HIV-related stigma negatively affects the lives of persons living with HIV/AIDS (PLWHA). Homeless/unstably housed PLWHA experience
myriad challenges and may be particularly vulnerable to the effects of HIV-related stigma. Homeless/unstably housed PLWHA
from 3 U.S. cities (
N = 637) completed computer-assisted interviews that measured demographics, self-assessed physical and mental health, medical
utilization, adherence, HIV disclosure, and risk behaviors. Internal and perceived external HIV stigma were assessed and combined
for a total stigma score. Higher levels of stigma were experienced by women, homeless participants, those with a high school
education or less, and those more recently diagnosed with HIV. Stigma was strongly associated with poorer self-assessed physical
and mental health, and perceived external stigma was associated with recent non-adherence to HIV treatment. Perceived external
stigma was associated with decreased HIV disclosure to social network members, and internal stigma was associated with drug
use and non-disclosure to sex partners. Interventions are needed to reduce HIV-related stigma and its effects on the health
of homeless/unstably housed PLWHA.
Keywords HIV stigma - Discrimination - Prejudice - Homelessness - Access to medical care - Adherence - Sexual risk behavior - HIV disclosure - Social support