The Impact of Anticipated HIV Stigma on Delays in HIV Testing Behaviors: Findings from a Community-Based Sample of Men Who Have Sex with Men and Transgender Women in New York City

Abstract

Treatment as prevention (TaSP) is a critical component of biomedical interventions to prevent HIV transmission. However, its success is predicated on testing and identifying undiagnosed individuals to ensure linkage and retention in HIV care. Research has examined the impact of HIV-associated stigma on HIV-positive individuals, but little work has explored how anticipated HIV stigma-the expectation of rejection or discrimination against by others in the event of seroconversion-may serve as a barrier to HIV testing behaviors. This study examined the association between anticipated stigma and HIV testing behaviors among a sample of 305 men who have sex with men (MSM) and transgender women living in New York City. Participants' mean age was 33.0; 65.5% were racial/ethnic minority; and 50.2% earned < $20,000 per year.

Sexually Transmitted Infection Related Stigma and Shame Among African American Male Youth: Implications for Testing Practices, Partner Notification, and Treatment

“…13,15,23,29 Some have attributed this to ''anticipated stigma,'' which can be measured using a different scale, and is designed to assess the extent to which individuals anticipate negative intra-and interpersonal consequences should they contract HIV/STIs in the future, and operates independently of personal endorsement of stigmatizing beliefs or stereotypes. 30,31 Although our research did not investigate anticipated stigma or potential delays in seeking care, we did see a large percentage of youth not seeing doctors regularly (34%). However in this area of San Francisco, where outreach services are numerous, a large proportion of men had been tested for STI and HIV, although approximately 18% of those tested had been tested in jail or juvenile hall; in California, all youth are STI tested at entry to correctional unit facilities.…”

“…32 Other investigators have called for a need to understand the sources of STI stigma and shame in order to better target responses. 13,31 Although rarely assessed in the literature on STI stigma, some have posited that stigma and shame stem from prevalent sociocultural norms; as sex has historically been a stigmatized behavior, STIs are stigmatized as well. As a result, sexual stigma combined with the perpetuated notion of individual responsibility/blame for not adopting certain behaviors has made STIs the ''symbols of immoral or irresponsible behavior.''…”

Patterns of Geographic Mobility Predict Barriers to Engagement in HIV Care and Antiretroviral Treatment Adherence

“…The HIV-associated stigma that leads to this fear, however, is a structural/societal barrier, and we join many others in arguing that this is appropriately addressed at the community rather than the individual level. 41,43,44 These findings add to the growing body of literature regarding the impact of HIV-related stigma on Hispanic communities. 38,39 This stigma may lead to reluctance to be tested for HIV and delays in seeking care that lead to presentation with more advanced disease.…”

Leading by Example: Web-Based Sexual Health Influencers Among Men Who Have Sex With Men Have Higher HIV and Syphilis Testing Rates in China (Preprint)

“…We measured anticipated HIV stigma [32], HIV testing social norms [33], HIV testing selfefficacy [34] and community engagement as continuous outcomes. The 7-item anticipated HIV stigma scale asked participants about their own feelings about themselves if they had HIV as well as perceived discriminating attitudes from other people.…”

“…Their higher HIV testing may be related to increased community engagement in sexual health [35] and HIV testing-related social media use. [37] The higher rates of HIV testing among influencers may also be related to lower HIV stigma and higher testing self-efficacy which are two important contributors to test uptake [32,38].…”