Abstract
Objectives: We aimed to determine the prevalence of HIV-related stigma among people with HIV (PWH) in Switzerland
Design: A cross-sectional multicentre study nested within the Swiss HIV Cohort Study (SHCS).
Methods: We included adult PWH enrolled in the SHCS, attending follow-up between March 1 st , 2020, and January 31 st , 2021. Inability to speak English, French, German, or Italian was the only exclusion criterion. Participants were invited to complete a validated 12-item HIV-stigma questionnaire comprising four stigma subscales (negative self-image, personalised stigma, disclosure concerns, and concerns regarding public attitudes), plus two healthcare-related stigma items. Questionnaire responses were graded using a four-point Likert-type scale, higher scores indicating higher stigma. “Non-applicable”, inferring HIV-status non-disclosure, was possible for personalised stigma; stigma scores from participants answering “non-applicable” to ≥1 items were analysed separately. Factors associated with HIV-stigma were identified through multivariable linear models.
Results: Of 9643 PWH with a SHCS visit, 5563 participated in the study: 26% were female, 13% Black and 37% heterosexual; median age was 53 years (interquartile range 44–59); 2067 participants (37%) gave ≥1 “non-applicable” responses. Disclosure concerns had the highest stigma scores and were reported by 4656/5563 (84%). HIV-stigma was reported across all demographic groups. However, being female, Black, and heterosexual were independently associated with higher scores. Higher education and longer follow-up duration were associated with lower scores. Healthcare-related stigma was reported in 37% of participants.
Conclusions: HIV-stigma was prevalent across all demographic groups. The association with being female and Black suggests that HIV-stigma accentuates pre-existing gender and race inequalities.
Design: A cross-sectional multicentre study nested within the Swiss HIV Cohort Study (SHCS).
Methods: We included adult PWH enrolled in the SHCS, attending follow-up between March 1 st , 2020, and January 31 st , 2021. Inability to speak English, French, German, or Italian was the only exclusion criterion. Participants were invited to complete a validated 12-item HIV-stigma questionnaire comprising four stigma subscales (negative self-image, personalised stigma, disclosure concerns, and concerns regarding public attitudes), plus two healthcare-related stigma items. Questionnaire responses were graded using a four-point Likert-type scale, higher scores indicating higher stigma. “Non-applicable”, inferring HIV-status non-disclosure, was possible for personalised stigma; stigma scores from participants answering “non-applicable” to ≥1 items were analysed separately. Factors associated with HIV-stigma were identified through multivariable linear models.
Results: Of 9643 PWH with a SHCS visit, 5563 participated in the study: 26% were female, 13% Black and 37% heterosexual; median age was 53 years (interquartile range 44–59); 2067 participants (37%) gave ≥1 “non-applicable” responses. Disclosure concerns had the highest stigma scores and were reported by 4656/5563 (84%). HIV-stigma was reported across all demographic groups. However, being female, Black, and heterosexual were independently associated with higher scores. Higher education and longer follow-up duration were associated with lower scores. Healthcare-related stigma was reported in 37% of participants.
Conclusions: HIV-stigma was prevalent across all demographic groups. The association with being female and Black suggests that HIV-stigma accentuates pre-existing gender and race inequalities.
| Original language | English |
|---|---|
| Journal | AIDS (London, England) |
| Early online date | 25 Jul 2024 |
| DOIs | |
| Publication status | Early online date - 25 Jul 2024 |
| Externally published | Yes |
Keywords
- HIV
- Stigma
- Healthcare-related stigma
- Cohort
