Associations between stigmatization toward HIV-related vulnerable groups and similar attitudes toward people living with HIV/AIDS: branches of the same tree?

This study tested the hypothesis that stigmatization toward people living with HIV/AIDS (PLWHA) was associated with stigmatization toward different vulnerable groups, including men who have sex with men (MSM), injecting drug users (IDUs), female sex workers (FSW) and their clients (CFSW). A number of scales and indicators were constructed for the purpose: the four Overall Stigmatization Scale for a Vulnerable Group (OSSVG) and the five Dimensional Stigmatization Scale (DSS) each measuring different dimensions of stigmatization toward the four vulnerable groups, together with four indicators measuring stigmatization toward PLWHA. A random sample of 2,008 Hong Kong Chinese adults aged 18-50 years in the general population were interviewed by telephone. Of these respondents, 22.8- 76.8% perceived that FSW, CFSW, MSM and IDU were pathological and 42-82.2% perceived them as immoral; 74.7% believed that PLWHA are promiscuous. Furthermore, the four OSSVG and the five DSS scales were inter-correlated with one another (Spearman coefficient = 0.11-0.67) and most of them were significantly associated with the four PLWHA stigmatization indicators (Odds Ratio = 1.25-4.27). Other factors were associated with the OSSVG and DSS scores (e.g. age, marital status, religion affiliation, education level, income and perceived severity of the HIV problem in Hong Kong). Campaigns for removing stigmatization toward these vulnerable groups are required in order to reduce stigmatization toward PLWHA. Stigmatization toward FSW and their clients might have been over-looked. The removal of the public's blame on these groups for spreading HIV may be useful. The impact of HIV prevalence of a vulnerable group onto the associations between stigmatization toward that particular group and PLWHA warrants investigation.