In 2013, San Francisco adopted a ‘Getting to Zero’ HIV strategy, with the aim of getting to zero new HIV infections, zero HIV deaths, and zero HIV stigma by 2030. While there has been great progress towards the first two indicators, a study published online ahead of print in AIDS and Behavior suggests no reduction in HIV stigma perceived by gay and bisexual men.
Cross-sectional surveys were conducted in gay venues in 2011, 2014 and 2017 as part of National HIV Behavioral Surveillance (NHBS). Over 400 men participated in each survey. One of the questions asked whether they would agree with the statement: “Most people in the San Francisco Bay Area would discriminate against someone with HIV.”
There was no significant change in the proportion of men agreeing or strongly agreeing with the statement (22%, 23% and 21% in the three surveys). There were no statistically significant differences between HIV-positive and HIV-negative men's perception of stigma.
Non-white men and those under the age of 30 were more likely to perceive stigma.
The researchers note that stigma – both experienced and anticipated – is a barrier to engagement with prevention and treatment. HIV stigma may be internalised, resulting in feelings of low self-worth, depression, and shame, making it harder for people to look after their health. HIV stigma may be compounded by stigma related to ethnicity, sexual orientation, gender identity, homelessness, sex work and substance use.
“Our findings are a wake-up call against complacency that we will achieve our goal of ending the HIV epidemic by 2030, particularly among the most vulnerable populations,” they say.
Beltran S et al. Will We Get to Zero HIV Stigma in San Francisco? AIDS and Behavior, online ahead of print, 5 April 2019.
