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Prevalence of HIV-related stigma among people with HIV in Switzerland: addressing the elephant in the room

Kampouri, E., Damas, J., Kusejko, K. , Ledergerber, B., Braun, D., Tshikung, O. N., Hachfeld, A., Weisser, M., Wissel, K., Bernasconi, E., Manuel, I. C., Jackson-Perry, D., Eriksson, L. E. ORCID: 0000-0001-5121-5325, Reinius, M., Cavassini, M. & Darling, K. E. A. (2024). Prevalence of HIV-related stigma among people with HIV in Switzerland: addressing the elephant in the room. AIDS, doi: 10.1097/qad.0000000000003983

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 1st, 2020, and January 31st, 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.

Publication Type: Article
Additional Information: This article is available under the Creative Commons CC-BY-NC-ND license and permits non-commercial use of the work as published, without adaptation or alteration provided the work is fully attributed.
Subjects: H Social Sciences > H Social Sciences (General)
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Departments: School of Health & Psychological Sciences
School of Health & Psychological Sciences > Nursing
SWORD Depositor:
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