HIV-related Stigma among People with HIV in Denmark and its Association with Psychosocial and Sexual Health: a cross-sectional Nationwide Study

Abstract

HIV-related stigma remains a major barrier to improving the lives of people with HIV (PWH) and curbing the epidemic globally. This cross-sectional study assessed HIV-related stigma, based on The HIV Stigma Framework, among PWH in Denmark, and examined its potential associations with sociodemographic characteristics, as well as with HIV-related, psychosocial and sexual health measures. Data from 630 participants (486 men and 144 women) in the SHARE study-a nationwide survey on psychosocial and sexual health among PWH in Denmark conducted from 2021 to 2022-were analysed using sex-stratified linear and logistic regression models adjusted for relevant confounders. Results showed that anticipated stigma was the most commonly reported stigma mechanism, with 68% of men and 77% of women expressing high levels of concern about HIV status sharing. In contrast, enacted stigma was reported by 9% of men and 22% of women. The multivariate regression analyses revealed that higher stigma levels were associated with originating from low- or middle-income countries and with a history of mental health problems, whereas non-heterosexual identity and a longer time since HIV diagnosis were linked to lower stigma. In both men and women, stigma was significantly associated with fewer close friends, loneliness, anxiety and reduced sexual desire. Among men, stigma was also significantly associated with sharing one's HIV status with fewer people, depression, suicidal tendencies and erectile dysfunction. In conclusion, HIV-related stigma, notably stigma related to anticipated stigma, remains prevalent among PWH in Denmark and it is significantly associated with a range of psychosocial and sexual challenges.

Keywords: HIV; HIV-related stigma; Mental health; Sexual health.