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
Methods: A secondary and exploratory analysis of the cross-sectional data from
the baseline measurement of a 2x2 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.
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