Skip to main content

Advertisement

SpringerLink
Log in

Alcohol Use, HIV Stigma and Quality of Life Among Alcohol Consuming Men Living with HIV in India: A Mediation Analysis

  • Original Paper
  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Abstract

This study examined the hypothesis that HIV-related stigma mediates the effect of alcohol use on health-related quality of life (HRQoL) among alcohol consuming Indian men living with HIV (PLWH). The study used baseline data from a randomized controlled clinical trial entitled ‘Alcohol and ART adherence: Assessment, Intervention, and Modeling in India. Participants completed surveys assessing demographic characteristics, alcohol use, HIV-related stigma, HRQoL. Mediation analysis was conducted to establish the mediation effect of HIV-related stigma on the relationship between alcohol use and HRQoL. The final mediation model showed that the effect of alcohol use on HRQoL were partially mediated by overall HIV-related stigma. Specially, 27.1% of the effects of alcohol use on HRQoL was mediated through overall HIV stigma. In the HIV stigma subdomain analyses, negative self-image mediated 14% and concerns with public attitudes (anticipated stigma) mediated 17.3% of the effect of alcohol use on HRQoL respectively. The findings suggest that efforts to reduce the negative impact of alcohol use on HRQoL and improve HRQoL among PLWH should include interventions addressing both alcohol use and specific forms of HIV-related stigma.

Resumen

Este estudio examinó la hipótesis de que el estigma relacionado con el VIH mediaría el efecto del consumo de alcohol en la calidad de vida relacionada con la salud entre hombres indios que consumen alcohol y viven con VIH. El estudio utilizó datos de línea base de un ensayo clínico aleatorizado controlado titulado "Consumo de alcohol y adherencia al TAR: evaluación, intervención y modelización en India". Los participantes completaron encuestas que evaluaron características demográficas, consumo de alcohol, estigma relacionado con el VIH y calidad de vida relacionada con la salud (CVRS). Se realizó un análisis de mediación para establecer el efecto de la mediación del estigma relacionado con el VIH en la relación entre el consumo de alcohol y la CVRS. El modelo final de mediación mostró que el efecto del consumo de alcohol en la CVRS fue parcialmente mediado por el estigma general relacionado con el VIH. Específicamente, el 27,1% de los efectos del consumo de alcohol en la CVRS se medió a través del estigma general relacionado con el VIH. En los análisis de subdominios del estigma del VIH, la imagen negativa de sí mismo medió el 14% y las preocupaciones sobre las actitudes públicas (estigma anticipado) mediaron el 17,3% del efecto del consumo de alcohol en la CVRS, respectivamente. Los resultados sugieren que los esfuerzos para reducir el impacto negativo del consumo de alcohol en la CVRS y mejorar la CVRS entre las personas que viven con VIH deberían incluir intervenciones que aborden tanto el consumo de alcohol como formas específicas de estigma relacionado con el VIH.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Data Availability

The data presented in this study are available on request from the corresponding author.

Code Availability

The statistical code used in this study are available on request from the corresponding author.

References

  1. UNAIDS. Global HIV & AIDS statistics — Fact sheet 2022. https://www.unaids.org/en/resources/fact-sheet.

  2. Statista. Number of people living with HIV in India from 2003 to 2020 2022. https://www.statista.com/statistics/1291688/india-number-of-people-living-with-hiv/.

  3. Duko B, Ayalew M, Ayano G. The prevalence of alcohol use disorders among people living with HIV/AIDS: a systematic review and meta-analysis. Subst Abuse Treat Prev Policy. 2019;14(1):52.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Balasubramani K, Paulson W, Chellappan S, Ramachandran R, Behera SK, Balabaskaran NP. Epidemiology, hot spots, and sociodemographic risk factors of alcohol consumption in indian men and women: analysis of National Family Health Survey-4 (2015–16), a nationally representative cross-sectional study. Front Public Health. 2021;9: 617311.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Schensul SL, Ha T, Schensul JJ, Vaz M, Singh R, Burleson JA, et al. The role of alcohol on antiretroviral therapy adherence among persons living with HIV in urban India. J Stud Alcohol Drugs. 2017;78(5):716–24.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Samet JH, Phillips SJ, Horton NJ, Traphagen ET, Freedberg KA. Detecting alcohol problems in HIV-infected patients: use of the CAGE questionnaire. AIDS Res Hum Retroviruses. 2004;20(2):151–5.

    Article  PubMed  Google Scholar 

  7. Probst C, Parry CDH, Wittchen H-U, Rehm J. The socioeconomic profile of alcohol-attributable mortality in South Africa: a modelling study. BMC Med. 2018;16(1):97.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Probst C, Parry CDH, Rehm J. HIV/AIDS mortality attributable to alcohol use in South Africa: a comparative risk assessment by socioeconomic status. BMJ Open. 2018;8(2): e017955.

    Article  PubMed  PubMed Central  Google Scholar 

  9. World Health Organization. Constitution of the World Health Organization. Geneva: WHO Basic Documents; 1948.

    Google Scholar 

  10. Group WH. WHOQOL-HIV for quality of life assessment among people living with HIV and AIDS: results from the field test. AIDS Care. 2004;16(7):882–9.

    Article  Google Scholar 

  11. Miners A, Phillips A, Kreif N, Rodger A, Speakman A, Fisher M, et al. Health-related quality-of-life of people with HIV in the era of combination antiretroviral treatment: a cross-sectional comparison with the general population. Lancet HIV. 2014;1(1):e32–40.

    Article  PubMed  Google Scholar 

  12. Kaplan RM, Hays RD. Health-related quality of life measurement in public health. Annu Rev Public Health. 2022;43:355–73.

    Article  PubMed  Google Scholar 

  13. Xu J-F, Ming Z-Q, Zhang Y-Q, Wang P-C, Jing J, Cheng F. Family support, discrimination, and quality of life among ART-treated HIV-infected patients: a two-year study in China. Infect Dis Poverty. 2017;6(1):152.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Safreed-Harmon K, Anderson J, Azzopardi-Muscat N, Behrens GMN, d’Arminio Monforte A, Davidovich U, et al. Reorienting health systems to care for people with HIV beyond viral suppression. Lancet HIV. 2019;6(12):e869–77.

    Article  PubMed  Google Scholar 

  15. Rosenbloom MJ, Sullivan EV, Sassoon SA, O’reilly A, Fama R, Kemper CA, et al. Alcoholism, HIV infection, and their comorbidity: factors affecting self-rated health-related quality of life. J Stud Alcohol Drugs. 2007;68(1):115–25.

    Article  PubMed  Google Scholar 

  16. Orwat J, Saitz R, Tompkins CP, Cheng DM, Dentato MP, Samet JH. Substance abuse treatment utilization among adults living with HIV/AIDS and alcohol or drug problems. J Subst Abuse Treat. 2011;41(3):233–42.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Tran BX, Nguyen LT, Do CD, Nguyen QL, Maher RM. Associations between alcohol use disorders and adherence to antiretroviral treatment and quality of life amongst people living with HIV/AIDS. BMC Public Health. 2014;14:27.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Pokhrel KN, GauleePokhrel K, Neupane SR, Sharma VD. Harmful alcohol drinking among HIV-positive people in Nepal: an overlooked threat to anti-retroviral therapy adherence and health-related quality of life. Glob Health Action. 2018;11(1):1441783.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Sullivan LE, Saitz R, Cheng DM, Libman H, Nunes D, Samet JH. The impact of alcohol use on depressive symptoms in human immunodeficiency virus-infected patients. Addiction. 2008;103(9):1461–7.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Jia H, Uphold CR, Wu S, Chen GJ, Duncan PW. Predictors of changes in health-related quality of life among men with HIV infection in the HAART era. AIDS Patient Care STDS. 2005;19(6):395–405.

    Article  PubMed  Google Scholar 

  21. Goffman E. Stigma and social identity. Understanding Deviance. London: Routledge; 2014. p. 256–65.

    Google Scholar 

  22. Loutfy MR, Logie CH, Zhang Y, Blitz SL, Margolese SL, Tharao WE, et al. Gender and ethnicity differences in HIV-related stigma experienced by people living with HIV in Ontario, Canada. PLoS ONE. 2012;7(12): e48168.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Chambers LA, Rueda S, Baker DN, Wilson MG, Deutsch R, Raeifar E, et al. Stigma, HIV and health: a qualitative synthesis. BMC Public Health. 2015;15:848.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Katz IT, Ryu AE, Onuegbu AG, Psaros C, Weiser SD, Bangsberg DR, et al. Impact of HIV-related stigma on treatment adherence: systematic review and meta-synthesis. J Int AIDS Soc. 2013;16(3 Suppl 2):18640.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Felker-Kantor EA, Wallace ME, Madkour AS, Duncan DT, Andrinopoulos K, Theall K. HIV stigma, mental health, and alcohol use disorders among people living with HIV/AIDS in New Orleans. J Urban Health. 2019;96(6):878–88.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Crockett KB, Kalichman SC, Kalichman MO, Cruess DG, Katner HP. Experiences of HIV-related discrimination and consequences for internalised stigma, depression and alcohol use. Psychol Health. 2019;34(7):796–810.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Guy AA, Zelaya DG, Surace A, Mastroleo NR, Pantalone DW, Monti PM, et al. Discrimination and alcohol problems among heavy drinking HIV-positive men who have sex with men: the buffering effect of a brief Motivational Intervention to reduce alcohol use. Drug Alcohol Depend. 2022;233: 109384.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Hojilla JC, Santiago-Rodriguez EI, Sterling S, Williams EC, Leyden W, Hare CB, et al. HIV stigma and its associations with longitudinal health outcomes among persons living with HIV with a history of unhealthy alcohol use. AIDS Behav. 2021;25(1):215–24.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Lunze K, Lioznov D, Cheng DM, Nikitin RV, Coleman SM, Bridden C, et al. HIV stigma and unhealthy alcohol use among people living with HIV in Russia. AIDS Behav. 2017;21(9):2609–17.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Reinius M, Wiklander M, Wettergren L, Svedhem V, Eriksson LE. The relationship between stigma and health-related quality of life in people living with HIV who have full access to antiretroviral treatment: an assessment of Earnshaw and Chaudoir’s HIV stigma framework using empirical data. AIDS Behav. 2018;22(12):3795–806.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Parcesepe AM, Nash D, Tymejczyk O, Reidy W, Kulkarni SG, Elul B. Gender, HIV-related stigma, and health-related quality of life among adults enrolling in HIV care in Tanzania. AIDS Behav. 2020;24(1):142–50.

    Article  PubMed  Google Scholar 

  32. Liu H, Xu Y, Lin X, Shi J, Chen S. Associations between perceived HIV stigma and quality of life at the dyadic level: the actor-partner interdependence model. PLoS ONE. 2013;8(2): e55680.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Ekstrand ML, Heylen E, Mazur A, Steward WT, Carpenter C, Yadav K, et al. The role of HIV stigma in ART adherence and quality of life among rural women living with HIV in India. AIDS Behav. 2018;22(12):3859–68.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Kalan ME, Han J, Taleb ZB, Fennie KP, Jafarabadi MA, Dastoorpoor M, et al. Quality of life and stigma among people living with HIV/AIDS in Iran. HIV/Aids (Auckland, NZ). 2019;11:287.

    Google Scholar 

  35. Rayanakorn A, Ong-Artborirak P, Ademi Z, Chariyalertsak S. Predictors of stigma and health-related quality of life among people living with HIV in northern Thailand. AIDS Patient Care STDS. 2022;36(5):186–93.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Wingood GM, Reddy P, Peterson SH, DiClemente RJ, Nogoduka C, Braxton N, et al. HIV stigma and mental health status among women living with HIV in the Western Cape, South Africa: research letters. S Afr J Sci. 2008;104(5):237–40.

    Google Scholar 

  37. Kamen C, Arganbright J, Kienitz E, Weller M, Khaylis A, Shenkman T, et al. HIV-related stigma: implications for symptoms of anxiety and depression among Malawian women. Afr J AIDS Res. 2015;14(1):67–73.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Armoon B, Fleury MJ, Bayat AH, Fakhri Y, Higgs P, Moghaddam LF, et al. HIV related stigma associated with social support, alcohol use disorders, depression, anxiety, and suicidal ideation among people living with HIV: a systematic review and meta-analysis. Int J Ment Health Syst. 2022;16(1):17.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Chan RCH, Mak WWS. Cognitive, regulatory, and interpersonal mechanisms of HIV stigma on the mental and social health of men who have sex with men living with HIV. Am J Mens Health. 2019;13(5):1557988319873778.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Ekstrand ML, Bharat S, Srinivasan K. HIV stigma is a barrier to achieving 90–90-90 in India. Lancet HIV. 2018;5(10):e543–5.

    Article  PubMed  PubMed Central  Google Scholar 

  41. UNAIDS. 90–90–90. An ambitious target to help end the AIDS epidemic. 2014. https://www.unaids.org/en/resources/909090.

  42. Singh RJ, Sarna A, Schensul JJ, Mahapatra B, Ha T, Schensul SL. A multilevel intervention to reduce stigma among alcohol consuming men living with HIV receiving antiretroviral therapy: findings from a randomized control trial in India. AIDS. 2020;34(Suppl 1):S83–92.

    Article  PubMed  Google Scholar 

  43. Schensul SL, Ha T, Schensul JJ, Grady J, Burleson JA, Gaikwad S, et al. Multilevel and multifactorial interventions to reduce alcohol consumption and improve ART adherence and related factors among HIV positive men in Mumbai. India AIDS Behav. 2021;25(Suppl 3):290–301.

    Article  PubMed  Google Scholar 

  44. Schensul JJ, Ha T, Schensul S, Sarna A, Bryant K. Identifying the intersection of alcohol, adherence and sex in HIV positive men on ART treatment in india using an adapted timeline followback procedure. AIDS Behav. 2017;21(Suppl 2):228–42.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Ha T, Schensul SL, Irving M, Brault MA, Schensul JJ, Prabhughate P, et al. Depression among alcohol consuming, HIV positive men on ART treatment in India. AIDS Behav. 2019;23(6):1623–33.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Lee H, Cashin AG, Lamb SE, Hopewell S, Vansteelandt S, VanderWeele TJ, et al. A guideline for reporting mediation analyses of randomized trials and observational studies: the AGReMA statement. JAMA. 2021;326(11):1045–56.

    Article  PubMed  PubMed Central  Google Scholar 

  47. EQ-5D. EQ-5D-3L User Guide December 2018. https://euroqol.org/publications/user-guides/.

  48. Dolan P. Modeling valuations for EuroQol health states. Medical Care. 1997;35:1095–108.

    Article  CAS  PubMed  Google Scholar 

  49. Jain S, Chauhan A, Rajshekar K, Vashist P, Gupta P, Mathur U, et al. Generic and vision related quality of life associated with different types of cataract surgeries and different types of intraocular lens implantation. PLoS ONE. 2020;15(10): e0240036.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  50. Jyani G, Chauhan AS, Rai B, Ghoshal S, Srinivasan R, Prinja S. Health-related quality of life among cervical cancer patients in India. Int J Gynecol Cancer. 2020;30(12):1887–92.

    Article  PubMed  Google Scholar 

  51. Thankappan K, Patel T, Ajithkumar KK, Balasubramanian D, Raj M, Subramanian S, et al. Mapping of head and neck cancer patient concerns inventory scores on to Euroqol-Five Dimensions-Five Levels (EQ-5D-5L) health utility scores. Eur J Health Econ. 2022;23(2):225–35.

    Article  PubMed  Google Scholar 

  52. Saunders JB, Aasland OG, Babor TF, de la Fuente JR, Grant M. Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption—II. Addiction. 1993;88(6):791–804.

    Article  CAS  PubMed  Google Scholar 

  53. Pal HR, Jena R, Yadav D. Validation of the Alcohol Use Disorders Identification Test (AUDIT) in urban community outreach and de-addiction center samples in north India. J Stud Alcohol. 2004;65(6):794–800.

    Article  PubMed  Google Scholar 

  54. World Health Organization. AUDIT: the alcohol use disorders identification test: guidelines for use in primary health care. Geneva: World Health Organization; 2001.

  55. Berger BE, Ferrans CE, Lashley FR. Measuring stigma in people with HIV: psychometric assessment of the HIV stigma scale. Res Nurs Health. 2001;24(6):518–29.

    Article  CAS  PubMed  Google Scholar 

  56. Kaai S, Bullock S, Sarna A, Chersich M, Luchters S, Geibel S, et al. Perceived stigma among patients receiving antiretroviral treatment: a prospective randomised trial comparing an m-DOT strategy with standard-of-care in Kenya. SAHARA J. 2010;7(2):62–70.

    Article  PubMed  Google Scholar 

  57. Chesney MA, Ickovics JR, Chambers DB, Gifford AL, Neidig J, Zwickl B, et al. Self-reported adherence to antiretroviral medications among participants in HIV clinical trials: the AACTG adherence instruments. Patient Care Committee & Adherence Working Group of the Outcomes Committee of the Adult AIDS Clinical Trials Group (AACTG). AIDS Care. 2000;12(3):255–66.

    Article  CAS  PubMed  Google Scholar 

  58. Radloff LS. The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas. 1977;1(3):385–401.

    Article  Google Scholar 

  59. Björgvinsson T, Kertz SJ, Bigda-Peyton JS, McCoy KL, Aderka IM. Psychometric properties of the CES-D-10 in a psychiatric sample. Assessment. 2013;20(4):429–36.

    Article  PubMed  Google Scholar 

  60. Chokkanathan S, Mohanty J. Factor structure of the CES-D scale among older adults in Chennai, India. Aging Ment Health. 2013;17(4):517–25.

    Article  PubMed  Google Scholar 

  61. Sherbourne CD, Stewart AL. The MOS social support survey. Soc Sci Med. 1991;32(6):705–14.

    Article  CAS  PubMed  Google Scholar 

  62. Justice A, Holmes W, Gifford A, Rabeneck L, Zackin R, Sinclair G, et al. Development and validation of a self-completed HIV symptom index. J Clin Epidemiol. 2001;54(12):S77–90.

    Article  PubMed  Google Scholar 

  63. Ramos-Goni JM, Rivero-Arias O. eq5d: A command to calculate index values for the EQ-5D quality-of-life instrument. Stand Genomic Sci. 2011;11(1):120–5.

    Google Scholar 

  64. VanderWeele TJ. Mediation analysis: a practitioner’s guide. Annu Rev Public Health. 2016;37:17–32.

    Article  PubMed  Google Scholar 

  65. VanderWeele TJ. A unification of mediation and interaction: a four-way decomposition. Epidemiology. 2014;25(5):749.

    Article  PubMed  PubMed Central  Google Scholar 

  66. VanderWeele T. Explanation in causal inference: methods for mediation and interaction. Oxford: Oxford University Press; 2015.

    Google Scholar 

  67. VanderWeele T. A unification of mediation and interaction: a 4-way decomposition (Vol 25, pg 749, 2014). Epidemiology. 2016;27(5):E36–8.

    Google Scholar 

  68. Baum MK, Rafie C, Lai S, Sales S, Page JB, Campa A. Alcohol use accelerates HIV disease progression. AIDS Res Hum Retroviruses. 2010;26(5):511–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  69. Hutton A, Prichard I, Whitehead D, Thomas S, Rubin M, Sloand E, et al. mHealth interventions to reduce alcohol use in young people: a systematic review of the literature. Compr Child Adolesc Nurs. 2020;43(3):171–202.

    Article  PubMed  Google Scholar 

  70. Guo Y, Li Y, Yu C, Xu H, Hong YA, Wang X, et al. Long-term effects of a social media-based intervention (Run4Love) on depressive symptoms of people living with HIV: 3-year follow-up of a randomized controlled trial. J Med Internet Res. 2022;24(6): e36809.

    Article  PubMed  PubMed Central  Google Scholar 

  71. Fuster-Ruizdeapodaca MJ, Molero F, Holgado FP, Mayordomo S. Enacted and internalized stigma and quality of life among people with HIV: the role of group identity. Qual Life Res. 2014;23(7):1967–75.

    Article  PubMed  Google Scholar 

  72. Nobre N, Pereira M, Roine RP, Sutinen J, Sintonen H. HIV-related self-stigma and health-related quality of life of people living with HIV in Finland. J Assoc Nurses AIDS Care. 2018;29(2):254–65.

    Article  PubMed  Google Scholar 

  73. van der Kooij YL, Kupková A, den Daas C, van den Berk GEL, Kleene MJT, Jansen HSE, et al. Role of self-stigma in pathways from HIV-related stigma to quality of life among people living with HIV. AIDS Patient Care STDS. 2021;35(6):231–8.

    Article  PubMed  PubMed Central  Google Scholar 

  74. Charles B, Jeyaseelan L, Pandian AK, Sam AE, Thenmozhi M, Jayaseelan V. Association between stigma, depression and quality of life of people living with HIV/AIDS in South India—a community based cross sectional study. BMC Public Health. 2012;12:463.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

The authors acknowledge the valuable contributions of the project partners in India, investigators, and participants.

Funding

NIH/NIAAA Grant: U01-AA021990R. Data in this manuscript were collected by the project entitled ‘Alcohol and ART adherence: Assessment, Intervention, and Modeling in India’. PD/principal investigator: Stephen L. Schensul, University of Connecticut Health, Farmington, Connecticut, USA. The contents of this publication are solely the responsibility of the authors and do not represent the official views of the National Institutes of Health (NIH)/ National Institute on Alcohol Abuse and Alcoholism (NIAAA).

Author information

Author notes

  1. Toan Ha and Hui Shi have contributed equally to this study.

Authors and Affiliations

  1. Department of Infectious Diseases and Virology, School of Public Health, University of Pittsburgh, 130 De Soto Street, Pittsburgh, PA, 15261, USA

    Toan Ha & Hui Shi

  2. Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA

    Hui Shi

  3. Population Council, New Delhi, India

    Roopal J. Singh

  4. Medical College & B.Y.L. Nair Ch. Hospital, Mumbai, India

    Sushma S. Gaikwad

  5. Seth G S Medical College, Mumbai, India

    Kavita Joshi

  6. Lokmanya Tilak Municipal Medical College, Mumbai, India

    Rupal Padiyar

  7. Institute for Community Research, Hartford, CT, USA

    Jean J. Schensul

  8. Department of Public Health Sciences, University of Connecticut School of Medicine, Farmington, CT, USA

    Toan Ha & Stephen L. Schensul

Authors
  1. Toan Ha
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hui Shi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Roopal J. Singh
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sushma S. Gaikwad
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kavita Joshi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Rupal Padiyar
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Jean J. Schensul
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Stephen L. Schensul
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

TH and HS: conceptualized the article. HS: conducted the data analysis and wrote the article. TH.: guided the data analysis and reviewed the manuscript. TH, SS, JS RJS, SS, JS, SG, KJ, RP: reviewed and edited the manuscript. All authors have read and agreed to the published version of the manuscript.

Corresponding author

Correspondence to Toan Ha.

Ethics declarations

Conflict of interest

All authors declare no conflict of interest.

Ethical Approval

The study was approved by the Institutional Review Board of the University of Connecticut Health Center, the India Council for Medical Research, the Health Ministry Screening Committee, the National AIDS Control Organization and Institutional Review Boards of all collaborating agencies and hospitals.

Consent to Participate

Consent was obtained from all participants involved in the study.

Consent for Publication

Not applicable.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ha, T., Shi, H., Singh, R.J. et al. Alcohol Use, HIV Stigma and Quality of Life Among Alcohol Consuming Men Living with HIV in India: A Mediation Analysis. AIDS Behav 27, 3272–3284 (2023). https://doi.org/10.1007/s10461-023-04047-7

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-023-04047-7

Keywords

Search

Navigation