Enacted HIV-Related Stigma Is Related to Sleep Disturbance Among People Living With HIV Through the Mediating Effect of Anxiety: The Florida Cohort Study, 2014 -2018.

HIV-related enacted stigma refers to experiencing discrimination because of one's HIV status and may be related to sleep disturbance. Using the Florida prospective cohort study ( n = 569), this study examines the direct association between enacted stigma and sleep disturbance and the indirect association between enacted stigma and sleep disturbance via anxiety. Data on stigma and anxiety were collected using self-report surveys at baseline and sleep disturbance at 6 months. Mediation analysis was conducted using structural equation modeling. Most participants were male (58.9%) and non-Hispanic Black (57.2%). Our findings suggested that anxiety fully mediated the association between enacted stigma and sleep disturbance (indirect effect: β = 0.11, 95% confidence interval [CI]: 0.05 to 0.18, p < .001; direct effect: β = 0.06, 95% CI: -0.07 to 0.19, p = .361; total estimated effect: β = 0.18, 95% CI: 0.03 to 0.32, p < .016). Reducing HIV-enacted stigma may improve anxiety and sleep disturbance among people with HIV.