HIV Treatment Scale-Up and HIV-Related Stigma in Sub-Saharan Africa: A Longitudinal Cross-Country Analysis

• Published in: American journal of public health (1971) 2015-08, Vol.105 (8), p.1581-1587
• Main Authors: Chan, Brian T, Tsai, Alexander C, Siedner, Mark J
• Format: Article
• Language: English
• Subjects: Acquired immune deficiency syndrome; Adolescent; Adult; Africa South of the Sahara - epidemiology; AIDS; Antiretroviral drugs; Antiviral Agents - therapeutic use; Attitudes; Behavior; Drug therapy; Female; Gender differences; Global Health; Health surveys; HIV; HIV Infections - drug therapy; HIV Infections - epidemiology; HIV Infections - psychology; HIV/AIDS; Human immunodeficiency virus; Humans; Longitudinal Studies; Low income groups; Male; Middle Aged; Patient Acceptance of Health Care - psychology; Patient Acceptance of Health Care - statistics & numerical data; Population; Public health; Regression analysis; Research and Practice; Sensitivity analysis; Sex Factors; Stereotyping; Stigma; Surveys and Questionnaires; Trends; Women; Young Adult
• ISSN: 0090-0036; 1541-0048
• DOI: 10.2105/AJPH.2015.302716

We estimated the association between antiretroviral therapy (ART) uptake and HIV-related stigma at the population level in sub-Saharan Africa. We examined trends in HIV-related stigma and ART coverage in sub-Saharan Africa during 2003 to 2013 using longitudinal, population-based data on ART coverage from the Joint United Nations Program on HIV/AIDS and on HIV-related stigma from the Demographic and Health Surveys and AIDS Indicator Surveys. We fitted 2 linear regression models with country fixed effects, with the percentage of men or women reporting HIV-related stigma as the dependent variable and the percentage of people living with HIV on ART as the explanatory variable. Eighteen countries in sub-Saharan Africa were included in our analysis. For each 1% increase in ART coverage, we observed a statistically significant decrease in the percentage of women (b = -0.226; P = .007; 95% confidence interval [CI] = -0.383, -0.070) and men (b = -0.281; P = .009; 95% CI = -0.480, -0.082) in the general population reporting HIV-related stigma. An important benefit of ART scale-up may be the diminution of HIV-related stigma in the general population.