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BACKGROUND: HIV-related stigma and discrimination continue to hamper efforts to prevent new infections and engage people in HIV treatment, care, and support programs. Stigma happens when others devalue a person or a group of people based on attributes or because they are associated with a certain disease, behavior, or practice. Working to end the stigma and discrimination experienced by people living with HIV/AIDS is a critical component of curtailing the epidemic. The objective of this study was to evaluate the level of stigma and discrimination experienced by HIV-infected adults receiving medical care in Houston, Texas.
METHODS: Data used for this study was obtained from the Medical Monitoring Project (MMP) survey conducted in Houston, Texas. The data comprised of 212 records of consented patients who were interviewed via face-to-face or telephone during the 2011 data collection cycle. The MMP is a supplemental HIV surveillance system that uses a three stage-probability sampling method to achieve annual representative samples of adults (18 years and above) receiving HIV medical care in the United States. The MMP provides information on risk behaviors, clinical outcomes, and identifies met and unmet needs for HIV care and prevention services. The study evaluated stigma and discrimination and their assocations with demographic factors. The data obtained from the survey was subjected to both descriptive and inferential statistics using the SAS software version 9.3 (SAS Institute Inc., Cary, North Carolina, USA).
RESULTS: The study finding indicates 66.5% of HIV-infected individuals find it difficult to tell others about their HIV status. As much as 56.5% stated that they hide their status from others with more than half of this population being males. Of the subjects that experienced discrimation, 11% reported that HIV care providers exhibited hostility or lack of respect towards them, 7% stated that they received less attention compared to other patients, and 4% noted that they were refused medical services because of their HIV status. HIV-infection status (p<0.01) and sexual orientation (p<0.05) of patients were identified as the main reasons for being discriminated against by HIV care providers. Individual-level educational attainment was significantly (p<0.05) associated with stigma such that more educated patients felt less stigmatized.
CONCLUSIONS: Our findings suggest the need for intervention programs in the population to reduce stigma and discrimination and recommend that future research efforts in these areas be linked to HIV prevention and treatment outcomes.