The effects of HIV stigma on health, disclosure of HIV status, and risk behavior of homeless and unstably housed persons living with HIV

Richard J. Wolitski, Sherri L. Pals, Daniel P. Kidder, Cari Courtenay-Quirk, David R. Holtgrave

Research output: Contribution to journalArticle

Abstract

HIV-related stigma negatively affects the lives of persons living with HIV/AIDS (PLWHA). Homeless/unstably housed PLWHA experience myriad challenges and may be particularly vulnerable to the effects of HIV-related stigma. Homeless/unstably housed PLWHA from 3 U.S. cities (N = 637) completed computer-assisted interviews that measured demographics, self-assessed physical and mental health, medical utilization, adherence, HIV disclosure, and risk behaviors. Internal and perceived external HIV stigma were assessed and combined for a total stigma score. Higher levels of stigma were experienced by women, homeless participants, those with a high school education or less, and those more recently diagnosed with HIV. Stigma was strongly associated with poorer self-assessed physical and mental health, and perceived external stigma was associated with recent non-adherence to HIV treatment. Perceived external stigma was associated with decreased HIV disclosure to social network members, and internal stigma was associated with drug use and non-disclosure to sex partners. Interventions are needed to reduce HIV-related stigma and its effects on the health of homeless/unstably housed PLWHA.

Original languageEnglish (US)
Pages (from-to)1222-1232
Number of pages11
JournalAIDS and behavior
Volume13
Issue number6
DOIs
StatePublished - Dec 1 2009

Keywords

  • Access to medical care
  • Adherence
  • Discrimination
  • HIV disclosure
  • HIV stigma
  • Homelessness
  • Prejudice
  • Sexual risk behavior
  • Social support

ASJC Scopus subject areas

  • Social Psychology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

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