XIX International AIDS Conference


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THPE443 - Poster Exhibition

HIV stigma among people living with HIV in Massachusetts and southern New Hampshire, 2009

J. Holman1, K. Schneider1, K. Cranston2, H.D. Fukuda3, M. Goldrosen4

1John Snow Inc., Boston, United States, 2Massachusetts Department of Public Health, Bureau of Infectious Disease, Boston, United States, 3Massachusetts Department of Public Health, Office of HIV/AIDS, Boston, United States, 4Boston Public Health Commission, HIV/AIDS Services Division, Boston, United States

Background: Stigma has been reported to affect care-seeking behavior and quality of life for people living with HIV/AIDS (PLWHA) in the US. Stigma related questions were included in a survey to assess the service needs, health, and quality of life of PLWHA in Massachusetts and Southern New Hampshire.
Methods: Twelve validated stigma statements were included on a 2009 survey distributed through healthcare providers to randomly selected PLWHA who received publicly-funded HIV care. Agreement with the statements indicated experiences of HIV-related stigma. Correlation between stigma statements was evaluated to identify clusters of different types of stigma. Responses were analyzed to identify differences between respondent groups based on demographics or other characteristics, as well as self-reported health status indicators. Differences between groups were evaluated using Chi-square tests (significant at p< .05).
Results: The response rate was 70% (1,029/1,528); respondent demographics were similar to those of reported HIV cases.

Male65%Non-Hispanic White50%At or below poverty level47%
Female35%Non-Hispanic Black19%  
18 to 4954%Other6%AIDS diagnosis60%
50 and older46%Unknown3%  
Sexual OrientationCountry of BirthMedical Care Access
Heterosexual50%US78%Saw doctor in prior six months95%
Homosexual43%Puerto Rico/Other US territory14%Taking HIV medications91%
Bisexual7%Other non-US8%  
[Sample Characteristics (N=1,029)]

Stigma items clustered around four factors: (1) negative self-image, (2) disclosure concerns, (3) negative perceptions of how others see PLWHA, and (4) experiences of discrimination and rejection. Experiences of stigma were highest for Factor 2 (disclosure) and Factor 4 (discrimination/rejection) item.

Agreement with Stigma Scale Items by Factor
[Agreement with Stigma Scale Items by Factor]

Respondent Agreement with Stigma Scale Items
[Respondent Agreement with Stigma Scale Items]

Those reporting stigma were significantly more likely to be under age 50, have a recent mental health diagnosis, and have concurrent mental health and substance abuse problems compared to those not reporting stigma. Further, those reporting stigma were also more likely to report factors suggestive of poorly controlled HIV.

Significant Variations in Stigma Experiences
[Significant Variations in Stigma Experiences]

Conclusions: HIV-related stigma persists locally, especially related to disclosure and experiences of rejection/discrimination. PLWHA who were younger, or who had mental health diagnoses or concurrent mental health and substance issues, were significantly more likely to report stigma. Additional analyses will help better understand those at highest risk for HIV-related stigma so interventions can target these groups.

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