HIV-related stigma is one of the greatest barriers to preventing and ending the HIV epidemic. The purpose of our study was to examine HIV-related stigma among urban adults voluntarily seeking HIV-oriented primary medical care and at risk for dropping out after enrolling. The baseline cross-sectional analysis of perceived HIV-related stigma upon enrolling in care examined the level of HIV-related stigma and its sub-domains: personalized, disclosure, negative self-image, and public attitudes. Our study also identified precursors of HIV-related stigma and associated outcomes. HIV-related stigma continues to be a significant problem for persons living with HIV; those perceiving higher levels of HIV-related stigma reported a poorer quality of life, both physically and mentally. The relationship between HIV-related stigma and mental health was closely connected in our sample.