AIDS and Behavior

, Volume 20, Issue 1, pp 85–97 | Cite as

Internalized HIV and Drug Stigmas: Interacting Forces Threatening Health Status and Health Service Utilization Among People with HIV Who Inject Drugs in St. Petersburg, Russia

  • Sarah K. Calabrese
  • Sara E. Burke
  • John F. Dovidio
  • Olga S. Levina
  • Anneli Uusküla
  • Linda M. Niccolai
  • Robert Heimer
Original Paper


Marked overlap between the HIV and injection drug use epidemics in St. Petersburg, Russia, puts many people in need of health services at risk for stigmatization based on both characteristics simultaneously. The current study examined the independent and interactive effects of internalized HIV and drug stigmas on health status and health service utilization among 383 people with HIV who inject drugs in St. Petersburg. Participants self-reported internalized HIV stigma, internalized drug stigma, health status (subjective rating and symptom count), health service utilization (HIV care and drug treatment), sociodemographic characteristics, and health/behavioral history. For both forms of internalized stigma, greater stigma was correlated with poorer health and lower likelihood of service utilization. HIV and drug stigmas interacted to predict symptom count, HIV care, and drug treatment such that individuals internalizing high levels of both stigmas were at elevated risk for experiencing poor health and less likely to access health services.


Stigma Injection drug use HIV Health Health services Russia 


La frecuente simultaneidad entre el VIH y el consumo de drogas inyectables en San Petersburgo, Rusia, sitúa a muchas personas en la necesidad de disponer de servicios de salud, bajo el riesgo de estigmatización basado en la ocurrencia de ambas características simultáneamente. El presente estudio examinó los efectos independientes y de interacción entre los estigmas internalizados hacia el VIH y hacia las drogas, sobre el estado de salud y la utilización de servicios de salud en 383 personas con VIH que se inyectan drogas en San Petersburgo. Los participantes realizaron autoinformes sobre el estigma internalizado hacia el VIH, el estigma internalizado hacia la droga, el estado de salud (valoración subjetiva y enumeración de síntomas), la utilización de servicios de salud (atención de VIH y tratamiento de drogas), las características sociodemográficas y la historia de salud/conductual. Para ambas formas de estigma internalizado, los niveles altos de estigma se correlacionaron con una salud más pobre y con una menor probabilidad de utilización de servicios. El VIH y el estigma hacia las drogas interactuaron para predecir la enumeración de síntomas, la atención del VIH y el tratamiento de drogas, de manera que los individuos que internalizan altos niveles de ambos estigmas se encontraban en riesgo elevado de experimentar problemas de salud y con menos probabilidades de acceder a servicios de salud.


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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Sarah K. Calabrese
    • 1
    • 2
  • Sara E. Burke
    • 3
  • John F. Dovidio
    • 1
    • 2
    • 3
  • Olga S. Levina
    • 4
  • Anneli Uusküla
    • 5
  • Linda M. Niccolai
    • 1
    • 2
  • Robert Heimer
    • 1
    • 2
  1. 1.Yale School of Public HealthYale UniversityNew HavenUSA
  2. 2.Center for Interdisciplinary Research on AIDSYale UniversityNew HavenUSA
  3. 3.Department of PsychologyYale UniversityNew HavenUSA
  4. 4.NGO-StellitSt. PetersburgRussia
  5. 5.Department of Public HealthUniversity of TartuTartuEstonia

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