Stigma, resilience and psychological well-being among men living with HIV in Kampala

Abstract

HIV remains a chronic manageable condition, yet psychological morbidity among men living with HIV (MLWH) persists as a critical public health challenge. Societal and internalized expectations of masculinity often compound HIV-related stigma, deterring care engagement and eroding mental health in urban settings like Kampala. Research Gap: While direct links between HIV stigma and psychological distress are established, limited quantitative evidence explains the psychological mechanisms (such as resilience pathways) specifically among adult urban men receiving routine antiretroviral care in high-volume Ugandan facilities. Objectives: This study aimed at establishing the relationship between HIV-related stigma, resilience, and psychological well-being among men living with HIV at TASO Mulago, Kampala. Using a quantitative cross-sectional correlational design. Methods and analysis: A quantitative cross-sectional correlational design was used. Data were collected from (N = 220) male participants via self-administered standardized questionnaires assessing HIV stigma, ego-resilience, and psychological well-being. Analyses included descriptive statistics, Pearson’s bivariate correlations, and PROCESS macro (Model 4) mediation analysis with 5,000 bootstrap samples. Results: Findings revealed that stigma was significantly and negatively associated with psychological well-being, while resilience positively associated with psychological well-being. Resilience partially mediated the relationship between stigma and psychological well-being, highlighting its role as a protective factor and the need for resilience-focused interventions for men living with HIV in Kampala. Conclusions: HIV-related stigma directly impairs psychological health in urban MLWH, but individual resilience acts as a vital partial protective shield. Interventions must move beyond clinical viral suppression to address psychosocial resilience capacities. Recommendations: Ministry of Health and facility management at TASO Mulago should integrate routine mental health screenings, Cognitive Behavioural Therapy (CBT) and male-targeted peer resilience support groups into standard ART care. Policy frameworks should allocate dedicated funding for community-level psychological interventions and stigma-reduction campaigns tailored to men.