Patient and Provider Perspectives on HIV Stigma in Healthcare Settings in Underserved Areas of the US South: A Mixed Methods Study

Kaylee B Crockett; Bulent Turan; Samantha Whitfield; Emma Sophia Kay; Henna Budhwani; Matthew Fifolt; Kris Hauenstein; Murray D Ladner; Joshua Sewell; Pamela Payne-Foster; Laura Nyblade; D Scott Batey; Janet M Turan

doi:10.1007/s10461-021-03470-y

Patient and Provider Perspectives on HIV Stigma in Healthcare Settings in Underserved Areas of the US South: A Mixed Methods Study

AIDS Behav. 2022 Jan;26(Suppl 1):112-124. doi: 10.1007/s10461-021-03470-y. Epub 2021 Sep 28.

Authors

Affiliations

¹ Department of Family and Community Medicine, School of Medicine, University of Alabama at Birmingham, Community Health Services Building, 930 20th St S, Birmingham, AL, 35205, USA. [email protected].
² Department of Psychology, Koc University, Istanbul, Turkey.
³ Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.
⁴ Department of Social Work, College of Arts and Sciences, University of Alabama at Birmingham, Birmingham, AL, USA.
⁵ Birmingham AIDS Outreach, Birmingham, AL, USA.
⁶ Department of Community and Rural Medicine/Population Health, College of Community Health Sciences, University of Alabama, Tuscaloosa, AL, USA.
⁷ Global Health Division, International Development Group, RTI International, Washington, DC, USA.

Abstract
in English, Spanish

Stigma experienced in healthcare settings is a barrier to ending the HIV epidemic. Using a convergent parallel mixed methods approach, we collected qualitative data from 14 focus groups with People with HIV (PWH) and Healthcare workers (HCW) and quantitative survey data (N = 762 PWH and N = 192 HCW) from seven HIV healthcare clinics outside of major urban areas in the southeastern US. Four key themes emerged: (1) HIV-related stigma and discrimination in healthcare settings; (2) experiences of intersectional stigma; (3) disclosure concerns in healthcare settings; and (4) impact of stigma on HIV-related health behavior. Implications for future stigma interventions in healthcare settings include the importance of engaging PWH in the development of interventions, the need for interventions in settings that do not specialize in HIV care, and the importance of engaging all staff when addressing HIV-related stigma.

El estigma experimentado en los entornos de atención médica es una barrera para poner fin a la epidemia del VIH. Utilizando un enfoque convergente de métodos mixtosparalelos, recopilamos datos cualitativos de 14 grupos focales con personas con VIH y trabajadores de la salud y datos de encuestas cuantitativas (N = 762 personas con VIH y N = 192 trabajadores de la salud) de siete clínicas de atención médica de VIH fuera de las principales áreas urbanas en el sureste de los Estados Unidos. Surgieron cuatro temas clave: (1) el estigma y la discriminación relacionados con el VIH en los entornos de atención médica; (2) experiencias de estigma interseccional; (3) preocupaciones de divulgación en entornos de atención médica; y (4) el impacto del estigma en el comportamiento de salud relacionado con el VIH. Las implicaciones para futuras intervenciones de estigma en entornos de atención médica incluyen la importancia de involucrar a las personas con VIH en el desarrollo de intervenciones, la necesidad de intervenciones en entornos que no se especializan en la atención del VIH y la importancia de involucrar a todo el personal al abordar el estigma relacionado con el VIH.

Keywords: HIV; Healthcare discrimination; Mixed methods; South; Stigma.

MeSH terms

Delivery of Health Care
HIV Infections*
Health Facilities
Humans
Medically Underserved Area*
Social Stigma

Abstract in English, Spanish

MeSH terms

Grants and funding

Abstract
in English, Spanish