University of Florida College of Nursing, Gainesville, FL, USA.
Department of Epidemiology, University of Florida College of Public Health and Health Professions & College of Medicine, Gainesville, FL, USA.
BMC Public Health. 2020 May 19;20(1):723. doi: 10.1186/s12889-020-08891-3.
Human Immunodeficiency Virus (HIV) disproportionately affects the Southern United States, accounting for approximately 46% of people living with HIV. HIV-related stigma is recognized as a barrier to testing, treatment, and prevention efforts. However, little is known about HIV-related stigma experiences in Florida. Using data collected from the Florida Medical Monitoring Project, we sought to examine individual characteristics associated with HIV-related stigma.
We analyzed secondary data from the 2015-2016 Medical Monitoring Project in Florida (n = 603). Stigma was measured using the 10-item HIV Stigma Scale. Exploratory factor analysis of the HIV Stigma Scale revealed three subscales: negative self-image, anticipated, and personalized stigma. Bivariate and multivariate regression models were used to determine the individual characteristics associated with the HIV Stigma Scale.
Multivariate analysis indicated that people with severe depression scores (OR: 3.13; CI: 1.38-7.13) and persons with disability (OR: 1.64; CI: 1.03-2.61) had significantly increased odds of higher overall stigma. In the subscale analyses, negative self-image was significantly associated with alcohol misuse (OR: 2.02; CI: 1.15-3.56) depression (OR: 2.81; CI: 1.38-5.72) and/or those who identify as homosexual (OR: 0.54; CI: 0.31-0.93). Anticipated stigma was significantly associated with people who had mild-moderate depression (OR: 3.03; CI: 1.20-7.65), severe depression (OR: 2.87; CI: 1.38-5.98), identified as Black (OR: 0.60; CI: 0.37-0.98), non-injection drug use (OR: 0.55; CI: 0.33-0.91), and/or people aged 50 years and older (OR: 0.28; CI: 0.09-0.82). Personalized stigma was not associated with any of the variables examined.
The implications of these findings reveal that certain individuals are more vulnerable to stigma. Researchers could consider distinct stigma interventions strategies based on the characteristics of specific individuals (i.e., targeting depression, disability, sexual orientation, avoidant coping, racial/ethnic groups, and youth) in Florida.
人类免疫缺陷病毒（HIV）在美国南部不成比例地流行，约占 HIV 感染者的 46%。HIV 相关耻辱感被认为是检测、治疗和预防工作的障碍。然而，对于佛罗里达州的 HIV 相关耻辱感体验知之甚少。本研究利用佛罗里达州医疗监测项目的数据，旨在研究与 HIV 相关耻辱感相关的个体特征。
我们分析了佛罗里达州 2015-2016 年医疗监测项目（n=603）的二次数据。使用 HIV 耻辱感量表测量耻辱感。HIV 耻辱感量表的探索性因子分析显示出三个亚量表：负面自我形象、预期和个性化耻辱感。使用双变量和多变量回归模型确定与 HIV 耻辱感量表相关的个体特征。
多变量分析表明，严重抑郁评分较高的人群（OR：3.13；95%CI：1.38-7.13）和残疾人群（OR：1.64；95%CI：1.03-2.61）具有更高的整体耻辱感的可能性显著增加。在亚量表分析中，负面自我形象与酒精滥用（OR：2.02；95%CI：1.15-3.56）、抑郁（OR：2.81；95%CI：1.38-5.72）和/或同性恋身份（OR：0.54；95%CI：0.31-0.93）显著相关。预期耻辱感与轻度至中度抑郁（OR：3.03；95%CI：1.20-7.65）、重度抑郁（OR：2.87；95%CI：1.38-5.98）、黑人身份（OR：0.60；95%CI：0.37-0.98）、非注射药物使用（OR：0.55；95%CI：0.33-0.91）和/或 50 岁及以上的人群（OR：0.28；95%CI：0.09-0.82）显著相关。个性化耻辱感与所检查的任何变量均无关。
这些发现的意义表明，某些人更容易受到耻辱感的影响。研究人员可以考虑根据佛罗里达州特定个体的特征（即针对抑郁、残疾、性取向、回避应对、种族/民族群体和青年）制定不同的耻辱感干预策略。
