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

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dc.contributor.authorStangl, Anne L.en_ZA
dc.contributor.authorPliakas, Triantafyllosen_ZA
dc.contributor.authorMaingad, Tilaen_ZA
dc.contributor.authorSteinhaus, Maraen_ZA
dc.contributor.authorMubekapi-Musadaidzwae, Constanceen_ZA
dc.contributor.authorViljoen, Larioen_ZA
dc.contributor.authorDunbare, Roryen_ZA
dc.contributor.authorSchaapd, Aben_ZA
dc.contributor.authorFloyd, Sianen_ZA
dc.contributor.authorMandla, Nomthaen_ZA
dc.contributor.authorBond, Virginiaen_ZA
dc.contributor.authorHoddinott, Graemeen_ZA
dc.contributor.authorFidler, Sarahen_ZA
dc.contributor.authorHayes, Richarden_ZA
dc.contributor.authorAyles, Helenen_ZA
dc.contributor.authorBock, Peteren_ZA
dc.contributor.authorDonnell, Deborahen_ZA
dc.contributor.authorHargreaves, James R.en_ZA
dc.date.accessioned2022-04-28T12:10:08Zen_ZA
dc.date.available2022-04-28T12:10:08Zen_ZA
dc.date.issued2020-11en_ZA
dc.descriptionCITATION: Stangl Anne L. 2020. The effect of universal testing and treatment on HIV stigma in 21 communities in Zambia and South Africa. AIDS, 34(14):2125-2135, doi: 10.1097/QAD.0000000000002658.en_ZA
dc.descriptionThe original publication is available at: https://pubmed.ncbi.nlm.nih.goven_ZA
dc.description.abstractObjectives: To assess the impact of a combination HIV prevention intervention including universal testing and treatment (UTT) on HIV stigma among people living with HIV, and among community members and health workers not living with HIV. Design: This HIV stigma study was nested in the HPTN 071 (PopART) trial, a three-arm cluster randomised trial conducted between 2013 and 2018 in 21 urban/peri-urban communities (12 in Zambia and nine in South Africa). Methods: Using an adjusted two-stage cluster-level analysis, controlling for baseline imbalances, we compared multiple domains of stigma between the trial arms at 36 months. Different domains of stigma were measured among three cohorts recruited across all study communities: 4178 randomly sampled adults aged 18–44 who were living with HIV, and 3487 randomly sampled adults and 1224 health workers who did not self-report living with HIV. Results: Prevalence of any stigma reported by people living with HIV at 36 months was 20.2% in arm A, 26.1% in arm B, and 19.1% in arm C (adjusted prevalence ratio, A vs. C 1.01 95% CI 0.49–2.08, B vs. C 1.34 95% CI 0.65–2.75). There were no significant differences between arms in any other measures of stigma across all three cohorts. All measures of stigma reduced over time (0.2–4.1% reduction between rounds) with most reductions statistically significant. Conclusion: We found little evidence that UTT either increased or decreased HIV stigma measured among people living with HIV, or among community members or health workers not living with HIV. Stigma reduced over time, but slowly.en_ZA
dc.description.versionPublisher's versionen_ZA
dc.format.extent11 pagesen_ZA
dc.identifier.citationStangl Anne L. 2020. The effect of universal testing and treatment on HIV stigma in 21 communities in Zambia and South Africa. AIDS, 34(14):2125-2135, doi: 10.1097/QAD.0000000000002658en_ZA
dc.identifier.issn0269-9370 (print)en_ZA
dc.identifier.otherdoi: 10.1097/QAD.0000000000002658en_ZA
dc.identifier.urihttp://hdl.handle.net/10019.1/124476en_ZA
dc.language.isoen_ZAen_ZA
dc.publisherWolters Kluwer Healthen_ZA
dc.rights.holderAuthors retain copyrighten_ZA
dc.subjectHIV infections -- Preventionen_ZA
dc.subjectAntiretroviral agentsen_ZA
dc.subjectMedical personnel -- Sub-Saharan Africaen_ZA
dc.subjectStigma (Social psychology)en_ZA
dc.subjectHIV-positive personsen_ZA
dc.subjectHIV infections – Treatmenten_ZA
dc.subjectSocial action -- Sub-Saharan Africaen_ZA
dc.titleThe effect of universal testing and treatment on HIV stigma in 21 communities in Zambia and South Africaen_ZA
dc.typeArticleen_ZA
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