Mixed evidence for the relationship between HIV stigma and Pain in two studies of people with HIV in Florida

Previous work suggests that HIV stigma is associated with greater pain severity. We sought to characterize this relationship by examining intersectional identities that tend to be stigmatized (i.e., gender; sexual orientation) in two cross-sectional studies of people with HIV (PWH). In Study 1 (N = 840), participants responded to the Enacted Stigma Scale and the Brief Pain Inventory. We found a significant positive association between HIV stigma and pain severity (and between sexual orientation and pain severity), but no interaction effects. In Study 2 (N = 309), participants responded to Internalized Stigma Scale and the Brief Pain Inventory. We did not find a relationship between HIV stigma and pain severity but conceptually replicated the relationship between sexual orientation and pain severity. Results may be due to a small sample size in Study 2, or because the relationship between HIV stigma and pain is specific to enacted stigma (i.e., overt acts of stigma; Study 1) rather than internalized stigma (i.e., an intrapersonal aspect of stigma; Study 2). PERSPECTIVE: Among people with HIV (PWH), there is a positive relationship between enacted stigma and pain. This relationship between stigma and pain should be studied among other intersectional groups including gay men and women of color. PWH should be provided with supportive care for both physical and psychosocial symptoms.