Institute for Collaboration on Health Intervention and Policy, University of Connecticut, Storrs, Connecticut, USA.
Department of Medicine, Mercer University Medical School, Macon, Georgia, USA.
AIDS Patient Care STDS. 2020 Nov;34(11):484-490. doi: 10.1089/apc.2020.0144.
The stigmatization of HIV infection impedes every step along the HIV continuum of care, particularly care engagement and retention. The differential effects of various sources of stigma on retention in HIV care have been the subject of limited research. We examined the accumulation of HIV stigma experiences over 1 year in relationship to treatment retention among 251 men and women marginally engaged in HIV care in the southeastern United States. Results showed that cumulative stigma experiences predicted poorer retention in care, with greater stigma experiences related to less consistency in attending scheduled medical appointments. HIV stigma originating from family members and acts of overt discrimination were the most frequently experienced sources of stigma and were most closely associated with disengagement from HIV care. In addition, analyses by gender indicated that retention in care for men was impacted by stigma to a greater extent than among women. These findings reaffirm the importance of HIV stigma as a barrier to HIV care and provide new directions for interventions to mitigate the negative effects of stigma on patients who are not fully engaged in HIV care. Clinical trials registration NCT104180280.
HIV 感染的污名化阻碍了 HIV 护理连续体的每一步，特别是护理的参与和保留。各种来源的污名对 HIV 护理保留的不同影响一直是有限研究的主题。我们研究了在东南美国有 251 名男性和女性处于 HIV 护理边缘的情况下，1 年内 HIV 污名体验的积累与治疗保留之间的关系。结果表明，累积的污名体验预示着较差的护理保留，较多的污名体验与定期预约就诊的一致性较差有关。来自家庭成员的 HIV 污名和明显的歧视行为是最常经历的污名来源，与脱离 HIV 护理的关系最密切。此外，按性别进行的分析表明，与女性相比，男性的护理保留受到污名的影响更大。这些发现再次证实了 HIV 污名是 HIV 护理障碍的重要因素，并为干预措施提供了新的方向，以减轻对未充分参与 HIV 护理的患者的污名的负面影响。临床试验注册 NCT104180280。
