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Age, Sex, Race, Ethnicity, Sexual Orientation: Intersectionality of Marginalized-Group Identities and Enacted HIV-Related Stigma Among People Living with HIV in Florida

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Abstract

HIV-related stigma is associated with many negative health outcomes among people living with HIV (PLHIV). The theory of intersectionality suggests that the interactions of social identities affect PLHIV’s experiences of stigma. This study aims to identify individual and interactive marginalized-group identities correlated with enacted HIV-related stigma among PLHIV in Florida. The sample (n = 932) was majority male (66.6%), Black (58.5%), and non-Latino (80.2%) with 53% reporting experiences of HIV-related stigma. In multinomial regression models, the interaction between race and ethnicity was significant where non-White Latinos had higher odds of experiencing high levels of enacted stigma [AOR (CI) 7.71 (2.41, 24.73), p < 0.001] compared to white non-Latinos. Additionally, racial minorities were less likely to have experienced moderate or high levels of enacted stigma [AOR (CI) 0.47 (0.31, 0.72), p < 0.001; AOR (CI) 0.39 (0.22, 0.70), p = 0.002, respectively]. Moreover, women had higher odds of experiencing high levels of enacted stigma [AOR (CI) 2.04 (1.13, 3.67), p = 0.018]. The results suggest that intersectionality is important to consider in HIV-related stigma research and future interventions.

Resumen

El estigma relacionado con el VIH se asocia con muchos resultados de salud negativos entre las personas que viven con el VIH. La teoría de la interseccionalidad sugiere que las interacciones de las identidades sociales afectan las experiencias de estigma de las personas que viven con el VIH. Este estudio tiene como objetivo identificar las identidades individuales e interactivas de grupos marginados correlacionadas con el estigma promulgado relacionado con el VIH entre las personas que viven con el VIH en Florida. La muestra (n = 932) fue mayoritariamente masculina (66.6%), negra (58.5%) y no Latina (80.2%) con 53% reportando experiencias de estigma promulgado relacionado con el VIH. En los modelos de regresión multinomial, la interacción entre raza y etnicidad fue significativa donde los Latinos no blancos tenían mayores probabilidades de experimentar altos niveles de estigma promulgado (ORa(IC) = 7.71(2.41, 24.73), p < 0.001) comparado con los blancos no Latinos. Además, las minorías raciales tenían menos probabilidades de haber experimentado niveles moderados o altos de estigma promulgado (ORa(IC) = 0.47(0.31, 0.72), p < 0.001; ORa(IC) = 0.39(0.22, 0.70), p = 0.002, respectivamente). También, las mujeres tenían mayores probabilidades de experimentar altos niveles de estigma promulgado (ORa(IC) = 2.04(1.13, 3.67), p = 0.018). Los resultados sugieren que es importante considerar la interseccionalidad en la investigación del estigma relacionado con el VIH y en futuras intervenciones.

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Abbreviations

PLHIV:

People living with HIV/AIDS

HIV:

Human immunodeficiency virus

AIDS:

Acquired immunodeficiency syndrome

SHARC:

Southern HIV & Alcohol Research Consortium

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Acknowledgements

Research reported in this publication was supported by the National Institutes of Health (NIH) under Grant Numbers U24AA020002 (PI: Cook) and U24AA020003 (PI: Cook) and a contract from the Florida Department of Health (PI: Cook). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or the Florida Department of Health.

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Authors and Affiliations

  1. Department of Epidemiology, Florida International University, 11200 SW 8th St., AHC5-505, Miami, FL, 33199, USA

    Angel B. Algarin & Gladys E. Ibañez

  2. Department of Epidemiology, University of Florida, 2004 Mowry Road, PO Box 100231, Gainesville, FL, 32610, USA

    Zhi Zhou & Robert L. Cook

  3. College of Nursing, University of Central Florida, 12201 Research Parkway Suite 300, Orlando, FL, 32826, USA

    Christa L. Cook

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Algarin, A.B., Zhou, Z., Cook, C.L. et al. Age, Sex, Race, Ethnicity, Sexual Orientation: Intersectionality of Marginalized-Group Identities and Enacted HIV-Related Stigma Among People Living with HIV in Florida. AIDS Behav 23, 2992–3001 (2019). https://doi.org/10.1007/s10461-019-02629-y

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