Do stigma and disclosure of HIV status are associated with adherence to antiretroviral therapy among men who have sex with men?

Abstract

Introduction: People living with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) (PLWHA), especially men who have sex with man (MSM) suffer from double stigma because of their sexual behavior and HIV status; therefore, many of them do not reveal their status to others. Unfair treatment of health workers experienced by MSM negatively impacts their health, particularly their adherence to antiretroviral therapy. Non-compliance with therapy leads to poor conditions of PLWHA and increased transmission of HIV to their sexual partners. The aim of this study was to examine whether perceived stigma and disclosed HIV status are associated with antiretroviral therapy (ART) non-adherence among MSM. Material and methods: A cross sectional study was conducted from April to July 2018 in two private clinics in DKI Jakarta, which are often visited by MSM. Thirty-eight adult MSM who had been on ART for ≥ 6 months with a complete medical record were included in this study, using a purposive sampling method. Quantitative data were collected with a structured direct interview and recorded in STATA v.14 for analysis. Results: The average age was 31 years (SD ± 5.38), 94.74% of participants did not have a formal employment and were not married, and 65.79% completed undergraduate education. 50% felt a high stigma related to their HIV status; however, 63.16% revealed their status to others, especially health workers and 52.63% had a good relationship with doctors. There was no significant relationship between perceived stigma and disclosure of status with adherence to ART therapy. Conclusions: Perceived stigma should be minimized by establishing a good patient-doctor relationship. Therefore, MSM would be willing to disclose their HIV status and sexuality, and hence help to achieve optimal adherence to antiretroviral therapy.