Personalized Stigma and Disclosure Concerns Among HIV-Infected Immigrant and Indigenous HIV-Infected Persons in the Netherlands

Abstract

This study examines stigmatization among immigrant and indigenous (a person whose parents were both born in the Netherlands) HIV-infected patients in the Netherlands. We interviewed 90 indigenous Dutch and 112 immigrant HIV-infected patients using the personalized stigma and disclosure concerns subscales of the HIV Stigma Scale. Use of these scales with HIV-infected immigrant patients was feasible as we found adequate reliability and patients were able to answer the questions after explanation. Personalized stigma was significantly higher among HIV-infected immigrants. Disclosure concerns were significantly higher among persons with an HIV transmission route other than men having sex with men. In multivariate analyses adjusting for age, sex, and number of years being HIV positive, having an immigrant status remained significantly associated with personalized stigma and HIV transmission routes other than men having sex with men remained significantly associated with having more disclosure concerns. Our findings suggest that social workers and counselors should be especially attentive to experienced and perceived HIV stigma among HIV-infected persons from these particular populations. Future studies should explore the mechanisms underlying stigmatization in the different subgroups so interventions to decrease stigmatization can be developed and examined.

KEYWORDS:

• disclosure concerns
• HIV
• immigrant patients
• personalized stigma

Acknowledgments

This work was supported by The AIDS Fonds, Amsterdam, The Netherlands (grant 6003 and grant 2006013).

We would like to thank all participants who took part in the interviews. Also, we would like to thank all the HIV treating physicians and HIV counselors of the Department of Internal Medicine, Division of Infectious Diseases, Tropical Medicine and AIDS of the Academic Medical Centre, Amsterdam and the Netherlands for asking patients to participate in our study. Last, we thank all interviewers.

Notes

*Other HIV transmission route than MSM: heterosexual HIV transmission route, injecting drug use, blood transfusion, and other. PS, personalized stigma; DC, disclosure concerns.

*Other HIV transmission route than MSM: heterosexual HIV transmission route, injecting drug use, blood transfusion, and other.

*p < .05.

*Other HIV transmission route than MSM: heterosexual HIV transmission route, injecting drug use, blood transfusion, and other.