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Experienced and perceived HIV-related stigma among young people living with HIV: Implications for preventive and supportive interventions

Dallas Swendeman, MPH1, Mary Jane Rotheram-Borus, PhD2, Scott Comulada, MPH2, and Robert E. Weiss, PhD3. (1) Center for Community Health, University of California, Los Angeles, 10920 Wilshire, Suite 350, Los Angeles, CA 90024-6521, 310-794-6144, metacom@ucla.edu, (2) Department of Psychiatry, University of California, Los Angeles, 10920 Wilshire, Suite 350, Los Angeles, CA 90024-6521, (3) Department of Biostatistics, UCLA, 51-269 CHS, Los Angeles, CA, CA 90095

Background: The consequences of stigma for people living with HIV (PLH) can impact serostatus disclosure, social support, emotional distress, coping resources, and possibly HIV transmission risks.

Method: PLH aged 16 to 29 years (n=147; median age = 23; 75% minority; 75% gay/bisexual men) were recruited in four U.S. AIDS epicenters from 1999-2000. Structured interviews included measures of HIV-related stigma experiences and corresponding perceptions. Factor analyses identified three conceptually coherent sub-dimensions: avoidance, social rejection, and abuse/shame. Regression analyses were performed to examine relationships between these measures and lifestyle and psychological covariates.

Results: Lifetime stigma experiences were generally associated with lifetime suicide attempts, current emotional distress, depression/withdrawal coping, social support, having more people know HIV status, and being Gay/bisexual with symptomatic HIV. Perceived stigma was associated with having less people know one’s serostatus, depression/withdrawal and passive problem solving coping, and being female.

Conclusion: These results highlight: 1) the increased risk of exposure to stigmatizing events that PLH must consider while pursuing the benefits of social support, and 2) the more visible a PLH is, either by disclosure or by being gay/bisexual with HIV symptoms, the more stigma is perceived and experienced. Broad disclosure of serostatus may not be an ideal global recommendation for PLH as it potentially increases exposure to stigma and discrimination, which may result in PLH reducing disclosure in transmission risk situations where it is most urgently needed and ethically required. Supporting PLH in making informed and well-planned decisions about serostatus disclosure will help them maximize benefits while minimizing risks.

Learning Objectives:

Keywords: HIV/AIDS, Youth

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

HIV/AIDS Among Youth and Adolescents

The 132nd Annual Meeting (November 6-10, 2004) of APHA