We characterized the prevalence of, and estimated associations between, (1) HIV-related healthcare stigma/discrimination and (2) unmet social, mental, and chronic condition healthcare needs among persons living with HIV (PLHIV) in England and Wales. We used data from Positive Voices 2017, a national, cross-sectional probability survey of PLHIV in England and Wales, in which N = 3,475 PLHIV provided complete data on demographic characteristics (control variables; age, ethnicity, gender, sexual identity), HIV-related healthcare stigma/discrimination (exposures; treated differently from other patients, care was refused/delayed, worried about being treated differently, avoided seeking needed care, all due to HIV status), and unmet needs (outcomes; unmet peer support, psychological care, management of chronic health conditions, and isolation help needs). Modified Poisson regression models with log links and robust variance estimators were used to produce prevalence ratios and 95% confidence intervals for unadjusted and adjusted associations between demographic characteristics, HIV-related healthcare stigma/discrimination (individual items and total scale score), and unmet needs variables. Two in five participants (40%) endorsed at least one HIV-related healthcare stigma/discrimination item; and 474 (14%), 428 (12%), 459 (13%), and 501 (14%) reported an unmet peer support, psychological care, chronic health condition management, and isolation help need, respectively. Each HIV-related healthcare stigma/discrimination item and the summed scale score were significantly, positively associated with all four unmet needs variables in unadjusted and adjusted models. Trainings for all healthcare workers in HIV-competent, non-stigmatizing care, as well as the development of engagement and delivery approaches for psychosocial care for PLHIV, are needed.
Bibliographical noteFunding Information: This study was funded by the National Institutes of Health, including support from the National Institute of Mental Health (R01MH110358). Additionally, JLM received research support from the National Institute of Allergy and Infectious Diseases (T32AI102623). The Positive Voices survey was supported by funding from Public Health England and research grants from Gilead Sciences Inc. The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The authors have no conflicts of interest to report.
Open Access: This is an open access article under the Open Government License (OGL) https://www.nationalarchives.gov.uk/doc/open-government-licence/version/3/
Publisher Copyright: © 2021 Published by Elsevier Inc.
Citation: John Mark Wiginton, Jessica L. Maksut, Sarah M. Murray, Jura L. Augustinavicius, Meaghan Kall, Valerie Delpech, Stefan D. Baral, Brief report: HIV-related healthcare stigma/discrimination and unmet needs among persons living with HIV in England and Wales, Preventive Medicine Reports, Volume 24, 2021, 101580, ISSN 2211-3355,
- HIV-related healthcare stigma/ discrimination
- Persons living with HIV
- Unmet needs