Discrimination in healthcare settings among adults with recent HIV diagnoses

ABSTRACT

The prevalence of discrimination in healthcare settings among HIV patients in the United States is unknown. The Medical Monitoring Project (MMP) is a complex sample survey of adults receiving HIV medical care in the United States. We analyzed nationally representative MMP data collected 2011–2015. We assessed the prevalence of self-reported healthcare discrimination, perceived reasons for discrimination, and factors associated with discrimination among persons with HIV diagnoses ≤5 years before interview (n = 3,770). Overall, 14.1% of patients living with HIV (PLWH) experienced discrimination, of whom 82.2% attributed the discrimination to HIV. PLWH reporting poverty, homelessness, or attending a non-Ryan White HIV/AIDS Program (RWHAP) facility were more likely to report discrimination compared with other groups. Of patients attending non-RWHAP facilities, discrimination was higher among those in poverty (27.5%) vs. not in poverty (15.1%). Discrimination was associated with homelessness regardless of facility type, and was highest among homeless persons attending non-RWHAP facilities.

Healthcare discrimination was commonly reported among PLWH, and was most often attributed to HIV status. Discrimination was higher among those reporting poverty or homelessness, particularly those attending non-RWHAP facilities. Incorporating practices, such as anti-discrimination training, in facilities may reduce healthcare discrimination.

KEYWORDS:

• Discrimination
• HIV/AIDS
• United States
• Ryan White

Acknowledgements

We thank participating MMP respondents, providers, community and provider advisory boards, and project areas. We also acknowledge the contributions of the Clinical Outcomes Team, the Behavioral and Clinical Surveillance Branch, and Antigone Dempsey and Heather Hauck from HRSA.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

Funding for the Medical Monitoring Project is provided by the Centers for Disease Control and Prevention.