Multilevel Stigma and Its Associations with Medical Care Ratings Among Men Who Have Sex With Men in HPTN 078

J Prim Care Community Health. 2023 Jan-Dec:14:21501319231175362. doi: 10.1177/21501319231175362.

Abstract

Introduction: Our research assessed associations between stigma-related variables and medical care ratings among clients with HIV in HIV Prevention Trials Network (HPTN) 078 who were men who have sex with men (MSM).

Methods: Logistic regression explored care ratings, stigma, socio-demographics (N = 637). Qualitative thematic coding and themes explored stigmatizing experiences in different settings (N = 111).

Results: Whites were twice as likely as African-Americans to report high care ratings (P < .05). Clients who reported familial exclusion due to having sex with men were 40% less likely to report high medical care ratings (P < .05). Clients who agreed healthcare providers think people with HIV "sleep around" were half as likely to report high care ratings (P < .08). Stigmatization included "treating me like they'll catch HIV from my hand," and care avoidance so others didn't "know I was having sex with men".

Conclusions: Providers can promote African American MSM client retention with more affirming healthcare provision, namely minimizing assumptions and addressing identities and client needs beyond just HIV care.

Trial registration: ClinicalTrials.gov NCT02663219.

Keywords: African Americans; HIV/AIDS; LGBT health; health disparities; healthcare utilization; men who have sex with men.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Female
  • HIV
  • HIV Infections* / prevention & control
  • Homosexuality, Male
  • Humans
  • Male
  • Sexual and Gender Minorities*
  • Social Stigma

Associated data

  • ClinicalTrials.gov/NCT02663219