# HIV-related Stigma and HIV Clinical Outcomes: Linkage and Mechanisms

> **NIH NIH R01** · UNIVERSITY OF SOUTH CAROLINA AT COLUMBIA · 2021 · $199,977

## Abstract

ABSTRACT. Stigma and discrimination relating to HIV/AIDS (“HIV-related stigma”) interfere with seeking and
receiving appropriate treatment and care, contribute to depression, lower quality of life and other psychiatric
disorders, and produce worsening clinical outcomes among people living with HIV/AIDS (PLWH). Despite global
efforts to tackle HIV-related stigma for decades, HIV stigma remains a critical public health issue in US and
globally, particularly in low and middle income countries including China. There are substantial knowledge gaps in
our understanding of HIV-related stigma and underlying mechanisms through which the stigma negatively
affected clinical outcomes of PLWH. Research has suggested both biological mechanism (e.g., increasing stress-
related hypothalamic-pituitary-adrenal [HPA] activity) and behavioral mechanism (e.g., decreasing adherence to
treatment and care) through which stigma may negatively impact clinical outcomes (e.g., CD4 counts, viral load,
disease progression). However, these possible biological and behavioral mechanisms, while hypothesized, have not
been empirically tested in longitudinal studies. In this US-China collaborative research project, investigators from
University of South Carolina (USC) and Guangxi Provincial Center for Disease Control and Prevention (Guangxi
CDC) propose a longitudinal epidemiological assessment among a cohort of 1,200 PLWH in Guangxi China where
we have built a strong research infrastructure and community collaboration through NIH-funded research since
2004. The primary outcomes will be HIV clinical outcomes (CD4 count, viral load, disease progression) and the
intermediate outcomes will include chronic stress response and adherence to treatment and care. In addition to
self-reported data (e.g., depression and anxiety, adherence to treatment and care), biomarkers of stress (hair
cortisol) and ART adherence (hair antiretroviral concentration) will be employed. The proposed research is
designed to address one of the priority HIV/AIDS topic areas in RFA-AI-16-006 (i.e., “…studies focusing on
reducing health disparities in the incidences of new HIV infections or in treatment outcomes of people living with
HIV/AIDS”) and stimulate further collaborative research between US and Chinese investigators in the areas of
HIV-related stigma and health disparities in treatment outcomes of PLWH.

## Key facts

- **NIH application ID:** 10102647
- **Project number:** 5R01MH112376-05
- **Recipient organization:** UNIVERSITY OF SOUTH CAROLINA AT COLUMBIA
- **Principal Investigator:** Xiaoming Li
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $199,977
- **Award type:** 5
- **Project period:** 2017-03-07 → 2023-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10102647

## Citation

> US National Institutes of Health, RePORTER application 10102647, HIV-related Stigma and HIV Clinical Outcomes: Linkage and Mechanisms (5R01MH112376-05). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10102647. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*