Persisting HIV-Related Stigma among an Outpatient US Clinic Population

Despite advancements in the public’s understanding of HIV infection, stigma towards individuals living with HIV persists. Stigma has been associated with adverse health outcomes, including diminished engagement in care, poor medication adherence, and increased participation in HIV transmission risk behaviors. We evaluated the level of perceived stigma and its relationship to other psychosocial and medical factors among a sample of 201 individuals with HIV engaged in care. The Reece Stigma Scale was utilized to determine the level of felt stigma experienced by participants, with stigma scores ranging from 0 (no perceived stigma) to 45 (high perceived stigma). 

The overall mean stigma score was 21.7 (SD 8.7, range 9–45). In univariate analysis, stigma scores were higher among women, African Americans, younger participants, and individuals with less education. Higher stigma scores were also found among individuals who reported having fair to poor overall health, moderate to severe symptoms of depression and anxiety, and those with a current diagnosis of alcohol dependence, GAD, agoraphobia, pain disorder, and current smokers (p < 0.05 for all). 

After controlling for significant factors in univariate analyses, higher stigma scores were independently associated with individuals with anxiety symptoms (p< 0.001) and heterosexual individuals (p < 0.05). 

These analyses highlight that stigma persists among individuals with HIV and may play an important role in HIV care. The relationship between psychiatric disorders and psychosocial factors highlights an opportunity to develop interventions that will reduce both stigma and these common comorbidities.

Full article at: http://goo.gl/a6lQnv

By: Enbal Shacham, PhD,1 Neal Rosenburg, PhD, RN, Nur F Önen, MD, Michael F Donovan, and E. Turner Overton, MD

1College for Public Health and Social Justice, Saint Louis University, St. Louis, MO

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