Experiences of provider AIDS-related discrimination: Results from the Southwestern PA HIV needs assessment

Background: Despite advancements in HIV/AIDS care, stigma and discrimination persists in the provision of services to persons living with HIV/AIDS (PLWHA). One goal of the Southwestern Pennsylvania HIV Needs Assessment was to identify barriers to care among PLWHA.

Methods: A total of 320 respondents, residing in 12 counties, completed surveys which were administered on-line, via telephone, and as paper hardcopy. Topics address included general health status, access to care, service need, barriers to care, and Shuster's (2005) established measure of provider AIDS-related discrimination.

Results: One quarter of the sample (28.6 %) reported experiencing provider AIDS-related discrimination. Respondents reported that a provider had been uncomfortable with them (22.5%), treated them as inferior (18.4%), preferred to avoid them (15.6%) or refused them service (9.1%). Adjusted regression analyses found that HIV-related health status was the only variable to be significiantly associated with experiences of discrimination. Medical and dental providers were the providers most often identified as delivering the discrimination. Of those who reported a provider had been uncomfortable with them, 60% reported that it was a medical provider and 53% that it was a dental provider. Respondent's experiences of discrimination were significantly related to unmet dental care and alternative therapies need. Lack of health care professionals adequately trained and competent in HIV/AIDS care was the most significant barrier to dental care services.

Conclusions: Provider AIDS-related discrimination still remains a concern for PLWHA in Southwestern Pennsylvania. Increasing medical and dental care provider's HIV sensitivity should contribute to improved health outcomes and quality of life.