Missed two or more doses of your HIV meds in the last month? Stigmatizing comments and experiences may be partly to blame, according to a study published in the journal AIDS and Behavior.

In a study of 762 people receiving HIV care in the Southeast, 51% reported that they had experienced HIV-related stigma during the past year. While rare, people said this came from clinic staff—from workers donning extra gloves, for example, during an exam to staff bad-mouthing people with HIV. Anecdotally, people living with HIV reported hearing staff denigrate clients for their HIV status, their drug use and their low income, among other things. Plus, 17% of participants had witnessed a staff person disclosing their HIV status without their consent.

These experiences were associated with missing two or more doses of antiretrovirals in a month. For each increase in perceived stigma in health care settings, people were 38% more likely to miss two or more daily doses of their meds. People who worried that just going to the clinic would reveal their status were 29% more likely to miss doses. Among people of color in the study, stigma in medical care was associated with a twofold decrease in regularly taking medications.

And these findings are for people currently in care, who generally stated that their own HIV clinic was nonjudgmental and provided extra support when they needed it. This led one respondent to worry about people not receiving care.

“I wonder how many people are not going to get the medical care they need, and not get the meds they need...because they don’t want to deal with that,” the participant told researchers. “They feel like we’ve all felt, and that’s scary to me.”