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Institutional and structural barriers to HIV testing: elements for a theoretical framework.

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  • 11 Applied Health Science, Indiana University , Bloomington, Indiana.

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Structural and institutional stigma hinder HIV testing. This study found these barriers present in over half of tested sites, impacting individuals seeking HIV services and potentially worsening health outcomes.

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Area of Science:

  • Public Health
  • Sociology
  • Medical Anthropology

Background:

  • Stigma is a known barrier to seeking HIV testing and care.
  • Limited research exists on institutional and structural stigma within HIV testing processes.

Purpose of the Study:

  • To examine evidence of institutional and structural stigma in HIV testing.
  • To identify how these stigmas manifest at different stages of the HIV testing visit.

Main Methods:

  • Qualitative, grounded theory approach.
  • Utilized secondary data from a 2011 HIV test site evaluation in a Midwestern state.
  • Analysis focused on identifying expressions of stigma during the HIV testing process.

Main Results:

  • Over half of the evaluated HIV testing sites exhibited structural and/or institutional stigma.
  • Stigma was observed at multiple stages: initial encounter, reception/entry, and during the HIV test itself.
  • Examples included social geography, organizational factors, and staff behaviors.

Conclusions:

  • Structural and institutional stigma are present in HIV testing settings, potentially compounding negative experiences for individuals.
  • Findings offer insights for organizations aiming to reduce barriers to HIV testing.
  • Results can inform the development of theoretical frameworks and practical interventions to mitigate stigma in HIV services.