Background Despite public health messaging that antiretroviral therapy (ART) has improved health outcomes for people living with HIV (PLWH) and is effective in preventing HIV transmission, many PLWH continue to experience HIV-related stigma. It is critical to assess HIV-related stigma experienced by PLWH accessing ART in the modern HIV treatment era.
Methods The STOP HIV/AIDS Program Evaluation (SHAPE) study is a longitudinal cohort of PLWH ≥19 years of age in British Columbia, Canada. This cross-sectional analysis uses SHAPE baseline survey data (collected January 2016-August 2018) and linked clinical registry data to examine factors associated with HIV-related stigma among individuals accessing ART. HIV-related stigma was self-reported using the ten-item Berger HIV stigma scale. Multivariable linear regression quantified the relationship between key explanatory variables and stigma.
Results Among 627 participants, 136(22%) identified as women, 326(52%) were aged ≥50 at enrolment, 374(60%) identified as men who have sex with men, and 133(21%) self-reported Indigenous ethnicity. The median stigma score was 47.5 (Q1-Q3: 32.5-62.5; range: 0-100). In the multivariable model, reporting injection drug use (IDU) in the past year (β=4.54, 95%CI= 0.23,8.86) or selecting prefer not to answer when asked about IDU history (β=9.52, 95%CI= 4.77,14.28); experiences of lifetime violence (β=7.62, 95%CI= 3.67,11.56); and having a mental health disorder diagnosis (β=5.30, 95%CI= 1.88, 8.73) were associated with higher stigma scores. Higher stigma scores were also associated with being 40-49 years old (β= 6.21, 95%CI= 1.58,10.85) compared to <40; age ≥50 had no significant association. Living in a city with a population ≥100,000 (β=-4.66, 95%CI= -8.53,-0.78) was associated with lower stigma scores.
Conclusion Age, city size, IDU experience, violence, and mental illness were independently associated with HIV-related stigma. These findings provide support for an intersectional investigation into how these factors propagate stigma and how this experience impacts the health and wellbeing of PLWH in this setting.
Disclosure No significant relationships.
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