Abstract

BackgroundHIV related stigma is a recognized barrier to early detection of HIV and causes great suffering for those affected. However, data regarding HIV related stigma among female sex workers (FSW) in China was limited, with none for comparison between FSW and general migrant women (GMW). Therefore, the aim of this study was to examine HIV related stigma among FSW and GMW in Shanghai, China.MethodsA community based cross-sectional study with face-to-face interviews was conducted in Shanghai (September 2011 through December 2012), using a structured questionnaire.HIV related stigma scores were examined graphically using boxplot. A logistic regression analysis with the proportional odds model was employed to identify factors affecting HIV related stigma scores.ResultsA total of 1,396 subjects, including 721 FSW and 675 GMW, were recruited in the present study. Both groups had substantial misconceptions about HIV/AIDS, although FSW had slightly higher scores on average. Both groups showed a medium level of HIV related stigma (38.34 ± 6.21 and 38.35 ± 6.86 for FSW and GMW, respectively). For the FSW, higher levels of stigma were observed for those who were in the older age groups (age 26-35 years, OR, 2.06, 95% CI 1.06-4.01), those who were married (OR, 1.62, 95% CI 1.03-2.54), and those who were working at lower-level sex service sites (OR, 1.60, 95% CI 1.06-2.43). Conversely, HIV knowledge was inversely associated with the level of HIV related stigma (OR, 0.93, 95% CI 0.87-0.98).Among GMW participating in the study, those age in the 26-35 years were more likely to show higher level of stigma (OR, 2.61, 95% CI 1.03-2.54), and HIV knowledge was found to be inversely associated with the HIV related stigma level as well (OR, 0.89, 95% CI 0.84-0.95).ConclusionsThe present study suggests that there is an urgent need for the development of appropriate education strategies to reduce HIV related stigma among FSW and GMW in Shanghai, China. In particular, older women, less educated women, and women that have lived in Shanghai a relatively long time should be targeted in future stigma reduction programs.Electronic supplementary materialThe online version of this article (doi:10.1186/s12905-014-0160-3) contains supplementary material, which is available to authorized users.

Highlights

  • HIV related stigma is a recognized barrier to early detection of HIV and causes great suffering for those affected

  • Participant characteristics A total of 1,396 subjects, including 721 female sex workers and 675 general migrant women, were recruited for the present study

  • Results for general migrant women (GMW) indicated that those in the older age group were more likely to express a higher level of stigma (OR, 2.61, 95% confidence intervals (CIs) 1.03-2.54), and HIV knowledge was found to be inversely associated with the level of HIV related stigma as well (OR, 0.89, 95% CI 0.84-0.95)

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Summary

Introduction

HIV related stigma is a recognized barrier to early detection of HIV and causes great suffering for those affected. HIV-related stigma refers to “prejudice, discounting, discrediting directed at people perceived to have HIV/ AIDS, as well as individuals, groups and communities with which they are associated” [1]. It has a profound effect on people’s decisions and behaviors, and can reduce people’s willingness to engage in HIV testing, treatment, China has experienced a rapid increase in the incidence of HIV. FSW bear a disproportionate burden of HIV in China, accounting for almost half (48.6%) of all HIV cases among women in that country [14] They continue to be excluded, sometimes systematically, from HIV services because of HIV/AIDS related stigma, discrimination, and criminalization

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