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October 23, 2009

Study: Stigma a Barrier to HIV Care and Medication Adherence

Stigma toward people living with HIV can prevent patients from seeking necessary care, according to research from the University of California in Los Angeles. The study is published in the October issue of the Journal of General Internal Medicine.

The two-year study surveyed 202 HIV-positive men and women, most of whom were low-income minorities with limited education. The questionnaire assessed internalized HIV stigma and self-reported access to medical care. One third of the participants reported experiencing high levels of stigma. On average, participants said they experience or perceive stigma a little less frequently than “some of the time.”

The study found that individuals who experienced high levels of perceived stigma were four times as likely to report poor access to health care as those who did not report high levels. They were also three times as likely to report less than optimal adherence to HIV medications. In addition, 10.5 percent of participants reported having no primary HIV care provider.

“We were surprised to find that in our models, experiencing high levels of internalized HIV stigma was one of the strongest predictors of poor access to medical care, even after controlling for sociodemographics such as gender, race and ethnicity, income, insurance status and clinical variables such as T-cell count and years since HIV diagnosis,” said lead investigator Jennifer Sayles, MD, in a statement.

She added that this study highlights the need for improved community dialogue, education and awareness about HIV to lessen stigma. “It also highlights the need to address some of the social and contextual aspects of HIV for those living with the disease and to develop interventions that reduce internalized HIV stigma as a barrier to care and treatment,” she said.

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