Display Settings:

Format

Send to:

Choose Destination
J Gen Intern Med. 2009 Oct;24(10):1101-8. doi: 10.1007/s11606-009-1068-8. Epub 2009 Aug 4.

The association of stigma with self-reported access to medical care and antiretroviral therapy adherence in persons living with HIV/AIDS.

Author information

  • 1Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at University of California-Los Angeles, 911 Broxton Ave., Los Angeles, CA 90024, USA. jsayles@mednet.ucla.edu

Abstract

BACKGROUND:

The stigma of HIV-infection may profoundly affect the lives of persons living with HIV/AIDS (PLHA). However few studies have examined the association of HIV stigma with multiple components of HIV treatment and care.

OBJECTIVES:

To estimate the association between HIV stigma and: self-reported access to care, regular source of HIV care, and antiretroviral therapy adherence; and to test whether mental health mediates these associations.

DESIGN:

Cross-sectional study.

PARTICIPANTS:

202 PLHA living in Los Angeles County in 2007.

MEASUREMENTS:

Participants completed an anonymous survey, assessing internalized HIV stigma (28-items, alpha = 0.93), self-reported access to medical care (six items, alpha = 0.75), regular source of HIV care, and antiretroviral therapy (ART) adherence.

RESULTS:

One-third of participants reported high levels of stigma; 77% reported poor access to care; 42.5% reported suboptimal ART adherence; and 10.5% reported no regular source of HIV care. In unadjusted analysis, those reporting a high level of stigma were more likely to report poor access to care (OR = 4.97, 95% CI 2.54-9.72), regular source of HIV care (OR = 2.48, 95% CI 1.00-6.19), and ART adherence (OR = 2.45, 95% CI 1.23-4.91). In adjusted analyses, stigma was significantly associated with poor access to care (OR = 4.42, 95% CI 1.88-10.37), but not regular source of HIV care or ART adherence. Mental health mediated the relationship between stigma and ART adherence, but not poor access to care or regular source of HIV care.

CONCLUSIONS:

The association of stigma with self-reported access to care and adherence suggests that efforts to improve these components of HIV care will require a better understanding of the possible effects of stigma and its mediators.

PMID:
19653047
[PubMed - indexed for MEDLINE]
PMCID:
PMC2762503
Free PMC Article

Images from this publication.See all images (1)Free text

FigureĀ 1
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Springer Icon for PubMed Central
    Loading ...
    Write to the Help Desk