HIV-related stigma and discrimination in health care and health-related quality of life among people living with HIV in England and Wales: A latent class analysis.

John Mark Wiginton*, Sarah Murray, Meaghan Kall, Jessica L. Maksut, Jura Augustinavicius, Valerie Delpech, Stefan D. Baral

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Though life expectancy of people living with HIV (PLHIV) is now comparable to that of HIV-negative persons, their health-related quality of life (HRQoL) lags behind. Lower HRQoL among PLHIV may vary meaningfully, shaped in part by social factors, including stigma. Using data from Positive Voices, a national cross-sectional probability survey of adults ≥18 years living with HIV and accessing HIV care services in England and Wales (N = 4,422), we conducted latent class analysis on responses to a HRQoL measure (problems with mobility, usual activities, self-care, pain/discomfort, anxiety/depression) to identify HRQoL patterns, followed by multinomial logistic regression to examine relationships between HRQoL classes and a 4-item measure of HIV-related stigma and discrimination in health care. Four classes emerged: All Problems (18% prevalence); Pain and Distress (18%); Pain and Mobility (9%); No Problems (55%). Scale scores of HIV-related stigma and discrimination in health care were positively, significantly associated with membership in the All Problems (adjusted odds ratio [aOR] = 2.16; 95% confidence interval [CI] = 1.94, 2.41), Pain and Distress (aOR = 1.62; CI = 1.46, 1.81), and Pain and Mobility classes (aOR = 1.33; CI = 1.16, 1.52) compared to the No Problems class. A similar trend was observed for individual stigma and discrimination items. HRQoL among PLHIV in England and Wales varies and may be underpinned or exacerbated by HIV-related stigma and discrimination in health care. Ensuring stigma-mitigation interventions reach all health care systems/providers and emotional support services reach all PLHIV may improve HRQoL for PLHIV. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

Original languageEnglish
JournalStigma and Health
DOIs
Publication statusAccepted/In press - 2021

Bibliographical note

Publisher Copyright:
© 2021 American Psychological Association American Psychological Association

Keywords

  • health-related quality of life
  • latent class analysis
  • people living with HIV
  • stigma

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