The feeling of stigmatization that people living with HIV frequently experience doesn’t only exact a psychological toll but could also result in quantifiably negative health outcomes. Atleast this is what a latest study by UCLA claims.
The two-year study was noted to have focused on approximately 202 HIV-positive men and women in Los Angeles County. Many of them were believed to be minorities and several with limited incomes and limited education. Study participants seemed to have completed unidentified surveys assessing internalized HIV stigma, self-reported access to medical care, their regular source of HIV care and ART adherence.
Scientists from the division of general internal medicine and health services research at the David Geffen School of Medicine at UCLA found that a huge number of HIV-positive individuals who reported feeling stigmatized also seemed to have reported poor access to care or suboptimal adherence to antiretroviral therapy (ART).
In reality, individuals who suffered from high levels of internalized stigma appear to be four times as likely as compared to those who did not report poor access to medical care. Also, they were believed to be three times as likely to report suboptimal adherence to HIV medications.
These findings may have been suitable, at least in part, to the poor mental health found among many of the participants. Furthermore, the study experts found that HIV stigma seems to be one of the strongest predictors of poor access to medical care.
Additionally, HIV stigma and poor mental health may perhaps have calculated suboptimal adherence to medicine. Supposedly, adherence to HIV medicines is already known to lead to better health outcomes, including survival, among people suffering from HIV.
“We were surprised to find that in our models, experiencing high levels of internalized HIV stigma was one of the strongest predictors of poor access to medical care, even after controlling for sociodemographics such as gender, race and ethnicity, income, insurance status, and clinical variables such as T-cell count and years since HIV diagnosis,” says the study’s lead author, Dr. Jennifer Sayles, an assistant professor of medicine at the David Geffen School of Medicine at UCLA and medical director of the Los Angeles County Department of Public Health’s Office of AIDS Programs and Policy.
The study is known to be the foremost one to have quantified how internalized feelings of stigmatization among people living with HIV negatively influence health outcomes.
“It also highlights the need to address some of the social and contextual aspects of HIV for those living with the disease and to develop interventions that reduce internalized HIV stigma as a barrier to care and treatment,” adds Sayles.
The study findings revealed that overall one-third of the participants appear to have experienced high levels of stigma. Moreover, on average, participants seemed to have described experiencing or perceiving stigma slightly less often in contrast to ‘some of the time.’ Also, about 77 percent of participants stated that they had poor access to care and nearly 42.5 percent reported suboptimal adherence to ART while 10.5 percent reported having no regular source of HIV care.
The authors were observed to have pointed to some drawbacks in the study. They were unable to find causality between internalized HIV stigma and negative outcomes which seems to be the only strong association between them. Besides, the study was believed to have not directly measured social inequality, social support, self-efficacy and other similar co-variates that may be related to HIV stigma.
The study could perhaps have also overlooked people, who do not access care or HIV services at all. Because, the study participants were observed to have been recruited from community organizations providing outreach and social services to people living with HIV and from HIV clinical care sites. Lastly, non-English speakers such as Latinos and Asian Americans were noted to have been underrepresented in the trial.
Sayles claimed that these findings seem to demonstrate the urgent need for more community dialogue, education and awareness about HIV and the stigma that surrounds the disease.
The findings of the study have been published in the Journal of General Internal Medicine.