Patterns and Consequences of HIV-Related Stigma.

This paper analyzes patterns of stigma as it is experienced by persons living with HIV/AIDS (PLWHAs) in the New York City metropolitan area and the barriers to health care and social services associated with stigma. Stigma and service barriers are assessed using client-level data from the Community Health Advisory and Information Network survey, an ongoing series of longitudinal cohort studies of PLWHAs that began in 1994 (n = 2059). The present study utilizes data from respondents interviewed between 2001 and 2003. The authors developed and validated a four-item HIV stigma scale that incorporates both expectations of and actual experiences of status loss due to an HIV/AIDS diagnosis. Younger respondents and respondents in the suburban cohort scored higher than others on the stigma scale, as did respondents who reported clinically relevant mental health symptoms of anxiety or depression. Respondents indicated barriers to care by reporting a delay in obtaining needed services or failure to obtain needed services at some time in the past six months. Multivariate logistic regression models indicated that perceived stigma is associated with increased risk for self-reported barriers to HIV care, above and beyond the effects of HIV disease stage, mental health functioning, HIV risk group, insurance status, geographic setting (urban vs. suburban), and sociodemographic characteristics. [ABSTRACT FROM AUTHOR]