Stigma impedes HIV treatment in multiple ways, including diminished engagement in care, refusing ART, and concealing ART to evade stigma. This study disentangled the degree to which intentionally not taking ART to evade stigma influences overall non-adherence to ART. Patients receiving ART at a community clinic in Cape Town, South Africa (N = 288) completed confidential surveys of demographic and health characteristics, stigma-avoidance non-adherence, and non-stigma-related predictors of non-adherence. Results found nearly half of participants (48%) had forgone taking their ART in social settings. Hierarchically structured regression models showed that alcohol use, medication concerns, and internalized HIV stigma significantly predicted ART non-adherence, accounting for 9.9% of the variance. Stigma-avoidance non-adherence explained an additional 2.6% of the variance in ART non-adherence. The current findings extend previous research to show that stigma-avoidance independently contributes to ART non-adherence, including over and above depression and alcohol use.

污名化以多种方式阻碍 HIV 治疗，包括减少对护理的参与、拒绝 ART 以及隐藏 ART 以逃避污名化。这项研究解开了故意不使用 ART 来逃避耻辱感对整体不依从 ART 的影响程度。在南非开普敦的社区诊所接受 ART 的患者（N = 288）完成了对人口统计学和健康特征、避免污名化的非依从性和非与污名相关的非依从性预测因素的保密调查。结果发现，近一半的参与者 (48%) 已放弃在社交场合接受 ART。分层结构的回归模型显示，饮酒、药物问题和内化的 HIV 污名显着预测 ART 不依从性，占方差的 9.9%。避免污名化的非依从性解释了额外的 2。ART 不依从性差异的 6%。当前的研究结果扩展了先前的研究，以表明避免耻辱感独立地导致 ART 不依从性，包括超过抑郁症和酒精使用。