title: Prevalence of Internalized HIV-Related Stigma Among HIV-Infected Adults in Care, United States, 2011-2013.
abstract: HIV-infected U.S. adults have reported internalized HIV-related stigma; however, the national prevalence of stigma is unknown. We sought to determine HIV-related stigma prevalence among adults in care, describe which socio-demographic groups bear the greatest stigma burden, and assess the association between stigma and sustained HIV viral suppression. The Medical Monitoring Project measures characteristics of U.S. HIV-infected adults receiving care using a national probability sample. We used weighted data collected from June 2011 to May 2014 and assessed self-reported internalized stigma based on agreement with six statements. Overall, 79.1% endorsed ≥1 HIV-related stigma statements (n = 13,841). The average stigma score was 2.4 (out of a possible high score of six). White males had the lowest stigma scores while Hispanic/Latina females and transgender persons who were multiracial or other race had the highest. Although stigma was associated with viral suppression, it was no longer associated after adjusting for age. Stigma was common among HIV-infected adults in care. Results suggest individual and community stigma interventions may be needed, particularly among those who are <50 years old or Hispanic/Latino. Stigma was not independently associated with viral suppression; however, this sample was limited to adults in care. Examining HIV-infected persons not in care may elucidate stigma's association with viral suppression.
authors.affiliation: Division of HIV/AIDS Prevention, Centers for Disease Control, 1600 Clifton Road NE, MS E-46, Atlanta, GA, 30329, USA. yda1@cdc.gov.
authors.forename: Amy R
authors.initials: AR
authors.lastname: Baugher
authors.affiliation: Division of HIV/AIDS Prevention, Centers for Disease Control, 1600 Clifton Road NE, MS E-46, Atlanta, GA, 30329, USA.
authors.forename: Linda
authors.initials: L
authors.lastname: Beer
authors.affiliation: Division of HIV/AIDS Prevention, Centers for Disease Control, 1600 Clifton Road NE, MS E-46, Atlanta, GA, 30329, USA.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Fagan
authors.affiliation: Division of HIV/AIDS Prevention, Centers for Disease Control, 1600 Clifton Road NE, MS E-46, Atlanta, GA, 30329, USA.
authors.forename: Christine L
authors.initials: CL
authors.lastname: Mattson
authors.affiliation: Division of HIV/AIDS Prevention, Centers for Disease Control, 1600 Clifton Road NE, MS E-46, Atlanta, GA, 30329, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Freedman
authors.affiliation: Division of HIV/AIDS Prevention, Centers for Disease Control, 1600 Clifton Road NE, MS E-46, Atlanta, GA, 30329, USA.
authors.forename: Jacek
authors.initials: J
authors.lastname: Skarbinski
authors.affiliation: Division of HIV/AIDS Prevention, Centers for Disease Control, 1600 Clifton Road NE, MS E-46, Atlanta, GA, 30329, USA.
authors.forename: R Luke
authors.initials: RL
authors.lastname: Shouse
mesh_terms: D000328:Adult; D001741:Black or African American; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D015497:HIV-1; D006630:Hispanic or Latino; D006801:Humans; D007389:Internal-External Control; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D015995:Prevalence; D044469:Racial Groups / Q000706:statistics & numerical data; D057566:Self Report; D017678:Sex Distribution; D057545:Social Stigma; D014481:United States / Q000453:epidemiology; D044465:White People; D055815:Young Adult
keywords: Age; HIV; Stigma; United States; Viral suppression