Stigma and HIV testing behavior in a nationally representative sample of US adults: implications for public health campaigns and stigma monitoring

Research has examined the impact of HIV stigma on people with HIV (PWH), but little work has explored how stigmatizing beliefs toward PWH and instrumental stigma - the misplaced fears of infection through everyday contact with PWH - may serve as a barrier to HIV testing. We analyzed responses from 3,271 US adults in the fall 2021 ConsumerStyles Survey to estimate the prevalence of these stigmas and examine associations with sociodemographic factors. Multivariate regression showed that adults who identify as heterosexual, those aged 65 years and older, those with lower educational attainment, those living in the South, and those who did not know someone with HIV reported higher stigmatizing beliefs about PWH and instrumental stigma. Men and individuals in non-metro areas also exhibited greater stigmatizing beliefs. Race was significantly associated with instrumental stigma, with non-white adults reporting higher levels than white adults. Higher stigmatizing beliefs scores were significantly associated with a lower likelihood of HIV testing. These findings highlight the persistence of stigmatizing beliefs toward PWH in the US, which may hinder engagement with HIV testing, a key component of HIV prevention efforts.