The Impact of Perceptions of Community Stigma on Utilization of HIV Care Services

• Published in: Journal of racial and ethnic health disparities Vol. 7; no. 2; pp. 383 - 391
• Main Authors: Green, Helena Danielle, Weeks, Margaret R., Berman, Marcie, Salvi, Apoorva, Gonzalez, Rosely, Rohena, Lucy, Ferguson, Alice, Li, Jianghong
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.04.2020; Springer Nature B.V
• Subjects: Acquired immune deficiency syndrome; Adolescent; Adult; AIDS; Case management; Chi-square test; Community; Demographics; Discrimination; Drug resistance; Epidemiology; Ethnicity; Female; Health care policy; HIV; HIV Infections - diagnosis; HIV Infections - ethnology; HIV Infections - psychology; HIV Infections - therapy; Human immunodeficiency virus; Humans; Male; Medical appointments; Medicine; Medicine & Public Health; Middle Aged; Patient Acceptance of Health Care - psychology; Perceptions; Privacy; Quality of Life Research; Services; Social Inequality; Social interaction; Social Stigma; Social Structure; Socioeconomic Factors; Statistical analysis; Stigma; Treatment compliance; Willingness; Young Adult; HIV; Service utilization; Perceived community stigma
• ISSN: 2197-3792; 2196-8837
• DOI: 10.1007/s40615-019-00667-9

The relationship between perceived community stigma and treatment adherence has been established in previous literature. Yet, less is known about explicit circumstances in which perceived community stigma deters people living with HIV (PLWH) from maintaining care. This research examines the impact of perceived community stigma against PLWH on self-reported barriers and supports to remain in HIV care services. We used survey data from a 3-year study of the HIV test and treat (T&T) continuum of services in Hartford, CT, surveying 200 PLWH. Logistic regression was used to determine if perceived community stigma had a statistically significant effect on the willingness of PLWH to utilize HIV care services. Results revealed that an increase in perceived stigma predicted willingness to see a doctor in 6 months for those who ‘had a fear of poor treatment’ (χ 2 (6) = 21.995, p < 0.001) and ‘were concerned about privacy’ (χ 2 (6) = 16.670, p < 0.01). An increase in perceived stigma was also a significant factor in the belief that supportive case managers helped with accessing HIV care services (χ 2 (1) = 6.817, p < 0.01). Our findings suggest that having a high degree of perceived community stigma is impactful in instances where individuals anticipate stigma or discrimination.