Kim Sue Hyon, Bonett Stephen, Bauermeister José, Buttenheim Alison M, Starbird Laura E
University of Pennsylvania School of Nursing, 418 Curie Boulevard, Philadelphia, PA, 19104, USA.
Center for Health Incentives and Behavioral Economics, University of Pennsylvania, Philadelphia, PA, USA.
AIDS Behav. 2025 Mar 24. doi: 10.1007/s10461-025-04684-0.
HIV testing is essential to achieving the 95-95-95 targets, yet lifetime HIV testing rates in the United States fall below established guidelines. Building on similar healthcare contexts where stigma hinders access and trust mitigates its negative effect, this exploratory study examined the relationship between HIV-related stigma (HRS) and testing behavior, focusing on the role of trust in healthcare providers (HCPs). We used data from the 2022 General Social Survey, a nationally representative sample of the general population. HRS was evaluated across three domains: perceived social discrimination towards people living with HIV (PLWH), avoidance due to unfounded fear of transmission, and moral judgement. Weighted stratified logistic regression was employed to examine how the relationship between HRS and testing behavior varied across different levels of trust in HCPs. Among participants with low trust in HCPs, the avoidance of PLWH due to unfounded fears was associated with lower odds of undergoing HIV testing. In the high trust group, none of the HRS domains were associated with HIV testing; instead, testing was linked to the individual's engagement in HIV-risk behaviors. Our findings reveal a complex interplay between HRS, trust, and testing behavior, highlighting the need for collective action to address misconceptions about HIV transmission and promote awareness of risk behaviors, with concurrent efforts to foster trust in HCPs.
艾滋病毒检测对于实现95-95-95目标至关重要,但美国的终身艾滋病毒检测率低于既定指南。基于类似的医疗环境,即耻辱感阻碍了人们获得检测服务,而信任则减轻了其负面影响,这项探索性研究考察了与艾滋病毒相关的耻辱感(HRS)与检测行为之间的关系,重点关注对医疗服务提供者(HCPs)的信任所起的作用。我们使用了2022年综合社会调查的数据,该调查是对一般人群具有全国代表性的样本。HRS在三个领域进行了评估:对艾滋病毒感染者(PLWH)的社会歧视感知、因无端恐惧传播而产生的回避行为以及道德评判。采用加权分层逻辑回归来研究HRS与检测行为之间的关系在对HCPs的不同信任水平上是如何变化的。在对HCPs信任度较低的参与者中,因无端恐惧而回避PLWH与接受艾滋病毒检测的较低几率相关。在高信任度组中,HRS三个领域均与艾滋病毒检测无关;相反,检测与个人参与艾滋病毒风险行为有关。我们的研究结果揭示了HRS、信任和检测行为之间复杂的相互作用,突出了采取集体行动来解决对艾滋病毒传播的误解、提高对风险行为的认识以及同时努力增强对HCPs信任的必要性。
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