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)
Summary
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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