Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #111383

Elizabeth Needham Waddell, PhD, Bureau of Maternal Infant and Reproductive Health, New York City Department of Health and Mental Hygienne, 2 Lafayette St., 18th Fl., New York, NY 10007, 212-442-1810, ewaddell@health.nyc.gov and David Abramson, PhD, Department of Sociomedical Sciences, Columbia University, 722 West 168th Street, room 1106, New York, NY 10032.

Stigma is increasingly recognized as a significant barrier to HIV care, particularly among women, racial/ethnic minorities, and sexual minorities. This study develops two measures of HIV stigma and identifies their associations with self-reported delays in seeking medical or social services.

Measures were constructed using client-level data from a longitudinal cohort study of persons living with HIV/AIDS. Drawing on data collected between 2002 and 2003 (n = 594, 39% female), the two multi-item stigma measures independently assessed respondents' 1) fear of labeling and avoidance of disclosing HIV status, and 2) direct experiences of ostracism or discrimination based on their HIV status.

Women and caregivers of minor children were more likely than others to report fears of labeling, but not to report direct experiences of ostracism/discrimination, perhaps because they were less likely to disclose their HIV status and thus become vulnerable to social censure. In addition to fears of labeling, respondents reporting insufficient money for food, inadequate social support, and mental health difficulties were most likely to report direct experiences of ostracism/discrimination.

While there was no significant association observed between fears of labeling and delayed care-seeking, a statistically significant association was observed between ostracism/discrimination and delayed care, controlling for sociodemographic characteristics, competing needs (e.g., childcare, money for food), social support, and physical and mental health status.

Study findings suggest that individuals who are dually-stigmatized – as a consequence of social disadvantage or mental health issues – are most vulnerable to delayed care-seeking associated with HIV stigma.

Learning Objectives: At the conclusion of the session the participant in this session will be able to

• Identify subpopulations most likely to report experiencing HIV stigma, including women and caregivers of minor children.
• Identify two specific dimensions of HIV-related stigma -- fear of labeling and direct experiences of discrimination and ostracism.
• Identify the relationship between HIV stigma and delayed use of HIV medical and social services in an urban population living with HIV/AIDS.

Keywords: Urban Women's Health Issues, Health Behavior

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Recorded presentation