The effects of HIV stigma on health, disclosure of HIV status, and risk behavior of homeless and unstably housed persons living with HIV

AIDS Behav. 2009 Dec;13(6):1222-32. doi: 10.1007/s10461-008-9455-4. Epub 2008 Sep 4.

Abstract

HIV-related stigma negatively affects the lives of persons living with HIV/AIDS (PLWHA). Homeless/unstably housed PLWHA experience myriad challenges and may be particularly vulnerable to the effects of HIV-related stigma. Homeless/unstably housed PLWHA from 3 U.S. cities (N = 637) completed computer-assisted interviews that measured demographics, self-assessed physical and mental health, medical utilization, adherence, HIV disclosure, and risk behaviors. Internal and perceived external HIV stigma were assessed and combined for a total stigma score. Higher levels of stigma were experienced by women, homeless participants, those with a high school education or less, and those more recently diagnosed with HIV. Stigma was strongly associated with poorer self-assessed physical and mental health, and perceived external stigma was associated with recent non-adherence to HIV treatment. Perceived external stigma was associated with decreased HIV disclosure to social network members, and internal stigma was associated with drug use and non-disclosure to sex partners. Interventions are needed to reduce HIV-related stigma and its effects on the health of homeless/unstably housed PLWHA.

Publication types

  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adaptation, Psychological
  • Adolescent
  • Adult
  • Female
  • HIV Infections / diagnosis
  • HIV Infections / psychology*
  • Health Services Accessibility
  • Health Status
  • Humans
  • Ill-Housed Persons / psychology*
  • Male
  • Middle Aged
  • Poverty
  • Prejudice
  • Risk-Taking*
  • Self Disclosure*
  • Socioeconomic Factors
  • Stereotyping*
  • Surveys and Questionnaires
  • Truth Disclosure
  • United States
  • Urban Population
  • Young Adult