Differences by Latino and White MSM in HIV-Related Stigma in Seattle, WA

Background: Despite advances in the care and treatment of people living with HIV infection, HIV-related stigma remains a challenge to HIV testing, care, and prevention. HIV disproportionately affects Latino men who have sex with men (MSM) and previous work has cited stigma as a barrier to HIV prevention practices in this population. Because stigma promotes negative attitudes that interfere with public health responses to HIV disparities, stigma is a formidable public health challenge. Our study compared the prevalence of perceptions of community stigma towards people living with HIV (PLWH) and experiences of HIV-related discrimination between white and Latino MSM. Methods: We conducted a secondary analysis of cross-sectional data from the CDC’s National HIV Behavioral Surveillance (NHBS) survey from the Seattle area. Participants (n=633) were selected from two of the MSM centered NHBS cycles (2014 and 2017). Results: After adjustment, race/ethnicity was not significantly associated with any of the HIV-related discrimination items overall or in any of the cycles, although 8% of MSM in our study reported being physically attacked or injured and 44% of our overall sample reported any discrimination. For each item related to perceived stigma towards PLWH, Latino MSM reported higher frequencies of perceived stigma compared to white MSM. After adjustment, Latino MSM were more likely to report perceived stigma towards a PLWH in the form of discrimination overall (aIRR=1.44, 95% CI, 1.05-1.96) and in the 2017 cycle (aIRR=1.78, 95% CI, 1.13-2.80), perceived stigma in the form of not supporting the rights of a PLWH but only in the 2017 cycle (aIRR=2.39, 95% CI, 0.99-5.79), perceived stigma in the form of not being friends with a PLWH but only in the 2014 cycle (aIRR= 2.04, 95% CI, 1.00-4.17). Conclusion: Latino MSM in Seattle were more likely to report perceived stigma toward PLWH compared to white MSM and reports of HIV-related discrimination were common among both white and Latino MSM. Both white and Latino MSM in Seattle may face the consequences of HIV-related stigma in discrimination including physical injury. Local public health practitioners and community organizations should develop targeted anti-stigma interventions that facilitate understanding of root causes of stigma while incorporating cultural and social context.