title: Stigma, discrimination and HIV outcomes among people living with HIV in Rio de Janeiro, Brazil: The intersection of multiple social inequalities.
abstract: Limited research has examined the social context surrounding stigma and discrimination and HIV outcomes among people living with HIV (PLHIV). We surveyed 900 PLHIV in Brazil and examined the relationship between stigma, discrimination and HIV outcomes utilising multivariable logistic regression. HIV stigma and discrimination were inversely associated with age (AOR Stigma 0.65, 95% CI 0.49-0.88; AOR Discrimination 0.72, 95% CI 0.54-0.95) and income (AOR Stigma 0.74, 95% CI 0.55-0.99; AOR Discrimination 0.62, 95% CI 0.46-0.82). Stigma was inversely associated with education (AOR 0.71, 95% CI 0.52-0.96) and no history of sex work (AOR 0.56, 95% CI 0.35-0.90), and positively associated with having children (AOR 1.71, 95% CI 1.18-2.48). Discrimination was inversely associated with no history of drug use (AOR 0.63, 95% CI 0.42-0.95). Stigma and discrimination were found to be inversely associated with overall health (AOR Stigma 0.54, 95% CI 0.40-0.74; AOR Discrimination 0.71, 95% CI 0.52-0.97). Discrimination was associated with having a sexually transmitted infection since HIV diagnosis (AOR 1.63, 95% CI 1.14-2.32). Findings suggest that future interventions should address multiple social inequalities faced by PLHIV to reduce HIV stigma and discrimination and improve health and HIV outcomes.
authors.affiliation: a Department of Health, Behavior and Society , Johns Hopkins Bloomberg School of Public Health , Baltimore , USA.
authors.forename: Deanna
authors.initials: D
authors.lastname: Kerrigan
authors.affiliation: a Department of Health, Behavior and Society , Johns Hopkins Bloomberg School of Public Health , Baltimore , USA.
authors.forename: Andrea
authors.initials: A
authors.lastname: Vazzano
authors.affiliation: b Institute for Scientific and Technological Information and Communication in Health (LIS/ICICT) , Oswaldo Cruz Foundation (FIOCRUZ) , Rio de Janeiro , Brazil.|c Sergio Arouca School of Public Health (DCS/ENSP) , Oswaldo Cruz Foundation (FIOCRUZ) , Rio de Janeiro , Brazil.
authors.forename: Neilane
authors.initials: N
authors.lastname: Bertoni
authors.affiliation: c Sergio Arouca School of Public Health (DCS/ENSP) , Oswaldo Cruz Foundation (FIOCRUZ) , Rio de Janeiro , Brazil.
authors.forename: Monica
authors.initials: M
authors.lastname: Malta
authors.affiliation: b Institute for Scientific and Technological Information and Communication in Health (LIS/ICICT) , Oswaldo Cruz Foundation (FIOCRUZ) , Rio de Janeiro , Brazil.
authors.forename: Francisco Inacio
authors.initials: FI
authors.lastname: Bastos
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000554:Ambulatory Care Facilities; D000704:Analysis of Variance; D023241:Antiretroviral Therapy, Highly Active / Q000706:statistics & numerical data / Q000639:trends*; D001938:Brazil / Q000453:epidemiology; D015897:Comorbidity; D017280:Condoms / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000191:economics / Q000453:epidemiology / Q000523:psychology*; D018451:Homosexuality, Male / Q000523:psychology / Q000706:statistics & numerical data; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012649:Self Concept; D060386:Sex Workers / Q000523:psychology / Q000706:statistics & numerical data; D012749:Sexually Transmitted Diseases / Q000175:diagnosis / Q000453:epidemiology; D063508:Social Discrimination / Q000523:psychology*; D057545:Social Stigma; D016896:Treatment Outcome; D055815:Young Adult
keywords: Brazil; HIV; STI; discrimination; socio-structural factors; stigma