The Effect of Social Stigma on Suicidal Ideation of Male HIV Infected People: Focusing on the Mediating Effect of Hope and Depression
    Image
    Figure 1. Path diagram for the research model.

    Figure 1.

    The Effect of Social Stigma on Suicidal Ideation of Male HIV Infected People: Focusing on the Mediating Effect of Hope and Depression

    Descriptive Statistics of the Observed Variables (N=180)

    Variables Range M±SD Skewness Kurtosis Tolerance VIF
    Social stigma 15~75 50.98±10.48 -.21 -.34 .85 1.18
    Hope 8~32 21.61±4.91 -.08 -.24    
      Agency thinking 4~16 11.62±2.79 -.20 -.44 .44 2.28
      Pathways thinking 4~16 9.99±2.50 .09 .03 .39 1.53
    Depression 0~60 18.55±13.87 .65 -.44    
      Depressed affect 0~27 8.25±7.07 .72 -.40 .16 6.16
      Interpersonal problems 0~15 4.11±3.77 .86 -.18 .16 6.08
      Positive affect 0~9 3.37±2.67 .34 -.86 .81 1.24
      Somatic complaints 0~9 2.82±2.46 .74 -.30 .34 2.92
    Suicidal ideation 0~180 38.68±4.05 1.06 .33    

    Correlations among Social Stigma, Hope, Depression, and Suicidal Ideation (N=180)

    Variables Social stigma Hope Y1 Y2 Depression Y3 Y4 Y5 Y6
    r (p) r (p) r (p) r (p) r (p) r (p) r (p) r (p) r (p)
    Hope -.22                
      (.003)                
    Y1 -.17 .94              
      (.026) (＜.001)              
    Y2 -.25 .92 .72            
      (＜.001) (＜.001) (＜.001)            
    Depression .34 -.56 -.47 -.57          
      (＜.001) (＜.001) (＜.001) (＜.001)          
    Y3 .36 -.51 -.41 -.54 .96        
      (＜.001) (＜.001) (＜.001) (＜.001) (＜.001)        
    Y4 .32 -.53 -.47 -.52 .94 .90      
      (＜.001) (＜.001) (＜.001) (＜.001) (＜.001) (＜.001)      
    Y5 .20 -.36 -.35 -.32 .54 .36 .39    
      (＜.001) (＜.001) (＜.001) (＜.001) (＜.001) (＜.001) (＜.001)    
    Y6 .21 -.47 -.39 -.50 .85 .78 .78 .33  
      (.004) (＜.001) (＜.001) (＜.001) (＜.001) (＜.001) (＜.001) (＜.001)  
    Suicidal ideation .29 -.37 -.33 -.35 .70 .71 .70 .26 .56
      (＜.001) (＜.001) (＜.001) (＜.001) (＜.001) (＜.001) (＜.001) (＜.001) (＜.001)

    Y1=Agency thinking; Y2=Pathways thinking; Y3=Depressed affect; Y4=Interpersonal problems; Y5=Positive affect; Y6=Somatic complaints.

    Goodness of Fit on Research Model (N=180)

    Model x2 df p x2/df TLI CFI RMSEA (90% CI) SRMR
    Research model 31.57 16 .011 1.97 .97 .98 .07 (.03~.11) .04

    TLI=Tucker-Lewis Index; CFI=Comparative Fit Index; RMSEA=root mean squared error of approximation; SRMR=standardized root mean-squared

    Path Coefficient and Direct ․ Indirect Effect of Modification Model (N=180)

    Dependent Independent Path coefficient Effect (standardized) SMC
    b p Direct (p) Indire ct (p) Total (p)
    Hope Social stigma -0.06 .001 -.28 (.002) -.28 (.002) .077
    Depression Social stigma 0.15 .001 .22 (.006) .15 (. .002) .37 (.002) .407
      Hope -1.71 ＜.001 -.54 (.005) -.54 (.005)  
    Suicidal Social stigma 0.20 .420 .05 (.391) .27 (. .002) .32 (.002) .563
    ideation Hope 1.94 .153 .10 (.111) -.42 (. .003) -.32 (.002)  
      Depression 4.70 ＜.001 .79 (.002) .79 (.002)  

    SMC=squared multiple correlations.
    Table 1. Descriptive Statistics of the Observed Variables (N=180)

    Table 2. Correlations among Social Stigma, Hope, Depression, and Suicidal Ideation (N=180)

    Y1=Agency thinking; Y2=Pathways thinking; Y3=Depressed affect; Y4=Interpersonal problems; Y5=Positive affect; Y6=Somatic complaints.

    Table 3. Goodness of Fit on Research Model (N=180)

    TLI=Tucker-Lewis Index; CFI=Comparative Fit Index; RMSEA=root mean squared error of approximation; SRMR=standardized root mean-squared

    Table 4. Path Coefficient and Direct ․ Indirect Effect of Modification Model (N=180)

    SMC=squared multiple correlations.

    Table 1.

    Table 2.

    Table 3.

    Table 4.

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