Concordance of mental health ratings between people living with HIV/AIDS and their primary informal caregivers

Objective: Low-income African-American, inner-city residents provide disproportionately high levels of informal (unpaid) HIV care (instrumental and emotional support) to family and friends living with HIV/AIDS. We examined evidence of the role of caregivers in care recipients' mental health and associations with their perceived associative stigma related to HIV caregiving. Methods: This study used a structural equation model to examine main effects of caregiver reports of recipients' mental health status and caregivers' self-reported associative stigma on care recipients' self-reported psychological distress (CES-D). Results: Results indicated that recipients' self-reported psychological distress was positively associated with caregiver reports of recipients' poor mental health (Beta=.24, p<.001) and with caregivers' associative stigma (Beta=.18, p<.05). In addition, stigma moderated the relationship between caregiver reports of recipients' mental health and recipient reports of their mental health (Beta=.43, p<.05), such that caregivers with higher perceived stigma and worse reports of recipients' mental health predicted recipient self reported poorer mental health. Conclusions: High agreement between caregivers' reports of recipients' mental health status and recipients' self reports of psychological distress suggest that caregivers were overall perceptive in assessing the mental health of their care recipients, and that caregivers who perceived high levels of associative stigma appeared to be most accurate in rating recipient's mental health status. These results suggest that, overall, the caregivers were aware of the mental health status of their care recipients and may provide a target population on which to focus interventions to monitor the mental health of PLHAs.