Gender, HIV Testing and Stigma: The Association of HIV Testing Behaviors and Community-Level and Individual-Level Stigma in Rural South Africa Differ for Men and Women.

Journal: AIDS and behavior

Volume: 21

Issue: 9

Year of Publication: 2018

Affiliated Institutions:  Department of Medicine, Center for AIDS Prevention Studies, University of California, San Francisco, San Francisco, CA, USA. kagan.sarah@gmail.com. Department of Obstetrics, Gynecology and Reproductive Sciences, Bixby Center for Global Reproductive Health, University of California, San Francisco, San Francisco, CA, USA. Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. Wits Reproductive Health and HIV Institute (WRHI), Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa. MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. Sonke Gender Justice, Cape Town, South Africa. Department of Medicine, Center for AIDS Prevention Studies, University of California, San Francisco, San Francisco, CA, USA.

Abstract summary 

Stigma remains a significant barrier to HIV testing in South Africa. Despite being a social construct, most HIV-stigma research focuses on individuals; further the intersection of gender, testing and stigma is yet to be fully explored. We examined the relationship between anticipated stigma at individual and community levels and recent testing using a population-based sample (n = 1126) in Mpumalanga, South Africa. We used multi-level regression to estimate the potential effect of reducing community-level stigma on testing uptake using the g-computation algorithm. Men tested less frequently (OR 0.22, 95% CI 0.14-0.33) and reported more anticipated stigma (OR 5.1, 95% CI 2.6-10.1) than women. For men only, testing was higher among those reporting no stigma versus some (OR 1.40, 95% CI 0.97-2.03; p = 0.07). For women only, each percentage point reduction in community-level stigma, the likelihood of testing increased by 3% (p < 0.01). Programming should consider stigma reduction in the context of social norms and gender to tailor activities appropriately.

Authors & Co-authors:  Treves-Kagan Sarah S El Ayadi Alison M AM Pettifor Audrey A MacPhail Catherine C Twine Rhian R Maman Suzanne S Peacock Dean D Kahn Kathleen K Lippman Sheri A SA

Study Outcome 

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Statistics
Citations :  World Health Organization. Prevalence of HIV among adults aged 15 to 49, estimates by country. 2013.
Authors :  9
Identifiers
Doi : 10.1007/s10461-016-1671-8
SSN : 1573-3254
Study Population
Men,Women
Mesh Terms
AIDS Serodiagnosis
Other Terms
Community;Gender;HIV;Rural;South Africa;Stigma
Study Design
Cross Sectional Study
Study Approach
Country of Study
South Africa
Publication Country
United States