Initial trends from five cities shed light on stigma experienced by people living with HIV, but reveal that overall quality of life is good among those who are on HIV treatment
London, UK, 30 November 2018 – Early findings from the Fast-Track Cities Quality of Life Survey fielded in 29 cities around the world, show that almost one in three people living with HIV (38%) report feelings of stigma by their community, and almost one in four in a healthcare setting (23%), of which 78% identified a healthcare worker as the source of stigma. These figures, alongside others highlighted in the survey, provide an insight into how the quality of life of people living with HIV is affected on a daily basis by a myriad of factors including stigma.
The Fast-Track Cities Quality of Life Survey was developed by the International Association of Providers of AIDS Care (IAPAC), in partnership with the Joint United Nations Programme on HIV/AIDS (UNAIDS), the Global Network for People Living with HIV (GNP+), and the International Community of Women Living with HIV (ICW). Supported by a grant from ViiV Healthcare, the survey aimed to seek answers to questions about the overall health and wellbeing of people living with HIV, as well as factors that can affect a persons’ quality of life while living with the disease, particularly in a city setting.
The initial findings released today, just before World AIDS Day, are the first to be announced from the survey and provide an overall global picture as well as specific city read-outs from five Fast-Track Cities: Bangkok (Thailand), Durban (South Africa), Madrid (Spain), Miami (USA), and Salvador (Brazil). Results show that there is a significant disparity in the levels of stigma experienced in a healthcare setting, and within communities, by people living with HIV in these five cities.
Reported stigma and discrimination experienced within the community within the past 12 months were relatively low in Salvador and Bangkok, at 16% and 11%, respectively, with stigma experienced in healthcare facilities and by healthcare workers in these two cities within the same timeframe similarly low at 7% and 12%, respectively. However, the figures jump sharply for Miami, Durban, and Madrid with 66%, 42%, and 32% of respondents, respectively, saying they had felt stigmatised by their community in the past year.
Moreover, 47% of Durban respondents said they had been stigmatised in a healthcare facility or by a healthcare worker, while Miami and Madrid respondents reported considerably less stigma experienced in their healthcare facilities at 16% and 13%, respectively.
“One of the four commitments undertaken by all Fast-Track Cities was to reduce the negative impact of stigma and discrimination experienced by people living with HIV, both as a human rights imperative but also as a means of increasing access to and utilisation of HIV services to attain the UNAIDS 90-90-90 targets,” said Dr José M. Zuniga, President/CEO of IAPAC, the core technical partner of the Fast-Track Cities initiative. “Where stigma exists against people living with HIV, the dignity that should be afforded every human being and the benefits that ‘Knowing Your Status’ (HIV prevention and treatment services) can confer are denied. We aim to use the findings from the Fast-Track Cities Quality of Life Survey to inform a global and local dialogue about the need to take a holistic approach to improve the quality of life of people living with HIV.”
Globally, initial trends indicate that approximately 40% of the more than 4,300 people living with HIV who responded to the survey, reported being satisfied with their quality of life. Percentages were significantly higher in Miami with 56% reporting satisfaction, followed by Durban and Salvador, both reporting close to 50% satisfaction. Eighty-eight percent and 70% of respondents from Salvador and Durban, respectively, who reported satisfaction with their quality of life were consistently on antiretroviral therapy (ART), while in Miami, 60% of respondents who were satisfied with their quality of life were on ART but admitted occasionally missing doses. With regards to their outlook on life and living with HIV, respondents in Bangkok (44%), Miami (43%), and Salvador (39%) most often reported a positive outlook. Significant percentages of people living with HIV who are consistently on ART across three cities reported a positive outlook on life – Madrid (100%), Bangkok (94%), and Salvador (94%), while in Durban and Miami only 66% and 65% of respondents consistently on ART, respectively, reported a positive outlook on life.
Michele Robbins, Senior Director, Global Strategic Initiatives, ViiV Healthcare said, “It is vitally important to recognise that quality of life is an essential part of HIV care and to understand how people living with HIV perceive it affects their ongoing care. We look forward to using these insights and working with partners to develop meaningful interventions that can support optimal care in HIV.”
Additional interim global findings from the survey showed that 25% of respondents had disclosed their status to their intimate partner or spouse, and that about the same proportion worry about disclosing their status to their intimate partner or spouse. Despite Salvador and Bangkok reporting low stigma and discrimination in the healthcare setting and within their communities, people living with HIV in all three cities were notably worried about disclosing their HIV status to family and friends – 62%, 50%, and 50% for Salvador, Bangkok, and Durban, respectively. In Miami and Madrid, 26% and 21% of respondents, respectively, reported being almost always worried about disclosing their HIV status to family and friends, while 27% of respondents in Madrid and 24% of respondents in Miami reported being worried about disclosing to their intimate partners or spouses.
Full findings from the Fast-Track Cities Quality of Life Survey are expected to be announced in 2019. The total number of respondents is expected to reach 7,500.
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About Fast-Track Cities
Cities bear a large share of the global HIV burden. In countries with large HIV epidemics, the numbers of people living with HIV (PLHIV) in urban areas are so high that effective city-level action is likely to influence national outcomes. Even where an HIV epidemic is smaller, cities are home to large numbers of people belonging to key populations at higher risk of HIV infection but which often receive limited attention in HIV programs. The Fast-Track Cities is a global partnership between more than 250 high HIV burden cities, the International Association of Providers of AIDS Care (IAPAC), the Joint United Nations Programme on HIV/AIDS (UNAIDS), and the United Nations Human Settlements Programme (UN-Habitat), and the city of Paris. The initiative was launched on World AIDS Day 2014 in Paris. For more information please visit: www.iapac.org/fast-track-cities.
About the International Association of Providers of AIDS Care (IAPAC)
IAPAC was founded more than three decades ago with a mission to improve access to, and the quality of, prevention, care, treatment, and support services deliver to people living with and affected by HIV and comorbid diseases, including tuberculosis and viral hepatitis (HBV and HCV). With more than 30,000 members globally, IAPAC is the largest association of clinicians and allied health professionals who are working to end AIDS as a public health threat by 2030. For more information, please visit: www.iapac.org
About ViiV Healthcare
ViiV Healthcare is a global specialist HIV company established in November 2009 by GlaxoSmithKline (LSE: GSK) and Pfizer (NYSE: PFE) dedicated to delivering advances in treatment and care for people living with HIV and for people who are at risk of becoming infected with HIV. Shionogi joined in October 2012. The company’s aim is to take a deeper and broader interest in HIV/AIDS than any company has done before and take a new approach to deliver effective and innovative medicines for HIV treatment and prevention, as well as support communities affected by HIV.
For more information on the company and our work towards 90-90-90, please visit www.viivhealthcare.com .
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 The theme for World AIDS Day 2018 is Know Your Status. The theme recognizes the importance of ensuring that people living with HIV, especially those disproportionately affected by HIV, have equitable access to and utilize timely care, treatment, and supportive services if they are diagnosed with HIV. Click here for more information: https://knowyourstatus.unaids.org/
 Through support from ViiV Healthcare, IAPAC developed training modules for clinicians in 35 Fast-Track Cities regarding the importance of eliminating stigma in healthcare settings. The modules were developed in partnership with UNAIDS, GNP+, and the International AIDS Society (IAS). Click here for more information: http://www.fast-trackcities.org/hiv-stigma