title: Exploring HIV-related stigma among HIV-infected men who have sex with men in Beijing, China: a correlation study.
abstract: Human immunodeficiency virus (HIV)-related stigma among HIV-infected men who have sex with men (MSM) has been associated with adverse health outcomes, including poor adherence to antiretroviral therapy and care, and increased participation in behaviors linked to higher rates of HIV transmission. In China, the incidence of HIV is growing more rapidly among MSM than among other subgroups. This study characterizes and quantifies HIV stigma among HIV-infected MSM in Beijing, China, which arguably may be driving this epidemic. A cross-sectional survey study was performed among 266 HIV-positive MSM in Beijing, China, in 2014. The Berger HIV Stigma Scale was used to measure levels of HIV-related stigma. Participants additionally answered questions regarding socio-demographic characteristics and HIV-associated risk factors; previously validated Mandarin-language scales assessed depression, coping style, and social support networks. Multivariable linear regression models were used to identify variables significantly associated with HIV stigma. The mean overall HIV stigma score among the study population was 112.78 ± 18.11 (score range: 40-160). Higher HIV stigma scores were positively associated with depression (β = 7.99, 95% CI:3.69, 12.29, p < .001) and negative coping skills (β = 0.64, 95% CI:0.21,1.08, p < .01), and was negatively associated with disclosed HIV status (β = -6.45, 95%CI:-11.80, -1.11, p < .05), and availability of social support networks (β = -0.12, 95%CI:-0.22, -0.02, p < .05). Other variables such as poor self-rated health status and presence of opportunistic infections were positively associated with individual dimensions of HIV-related stigma. The results of this study can inform the development of culturally sensitive interventions to reduce HIV-related stigma among MSM with HIV in China, with the overarching goal of reducing HIV transmission in this vulnerable population.
authors.affiliation: a School of Nursing , Peking Union Medical College , Beijing , People's Republic of China.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Li
authors.affiliation: b Department of Internal Medicine , Yale School of Medicine , New Haven , CT , USA.
authors.forename: Evelyn
authors.initials: E
authors.lastname: Hsieh
authors.affiliation: c Division of Infectious Diseases and International Medicine , University of South Florida, Morsani College of Medicine and College of Public Health , Tampa , FL , USA.|d Yale University Center for Interdisciplinary Research on AIDS (CIRA) , New Haven , CT , USA.
authors.forename: Jamie P
authors.initials: JP
authors.lastname: Morano
authors.affiliation: e Department of Basic Nursing, School of Nursing , Peking Union Medical College , Beijing , People's Republic of China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Sheng
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D000068476:Beijing; D003430:Cross-Sectional Studies; D003863:Depression / Q000209:etiology; D030881:Disclosure; D015658:HIV Infections / Q000523:psychology*; D006304:Health Status; D018451:Homosexuality, Male / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D057545:Social Stigma; D012944:Social Support; D055815:Young Adult
keywords: AIDS; China; HIV; MSM; Stigma