Stigma and access to HIV care among HIV-infected women in Kolkata, West Bengal

• Type of Material: Article
• Authors: Sharoda Dasgupta, Emory University; Patrick S Sullivan, Emory University; Aparajita Dasgupta, All-India Institute of Hygiene and Public Health; Bibhuti Saha, School of Tropical Medicine; Laura F. Salazar, Emory University
• Language: English
• Date: 2013-01-01
• Publisher: SAGE Publications (UK and US): Open Access Titles
• Publication Version: Final Published Version
• Copyright Statement: © The Author(s) 2013.
• Final Published Version (URL): http://dx.doi.org/10.1177/1545109711401410
• Title of Journal or Parent Work: Journal of the International Association of Providers of AIDS Care
• ISSN: 2325-9574
• Volume: 12
• Issue: 1
• Start Page: 44
• End Page: 49
• Grant/Funding Information: This study would not have been possible without the Emory University Global Field Experiences “Global Frameworks” grant.; The author(s) disclosed receipt of the following financial support for the research and/or authorship of this article: Emory University Global Field Experiences “Global Frameworks” grant.
• Keywords: Surveys and Questionnaires; Clinic appointments; Logistic Models; Employment; Demographic factors; Residence Characteristics; Female; HIV; India; Social Stigma; Family Characteristics; Stigma; HIV Infections; Adult; Health Services Accessibility; Women; CD4; Cross-Sectional Studies; Humans; CD4 Lymphocyte Count; Compliance
• Research Categories: Health Sciences, Public Health; Biology, Virology; Health Sciences, Epidemiology

Abstract

Objectives: Stigma is an important issue for marginalized HIV-infected populations. We describe stigma among HIV-infected women on antiretroviral therapy and associations with access to clinical care, demographic factors, and structural elements of support. Methods: HIV-infected women attending a government-supported clinic in Kolkata, India, were asked about experiences with stigma. Clinical information was abstracted from medical records. We described factors associated with stigma using ordinal logistic regression. Results: Among 198 women, higher levels of stigma were associated with lower CD4 count upon entry into care (aOR = 0.78; 95% confidence interval [CI]: [0.65, 0.94] ), district of residence (aOR = 1.9; CI: [1.0, 3.4]), presence of extended family in the household (aOR = 0.57; CI: [0.32, 1.0] ), and employment at the time of the interview (aOR = 0.48; CI: [0.26, 0.90]). Stigma was not associated with having missed scheduled HIV care appointments. Conclusion: Stigma is prevalent among Indian women with HIV, should be further explored, and may be important in considering public health interventions for better access to care.