Trends in HIV-related Stigma in the General Population During the Era of Antiretroviral Treatment Expansion: An Analysis of 31 Sub-Saharan African Countries.

Author Information (click to view)

Chan BT, Tsai AC,

Chan BT, Tsai AC, (click to view)

Chan BT, Tsai AC,

Share on FacebookTweet about this on TwitterShare on LinkedIn

Journal of acquired immune deficiency syndromes (1999) 2016 3 31()

HIV-related stigma is associated with increased risk-taking behavior, reduced uptake of HIV testing, and decreased adherence to antiretroviral therapy (ART). Although ART scale-up may reduce HIV-related stigma, the extent to which levels of stigma in the general population have changed during the era of ART scale-up in sub-Saharan Africa is unknown.

Social distance and anticipated stigma were operationalized using standard HIV-related stigma questions contained in the Demographic and Health Surveys (DHS) and AIDS Indicator Surveys (AIS) of 31 African countries between 2003-2013. We fitted multivariable linear regression models with cluster-correlated robust standard errors and country fixed effects, specifying social distance or anticipated stigma as the dependent variable and year as the primary explanatory variable of interest.

We estimated a statistically significant negative association between year and desires for social distance (b=-0.020; p<0.001; 95% Confidence Interval [CI], -0.026 to -0.015) but a statistically significant positive association between year and anticipated stigma (b=0.023; p<0.001; 95% CI, 0.018-0.027). In analyses stratified by HIV prevalence above or below the sample median, declines in social distancing over time were more pronounced among countries with a higher HIV prevalence. CONCLUSION
Concomitant with ART scale-up in sub-Saharan Africa, anticipated stigma in the general population increased despite a decrease in social distancing towards people living with HIV (PLHIV). Although ART scale-up may help reduce social distancing toward PLHIV, particularly in high-prevalence countries, other interventions targeting symbolic or instrumental concerns about HIV may be needed.

Submit a Comment

Your email address will not be published. Required fields are marked *

eighteen − 3 =