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

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. © The Author(s) 2013.