title: The impact of HIV treatment-related stigma on uptake of antiretroviral therapy.
abstract: HIV-related stigma has been linked to avoidance of health care services and suboptimal adherence to antiretroviral therapy (ART). However, less is known about concerns of stigma related specifically to the taking of ART in uptake of treatment. This study examines experiences of HIV treatment-related stigma and assesses if these experiences are associated with ART uptake, independent of general HIV-related stigma. People living with HIV (PLHIV; n = 697) were targeted to complete an online questionnaire measuring perceived HIV- and treatment-related stigma, social support, self-esteem, resilience, psychological distress, health satisfaction and quality of life. Findings suggest that experiences of general and treatment-related stigma were common, and that participants appear to experience greater stigma related to taking HIV treatment than general stigma associated with HIV. Neither general nor treatment-related stigma uniquely impacted HIV treatment uptake. Instead, treatment uptake was associated with being older (adjusted OR 1.05; 95% CIs: 1.03, 1.08), greater duration of HIV infection (adjusted OR 1.07; 95% CIs: 1.03-1.11) and having greater health satisfaction (adjusted OR 1.28; 95% CIs: 1.03, 1.59). Findings highlight that concerns around taking HIV treatment can be an added source of stigma for PLHIV, however other factors may be greater contributors to the likelihood of taking HIV treatment.
authors.affiliation: a Centre for Social Research in Health , University of New South Wales , Sydney , NSW , Australia.
authors.forename: Elena
authors.initials: E
authors.lastname: Cama
authors.forename: Loren
authors.initials: L
authors.lastname: Brener
authors.forename: Sean
authors.initials: S
authors.lastname: Slavin
authors.forename: John
authors.initials: J
authors.lastname: de Wit
mesh_terms: D000328:Adult; D001315:Australia / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D011788:Quality of Life; D055500:Resilience, Psychological; D012649:Self Concept; D064890:Social Determinants of Health; D057545:Social Stigma; D012944:Social Support; D011795:Surveys and Questionnaires; D016903:Drug Monitoring
keywords: HIV; antiretroviral therapy; stigma; treatment uptake