HIV-related stigma and its association with HIV transmission risk behaviors among boda boda motorcyclists in Mbarara Municipality, southwestern Uganda

Abstract

Background: Key populations have a disproportionate burden of HIV compared with the general population. HIV-related stigma has been recognized as a major barrier to HIV prevention and treatment efforts. It remains unclear whether HIV-related stigma is a significant driver of HIV transmission risk behavior among boda boda (motorcycle taxi) riders, a key population in Uganda. Methods: We conducted a cross-sectional study among boda boda motorcyclists in Mbarara Municipality of southwestern Uganda. Using multistage sampling, we recruited participants aged 18–59 years who had been riding for at least 6 months. The primary explanatory variable of interest was HIV-related stigma, measured using the 7-item STRIVE scale and dichotomized at “no stigma” versus “any stigma.” Self-reported HIV transmission risk behaviors included: condomless sexual intercourse, sexual intercourse under the influence of alcohol, having non-primary sexual partners, and sexual intercourse with a commercial sex worker. We used multivariable logistic regression to estimate the association between HIV-related stigma and HIV transmission risk behavior. Results: We enrolled 401 boda boda motorcyclists. All were men. Most [330 (82%)] were classified as having HIV-related stigma, particularly among younger men aged 18–29 years. One hundred and thirty-two (34%) participants reported their last sexual encounter was with a non-primary partner, 153 (39%) did not know the serostatus of their last sexual partner, and 138 (36%) reported sexual intercourse with a sex worker in the past 6 months. In multivariable logistic regression, HIV-related stigma (adjusted odds ratio [aOR] = 1.88, 95% CI: 1.06–3.34) had a statistically significant association with any HIV transmission risk behavior. Men who reported either minimal alcohol use (aOR = 1.81, 95% CI: 1.07–2.95) or harmful alcohol use (aOR = 3.5, 95% CI: 1.92–6.54), compared with men who reported no alcohol use, also reported greater odds of HIV transmission risk behavior. Conclusions: HIV transmission risk behavior is common among boda boda motorcyclists in the municipality and is associated with both HIV-related stigma and alcohol use. Interventions aimed at reducing HIV-related stigma and alcohol use may potentially reduce the high rates of HIV transmission risk behavior in this key population.

The association between HIV stigma and HIV incidence in the context of universal testing and treatment: analysis of data from the HPTN 071 (PopART) trial in Zambia and South Africa

“…A study in Cape Town bars found that participants agreeing with statements indicating AIDS‐related stigma reported higher levels of some risk behaviours [21]. In another study in Uganda, authors concluded that HIV risk was high among “boda boda” motorcyclists, was associated with HIV‐related stigma and that “interventions aimed at reducing HIV‐related stigma and alcohol use may potentially reduce the high rates of HIV transmission risk behavior” [22]. Data from Sierra Leone showed community‐level HIV disclosure concerns among women to be a driver of risky sex and self‐reported sexually transmitted infections [23].…”

Medicinal plants used by traditional medicine practitioners in treatment of alcohol-related disorders in Bushenyi District, southwestern Uganda

“…Furthermore, 28.8% of adult Ugandans aged 18 years and above are current alcohol drinkers, and 9.8% have an alcohol-related disorder ( Kabwama et al, 2016 ). A high burden of alcohol has been demonstrated in studies in southwestern Uganda where it has been associated with risk of HIV infection and its treatment outcomes ( Santos et al, 2014 ), intimate partner violence ( Ohurira et al, 2023 ), risky behaviors ( Bajunirwe et al, 2013 ; Nabifo et al, 2021 ), risk of mental illness ( Bajunirwe et al, 2014 ) and injuries ( Diamond et al, 2018 ).…”