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Understanding the role healthcare professionals and service environments play in perpetuating stigma and hindering quality care for people living with HIV
The Stigma Index is a global project designed to document experiences of stigma and discrimination in order to mobilize and support key populations of people living with HIV (PLHIV). While Stigma Index interviews had been conducted in over forty-five countries around the world, we implemented it in the United States for the first time in Detroit, Michigan.
methods
As the Stigma Index is implemented in each context; the data collection priorities are determined by a local Steering Committee. The Steering Committee in Detroit, fully comprised of PLHIV, identified healthcare comfort and denial of services as a priority given their own experiences and knowledge of the local context. Experiences of stigma amongst PLHIV within the healthcare system were assessed through structured interviews (n=70) facilitated by trained HIV-positive community leaders. We produced descriptive statistic using SPSS.
results
Participants who earned less than $1,500/month or who identified as a racial/ethnic minority were more likely to have delayed HIV care upon initial diagnosis. A majority of participants (91.4%) also reported going more than a year without seeking health services because they feared being recognized. Furthermore, 11% of participants acknowledged being denied health services due to their HIV status.
conclusion
HIV stigma persists within the healthcare system in Southeast Michigan, ranging from provider rejection to overall patient discomfort. We will discuss our social advocacy efforts and actions to address health care equity in Southeast Michigan for PLHIV, as well as the planned efforts to implement the Stigma Index in other U.S. contexts.
Learning Areas:
Provision of health care to the publicPublic health or related research
Learning Objectives:
Name three take-away points Healthcare Practitioners can use to provide better services for people living with HIV
To be able to list a concrete example of HIV stigma in a healthcare setting
Discuss the initial steps of implementing the stigma index in a metropolitan community
Keyword(s): Health Care Access, Quality of Care
Qualified on the content I am responsible for because: I am a skilled public health professional with over 5 years of a diverse background of practical and research experiences working with people living with HIV. Currently, I am the Community Mobilization and Research Manager for AIDS Partnership Michigan.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.