Abstract

BackgroundAIDS-related stigma and mental disorders are the most common conditions in people living with HIV (PLHIV). We therefore conducted this study to examine the association of AIDS-related stigma and discrimination with mental disorders among PLHIV in Cambodia.MethodsA two-stage cluster sampling method was used to select 1,003 adult PLHIV from six provinces. The People Living with HIV Stigma Index was used to measure stigma and discrimination, and a short version of general health questionnaire (GHQ-12) was used to measure mental disorders. Multivariate logistic regression analysis was conducted.ResultsThe reported experiences of discrimination in communities in the past 12 months ranged from 0.8% for reports of being denied health services to 42.3% for being aware of being gossiped about. Internal stigma was also common ranging from 2.8% for avoiding going to a local clinic and/or hospital to 59.6% for deciding not to have (more) children. The proportions of PLHIV who reported fear of stigma and discrimination ranged from 13.9% for fear of being physically assaulted to 34.5% for fear of being gossiped about. The mean score of GHQ-12 was 3.2 (SD = 2.4). After controlling for several potential confounders, higher levels of mental disorders (GHQ-12≥ 4) remained significantly associated with higher levels of experiences of stigma and discrimination in family and communities (AOR = 1.9, 95% CI = 1.4–2.6), higher levels of internal stigma (AOR = 1.7, 95% CI = 1.2–2.3), and higher levels of fear of stigma and discrimination in family and communities (AOR = 1.5, 95% CI = 1.1–2.2).ConclusionsAIDS-related stigma and discrimination among PLHIV in Cambodia are common and may have potential impacts on their mental health conditions. These findings indicate a need for community-based interventions to reduce stigma and discrimination in the general public and to help PLHIV to cope with this situation.

Highlights

  • Despite care and treatment advances that have turned HIV into a chronic and manageable condition, people living with HIV (PLHIV) continue to suffer from stigma and discrimination from their family and communities

  • AIDS-related stigma and mental disorders are the most common conditions in people living with HIV (PLHIV)

  • After controlling for several potential confounders, higher levels of mental disorders (GHQ-12 4) remained significantly associated with higher levels of experiences of stigma and discrimination in family and communities (AOR = 1.9, 95% confidence interval (CI) = 1.4–2.6), higher levels of internal stigma (AOR = 1.7, 95% CI = 1.2–2.3), and higher levels of fear of stigma and discrimination in family and communities (AOR = 1.5, 95% CI = 1.1– 2.2)

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Summary

Introduction

Despite care and treatment advances that have turned HIV into a chronic and manageable condition, people living with HIV (PLHIV) continue to suffer from stigma and discrimination from their family and communities. AIDS-related stigma and discrimination have been found to be associated with delays in seeking care [3] and potential barriers to HIV counseling and testing [4], disclosure of HIV sero-status [5,6], retention in care and treatment [7], and uptake of and adherence to antiretroviral therapy (ART) [8,9]. Mental disorders are associated with several health and healthcare seeking behaviors such as poor adherence to medications [25,26,27], low rates of retention in ART care [28], and poor ART-related clinical outcomes [29]. AIDS-related stigma and mental disorders are the most common conditions in people living with HIV (PLHIV). We conducted this study to examine the association of AIDS-related stigma and discrimination with mental disorders among PLHIV in Cambodia.

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