Investigating the Relationship Between Stigma and Relapse in IDUs with HIV/AIDS in Pakistan

Background: 
Injecting drug users (IDUs) with HIV/AIDS face a double burden: the chronic illness and the associated stigma . This stigma can negatively impact treatment adherence and lead to relapse in IDUs with HIV/AIDS. This study investigates the relationship between stigma and relapse in IDUs with HIV/AIDS in Pakistan.
Methods:
A cross-sectional survey was conducted with 200 IDUs with HIV/AIDS recruited from three antiretroviral therapy (ART) clinics in Lahore, Karachi and Islamabad. Participants completed self-administered questionnaires assessing sociodemographic factors, HIV/AIDS knowledge, percieved stigma, and recent drug use ( relapse). Statistical analysis included descriptive statistics, bivariate correlation, and logistic regression to assess the association between stigma and relapse.
Results:
The mean age of participants was 35 years and most were male (85%). Approximately 28% reported experiencing high levels of stigma, associated factors like social isolation and discrimination. Overall, 42% participants reported relapse in the past month.  Bivariate correlation indicated a significant positive association between perceived stigma and relapse ( r=0.32, p<0.001). Logistic regression analysis confirmed this association, with an increased risk of relapse for individuals experiencing high levels of stigma ( adjusted OR=2.45, 95% CI: 1.23-4.89).
Conclusion:
This study found a significant association between perceived stigma and relapse in IDUs with HIV/AIDS in Pakistan. Addressing stigma through interventions focused on awareness , education, and social support may be crucial for improving treatment adherence and reducing relapse in this vulnerable population.