Individual and community-level risk factors for HIV stigma in 21 Zambian and South African communities: analysis of data from the HPTN071 (PopART) study.
AIDS
; 32(6): 783-793, 2018 03 27.
Article
en En
| MEDLINE
| ID: mdl-29369164
ABSTRACT
OBJECTIVE:
To describe the prevalence and determinants of HIV stigma in 21 communities in Zambia and South Africa.DESIGN:
Analysis of baseline data from the HPTN 071 (PopART) cluster-randomized trial. HIV stigma data came from a random sample of 3859 people living with HIV. Community-level exposures reflecting HIV fears and judgements and perceptions of HIV stigma came from a random sample of community members not living with HIV (nâ=â5088), and from health workers (HW) (nâ=â851).METHODS:
We calculated the prevalence of internalized stigma, and stigma experienced in the community or in a healthcare setting in the past year. We conducted risk-factor analyses using logistic regression, adjusting for clustering.RESULTS:
Internalized stigma (868/3859, prevalence 22.5%) was not associated with sociodemographic characteristics but was less common among those with a longer period since diagnosis (Pâ=â0.043). Stigma experienced in the community (853/3859, 22.1%) was more common among women (Pâ=â0.016), older (Pâ=â0.011) and unmarried (Pâ=â0.009) individuals, those who had disclosed to others (Pâ<â0.001), and those with more lifetime sexual partners (Pâ<â0.001). Stigma experienced in a healthcare setting (280/3859, 7.3%) was more common among women (Pâ=â0.019) and those reporting more lifetime sexual partners (Pâ=â0.001) and higher wealth (Pâ=â0.003). Experienced stigma was more common in clusters wherever community members perceived higher levels of stigma, but was not associated with the beliefs of community members or HW.CONCLUSION:
HIV stigma remains unacceptably high in South Africa and Zambia and may act as barrier to HIV prevention and treatment. Further research is needed to understand its determinants.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Infecciones por VIH
/
Estigma Social
Tipo de estudio:
Clinical_trials
/
Etiology_studies
/
Prevalence_studies
/
Risk_factors_studies
Límite:
Adolescent
/
Adult
/
Female
/
Humans
/
Male
País/Región como asunto:
Africa
Idioma:
En
Revista:
AIDS
Asunto de la revista:
SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS)
Año:
2018
Tipo del documento:
Article
País de afiliación:
Reino Unido