Lack of virologic suppression is associated with lower HIV-related disclosure stigma in people living with HIV

Michelle Matheu, Thankam Sunil, Alexandra Castro-Peña, Camille Elena Spears, Christopher James Smith, John Michael Flores, Barbara S. Taylor

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Stigma remains a leading barrier to HIV care. To determine the influence of disclosure stigma (DS), fear of disclosing one’s serostatus, on virologic suppression, a cross-sectional study was performed at the largest publicly-funded HIV clinic in South Texas. A survey was administered to participants who were: ≥18 years old, living with HIV, and receiving antiretroviral therapy. Surveys included demographics, adherence questionnaire, and a validated HIV-stigma scale with DS as the sum of 10 items ranked 0–3, with score of 30 indicating highest stigma. The primary outcome was lack of virologic suppression (LOVS): most recent HIV-1 RNA > 20 copies/ml. A bivariate analyses examined predictors of DS, dichotomized at the median. Depression score, perceived stress, and lack of friend/family support were associated with DS. Logistic regression models examined the relationship between DS, as a continuous variable, and LOVS. For 275 participants (69% Hispanic), median DS score was 18.5. DS was significantly inversely associated with LOVS (aOR 0.94 per 1 scale point; CI 0.89, 0.99) after adjustment for age, gender/sexual orientation, race/ethnicity, and drug use. The unanticipated inverse association between DS and LOVS highlights the complexity of this relationship. However, the balance of data in this cohort demonstrate an overall negative impact of DS.

Original languageEnglish (US)
Pages (from-to)1001-1007
Number of pages7
JournalAIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
Issue number8
StatePublished - Aug 2 2020


  • Disclosure stigma
  • HIV
  • medication adherence
  • virologic suppression

ASJC Scopus subject areas

  • Social Psychology
  • Health(social science)
  • Public Health, Environmental and Occupational Health


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