Exploring HIV-related stigma among HIV-infected men who have sex with men in Beijing, China: a correlation study

ABSTRACT

Human immunodeficiency virus (HIV)-related stigma among HIV-infected men who have sex with men (MSM) has been associated with adverse health outcomes, including poor adherence to antiretroviral therapy and care, and increased participation in behaviors linked to higher rates of HIV transmission. In China, the incidence of HIV is growing more rapidly among MSM than among other subgroups. This study characterizes and quantifies HIV stigma among HIV-infected MSM in Beijing, China, which arguably may be driving this epidemic. A cross-sectional survey study was performed among 266 HIV-positive MSM in Beijing, China, in 2014. The Berger HIV Stigma Scale was used to measure levels of HIV-related stigma. Participants additionally answered questions regarding socio-demographic characteristics and HIV-associated risk factors; previously validated Mandarin-language scales assessed depression, coping style, and social support networks. Multivariable linear regression models were used to identify variables significantly associated with HIV stigma. The mean overall HIV stigma score among the study population was 112.78 ± 18.11 (score range: 40–160). Higher HIV stigma scores were positively associated with depression (β = 7.99, 95% CI:3.69, 12.29, p < .001) and negative coping skills (β = 0.64, 95% CI:0.21,1.08, p < .01), and was negatively associated with disclosed HIV status (β = −6.45, 95%CI:−11.80, −1.11, p < .05), and availability of social support networks (β = −0.12, 95%CI:−0.22, −0.02, p < .05). Other variables such as poor self-rated health status and presence of opportunistic infections were positively associated with individual dimensions of HIV-related stigma. The results of this study can inform the development of culturally sensitive interventions to reduce HIV-related stigma among MSM with HIV in China, with the overarching goal of reducing HIV transmission in this vulnerable population.

KEYWORDS:

• Stigma
• HIV
• AIDS
• MSM
• China

Acknowledgements

We would like to thank the staff of the Red Ribbon Home of the Beijing Ditan Hospital and all the study participants who have given their time and effort to assist us to better understand the needs of MSM with HIV. We would also like to acknowledge Dr Kaveh Khoshnood for his editorial assistance in preparing this manuscript.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This study was funded by the Youth Foundation of Peking Union Medical College [grant number 3332013013]; Dr Hsieh and Dr Morano were supported by NIH/FIC [grant number U2RTW006918].