The impact of HIV stigma on intimate relationships

A Hudson1 , L Benton1 , I Lut1 , C Ferraro1 , S Okala2 , V Delpech2 , P Kirwan2 , J Jefferies2 , R Mbewe3 , J Morton3 , W Sseruma3 , C Kunda4 , Z Jamal4 , H Cardwell5 , L Sharp5 , M Nelson6 , I Reeves7 , M Ross8 , A Wolton8 and G Valiotis9 1 Family Planning Association, London, UK; 2 Public Health England, London, UK; 3 StigmaIndexUK, UK, UK; 4 NAZ, London, UK; 5 Glasgow University, UK; 6 Chelsea and Westminster Hospital, London, UK; 7 Homerton University Hospital, London, UK; 8 Clinic Q, London, UK; 9 HIV Scotland, UK

Background: Stigma and discrimination impact on the wellbeing of people living with HIV. We present findings of the UKStigmaSurvey focusing on intimate relationships. The survey was co-designed by people living with HIV, clinicians and researchers. People were recruited through community organisations and clinics to complete an online survey about their experience of living with HIV. Responses were anonymised, stored securely and analysed with engagement from community members.

Results: 1576 people (1180 men, 359 women, 27 transpersons) completed the survey; 75% were men (62% identified as men who have sex with men (MSM)); 37% were of Black, Asian, or another ethnic minority (BAME); 92% were on treatment. Overall, two-thirds felt in control of their health and positive about life; 95% had disclosed to at least one member of their family, friends, to a partner or in their workplace. Among the 840 (53%) people currently in a relationship, 84% reported that their partner/s was aware of their HIV status. A quarter did not feel in control to disclose or supported by sexual partners, 47% worried about being rejected by a sexual partner and 49% had avoided having sex in the last year. Four in five respondents were aware of prosecutions for recklessly transmitting HIV and one in five believed that transmission of HIV should be a criminal offence. The risk of criminal prosecution relating to HIV transmission influences decisions about disclosure for 40% of respondents. Overall 87% felt that both partners, regardless of HIV status, equally share responsibility for preventing HIV transmission. Some differences by gender, age and risk group were observed.

Conclusion: The majority of people living with HIV feel in control of their health and positive about their life. Nevertheless, in 2015, “in an age of undetectability” and effective treatments, HIV continues to have a profound impact on intimate and sexual relationships. Greater awareness of “treatment as prevention” would reduce fear and stigma within relationships.

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