Homosexuality-related stigma and sustained viral suppression among men who have sex with men living with HIV in Vietnam
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Homosexuality-related stigma is associated with increased HIV risk behaviours among men who have sex with men (MSM) in low- and middle-income countries, but its impact on HIV treatment outcomes is less well understood. We examined the relationship between homosexuality-related stigma and failure to achieve sustained viral suppression among MSM on antiretroviral therapy (ART) in Hanoi, Vietnam. Between 2017 and 2020, 292 MSM were diagnosed with HIV in a prospective study. Socio-demographic, behavioural, homosexuality-related stigma, and HIV treatment data were collected. Multivariable Cox regression models examined associations between enacted, perceived, internalized, overall homosexuality-related stigma, and failure to achieve sustained viral suppression. Among 226 MSM on ART for ≥ 180 days (median age 24 years; median ART duration 23 months), 197 (87.2%) achieved sustained viral suppression. High overall stigma was reported by 86 men (38.1%), including enacted (26.1%), perceived (20.8%), and internalized (25.2%) stigma. After adjusting for potential confounders, no significant associations were found between enacted, perceived, internalized, or overall homosexuality-related stigma and sustained viral suppression. We observed a high level of homosexuality-related stigma and sub-optimal sustained viral suppression in this sample of MSM on ART. Targeted interventions are needed to decrease stigma and improve treatment outcomes for MSM living with HIV in Vietnam
Men who have sex with men · Proportional hazards model · Psychological intervention · Social stigma · Viral load · Young adult · HIV Research and Treatment · HIV/AIDS drug development and treatment · HIV/AIDS Research and Interventions
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