Multilevel Stigma and Its Associations with Medical Care Ratings Among Men Who Have Sex With Men in HPTN 078

Abstract

Introduction: Our research assessed associations between stigma-related variables and medical care ratings among clients with HIV in HIV Prevention Trials Network (HPTN) 078 who were men who have sex with men (MSM). Methods: Logistic regression explored care ratings, stigma, socio-demographics (N = 637). Qualitative thematic coding and themes explored stigmatizing experiences in different settings (N = 111). Results: Whites were twice as likely as African-Americans to report high care ratings ( P < .05). Clients who reported familial exclusion due to having sex with men were 40% less likely to report high medical care ratings ( P < .05). Clients who agreed healthcare providers think people with HIV “sleep around” were half as likely to report high care ratings ( P < .08). Stigmatization included “treating me like they’ll catch HIV from my hand,” and care avoidance so others didn’t “know I was having sex with men” . Conclusions: Providers can promote African American MSM client retention with more affirming healthcare provision, namely minimizing assumptions and addressing identities and client needs beyond just HIV care.