Factors associated with HIV-related stigma among adults living with HIV on antiretroviral therapy in the Asia-Pacific region.

Abstract

People with HIV (PWH) continue to experience stigma across community, social, and healthcare settings, yet data from the Aisa-Pacific region remains limited. We conducted a cross-sectional study at five HIV clinics in Hong Kong SAR, Malaysia, the Philippines, South Korea, and Thailand from July 2019 to June 2020 to assess HIV-related stigma and associated factors. Perceived stigma was measured using the 40-item Berger's HIV Stigma Scale. Depression, substance use, and disability were assessed using the Patient Health Questionnaire-9, the Alcohol, Smoking, and Substance Involvement Screening Test, and the WHO Disability Assessment Schedule 2.0, respectively. Of 864 participants (88% male, median age 39 years), 97% were on ART, and 5.7% had HIV viral load >1000 copies/mL. Males reported significantly higher stigma score than females (mean 97.5 vs 90.7 ). In the multivariate analysis, higher stigma was associated with older age (difference = 5.3for age 40-50; 3.1 for >50 years vs ≤30 years), moderate to severe depression (+14.3), disability (+6.8), and HIV non-disclosure (+21.2), while being female was associated with lower stigma (-4.6). These findings underscore the high burden of stigma among PWH in the region and highlight the need for integrated stigma screening and interventions addressing mental health, disclosure, and disability in HIV care.