Prevalence of HIV-related stigma manifestations and their contributing factors among people living with HIV in Sweden - a nationwide study

• Published in: BMC public health 2024-05, Vol.24 (1), p.1360-1360, Article 1360
• Main Authors: Nilsson Schönnesson, Lena, Dahlberg, Marie, Reinius, Maria, Zeluf-Andersson, Galit, Ekström, Anna-Mia, Eriksson, Lars E
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Antiretroviral agents; Antiretroviral therapy; Attitudes; Chronic illnesses; Chronic infection; Cross-Sectional Studies; Customization; Diagnosis; Discrimination; Discrimination against AIDS virus carriers; Emotions; Female; Females; Gender; HIV; HIV infection; HIV Infections - epidemiology; HIV Infections - psychology; Human immunodeficiency virus; Humans; Infections; Male; Medicin och hälsovetenskap; Mental health; Middle Aged; People living with HIV; Prevalence; Quality of life; Regression analysis; Sexual orientation; Sexually transmitted diseases; Social aspects; Social Stigma; STD; Stigma; Sweden; Sweden - epidemiology; Young Adult
• ISSN: 1471-2458; 1471-2458
• DOI: 10.1186/s12889-024-18852-9

With access to  antiretroviral therapy (ART) HIV infection is a chronic manageable condition and non-sexually transmissible. Yet, many people living with HIV still testify about experiencing HIV-related stigma and discrimination. It is well-documented that HIV-related stigma and discrimination continue to be critical barriers to prevention, treatment, care and quality of life. From an individual stigma-reduction intervention perspective, it is essential to identify individual and interpersonal factors associated with HIV-related stigma manifestations. To address this issue and to expand the literature, the aim of this study was to assess the prevalence of HIV-related stigma manifestations and their associated factors among a diverse sample of people living with HIV in Sweden. Data from 1 096 participants were derived from a nationally representative, anonymous cross-sectional survey "Living with HIV in Sweden". HIV-related stigma manifestations were assessed using the validated Swedish 12-item HIV Stigma Scale encompassing four HIV-related stigma manifestations: personalised stigma, concerns with public attitudes towards people living with HIV, concerns with sharing HIV status, and internalized stigma. Variables potentially associated with the HIV-related stigma manifestations were divided into four categories: demographic characteristics, clinical HIV factors, distress and ART adherence, and available emotional HIV-related support. Four multivariable hierarchical linear regression analyses were employed to explore the associations between multiple contributors and HIV-related stigma manifestations. The most dominating stigma feature was anticipation of HIV-related stigma. It was manifested in high scores on concerns with sharing HIV status reported by 78% of the participants and high scores on concerns about public attitudes towards people living with HIV reported by 54% of the participants. High scores on personalised stigma and internalized stigma were reported by around one third of the participants respectively. Between 23 and 31% of the variance of the four reported HIV-related stigma manifestations were explained mainly by the same pattern of associated factors including female gender, shorter time since HIV diagnosis, feelings of hopelessness, non-sharing HIV status, and lack of available emotional HIV-related support. The most dominating stigma feature was anticipation of stigma. Female gender, shorter time since HIV diagnosis, feelings of hopeles