STIGM(

"As a gay man, and part of a minority group, it is ok for you to feel a sense of guilt and shame""Guilt and shame are not part of my emotional repetoir"Real conversation at point of positive diagnosis at one of the best HIV clinics in the country, Sept 2006. Guilt and shame are STILL not part of my emotional repetoir.Nearly a third of HIV-positive people in London report discrimination, often from healthcare staff www.aidsmap.com/en/news/53474C80-530A-4941-8781-E3C8AE2AE...Almost a third of HIV-positive individuals surveyed in London have experienced HIV-related discrimination, according to a study to be published in the December edition of AIDS and Behaviour (currently in press). Half of the individuals who reported discrimination said that it had involved healthcare staff. HIV-related discrimination (or the fear of such discrimination) can have far-reaching consequences, including a failure to test for HIV or access HIV care. Some research even suggests that discrimination may contribute to HIV risk behaviour. Tackling HIV-related discrimination was a key aim of the UK’s national HIV strategy, which was published in 2001. And in 2006 the UK government has published a draft action plan on address the stigma and discrimination attached to HIV. As part of this plan, NAM, the publisher of aidsmap.com, was commissioned by the Department of Health to write a booklet on HIV, stigma and discrimination. It can be read here. But there is very little UK research on the number of HIV-positive individuals who have experienced HIV-related discrimination. Investigators from London’s City University and the Centre for the Study of Sexual Health and HIV at Homerton University Hospital therefore designed a study to determine the extent to which people with HIV living in London have been discriminated against because of their HIV infection and by whom. The study was also designed to see if there were any factors associated with reporting such discrimination. The study ran between June 2004 and June 2005 and patients attending NHS HIV outpatient clinics in north east London aged 18 or over were eligible for recruitment. Individuals were asked if they had ever been discriminated against because they had HIV. If they answered ‘yes’ they were asked to say by whom. There was also an opportunity for individuals to describe their experience of discrimination. To establish the factors associated with discrimination, study participants were asked to provide details of their age, sex, ethnicity, sexual orientation, immigration status, country of birth, and relationship status. They were also asked to say how many years they had been living with diagnosed HIV infection, if they were taking antiretroviral therapy, if they had experienced any treatment side-effects, or if they thought their body shape had changed as a consequence of taking anti-HIV drugs. Because the investigators wanted to see if discrimination was related to risky sexual behaviour, the study participants were asked to say if they had had anal or vaginal sex in the previous three months and with whom. A total of 2680 patients were eligible for inclusion in the study and 1687 completed and returned questionnaires. Results Gay men (758 individuals), black African heterosexual women (480 patients), and black African men (224 individuals) comprised 87% of the study sample and were included in the investigators’ analysis. Although questionnaires were returned by white heterosexual men and women and patients of other black and Asian ethnicities their numbers were too small for statistical analysis. The investigators found that 30% (414) of their study sample reported discrimination because of their HIV status. In initial ‘univariate’ analysis, gay men were statistically more likely to report discrimination than black African women or men (34% vs. 28% vs. 21%, p < p =" 0.06).">