Description
Early during the human immunodeficiency virus (HIV) epidemic, the stigmatizing of individuals who were identified with the acquired immune-deficiency syndrome (AIDS) became a serious concern. HIV/AIDS stigma consequences include discouraging individuals from seeking voluntary counseling and testing (VCT) and from disclosing their seropositive status to sexual partners, family, and friends. Injection drug users (IDUs) have been an important risk group for HIV/AIDS and are highly stigmatized. Therefore, increased understanding about the correlates of stigma among this HIV/AIDS risk group is necessary in order to design and implement better preventive measures, programming, and surveillance systems. The purpose of this analytic study was to evaluate the relationship between injection drug use behavior and reported stigma among IDUs in Kazakhstan to determine if length of time using injection drugs is predictive of self-reported stigmatization. A cross-sectional survey of IDUs in Kazakhstan was conducted in 2007 using a Centers for Disease Control and Prevention (CDC) Sentinel Surveillance System Survey and an additional appended survey that focused on questions related to VCT in the presence of stigma. Demographic data collected from 1043 participants included age, gender, nationality, city or location, highest education level attained, and current occupation. Additional questions assessed participants' length of time injecting drugs, perceived discrimination or stigmatization, knowledge on how HIV/AIDS is acquired, and single syringe sharing behavior and handling practices. Descriptive statistics were used to summarize general findings about the population. Linear regression models were constructed and bivariate analyses were conducted to determine the association between self-reported stigmatization scores and all variables. Statistical significance was determined by One-way analysis of variance (ANOVA) and T-tests, using 95% confidence intervals and p = 0.05. Selected variables were further analyzed using Tukey-Kramer's test. A linear regression model was developed to include variables with significance at the p = (0.05 level) to obtain a final parsimonious model. This analysis revealed that length of injection drug use, knowledge about ways of contracting HIV/AIDS, and the interaction these two variables held, were significantly associated with self-reported stigmatization. In general, it was found that the longer an individual continued to be an IDU, the lower self-reported stigmatization he or she experienced. Participants demonstrated they were very knowledgeable about ways in which HIV is contracted. Further analyses participants' understanding of how HIV is contracted aided them in feeling less stigmatized. This finding provides a compelling account since public health interventions against HIV/AIDS typically include the increase of knowledge via healthy behavior promotion.
