Stigma Is Associated with Delays in Seeking Care among HIV-Infected People in India

Abstract

Background: Stigma shapes the lives of people living with HIV and may affect their willingness to seek medical care. But treatment delays can compromise health and increase the risk of transmission to others. Purpose: To examine whether the 4 stigma manifestations— enacted (discrimination), vicarious (hearing stories of discrimination), felt normative (perceptions of stigma’s prevalence), and internalized (personal endorsement of stigma beliefs)—were linked with delays in seeking care among HIV-infected people in India. Methods: A cross-sectional survey was conducted with 961 HIV-positive men and women in Mumbai and Bengaluru. Results: Enacted and internalized stigmas were correlated with delays in seeking care after testing HIV positive. Depression symptoms mediated the associations of enacted and internalized stigmas with care-seeking delays, whereas efforts to avoiding disclosing HIV status mediated only the association between internalized stigma and care-seeking delays. Conclusion: It is vital to develop stigma reduction interventions to ensure timely receipt of care.