Perceived HIV-Related Stigma and Homophobia within a Nationally Representative Sample

Theoretical Background and research questions/hypothesis: In the US, stigmatizing beliefs persist about people living with HIV and individuals or groups most at risk for HIV infection, including gay, bisexual, and other men who have sex with men (MSM). Perceived HIV-related stigma can moderate the success of HIV prevention efforts, as fear of discrimination is has been shown to discourage individuals from obtaining HIV test, disclosing HIV status, and accessing medical care after receiving a positive diagnosis. To inform CDC’s HIV-related communication campaigns and monitor the prevalence of stigmatizing beliefs, CDC’s Prevention Communication Branch routinely measures public attitudes about HIV and groups at risk for infection. This presentation summarizes the findings from a recent national consumer survey.

Methods: We analyzed items included on the ConsumerStyles survey fielded from March 29 to April 16, 2013. The nationally representative sample of US adults (aged 18 years and older) was randomly recruited using probability-based sampling to reach members of an online research panel. For this analysis, one item was used as a proxy indicator for HIV-related stigma: “I would be uncomfortable having my food prepared by someone who has HIV or AIDS.” Agreeing or strongly agreeing with this item was considered a stigmatizing response. Homophobia was assessed as disagreeing or strongly disagreeing with the item “Homophobia is acceptable to me.” Unadjusted chi-square tests were used to examine the bivariate associations between HIV-stigma and the following variables: expressing homophobic beliefs; age; income; gender; education; and region.

Results: Slightly less than half of the participants (n=3,007, 45.5%) indicated that they would be uncomfortable having food prepared by someone who has HIV or AIDS. A smaller proportion of individuals (n=2032, 30.8%) indicated that homosexuality was not acceptable to them. Stigmatizing responses were more common among men (n=1,512, 47.6%), respondents in the “other” race/ethnicity category (n=225, 49.7%), persons living in the South (n=1156, 47.5%), persons aged 60 years and older (n=944, 55%), those with only a high school education (n=932, 47.5%), those with an annual household income less than $30,000 (n=705, 46.7%), and those expressing homophobic beliefs (n=1,241, 61.8%). While no statistically significant association existed between education and stigmatizing beliefs, all other associations were significant.

Conclusions: These preliminary findings indicate that nearly half of respondents report stigmatizing beliefs towards people living with HIV or AIDS, with a smaller percentage of individuals maintaining homophobic beliefs. Furthermore, the majority of consumers expressing homophobic beliefs also reported HIV-related stigma. Statistically significant associations exist between a number of demographic characteristics and HIV-related stigma.

Implications for research and/or practice: HIV-related stigma and homophobia are more prevalent among particular audience segments. To reduce unintended consequences, such as exacerbating stigmatizing beliefs, communicators should test materials with all potentially exposed audience segments, and make strategic decisions about placements before launching.