Persistent HIV-related stigma among an outpatient US clinic population.
Despite advancements in the public's understanding of HIV infection, felt stigma towards individuals living with HIV persists. Stigma has been associated with adverse health outcomes, including poor adherence to care, and increased participation in HIV transmission risk behaviours. We evaluated the level of felt stigma and its relationship to other psychosocial and medical factors among a sample of 201 individuals with HIV engaged in care. The overall mean stigma score, as measured by the Reece Stigma Scale, was 21.7 (SD 8.7). In univariate analysis, felt stigma scores were higher among women, African Americans, younger participants, and individuals with less education. Higher felt 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, generalised anxiety disorder, agoraphobia, pain disorder, and current smokers. Higher felt stigma scores were independently associated with individuals with anxiety symptoms. 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 address these common comorbidities and reduce stigma.
College for Public Health and Social Justice, Saint Louis University, St. Louis, MO, USA eshacham@slu.edu.
Enbal
E
Shacham
School of Nursing, Nevada State College, Henderson, NV, USA.
Neal
N
Rosenburg
Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA.
Nur F
NF
Önen
University of Illinois, School of Medicine, Chicago, IL, USA.
Michael F
MF
Donovan
Division of Infectious Diseases, Department of Medicine, University of Alabama, Birmingham, AL, USA.
E Turner
ET
Overton
D000328:Adult; D000554:Ambulatory Care Facilities; D001008:Anxiety Disorders / Q000453:epidemiology / Q000523:psychology; D018791:CD4 Lymphocyte Count; D003865:Major Depressive Disorder / Q000453:epidemiology / Q000523:psychology; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology*; D006801:Humans; D007407:Interviews as Topic; D008875:Middle Aged; D010045:Outpatients / Q000523:psychology* / Q000706:statistics & numerical data; D015995:Prevalence; D017678:Sex Distribution; D057545:Social Stigma; D012959:Socioeconomic Factors; D013001:Somatoform Disorders / Q000453:epidemiology / Q000523:psychology; D013315:Stress, Psychological; D011795:Surveys and Questionnaires; D019562:Viral Load; D014861:Washington
HIV management; HIV/AIDS; Stigma; mental illness; psychiatric disorders; psychological distress