HIV-related stigma, service utilization, and status disclosure among truck drivers crossing the Southern borders in Brazil

J Pulerwitz, A P Michaelis, S A Lippman, M Chinaglia, J Díaz
AIDS Care 2008, 20 (7): 764-70
HIV-related stigma and discrimination (S&D) have been shown to impede prevention, care and treatment. Yet, few quantitative studies have tested the associations between stigma, service utilization and status disclosure, especially in countries with concentrated HIV epidemics. Surveys, administered to a random sample of 1,775 truck drivers crossing Southern borders in Brazil, included items on multiple conceptual domains of S&D, such as fear of casual contact and blame towards people living with HIV/AIDS. Pearson's chi-square tests and logistic regression were used to examine correlations. Less stigma (both individual items and grouped as a scale) was significantly correlated with VCT use (p<or=0.001), knowing where to get tested (p<or=0.001) and willingness to disclose HIV-positive test results (p=0.013). Findings indicate that stigma is an important barrier to HIV testing and disclosure among truck drivers in Southern Brazil. Learning more about stigma is important given the growing assertions that testing is a 'critical gateway' to HIV prevention and treatment. As access to HIV testing and treatment improves, providers increasingly need to understand and address how stigma acts as a barrier to services.

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