HIV-related stigma among people living with HIV/AIDS in rural Central China

Zhen Li,Kaveh Khoshnood,Evelyn Hsieh,Yu Sheng,Jamie P Morano

doi:10.1186/s12913-018-3245-0

Abstract

BackgroundHIV-related stigma among people living with HIV/AIDS (PLWHA) has been associated with many negative consequences, including poor adherence to therapy and undue psychological stress. However, the relative influence of specific demographic and situational factors contributing to HIV-related stigma among rural PLWHA in central China remains unknown. The aim of this study was to explore the level of HIV-related stigma among rural PLWHA across specific demographic and situational factors in central China.MethodsA cross-sectional study was conducted among PLWHA receiving care through the Chinese Centers for Disease Control of Zhenping county in Henan Province, China. Participants completed a 55-item questionnaire which included demographic and disease-related factors, HIV-related stigma was measured utilizing the validated Berger HIV Stigma Scale which has good psychometric characteristics in Chinese PLWHA.ResultsA total of 239 PLWHA completed the survey. The mean total HIV-related stigma score was 105.92 (SD = 12.35, 95% CI: 104.34, 107.49). Multivariable linear regression analysis revealed a higher level of HIV-related stigma in younger PLWHA (β = − 0.57, 95% CI = − 0.78,-0.35, p<0.001) and those who self-reported opportunistic infections (β = 6.26, 95% CI = 1.26, 11.26, p < 0.05).ConclusionsThe findings in the current study suggest that rural PLWHA in central China suffer from the burden of HIV-related stigma at a moderate to high level. Younger PLWHA and PLWHA that have opportunistic infections tend to perceive a higher level of HIV stigma.

Highlights

Human immunodeficiency virus (HIV)-related stigma among people living with HIV/Acquired immune deficiency syndrome (AIDS) (PLWHA) has been associated with many negative consequences, including poor adherence to therapy and undue psychological stress
Younger people living with HIV/AIDS (PLWHA) and PLWHA that have opportunistic infections tend to perceive a higher level of HIV stigma
In terms of the four subscales, we found that personalized stigma was positively correlated with married status and negatively associated with increasing age; disclosure concern was positively correlated with increasing education level and history of opportunistic infection, while negatively associated with increasing age and years since HIV diagnosis

Summary

Introduction

HIV-related stigma among people living with HIV/AIDS (PLWHA) has been associated with many negative consequences, including poor adherence to therapy and undue psychological stress. The relative influence of specific demographic and situational factors contributing to HIV-related stigma among rural PLWHA in central China remains unknown. The aim of this study was to explore the level of HIV-related stigma among rural PLWHA across specific demographic and situational factors in central China. Numerous studies have shown that stigma is associated with poor adherence to antiretroviral therapy (ART) [2], mental health disorders such as loneliness, depression and anxiety [3], non-disclosure of HIV status, and overall poor health outcomes [4, 5]. The national HIV/AIDS epidemic maintains a higher-prevalence in areas such as Central China, including the largely agrarian Henan and Hubei provinces. The AIDS epidemic in China first established a rural foothold through illegal, unsanitary commercial plasma donation activities in the late 1980s and early 1990s among unknowing, heterosexual agrarian populations who were paid for plasma donations that involved receiving contaminated pooled blood products [19]

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