Key and general population HIV-related stigma and discrimination in HIV-specific health care settings: results from the Stigma Index Brazil

ABSTRACT

HIV-related stigma and discrimination lead to poorer mental health, lower levels of services usage, and less adherence to antiretroviral medications. Due to the overlap of different kinds of stigmas, HIV-positive key populations are the most susceptible to negative health outcomes. The Stigma Index is an instrument that measure worldwide trends in HIV-related stigma from the perspective of people living with HIV/AIDS (PLWHA). The present community-based study aims to estimate the prevalence of HIV-related discrimination in the past 12 months in HIV-related care, comparing general and key populations in Brazil. A total of 30 PLWHA were trained to recruit participants among their peer networks; 1768 PLWHA participated in the study and were asked if, in the past 12 months when seeking HIV-specific healthcare, they had experienced discrimination from health facility staff because of their HIV status. Overall, 269 (15.21%) participants experienced this kind of discrimination. The odds of experiencing discrimination in HIV-specific healthcare settings in the general versus key populations was OR 1.77 95% CI [1.30 −2.42]. It is noteworthy that in Brazil, after four decades of a human rights-based approach to the epidemic, we found high levels of discrimination in the HIV-specific healthcare context affecting the key populations more severely.

KEYWORDS:

• HIV-related discrimination
• Brazil
• stigma
• key populations

Acknowledgments

We thank the representatives of PLWHA networks who contributed to the Stigma Index adaptation process and implementations, and PLWHA who responded to the survey.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was suportted by the Joint United Nations Program on HIV/AIDS (UNAIDS-Brazil) and the United Nations Development Programme (UNDP- Brazil).