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Published Online: 22 August 2008

HIV Provider Perspectives: The Impact of Stigma on Substance Abusers Living with HIV in a Rural Area of the United States

Publication: AIDS Patient Care and STDs
Volume 22, Issue Number 8

Abstract

Recent literature has documented growing concerns related to access to HIV care services for rural individuals living with both HIV and a dual diagnosis of substance abuse. Previous research has investigated issues from a client perspective, but limited research has investigated provider perspectives of rural issues surrounding HIV and substance abuse. The purpose of this qualitative study was to examine issues that impact the ability of care providers to create sustainable linkages to care for dual diagnosed individuals who live in rural areas. In-depth interviews were conducted in late 2005 with 39 HIV service providers at 11 agencies that provided HIV-related services to individuals in rural areas of a Midwestern state in the United States. Findings suggest multidimensional stigma in the medical referral network as the leading factor that presents challenges to service providers in rural areas. The service providers reported verbal stigma in the form of insults, a loss of role/respect, and a global loss of resources such as poorer quality health care or no health care provided. The stigma is conceptualized in four themes: (1) staff of medical referral sources stigmatizing against rural dual-diagnosis clients, (2) physicians stigmatizing against rural dual-diagnosis clients, (3) medical specialists stigmatizing against rural dual-diagnosis clients, and (4) client-perceived stigma. These themes were expressed equally among all of the providers, regardless of geographic location, type of HIV-related organization, or job title.

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cover image AIDS Patient Care and STDs
AIDS Patient Care and STDs
Volume 22Issue Number 8August 2008
Pages: 669 - 675
PubMed: 18627281

History

Published online: 22 August 2008
Published in print: August 2008
Published ahead of print: 15 July 2008

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John F. Yannessa
Coastal Carolina University, Department of Health, Kinesiology and Sports Studies, Conway, South Carolina.
Michael Reece
Indiana University, Department of Applied Health Science, Bloomington, Indiana.
Tania B. Basta
Ohio University, School of Health Sciences, Athens, Ohio.

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