One-fourth of HIV patients believe their doctors stigmatize them

Aug 31, 2007

Physicians might want to be extra careful about how they treat HIV-infected patients —not just in the clinical sense but in the way they behave toward them.

Even the perception that physicians are stigmatizing patients for carrying the virus that causes AIDS can discourage these individuals from seeking proper medical care, according to a new UCLA study.

The study, published in the August issue of the peer-reviewed journal AIDS Patient Care and STDs, found that up to one-fourth of patients surveyed in the Los Angeles area reported feeling stigmatized by their health care providers. This perception was also linked to low access to care among these patients, a large proportion of whom are low-income and minorities.

“Whether or not it is actual stigmatization is hard to measure, because it’s coming from the patients that we interviewed,” said UCLA researcher Janni J. Kinsler, the study’s project director and lead researcher. “The point is that these people feel that way, and that’s bad enough, because they’re less likely to seek the care they need.”

The study results were based on surveys of 223 HIV-positive individuals in Los Angeles County, with initial baseline interviews taking place between May 2004 and June 2005 and follow-up interviews conducted six months later, from November 2004 to December 2005. Of the respondents, 80 percent were male, 46 percent were African American and 40 percent were Latino. Nearly three-quarters had a high school education or less, half had annual incomes below $8,000 and 46 percent did not have insurance. In addition, 54 percent of the patients reported that they became infected through homosexual contact, 30 percent through heterosexual contact and 16 percent through intravenous drug use.

There are two types of stigma: external, or “public,” stigma and personal, or “perceived,” stigma. The latter refers to individuals’ anticipated fears of societal attitudes or discrimination because their HIV infection.

Researchers questioned 223 patients during the baseline interviews and 171 during the follow-up. They were asked the following questions about stigmatization:

Since you contracted HIV, has any health care provider:
• Been uncomfortable with you?
• Treated you as inferior or in an inferior manner?
• Preferred to avoid you?
• Refused to serve you?

Patients were also asked six questions related to their access to health care: whether they had gone without medical care due to expense, if medical care was conveniently located, whether they could obtain medical care whenever they needed it, if they had easy access to medical specialists, if emergency care was easily obtainable and if they could be admitted to hospitals with no trouble.

The researchers found that at baseline 26 percent of the patients reported at least one of the four types of perceived stigma from a health care provider, and 19 percent reported the same at follow-up. Also, 58 percent claimed low access to care on at least one of the six relevant questions at baseline, as did 57 percent at follow-up.

“Most importantly, we found that those who perceived stigma from a health care provider had more than twice the odds of reporting low access to care, even after examining the effect prospectively and adjusting for a host of sociodemographic and clinical characteristics,” the researchers said.

Researchers noted the significance that perceived stigma “could greatly affect [patients’] use of needed medical services, including antiretroviral therapy.” Because of this, patients may seek medical care only when their illness has progressed to a more severe stage, leading to more intensive medical interventions, hospitalization and earlier death.

The next step is to investigate whether physicians are in fact stigmatizing these patients, Kinsler said.

In addition to Kinsler, researchers included Mitchell Wong, Jennifer N. Sayles and William Cunningham of UCLA, and Cynthia Davis of Charles R. Drew University of Medicine and Science in Los Angeles.

Source: University of California - Los Angeles

Explore further: Intimacy a strong motivator for PrEP HIV prevention

add to favorites email to friend print save as pdf

Related Stories

Virtual reality guides those whose memory is failing

4 hours ago

Experts agree that the ability to navigate a neighborhood or built space is one of the first faculties to suffer at the onset of cognitive decline. They also agree that early intervention is crucial for stemming ...

Straight to the heart

Aug 18, 2014

A battery-less, wirelessly-powered implantable defibrillator for atrial fibrillation is being developed by an international team of researchers in the UK, Venezuela and the US. With the ability to sense the ...

New technologies are improving the lives of seniors

Aug 14, 2014

If Betty Lewis falls at the Edgemere senior living community, a pendant she wears around her neck will alert the staff. The device picks up the motion of the fall and notifies staff members at the North Dallas facility so ...

Recommended for you

Obese British man in court fight for surgery

Jul 11, 2011

A British man weighing 22 stone (139 kilograms, 306 pounds) launched a court appeal Monday against a decision to refuse him state-funded obesity surgery because he is not fat enough.

2008 crisis spurred rise in suicides in Europe

Jul 08, 2011

The financial crisis that began to hit Europe in mid-2008 reversed a steady, years-long fall in suicides among people of working age, according to a letter published on Friday by The Lancet.

New food labels dished up to keep Europe healthy

Jul 06, 2011

A groundbreaking deal on compulsory new food labels Wednesday is set to give Europeans clear information on the nutritional and energy content of products, as well as country of origin.

Overweight men have poorer sperm count

Jul 04, 2011

Overweight or obese men, like their female counterparts, have a lower chance of becoming a parent, according to a comparison of sperm quality presented at a European fertility meeting Monday.

User comments : 0