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

Abstract

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). Logistic regression explored care ratings, stigma, socio-demographics (N = 637). Qualitative thematic coding and themes explored stigmatizing experiences in different settings (N = 111). Whites were twice as likely as African-Americans to report high care ratings (<i>P</i> < .05). Clients who reported familial exclusion due to having sex with men were 40% less likely to report high medical care ratings (<i>P</i> < .05). Clients who agreed healthcare providers think people with HIV <i>"sleep around"</i> were half as likely to report high care ratings (<i>P</i> < .08). Stigmatization included <i>"treating me like they'll catch HIV from my hand,"</i> and care avoidance so others didn't <i>"know I was having sex with men"</i>. 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.