Geographic differences in experiences with HIV stigma among U.S. persons with diagnosed HIV

Background: HIV stigma is a deterrent to ending HIV and improving people with HIV (PWH)’s lives. Building upon existing work, we described specific HIV stigma experiences among PWH across four domains: personalized stigma during the past 12 months, current disclosure concerns, current negative self-image, and stigmatizing public attitudes about people with HIV (PWH), by jurisdiction and urbanicity of current residence. Setting: 2022 cycle data from CDC’s Medical Monitoring Project on 3,818 U.S. PWH. Methods: Using MMP’s 2022 cycle data, we reported weighted prevalence estimates of domain-specific experiences with HIV stigma using a validated 10-item scale. We evaluated differences between groups using prevalence differences (PDs) and 95% confidence intervals (CIs) using predicted marginal means. Results: Overall, 89.9% experienced any HIV stigma; 22.7% experienced personalized stigma during the past 12 months, 83.3% experienced disclosure stigma, 24.7% experienced negative self-image, and 57.1% reported stigmatizing public attitudes about PWH. HIV stigma experiences ranged widely by MMP jurisdiction. Experiences with personalized stigma were more prevalent among PWH residing in nonmetropolitan versus large metropolitan counties (32.1% vs. 21.7%, PD: 10.4 95% CI: 1.9–19.0). Experiences with disclosure stigma (88.8% vs. 83.3%, PD: 5.5 95% CI: 2.0–8.9 and stigmatizing public attitudes about PWH (66.0% vs. 55.7%, PD: 10.3 95% CI: 1.2–19.5 were more prevalent among PWH residing in small versus large metropolitan counties. Conclusions: Our findings underscore the importance of tailoring HIV stigma reduction efforts based on needs within jurisdictions and by urbanicity to increase service access and improve health and quality of life among U.S. people with diagnosed HIV.