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: Indiana HIV outbreak, hepatitis C epidemic sparks US alert

Related Stories

Hackers keep trying new targets in search of easy data

Apr 14, 2015

The health care sector has become the hot target for hackers in recent months, according to researchers at Symantec, a leading cybersecurity company that says it's also seeing big increases in "spear-phishing," ...

Communication devices enable children with disabilities

Apr 08, 2015

An interdisciplinary group of Northeastern University students and faculty have combined their knowledge of engineering and physical therapy to design, develop, and then deliver two low-cost communication ...

Recommended for you

Indiana HIV outbreak, hepatitis C epidemic sparks US alert

Apr 24, 2015

Federal health officials helping to contain an HIV outbreak in Indiana state issued an alert to health departments across the U.S. on Friday, urging them to take steps to identify and track HIV and hepatitis C cases in an ...

Why are HIV survival rates lower in the Deep South than the rest of the US?

Apr 22, 2015

The Deep South region has become the epicenter of the US HIV epidemic. Despite having only 28% of the total US population, nine states in the Deep South account for nearly 40% of national HIV diagnoses. This region has the highest HIV diagnosis rates and the highest number of people living with HIV of any ...

A bad buzz: Men with HIV need fewer drinks to feel effects

Apr 20, 2015

Researchers at Yale and the VA Pittsburgh Healthcare System compared the number of drinks that men with HIV infection, versus those without it, needed to get a buzz. They found that HIV-infected men were more sensitive to ...

User comments : 0

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.