HIV stigma and discrimination experiences in an HIV health care setting are commonly reported among Hispanic persons with HIV and vary by race, gender, and English proficiency, according to an analysis from CDC’s Medical Monitoring Project.
Padilla and colleagues in the CDC’s National Center for HIV, Viral Hepatitis, STD, and TB Prevention used self-reported 2018 to 2020 data from the CDC’s medical monitoring project to measure HIV stigma and health care discrimination. The researchers measured four dimensions of HIV stigma: Personalized stigma (consequences of other people knowing their status), disclosure concerns, negative self-image, and public attitudes. They also measured the frequency of reports of healthcare discrimination.
The researchers interviewed over two thousand six hundred people for this study. Of the people interviewed, sixty-six percent identified as white, thirteen percent as black, and four percent as American Indian or Alaska native. Thirty-six percent identified their Hispanic origin as Mexican, Mexican American, or Chicano, and thirty-four percent identified as Puerto Rican. Of note, forty-two percent had limited English proficiency.
Most participants expressed disclosure concern—”fearing others will disclose one’s HIV status and being careful about whom one tells about one’s HIV status.” Disclosure concerns and perceived public attitudes about persons with HIV were the most reported HIV stigma concerns.
According to the research findings, nearly twenty-three percent of Hispanic adults with HIV also reported experiencing one and more instances of healthcare discrimination during the previous twelve months. In addition, the researchers found that healthcare discrimination was more frequently experienced by Black or African-American Hispanic adults (28%) compared to white Hispanic adults (21%).
Furthermore, the researchers found that men faced more healthcare discrimination than women. Padilla and her team pointed out that the higher rate of discrimination reported by men may be because more Hispanic men with HIV identify as gay or bisexual than Hispanic women with HIV.
Among those who reported experiencing healthcare discrimination, sixty-two percent felt their doctor or nurse didn’t listen to them, forty-eight percent felt they were treated with less respect than others, and forty-eight percent felt they were treated with less civility. In addition, thirty percent blamed this discrimination on HIV infection, twenty-three percent on their sexual orientation, and twenty percent on their race or ethnicity.
“HIV stigma and discrimination are human rights issues associated with adverse HIV outcomes; eliminating stigma and discrimination, which are barriers to HIV care and treatment, is a national priority,” the researchers wrote. “Understanding disparities in experiences of stigma and discrimination is important when designing culturally appropriate interventions to reduce stigma and discrimination,” they added.
The researchers emphasized the need for interventions at several levels involving individuals, providers, facilities, and communities to eradicate stigma and discrimination.
“Provider-focused training, policies, and practices are needed to address HIV stigma and discrimination experienced by Hispanic persons with HIV,” the authors wrote.
Original Source: CDC