HIV-related stigma among people living with HIV in metropolitan and regional areas of New South Wales, Australia

Background This exploratory study aimed to investigate differences between metropolitan and regional people living with HIV (PLHIV) in relation to experiences of stigma and openness about HIV status. Methods PLHIV attending publicly funded sexual health services in metropolitan Sydney or regional NSW completed an anonymous, cross-sectional survey about experiences of HIV-related stigma in the past year. Multivariable logistic regression analysis identified differences between metropolitan and regional participants. Results Among 89 participants, 79.8% (n = 71) were from metropolitan Sydney and 20.2% (n = 18) were from regional NSW. Approximately 50% of both groups reported any past-year experience of HIV-related stigma. Multivariable analysis found that regional participants were older than metropolitan participants (aOR 2.26, 95% CI: 1.18–4.32), were less likely to report sexual or intimate partner rejection (aOR 0.11, 95% CI: 0.02–0.64) and were more likely to report any past-year stigma from doctors (aOR 5.57, 95% CI: 1.05–29.66). Conclusions Although similar proportions of regional and metropolitan participants experienced HIV-related stigma, results suggest that these experiences were contextually different. Initiatives to reduce stigma and promote healthcare engagement among PLHIV may benefit from considering demographic differences and regional contexts (including healthcare settings). Opportunities may also exist to expand sexual health services (e.g. telehealth) to alleviate concerns about disclosing HIV status in smaller communities.