학술논문

HIV and Substance Use Stigma, Intersectional Stigma and Healthcare Among HIV-Positive PWID in Russia
Document Type
article
Source
AIDS and Behavior. 25(9)
Subject
Health Services and Systems
Health Sciences
Behavioral and Social Science
Clinical Research
HIV/AIDS
Health Services
Substance Misuse
Health and social care services research
8.1 Organisation and delivery of services
Infection
Good Health and Well Being
Delivery of Health Care
HIV Infections
Health Facilities
Humans
Russia
Social Stigma
Substance Abuse
Intravenous
HIV
Stigma
Key and vulnerable population
Health services accessibility
Substance-related disorders
Public Health and Health Services
Social Work
Public Health
Public health
Language
Abstract
Little is known about the intersection of HIV stigma and substance use stigma. Using data from 188 HIV-positive people who inject drugs (PWID) in Russia, we examined the associations of these stigmas and their interaction with access and utilization of healthcare. While substance use stigma was significantly associated with poor access to care (AOR 2.31, 95%CI 1.50-3.57), HIV stigma was not. HIV stigma was associated with lower inpatient care utilization (AOR 0.32, 95%CI 0.14-0.65), while substance use stigma was not. We did not detect a significant interaction between the two forms of stigma for either of the primary outcomes. However, those with high levels of both substance use stigma and HIV stigma had higher odds of poor general access to healthcare (AOR 1.86, 95%CI 1.19-2.92), and lower odds of recent general outpatient (AOR 0.52, 95%CI 0.32-0.85) and any inpatient (AOR 0.48, 95%CI 0.22-0.99) care utilization compared to those with low levels of both types of stigma. Interventions addressing both substance use and HIV stigma in general healthcare settings might improve care in this HIV key population.