According to a survey, conducted by the researchers, one-fourth of the HIV patients feel stigmatized by their physicians. This perception emerged due to less attention given to these patients especially among the low-income and minorities, reports the study, published in the August issue of the peer-reviewed journal AIDS Patient Care and STDs.
"Whether or not it is actual stigmatization is hard to measure, because it's coming from the patients that we interviewed," says Janni J. Kinsler, study's project director and lead researcher.
"The point is that these people feel that way, and that's bad enough, because they're less likely to seek the care they need," he adds.
The study results were based on surveys of 223 HIV-positive individuals in Los Angeles County, with initial baseline interviews taking place between May 2004 and June 2005 and follow-up interviews conducted six months later, from November 2004 to December 2005.
The researchers report that there are two types of stigma: external, or "public," stigma and personal, or "perceived," stigma. The latter refers to individuals' anticipated fears of societal attitudes or discrimination because their HIV infection.
The researchers found that at baseline 26 percent of the patients reported at least one of the four types of perceived stigma from a health care provider, and 19 percent reported the same at follow-up. Also, 58 percent claimed low access to care on at least one of the six relevant questions at baseline, as did 57 percent at follow-up.
"Most importantly, we found that those who perceived stigma from a health care provider had more than twice the odds of reporting low access to care, even after examining the effect prospectively and adjusting for a host of sociodemographic and clinical characteristics," the researchers said.
Researchers noted the significance that perceived stigma "could greatly affect [patients'] use of needed medical services, including antiretroviral therapy." Because of this, patients may seek medical care only when their illness has progressed to a more severe stage, leading to more intensive medical interventions, hospitalization and earlier death.
The next step is to investigate whether physicians are in fact stigmatizing these patients, Kinsler said.