Predictors of enacted, internal, and anticipated stigma among PLHIV in New Jersey

ABSTRACT

This article describes findings from the first statewide implementation of the People Living with HIV (PLHIV) Stigma Index in the United States. The goals of the study were to identify sources of stigma and contributing factors as a means of developing stigma-reduction interventions in New Jersey. Based on a sample of 371 PLHIV, the study found high levels of internal and anticipated stigma, particularly feelings of self-blame, anger, low self-esteem, fear of gossip, and fear of lack of sexual intimacy. Forty-nine percent of participants stated that they had experienced gossip in the past year, which was the most common type of enacted stigma. Current use of antiretroviral medications was the factor most strongly associated with enacted stigma, while self-rated health had the strongest association with internal and anticipated stigma. These findings were consistent with studies implementing the Stigma Index in other countries and locations within the United States. In New Jersey, people who were unemployed or homeless and those who identified as someone diagnosed with a mental illness or as a sex worker, most frequently reported experiencing all three types of stigma. The study’s findings suggest the need to invest in interventions to address needs for job training, mental health services, and housing supports for PLHIV. One result of the study was the formation of a new advocacy group, the Coalition to End Discrimination, which seeks to develop new policies and interventions to reduce HIV-related stigma in New Jersey.

KEYWORDS:

• PLHIV Stigma Index
• enacted stigma
• internal stigma
• anticipated stigma
• New Jersey

Acknowledgements

This project could not have been completed without the support and active involvement of project staff; staff from the New Jersey Department of Health’s Division of HIV, STD, and TB Services; members of the New Jersey HIV/AIDS Planning Group’s Stigma Committee; staff from our partnering agencies; the interviewers; and all of the people living with HIV who came forward courageously to share their stories.

Disclosure statement

No potential conflict of interest was reported by the authors.

ORCID

Ann D. Bagchi http://orcid.org/0000-0002-5724-0908

William Holzemer http://orcid.org/0000-0002-4400-9432

Additional information

Funding

This work was supported by State of New Jersey Department of Health.