Perceptions of stigma and discrimination related to HIV status in MSM and TG in Lima, Peru
R.F. Sandler1,2, E. Segura2, S. Leon2, C. Caceres2, T. Coates3
1University of Iowa, Carver College of Medicine, Iowa City, United States, 2Universidad Peruana Cayetano Heredia, Lima, Peru, 3UCLA School of Medicine, Los Angeles, United States
Background: Stigma and discrimination create barriers to HIV diagnosis and treatment, most notably in vulnerable populations like men who have sex with men (MSM) and transgender males (TG) in Lima, Peru. Identifying perceptions of stigma and discrimination within these populations is important to understand barriers to optimal care and to enhance quality of life.
Methods: A secondary and exploratory analysis of the cross-sectional data from the baseline measurement of a 2×2 factorial, randomized clustered, community-based trial conducted in Lima, Peru was performed. Data on stigma and discrimination were collected using 23 statements that included perceptions of stigmatization of HIV-positive individuals by the community and of stigmatization of the subject if he were to be HIV positive. A 5-item Likert scale reflecting agreement with these statements was used initially and converted to a 3-item version for analysis. A total score was then calculated for each subject.
Results: The study population consisted of 701 males ages 18 to 45 who self-identified as 64.8% homosexual, 5.7% bisexual, and 28.9% TG. The general result in a median score of 30 out of 69 (range 21-44). Scores were inversely related to perceived stigma. Among the 80% of subjects who were previously tested for HIV, regardless of the result, a higher sense of perceived stigma was reported as compared to those subjects without prior testing (mean 30.6 vs. 31.8, p< 0.05). The 41 (8.6%) of subjects reporting a previous positive HIV test result demonstrated a lower sense of stigma than those 435 subjects reporting previous negative HIV test results (mean 32. 8 vs. 30.6, p< 0.05).
Conclusions: Perceptions of stigma and discrimination varied in this population based upon previous HIV testing. However, these same perceptions seem to be less pronounced in subjects with previously known positive HIV test results, suggesting a change in perception when HIV status is known.