Methodology

AMIS Stigma and Socio-Behavioral Measures

The model visualizes the proportion of participants from AMIS responding “yes” to individual socio- behavioral variables, including the three stigma scales (general social stigma, stigma from family members, anticipated healthcare stigma), healthcare provider disclosure, and risk behavior. For stigma scales, to more finely characterize temporal trends, responses of “yes” are coded as positive evidence of stigma experience only if experienced within the last 6 months.To facilitate accurate trend visualization and cross-state comparisons, this data is grouped into two-year intervals and reweighted across time.

CDC HIV-related Indicators

The model visualizes key epidemiological and service indicators among MSM, specifically:

MSM prescribed Pre-Exposure Prophylaxis, or PrEP
Derived from the CDC surveillance indicator “PrEP coverage and number of persons prescribed.” The number of MSM prescribed PrEP is estimated as 85% of male PrEP users, based on national estimates.

Estimated HIV incidence among MSM
Derived from the CDC surveillance indicator “Estimated HIV incidence,” which is reported by aggregate population at each geographic level. Incidence is estimated by allocating total incidence based on the proportion of new HIV diagnoses attributed to MSM.

Note: This approach assumes that the share of new diagnoses among MSM reflects the share of new infections.

HIV diagnoses among MSM
Taken directly from CDC surveillance indicator: “HIV diagnoses.

Housing and Employment Support

Comprised of organizations that indicate they provide the following service: Housing Opportunities for Persons with AIDS/HOPWA

Mental Health Services

Comprised of organizations that indicate they provide the following service: Support Groups

Substance Use Disorder Treatment and Prevention

Comprised of organizations that indicate they provide the following services:

• • (a) Harm Reduction Services
  • (b) Needle Cleaning, Needle Exchange, or Needle Distribution Services
  • Both types of services (a and b)

Sexual Health Services

HIV & Stigma Prevention and Education

Comprised of organizations that indicate they provide all the following services:

• • PrEP Navigation
  • Drug Purchasing Assistance, including AIDS Drug Purchasing Assistance (ADAP)
  • HIV Test Counseling
  • HIV/AIDS Prevention/Education
  • STI Prevention/Education
  • Condom Distribution

HIV & STI Testing and Treatment Services

Comprised of organizations that indicate they provide all the following services:

• • Chlamydia Test
  • Gonorrhea Test
  • Conventional HIV Test
  • Syphilis Test
  • STI Treatment
  • Doxy PEP

Both

Comprised of organizations that indicate they provide all the services listed under HIV & STI Prevention and Education, and HIV & STI Testing and Treatment Services

Note: On the National Profile Support Services tab, states that did not have organizations that provided both HIV & STI Prevention and Education and HIV & STI Testing and Treatment Services are visually indicated using a hash pattern. Additionally, stigma interventions that occurred in a non-specified region are listed below the Support Services map on the National Profile.

MSM who complete AMIS are asked to respond to various questions (items), regarding experiences of stigma they may have had over varying time frames (e.g. yes, in the past 12 months; yes, not in the last 12 months). When reporting the data, responses of “yes,” to an individual item, regardless of time frame, are coded as positive evidence of experiencing stigma.

To calculate individual stigma item prevalence, responses of “yes” or “no” to an item are summed, and the proportion of individuals who indicated “yes” to an individual item are calculated. The proportion of individuals who indicated “yes” is displayed by individual item on the Stigma Indicator Tab.

To describe how different types of stigma persist, validated stigma scales exist to measure distinct experiences of stigma. Each scale consists of multiple individual stigma items that together characterize a specific type of stigma. StigmaScope uses individual stigma items, as can be seen on the Stigma Indicator tab, to calculate scores for the following three scales:

• • General Social Stigma
  • Stigma from Family
  • Anticipated Healthcare Stigma

The General Social Stigma Scale is comprised of individual items that capture experiences of negative treatment, harassment, or physical / sexual violence perpetrated by police or community members in public spaces.⁶

The Stigma from Family Scale is comprised of individual items that capture experiences of exclusion, discrimination, or rejection perpetrated by family members. ⁶

The Anticipated Healthcare Stigma Scale is comprised of individual items that capture fear of negative experiences while accessing or engaging with healthcare services that may lead to avoidance of care.⁶

Note: Further information on the stigma items, scales, and scores can be found on the Center for HIV and Stigma Elimination Strategies (CHIMES) Stigma Measurement Library.

Collated from MAP’s HIV Criminalization and Hate Crime legislation pages, this policy data displays active HIV criminalization laws, hate crime data collection, and annual hate crime incidence.

General Social Stigma Scale: Experiences or perceptions of negative treatment, harassment, or physical / sexual violence perpetrated by police or community members in public spaces.

Stigma from Family Scale: Experiences of exclusion, discrimination, or rejection perpetrated by family members.

Anticipated Healthcare Stigma Scale: Fear of negative experiences while accessing or engaging with healthcare services that may lead to avoidance of care.

Responses of “yes,” across the items that comprise the overall scale, regardless of time frame, are coded as positive evidence of experiencing stigma. For any missing responses, the mean from the respective scale is imputed. Scores are aggregated to calculate state-level proportions.

Note: US States failing to meet a minimum threshold of 30 respondents for a specific item in a given survey year are suppressed and shaded grey.