UCSF

Background: Asian Pacific Islander is the only racial group which significantly increased in estimated annual percentage of HIV newly diagnosed individuals between 2001-2008. As rates of HIV infection rise in the Asians population, it is important for us to increase our understanding about what facilitates HIV infection in this population and to focus on decreasing HIV related morbidity and mortality. Stigma, an important concept in the field of international HIV research, is increasingly being associated with access to prevention, care, and treatment outcomes in the population of people living with HIV in the US.

Objective: The purposes of my dissertation study were: (1) to report on the steps taken to develop a HIV stigma scale that are relevant for Asians living with HIV (ALH) and test the psychometric properties of the scale; (2) to assess the level of stigma experienced by ALH by using the scale and explore the association to the acculturation and self-rated general health in a sample of ALH; and (3) to explore the level of knowledge, attitudes, and self-perceived risk of cardiovascular disease (CVD) and acute coronary syndrome (ACS) in a sample of ALH and how these factors are influenced by the stigma.

Methods: This study used a convenience sample comprised 83 ALH from November 2010 to June 2013 (n=5 in face-to-face interviews, n=11 in focus groups, and n=67 in cross-sectional study).

Results: This study developed the first HIV stigma scale culturally adapted to ALH and found the HIV stigma was often experienced by ALH and negatively associated to acculturation and health outcomes. Also, the study sample had limited knowledge of, positive attitude toward, and low self-perceived risk regarding CVD and ACS. HIV stigmatization was independently correlated with attitude; acculturation was an independent predictor of level of knowledge.

Conclusions: Such a high level of HIV stigma experienced by ALH, poor knowledge, positive attitude, and low self-perceived risk of CVD and ACS are matters of concern. Since HIV stigma is negatively associated to acculturation, health outcomes and attitude toward CVD and ACS, we need for culturally-appropriate interventions to reduce HIV stigma experienced by ALH.