Impact of HIV/AIDS-related social stigma on HIV testing, treatment, and care among adults in Lesotho, 2016–2017 Open Access
Lalani, Kiran (Spring 2022)
Abstract
Introduction: Since the first reported cases in 1981, approximately 79.3 million people have become infected with HIV. In 2020, it was reported that an estimated 37.7 million people were living with HIV/AIDS, with more than half of them residing in eastern and southern Africa. According to the UNAIDS, Lesotho currently has the second highest HIV/AIDS prevalence in the world (22.8%) among adults aged 15 to 59 years. Despite advances in testing, treatment, and care there are still social barriers in place that continue to complicate these HIV/AIDS control effects. One social barrier that has been emphasized in biomedical literature is social stigma. As such, understanding the association between social stigma and HIV/AIDS testing, treatment, and care-seeking behavior is vital in the development of effective interventions to help facilitate access to prevention, treatment, and care programs for vulnerable populations in Lesotho.
Methods: This study analyzed cross-sectional data collected as part of the Population-based HIV Impact Assessment (PHIA) surveys between November 2016 and May 2017 in Lesotho. We analyzed data from individuals who completed the PHIA adult interview, biomarker testing, and the additional HIV/AIDS-knowledge and attitudes interview module (N = 6,528). Answers from the HIV/AIDS-knowledge and attitudes interview module were used to determine the association between HIV/AIDS-related stigma and HIV/AIDS testing, treatment, and care using logistic regression. Demographic characteristics of interest were also examined.
Results: Awareness of HIV status was positively associated with willingness to buy vegetables from a vendor with HIV/AIDS (87.1%; OR = 2.2; 95% CI 1.3, 3.7), agreeing that HIV-positive children should be allowed to attend schools with HIV-negative children (87.2%; OR = 2.0; 95% CI 1.1, 3.3), agreeing that people hesitate to get tested due to fear of a positive result (77.3%; OR = 1.5; 95% CI 1.0, 2.3), and agreeing that people talk badly about people living with HIV/AIDS (PLWH) (60.7%; OR = 1.4; 95% CI 1.0, 2.0). Age was positively associated with awareness of HIV status (aOR = 1.3; 95% CI 1.2, 1.4), being on antiretroviral treatment (ART) (aOR = 1.2; 95% CI 1.1, 1.3), and being virally suppressed (aOR = 1.2; 95% CI 1.1, 1.3), when controlling for cumulative social stigma score, gender, and wealth quintile. Gender was positively associated with awareness of HIV status (aOR = 1.8; 95% 1.3, 2.5) when controlling for cumulative social stigma score, age, and wealth quintile.
Discussion: The results of this study indicate that HIV/AIDS-related social stigma is statistically associated with awareness of HIV infection, in turn affecting one’s testing and care-seeking behavior. Further research is needed to understand the association between HIV/AIDS-related stigma and HIV testing, treatment, and care among the adult population to help Lesotho reach and surpass its 95-95-95 target by 2030.
Table of Contents
Introduction ……………………………………………………………………………………… 1
Methods …………………………………………………………………………………..…….… 8
Results ………………………………………………………………………………………..…. 15
Discussion …………………………………………………………………………………..….. 18
References …………………………………………………………………………………….... 24
Appendix …………………………………………………………………………………..….… 30
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