Persistent HIV-related stigma in rural Uganda during a period of increasing HIV incidence despite treatment expansion

Brian T. Chan, Sheri D. Weiser, Yap Boum, Mark J. Siedner, A. Rain Mocello, Jessica E. Haberer, Peter W. Hunt, Jeffrey N. Martin, Kenneth H. Mayer, David R. Bangsberg, Alexander C. Tsai

Research output: Contribution to journalArticle

32 Scopus citations

Abstract

Objective: Programme implementers have argued that the increasing availability of antiretroviral therapy (ART) will reduce the stigmaof HIV.Weanalyzed data from Uganda to assess how HIV-related stigma has changed during a period of ART expansion. Design: Serial cross-sectional surveys . Methods: We analyzed data from the Uganda AIDS Rural Treatment Outcomes study during 2007-2012 to estimate trends in internalized stigma among people living with HIV (PLHIV) at the time of treatment initiation. We analyzed data from the Uganda Demographic and Health Surveys from 2006 to 2011 to estimate trends in stigmatizing attitudes and anticipated stigma in the general population. We fitted regression models adjusted for sociodemographic characteristics, with year of data collection as the primary explanatory variable . Results: We estimated an upward trend in internalized stigma among PLHIV presenting for treatment initiation [adjusted b=0.18; 95% confidence interval (CI), 0.06-0.30]. In the general population, the odds of reporting anticipated stigma were greater in 2011 compared with 2006 [adjusted odds ratio (OR)=1.80; 95% CI, 1.51-2.13], despite an apparent decline in stigmatizing attitudes (adjusted OR=0.62; 95% CI, 0.52-0.74) . Conclusion: Internalized stigma has increased over time among PLHIV in the setting of worsening anticipated stigma in the general population. Further study is needed to better understand the reasons for increasing HIV-related stigma in Uganda and its impact on HIV prevention efforts .

Original languageEnglish (US)
Pages (from-to)83-90
Number of pages8
JournalAIDS
Volume29
Issue number1
DOIs
StatePublished - Jan 1 2015

Keywords

  • HIV
  • Incidence
  • Stigma
  • Trends
  • Uganda

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases

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    Chan, B. T., Weiser, S. D., Boum, Y., Siedner, M. J., Mocello, A. R., Haberer, J. E., Hunt, P. W., Martin, J. N., Mayer, K. H., Bangsberg, D. R., & Tsai, A. C. (2015). Persistent HIV-related stigma in rural Uganda during a period of increasing HIV incidence despite treatment expansion. AIDS, 29(1), 83-90. https://doi.org/10.1097/QAD.0000000000000495