The effect of universal testing and treatment on HIV stigma in 21 communities in Zambia and South Africa

Stangl, Anne; Pliakas, Triantafyllos; Mainga, Tila; Steinhaus, Mara; Mubekapi-Musadaidzwa, Constance; Viljoen, Lario; Dunbar, Rory; Schaap, Ab; Floyd, Sian; Mandla, Nomtha; Bond, Virginia; Hoddinott, Graeme; Fidler, Sarah; Hayes, Richard; Ayles, Helen; Böck, Peter; Donnell, Deborah; Hargreaves, James; Team, Hptn Study

doi:10.1097/qad.0000000000002658

Cited by 15 publications

(19 citation statements)

References 109 publications

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“…CHiPs and HWs were followed up in 2 rounds (R2 between June 2015 to June 2016 and R3 between January 2017 and February 2018). 16 We generated community-level measures of stigma among HWs, using the same approach described above, reflecting the level of fear and judgment of PLHIV by CHIPs and HWs (including only data from those not self-reporting living with HIV, n = 516 and 1533, respectively, in R3) and perceptions of stigma in the community and by coworkers in the health facilities (including all individuals regardless of HIV status, n = 635 and 1802, respectively, in R3). Finally, for PC-HIV+ SR , we also summarized the indicators used in individual analysis at the community level.…”

Section: Methodsmentioning

confidence: 99%

HIV Stigma and Viral Suppression Among People Living With HIV in the Context of Universal Test and Treat: Analysis of Data From the HPTN 071 (PopART) Trial in Zambia and South Africa

Hargreaves

Pliakas

Hoddinott

et al. 2020

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Section: Methodsmentioning

confidence: 99%

HIV Stigma and Viral Suppression Among People Living With HIV in the Context of Universal Test and Treat: Analysis of Data From the HPTN 071 (PopART) Trial in Zambia and South Africa

Hargreaves

Pliakas

Hoddinott

et al. 2020

JAIDS Journal of Acquired Immune Deficiency Syndromes

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“…31,[36][37][38] Even though, magnitude of discrimination towards PLWHA is reduced in the last decade in Africa, it is still a public health problem which affects the successes of HIV-related programs in the continent. [39][40][41][42][43] In Ethiopia, the prevalence of HIV/AIDS-related discrimination is high. In Dessie (41.93%), 44 Jimma referral hospital (56%), 45 Oromia (62%), 24 Amhara (34%).…”

Section: Introductionmentioning

confidence: 99%

Predictors of Discrimination Towards People Living with HIV/AIDS Among People Aged 15–49 Years in Ethiopia: A Multilevel Analysis

Arefaynie¹,

Damtie²,

Kefale³

et al. 2021

HIV

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Background: There is limited national representative evidence on determinants of discrimination towards people living with HIV/AIDS especially, community-level factors that are not investigated in Ethiopia. Thus, this study aimed to assess individual and community-level factors associated with discrimination towards people living with HIV/AIDS among 15-49 age people in Ethiopia. Methods: A secondary data analysis was done on the 2016 Ethiopian Demographic and Health Survey dataset which was collected cross-sectional. A total of 25,927 weighted 15-49 age people were included in the analysis. Multi-level mixed-effect logistic regression analysis was done by STATA version 14.0 to identify individual and communitylevel factors. Adjusted odds ratio with 95% confidence interval was used to show the strength and direction of the association and statistical significance was declared at P value less than 0.05. Results: From individual level factors, being female [AOR=1.47, 95% CI= (1.18, 1.83)], not attend education [AOR=5.88,95% CI= (4.50, 7.67)], attending primary education [AOR=3.03, 95% CI= (2.40, 3.81)] and attending secondary education [AOR=1.48, 95% CI= (1.19, 1.82)] have discrimination attitude towards people living with HIV/AIDS. From community level factors, live in low proportion of educated communities [AOR=1.33, 95% CI= (1.01, 1.65)], rural dweller [AOR=1.65, 95% CI= (1.23, 2.21)], live in low proportion of HIV tested communities [AOR=1.61, 95% CI= (1.33, 1.93)] were significantly associated with discrimination attitude towards people living with HIV/AIDS. Conclusion: Sex of the respondent, religion, educational status, household wealth index, marital status, media exposure, internet use, HIV test status, region, and residence, community level of education, and community level of HIV test status were predictors of discrimination attitude towards people living with HIV/AIDS in Ethiopia. Improving educational and community-level HIV/AIDS test coverage are important interventions to reduce discrimination towards people living with HIV/AIDS in the country.

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“…However, quantitative analyses of the effect of the study intervention showed no impact on HIV stigma levels (Stangl et al . 2020). We used qualitative data to explore study community members’ stigma‐related experiences.…”

Section: Introductionmentioning

confidence: 99%

“…The trial showed a significant reduction in population level HIV incidence amongst communities receiving the household testing intervention. However, quantitative analyses of the effect of the study intervention showed no impact on HIV stigma levels (Stangl et al 2020). We used qualitative data to explore study community members' stigma-related experiences.…”

Section: Introductionmentioning

confidence: 99%

Universal HIV testing and treatment and HIV stigma reduction: a comparative thematic analysis of qualitative data from the HPTN 071 (PopART) trial in South Africa and Zambia

Viljoen

Bond

Reynolds

et al. 2020

Sociology Health & Illness

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Despite continued development of effective HIV treatment, expanded access to care and advances in prevention modalities, HIV‐related stigma persists. We examine how, in the context of a universal HIV‐testing and treatment trial in South Africa and Zambia, increased availability of HIV services influenced conceptualisations of HIV. Using qualitative data, we explore people’s stigma‐related experiences of living in ‘intervention’ and ‘control’ study communities. We conducted exploratory data analysis from a qualitative cohort of 150 households in 13 study communities, collected between 2016 and 2018. We found that increased availability of HIV‐testing services influenced conceptualisations of HIV as normative (non‐exceptional) and the visibility of people living with HIV (PLHIV) in household and community spaces impacted opportunities for stigma. There was a shift in community narratives towards individual responsibility to take up (assumingly) widely available service – for PLHIV to take care of their own health and to prevent onward transmission. Based on empirical data, we show that, despite a growing acceptance of HIV‐related testing services, anticipated stigma persists through the mechanism of shifting responsibilisation. To mitigate the responsibilisation of PLHIV, heath implementers need to adapt anti‐stigma messaging and especially focus on anticipated stigma.

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The effect of universal testing and treatment on HIV stigma in 21 communities in Zambia and South Africa

Abstract: A cluster-randomized trial of the impact of a combination prevention package on population-level HIV incidence in Zambia and South AfricaFinal Version 1.0

Cited by 15 publications

References 109 publications

HIV Stigma and Viral Suppression Among People Living With HIV in the Context of Universal Test and Treat: Analysis of Data From the HPTN 071 (PopART) Trial in Zambia and South Africa

HIV Stigma and Viral Suppression Among People Living With HIV in the Context of Universal Test and Treat: Analysis of Data From the HPTN 071 (PopART) Trial in Zambia and South Africa

Predictors of Discrimination Towards People Living with HIV/AIDS Among People Aged 15–49 Years in Ethiopia: A Multilevel Analysis

Universal HIV testing and treatment and HIV stigma reduction: a comparative thematic analysis of qualitative data from the HPTN 071 (PopART) trial in South Africa and Zambia

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