A Cross-Sectional Study on the Affordable Care Act from the Perspective of People Living with HIV: The Interplay between Knowledge, Stigma, Trust, and Attitudes
Table 2
Respondents’ Affordable Care Act (ACA) knowledge, HIV stigma, trust in the healthcare system and government, and ACA attitudes.
ACA knowledge1: n (%)
Overall n = 53
ACA subsidies
Correct
41 (77%)
Not correct
12 (23%)
Pre-existing conditions
Correct
23 (43%)
Not correct
30 (57%)
ACA/Ryan White interaction
Correct
37 (70%)
Not correct
16 (30%)
Virginia Medicaid expansion
Correct
6 (11%)
Not correct
47 (89%)
Correct ACA knowledge2
Yes
16 (30%)
No
37 (70%)
HIV Berger Stigma Scale3: mean (SD)
Total stigma
104 (20.0)
Trust in clinicians/insurance companies4
Mean (SD)
Trust in HIV clinicians
21.8 (2.5)
Trust in general clinicians
19.5 (3.6)
Trust in insurance companies
13.6 (3.8)
Trust in governmental bodies5: n (%)
How often can you trust the federal government to do what is right?
Always
2 (3.8%)
Most of the time
8 (15.1%)
About half the time
12 (22.6%)
Some of the time
15 (28.3%)
Never
8 (15.1%)
Don’t know
8 (15.1%)
How often can you trust the Virginia state government to do what is right?
Always
3 (5.7%)
Most of the time
9 (17.0%)
About half the time
13 (24.5%)
Some of the time
12 (22.6%)
Never
8 (15.1%)
Don’t know
8 (15.1%)
Attitudes toward the ACA1: mean (SD)
Does insurance improve healthcare?
3.9 (1.0)
Will the ACA improve US health outcomes?
3.5 (0.9)
Will the ACA improve your HIV health outcomes?
3.7 (1.0)
Will the ACA improve your non-HIV health outcomes?
3.4 (0.9)
Do you have enough information on the ACA to understand its impact on your HIV care?
Agree
28 (53%)
Disagree
25 (47%)
1ACA knowledge and attitudes toward the ACA were assessed using questions from McManus et al. [19]. 2 Correct ACA knowledge was defined as getting the first three questions correct (ACA subsidies, pre-existing conditions, and ACA/Ryan White interaction) as there was a very low correct response rate about Virginia’s Medicaid expansion status. 3Stigma was assessed using the Berger HIV Stigma Scale [20]. 4Trust in clinicians and insurance companies was assessed using methods from Dugan et al. [21]. 5Trust in governmental bodies was assessed using methods from the American National Election Studies [22].
