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Brief Report: Geographic Differences in Experiences With HIV Stigma Among US Persons With Diagnosed HIV
Sharoda Dasgupta1, Yunfeng Tie1, Stacy M Crim1
1Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, GA; and.
Journal of Acquired Immune Deficiency Syndromes (1999)
|March 16, 2026
Summary
HIV stigma remains a significant barrier, with most people with HIV (PWH) experiencing it. Stigma varies by location and urbanicity, highlighting the need for tailored interventions to improve PWH health and quality of life.
Area of Science:
- Public Health
- Epidemiology
- Social Science
Background:
- HIV stigma significantly hinders efforts to end the HIV epidemic and improve the lives of people with HIV (PWH).
- Understanding specific HIV stigma experiences is crucial for developing effective interventions.
- This study examines HIV stigma across four domains: personalized stigma, disclosure concerns, negative self-image, and public attitudes.
Purpose of the Study:
- To describe specific HIV stigma experiences among U.S. PWH.
- To analyze these experiences by jurisdiction and urbanicity.
- To inform the development of targeted HIV stigma reduction strategies.
Main Methods:
- Utilized data from the 2022 cycle of the CDC's Medical Monitoring Project (MMP), including 3,818 U.S. PWH.
- Employed a validated 10-item scale to assess domain-specific HIV stigma experiences.
- Calculated weighted prevalence estimates and used prevalence differences (PDs) with 95% confidence intervals (CIs) to evaluate group differences.
Main Results:
- Nearly 90% of PWH experienced some form of HIV stigma; 22.7% faced personalized stigma, 83.3% had disclosure concerns, 24.7% reported negative self-image, and 57.1% perceived stigmatizing public attitudes.
- Significant variations in stigma experiences were observed across different MMP jurisdictions and levels of urbanicity.
- PWH in nonmetropolitan areas reported higher personalized stigma (32.1%) compared to those in large metropolitan areas (21.7%).
- PWH in small metropolitan counties reported higher disclosure stigma (88.8%) and perceived stigmatizing public attitudes (66.0%) than those in large metropolitan counties.
Conclusions:
- HIV stigma experiences are diverse and influenced by geographic location and urbanicity.
- Tailoring HIV stigma reduction efforts to specific jurisdictional needs and urbanicity levels is essential.
- Addressing these nuanced experiences can improve service access, health outcomes, and quality of life for U.S. PWH.
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