Human Immunodeficiency Virus Stigma Research Articles

Pre- and Post-Exposure Prophylaxis for HIV in Patients Taking Anti-Seizure Medications

The prevention of human immunodeficiency virus (HIV) infection has recently emphasized the use of pre- and post-exposure prophylaxis (PrEP and PEP), both of which were highly effective in prevention of HIV infection. Since the last published guidance regarding the cotreatment of people with anti-seizure medications (ASM) and antiretroviral treatments (ARTs) in 2012, both fields have numerous new medication options. Historically, cotreatment of HIV and seizures could be challenging with increased risk of virologic failure and barriers in access to health care due to global availability, social determinants of health, and stigma of both HIV and seizures. In this narrative review, we describe the data-driven and expected bidirectional pharmacokinetic (PK) interactions between guideline-based PrEP and PEP treatment and ASM, as well as overlapping side effects. There are many ASMs with no known interaction with PrEP or PEP regimens. The interactions focus on enzyme inducing ASMs, valproate, and lamotrigine. Most prominently, enzyme inducing ASMs lower serum levels of tenofovir-containing PrEP regimens and elements of PEP (dolutegravir, raltegravir, and ritonavir), which increased risk of virologic treatment failure in people with HIV but have unclear clinical significance on the effectiveness of PrEP and PEP. In addition, ritonavir treatment in PEP may significantly lower lamotrigine serum levels even during the 4 weeks of treatment, which may increase risk for breakthrough seizures during PEP and skin reactions after discontinuation of ritonavir. In addition to PK interactions, overlapping side effects are common including osteopenia, hepatic toxicity, and other gastrointestinal effects. This narrative review aims to be a resource for all clinicians prescribing ASMs so that they can create a welcoming environment to enable successful treatment of seizures and reduce the risk of HIV infection in people at risk. In addition, we highlight knowledge gaps and areas of unmet need that can be addressed with future studies.

Acceptability of a future HIV vaccine: A rapid scoping review

Background: A human immunodeficiency virus (HIV) vaccine is not available yet, but perceptions of HIV vaccines will be important to explore before their roll-out for effective vaccine promotion. This paper presents the findings of a rapid scoping review of the literature to identify individual, social, and vaccine-related factors associated with the acceptability of a future HIV vaccine. Methods: We searched five databases (Medline OVID, Embase, PsycINFO, Web of Science, and Cochrane) using relevant keywords and Medical Subject Headings. All articles, regardless of study design, publication year, and geographic location, were included if they examined HIV vaccine acceptability and its underlying factors. Results: We retrieved 2,386 unique articles, of which 76 were included in the final review. Perceived benefits (34.2%) and perceived susceptibility (25.0%) were primary individual factors of HIV vaccine acceptability. Misinformation (17.1%) and distrust (22.4%) regarding future HIV vaccines, HIV stigma (30.3%), and social support (10.5%) were social factors of HIV vaccine acceptability. Vaccine efficacy (42.1%), cost (28.9%) and side effects (67.1%) were common vaccine characteristics influencing HIV vaccine acceptability. Altruism (10.5%) and risk compensation (26.3%) were also key factors. Conclusions: Our analyses revealed that skeptical beliefs, negative perceptions, and misconceptions about HIV vaccines are real barriers to their acceptability. To alleviate HIV vaccine hesitancy and address trust concerns, strategic vaccine communication should be disseminated by trustworthy sources. Messages should impart accurate vaccine information and emphasize both individual and social benefits of HIV vaccination, as well as leverage social support in increasing willingness to get a future HIV vaccine.

I´m not a threat: A qualitative study on the mental health´s aspects of women living with HIV in Brazil

This study aimed to analyze aspects of the mental health of women living with Human Immunodeficiency Virus (HIV) in Brazil. To this end, was carried out qualitative research, anchored in the theoretical framework of Interpretive Anthropology, from January to March 2022, based on interviews with ten women living with HIV of reproductive age and undergoing treatment in a specialized public service in São Paulo, Brazil. Thematic Analysis was adopted as a methodological reference. Three thematic categories emerged from the data: Perception of the received care and its impact on mental health; Feelings related to living with HIV; and Perception of social stigma of HIV. The results showed that the mental health of women living with HIV was directly related to perceived health care, the information they receive, the way communication is established, and the bonds built in care. Feelings of fear, guilt and loneliness related to living with HIV and social stigma are elements that promote psychological suffering for these women. Sensitive and open strategies are essential to providing effective support and improving the lives of women living with HIV.

Emotion regulation as a potential moderator of the association between HIV stigma and nonadherence to antiretroviral therapy among youth living with HIV.

Human immunodeficiency virus (HIV)-related stigma affects adherence to antiretroviral therapy (ART) for youth living with HIV. Emotion regulation strategies such as cognitive reappraisal (reinterpreting adversity to mitigate emotional impact) and expressive suppression (inhibiting emotion-expressive behavior activated by adversity) may moderate the HIV stigma-ART adherence relationship in this group. Using baseline data from 208 youth living with HIV aged 15-24 years enrolled in an mHealth ART-adherence intervention, we performed modified Poisson regressions with robust variance between HIV stigma (internalized, anticipated, enacted) and ART nonadherence. We tested for multiplicative interaction via product terms between HIV stigma and emotion regulation scores, and additive interaction via relative excess risk due to interaction and attributable proportion using dichotomous HIV stigma and emotion regulation variables. Mean age was 21 years; ≥50% of participants were cisgender male, non-Hispanic Black, and gay-identifying; 18% reported ART nonadherence. Confounder-adjusted regressions showed positive associations between each HIV stigma variable and ART nonadherence. Internalized HIV stigma and cognitive reappraisal negatively, multiplicatively interacted (as internalized HIV stigma increased, ART nonadherence increased for those with low cognitive reappraisal). High internalized HIV stigma positively, additively interacted with low cognitive reappraisal and low expressive suppression (when high internalized HIV stigma and low levels of either emotion regulation strategy were present, ART nonadherence increased dramatically). Cognitive reappraisal and expressive suppression may protect against internalized HIV stigma's harmful association with ART nonadherence. These modifiable emotion regulation strategies may be targeted to potentially buffer the effects of internalized HIV stigma and support ART adherence for youth living with HIV.

Ubuntu Is a Critical Component in the Fight against Human Immunodeficiency Virus and Tuberculosis Stigma: Nursing Students' Perceptions.

Stigma is one of the documented barriers to achieving universal access to human immunodeficiency virus (HIV) and tuberculosis (TB) prevention, treatment, care, and support programs. The lack of African social theories to emphasize these issues may be the cause of the continent's failure to reduce stigma. We can use Ubuntu, an African philosophy that emphasizes sociability and ethics, to deepen our understanding of how to reduce HIV- and TB-related stigma in South Africa. In many African regions, Ubuntu values and principles were found to assist in reducing problems related to HIV. Ubuntu is a comprehensive phrase used by Africans to signify the characteristics that incorporate the core human virtues of compassion and humanity. We explored the perceptions of nursing students regarding the use of Ubuntu in the fight against HIV and TB stigma. Qualitative participatory research was used to engage all first- and second-level nursing students enrolled for the 2023 academic year at the selected university in South Africa. Purposive sampling was used to recruit the participants. An interactive workshop was used to gather data. The data from the recordings and flip charts were analysed together. Throughout the study, trustworthiness and ethical principles were upheld. Two primary themes emerged as expressions of Ubuntu in relation to a reduction in HIV and TB stigma and recognition of Ubuntu as a tool to combat stigma associated with HIV and TB. This confirms that within Ubuntu, there are elements that might be applied to reduce stigma attached to HIV and TB.

Feasibility and Acceptability of Human Immunodeficiency Virus Self-Testing for Men of Middle-to-Upper Socioeconomic Status in Botswana: A Pilot Study at 4 Worksites in the Financial Sector.

Although Botswana has made great progress in expanding human immunodeficiency virus (HIV) testing, men are less likely to be tested for HIV and test at a later stage compared with women. For Botswana to increase HIV testing coverage among men, HIV self-testing (HIVST) may be a promising supplement to standard, healthcare facility-based HIV testing. We conducted a pilot test of the feasibility and acceptability of HIVST for men of middle-to-upper socioeconomic status in Botswana. Thirty-five men were recruited through 4 workplaces (banking sector). Wellness officers emailed all potentially eligible male employees about the opportunity to participate. Men were surveyed at baseline and follow-up on basic sociodemographic characteristics, HIV testing history, HIV stigma, use of the HIVST kit (at follow-up), and confirmatory testing and linkage to care if a preliminary positive result is obtained (at follow-up). All 35 men used the kit. The proportion who agreed with the statement that getting tested for HIV helps people feel better increased significantly from 80.7% at baseline to 100% at follow-up. In open-ended questions, men described the advantages of HIVST, including improved privacy and convenience, lowered HIV stigma, and enhanced control over testing. Concerns about HIVST included potential negative mental health consequences owing to not receiving pretest and posttest counseling, and not linking to care after a reactive result. Results suggest that an intervention in which HIVST is discrete, private, and under men's control can help overcome stigma around HIV testing, resulting in a greater number of men tested.

“Discrimination is harder to live with than the disease”: an interview study of the perceptions and experiences of sexual and reproductive health and rights among women living with HIV in Sweden

Around 40% of people living with human immunodeficiency virus (HIV) in Sweden are women. However, little is known about their experiences, particularly those related to sexual and reproductive health and rights (SRHR). This study aims to explore perceptions and experiences of SRHR among women living with HIV (LWH). Twelve interviews were conducted with women LWH from September to October 2019 and analysed using thematic analysis. The central theme describing participants’ experiences of social relationships, intimate encounters and reproductive life, “Discrimination is harder to live with than the disease itself”, is based on three themes that contain subthemes. Theme 1 describes how participants reconsider and reorient their sexual and reproductive life after diagnosis. Theme 2 highlights how (mis)perceptions of HIV affect sexual and reproductive life and lead to abusive treatment and internalisation. Theme 3 describes a paradoxical shift of responsibilities where participants experience being compelled to take greater responsibility in some situations and stripped of the right to decide in others. This study suggests that despite notable progress in HIV treatment, stigma and discrimination stemming from outdated beliefs and (mis)conceptions, ambiguous policies and guidelines, and unequal access to information affect SRHR experiences of women LWH more than the virus itself. The results emphasise the need to: update knowledge within healthcare settings and among the public; clarify ambiguous legislations and guidelines; ensure equal access to information to enable all women LWH to take informed decisions, make fully informed choices and realise their SRHR; and consider the diversity of women LWH and enable shared decision-making.

A cross-lagged longitudinal investigation of the relationship between stigma and job effectiveness among employees with HIV.

Growing diversity in the workforce has compelled scholars and managers to create inclusive organizational environments for employees who belong to marginalized groups. Yet, little is known about how employees with stigmatized medical conditions manage their job demands. In this article, we examine the role of stigma associated with human immunodeficiency virus (HIV) in shaping the ability of employees with HIV to contribute to their organizations. Drawing on stigma and emotions literatures, we investigate the influence of HIV stigma on job effectiveness (i.e., in-role performance and organizational citizenship behaviors) through the mediated paths of fear and shame. We further examine whether a psychological (i.e., core self-evaluation [CSE]) and a physiological (i.e., CD4 cell count, defined as the biological indicator of HIV severity) factor would moderate these mediating relationships at the first and second stages, respectively. Using a sample of 225 employees with HIV surveyed across three measurement periods with a time lag of 3 months, we found support for the dual-stage moderated mediation model linking HIV stigma and job effectiveness via shame under lower (vs. higher) levels of CSE and CD4 cell count. By contrast, we did not find evidence for the mediating role of fear. Implications of our findings for theory and practice are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Pilot study of an arts- and theatre-based HIV prevention intervention for men who have sex with men and transgender women migrants in South Africa: acceptability, feasibility and preliminary efficacy.

Innovative approaches addressing the elevated human immunodeficiency virus (HIV) risk among men who have sex with men (MSM) or transgender women (TGW) migrants in South Africa are urgently needed. We sought to present the acceptability, feasibility and preliminary efficacy of 'Externalize and Mobilize!', a multi-session arts- and theatre-based HIV prevention group intervention for MSM and TGW migrants in South Africa. Fourteen participants-MSM (n = 7; 50%), genderqueer/nonbinary persons (n = 4; 29%) and TGW (n = 3; 21%)-in Cape Town were recruited and enrolled in the intervention and administered pre- and post-intervention assessments of HIV knowledge, HIV risk-reduction self-efficacy, stigma and resilience. The intervention, delivered over 4 days, was completed by all 14 participants. Scores on HIV knowledge and HIV risk-reduction self-efficacy were statistically significantly higher at post-intervention compared with pre-intervention. Additionally, participants responded affirmatively (i.e. 'Agree' or 'Strongly agree') on all items assessing intervention acceptability. Findings demonstrate the high acceptability, feasibility and preliminary efficacy of an arts- and theatre-based intervention for increasing HIV knowledge and HIV risk-reduction self-efficacy among MSM and TGW migrants in South Africa. This study provides further support for the use of creative and innovative interventions to address entrenched HIV disparities in South Africa.

Coping with loneliness and stigma associated with HIV in a resource-limited setting, making a case for mental health interventions; a sequential mixed methods study

BackgroundChallenges such as stigma and loneliness may increase vulnerability to Human Immunodeficiency Virus (HIV) infection and negatively affect the quality of life of people living with HIV (PLHIV) despite the massive investment in access to antiretroviral therapy. This study aims to determine the level of loneliness and stigma and explore the coping resources employed by PLHIV in a resource-constrained setting.MethodsThis was a sequential mixed methods study conducted at the Cape Coast Teaching Hospital (CCTH) in Ghana between May and December 2021. A total of 395 adults were selected using a simple random sampling technique. HIV Stigma Scale and UCLA Loneliness Scale were used to collect quantitative data. A purposive sampling technique was applied to recruit 18 participants to saturation using a semi-structured interview guide. SPSS version 21 was used for the statistical analysis of the quantitative data. HIV-related loneliness and stigma levels were estimated, and bivariate and multivariable logistic regression were used to evaluate associated factors using a statistical significance of p-value (p < .05). In general, the thematic analysis approach by Braun and Clark was employed to analyse the qualitative data. Findings were then triangulated.ResultsThe mean age was 46.79 years (± 12.53), 75.4% of the participants were female, with a prevalence of stigma of 99.0% (95%CI = 97.4–99.7) and loneliness of 30.1% (95%CI = 25.6–34.9). Tertiary-level education and instrumental support were associated with lower levels of loneliness. In contrast, comorbidity, personalised stigma, negative self-image, and self-blame were positively related to loneliness. Thematic analyses of the qualitative data produced a range of themes that showed that people living with HIV rely on personal resources, social support networks, and behaviour modification strategies to manage their condition. In particular, some of these strategies include; religiosity and spirituality, family and friends, medication and professional support systems.ConclusionThe results suggest that PLHIV in the developing world face enormous challenges, socially, psychologically and financially. Although there have been global efforts to make HIV services accessible, the findings suggest a need for integrating mental health services contextually to reduce loneliness and HIV-related stigma to improve quality of life.

Depressive symptoms, perceived social support, and anticipated HIV stigma among HIV-negative/unknown men who have sex with men in China during the COVID-19 pandemic: A multicenter online cross-sectional study.

To investigate the prevalence of depressive symptoms among human immunodeficiency virus (HIV)-negative/unknown men who have sex with men (MSM) in China and explore the relationship between perceived social support, anticipated HIV stigma, and depressive symptoms. Participants in this study were recruited from a gay social networking app (Blued) in China by convenience sampling from December 16, 2020 to March 1, 2021. Perceived Social Support Questionnaire, Anticipated HIV Stigma Questionnaire, and Center for Epidemiologic Studies Depression Scale were used to measure the social support, anticipated HIV stigma, and depressive symptoms of participants. Confirmatory factor analysis was performed to assess the reliability and validity of the measurement model. Structural equation modeling was employed to evaluate the association of perceived social support, anticipated HIV stigma, and depressive symptoms, as well as the mediation effects. Overall, 47.70% (665/1394) of the participants had depressive symptoms. Perceived social support could have both direct and indirect effects on depressive symptoms with the mediating role of anticipated HIV stigma among HIV-negative/unknown MSM. Tailored interventions regarding perceived social support and anticipated HIV stigma, such as group therapy, mutual support groups and mindfulness training, with the involvement of non-governmental or governmental organizations, should be taken into account to reduce depressive symptoms and stigma among HIV-negative/unknown MSM in China.

Improving HIV stigma in the marginalized population in Khorramabad, Iran: A single-blinded randomized, controlled educational trial using role-playing and lecturing.

This study aimed to investigate the effect of role-playing and lecture on improving the attitudes of the Khorramabad suburban population toward the human immunodeficiency virus (HIV). In 2019, 270 people aged 18 and above participated in a randomized controlled trial in Khorramabad, Iran. Individuals were randomly assigned to one of three groups: role-playing, lecture, or control. To collect data before and after the intervention, we used a standard HIV knowledge and attitude questionnaire. Before the educational intervention, three marginalized groups' attitudes toward HIV were stigmatized. After the intervention, the attitudes of both the role-playing and lecture groups improved significantly relative to the control group (P<0.0001); there was no significant difference between the two methods (P>0.05). The correlation between attitude and knowledge scores was positive (P<0.0001). This study demonstrates that education is a fundamental pillar of improving attitudes toward people living with HIV (PLHIV) and can reduce stigma against them, thereby increasing their desire to disclose their condition and seek medical care. Trial registration: The trial registration code is IRCTID: IRCT20190807044467N1 (https://en.irct.ir/trial/41464).

Quality of life and its determinants in people living with Human Immunodeficiency Virus infection in Kannur District, Kerala

Introduction: The prevalence of Human Immunodeficiency Virus (HIV) infection in India is on decline. Since the introduction of Anti Retroviral Therapy, the survival of HIV positives has improved a lot. HIV/acquired immunodeficiency syndrome (AIDS) is now a chronic yet manageable disease. However, social factors like stigma and discrimination still exist, affecting the quality of life (QoL) of people living with HIV (PLHIV)/AIDS. The objectives of the study were to assess the QOL among HIV-positive patients using the World Health Organization-QOL BREF (WHO-QOL BREF) questionnaire, the factors determining the QoL of HIV-positive patients, and the stigma and discrimination faced by HIV positives in the medical field. Methods: A cross-sectional study was done during the study period of 1 year. A total of 150 PLHIV from Kannur district in Kerala participated in the study. The WHO-QOL BREF, Scale and the HIV stigma scale were used to collect the data. Results: The QoL score found in the study was 15.36 ± 2.18, 2.18. The overall QoL was influenced by education, the Stigma Scale score, having a constant income or an increased income after diagnosis, and a Perceived Social Support Scale score. The study also found that 22% (33) of the participants faced stigma and discrimination from the medical field in one form or another. Conclusion: The study found that the QOL of PLHIV in the Kannur district of Kerala revealed no difference between men and women. The determinant factors for QOL were found to vary in each domain. Education was found to have a negative impact on QOL.

Bifactor SEM and MIRT Structure of a 12-Item Human Immunodeficiency Virus Stigma Scale in Peruvian Adults.

The stigma associated with human immunodeficiency virus (HIV) can lead to prejudice and discrimination against people who have been infected by this virus, consequently, it is important to have a validated tool to measure this phenomenon. However, there is only 1 national precedent that has validated the scores of this instrument in its 21-item version. Therefore, this study examined the bifactor structural equation method (SEM) and multidimensional item response theory (MIRT) structure of a 12-item human immunodeficiency virus stigma scale in Peruvian adults. We evaluated 342 patients (57.6% female and 42.45% male) diagnosed with HIV receiving highly active antiretroviral therapy (HAART) from a hospital located in East Lima, aged 18 to 45 years (M = 31.4, SD = 9.79). A SEM was used to test 2 measurement models, a 4-factor correlated oblique model and a bifactor model due to high interfactor relationships. Acceptable fit indices were identified for the oblique model (χ2/df = 1.26, SRMR = 0.044, RMSEA [90% CI] = 0.028 [0.000-0.047], CFI = 0.996, TLI = 0.994). In the same way, similar results were evident for the bifactor model (χ2/df = 1.14, SRMR = 0.039, RMSEA [90% CI] = 0.020 [0.000-0.044], CFI = 0.998, TLI = 0.997), however, in the latter it showed a greater explanation for the unidimensional model (H = 0.87, PUC = 0.82, LCA = 0.70), which was also evidenced by the bifactor MIRT analysis. It is concluded that the 12-item HIV Stigma Scale meets the psychometric properties of internal structure and unifactorial reliability.

THE RELATIONSHIP BETWEEN THE UPTAKE OF HUMAN IMMUNODEFICIENCY VIRUS (HIV) TESTING AND STIGMA AMONG UNIVERSITY STUDENTS IN THE KLANG VALLEY

The prevalence of Human Immunodeficiency Virus (HIV) is on the rise among adolescents and young people and these people are frequently subjected to significant levels of stigma, resulting in most of them avoiding HIV testing services. This study aimed to identify the prevalence of HIV testing uptake and its associated factors among students who were willing to undergo HIV testing. A cross-sectional study across five campuses within the Klang Valley was conducted between March to May 2020. Data were collected using an online self-administered questionnaire and the HIV Stigma Scale (HSS) was used to assess perceived stigma towards people with HIV. The results were analyzed using SPSS 26.0 and the prevalence of HIV testing uptake and its associated factors were assessed using multiple logistic regression. A total of 305 students showed a willingness to undergo HIV testing, with only 17% (95% CI; 13.0,21.0)(N=52) of the students ever undergoing an HIV test. The overall stigma associated with HIV was found to be high (93.4%) among the students. Students enrolled in non-health-related courses (AOR=0.33, 95% CI; 0.15,0.73), 5th year students (AOR=0.13, 95%CI; 0.02, 0.78), older aged people (AOR=1.35, 95% CI; 1.03,1.78), and those who had multiple sexual partners (AOR=5.28, 95% CI 1.42,19.60) were significantly associated with HIV testing uptake. Although stigma was associated with HIV testing in simple logistic regression, it was not significant in the multivariate logistic analysis and there was no correlation between HIV uptake and HIV-related stigma. The prevalence of HIV uptake among students was low, and it was discovered that variables acting as facilitators were students who engaged in risky behaviors, and that these variables should be formulated and incorporated into advanced university-based programs to harness the potential of testing and expand it to periodic HIV testing.

Perceptions and attitudes regarding HIV pre-exposure prophylaxis (PrEP) among dermatology clinicians and trainees.

In 2020, over 1.2 million people were at risk of acquiring human immunodeficiency virus (HIV), though only 25% were prescribed pre-exposure prophylaxis (PrEP). Given the multitude of dermatologic manifestations of HIV and other sexually transmitted infections, dermatologic care can serve as the entry point to the HIV care continuum. Currently, there is limited data on specialists' perspectives on HIV PrEP prescribing. We aimed to survey clinicians and trainees in an academic dermatology department about HIV PrEP-related knowledge, attitudes, and practices. Survey questions were adapted from existing literature on HIV stigma and PrEP-related knowledge, attitudes, and practices. Composite scores for each domain were averaged and compared between clinicians and trainees using Wilcoxon's signed rank test or Fisher's exact test. Of 135 providers invited, 31 (23%) completed the survey (11 clinicians and 20 trainees). Of the 31 participants, 16 (52%) had specialized HIV experience and training. When asked about discriminatory beliefs, nine participants (29%) agreed that HIV infection is a "consequence of irresponsible behavior." PrEP knowledge was low, with 13 (42%) participants answering zero out of 3 PrEP knowledge questions correctly. Additionally, 10 (91%) clinicians reported poor knowledge of PrEP side effects, and eight clinicians (73%) indicated they were "not comfortable at all" in prescribing PrEP. No participant had prescribed PrEP, and 22 (70%) participants had never discussed PrEP with patients. Dermatology clinicians and trainees reported some levels of HIV stigma. Substantial gaps in PrEP knowledge and discussion were reported despite prior HIV discrimination training and HIV-related practice experience. Study limitations include a small sample size and a modest response rate. Addressing stigma among dermatologists and improving HIV PrEP education is vital to enhancing the healthcare outcomes of people living with HIV.

HIV testing and associated factors among men (15-64 years) in Eastern Africa: a multilevel analysis using the recent demographic and health survey

BackgroundDespite significant efforts made to prevent human immunodeficiency virus (HIV) transmission, its testing coverage among men is still low and remains a major concern in low-income countries, particularly in East Africa. Therefore, this study aimed to determine the prevalence and associated factors of HIV testing among men in Eastern Africa.MethodsWe analyzed secondary data using Demographic and Health Surveys (DHS) drawn from Eastern African countries. Besides, we merged DHS data from eleven Eastern African countries. In this study, we included secondary data from 113, 270 men aged 15-64 years. The outcome variable of this study was “ever been tested for HIV”. Bivariable and multivariable multi-level logistic regression analyses were employed. In the bivariable analysis, variables having a P-value of less than 0.2 were selected for multivariable analysis. Lastly, variables with a P-value of < 0.05 in the multivariable analysis were declared as a significant factor associated with HIV testing and the adjusted odds ratio (AOR) with the 95% confidence interval (CI) were computed to determine the strength and direction of the association.ResultsThe overall prevalence of HIV testing among men in eastern Africa was 60.5% (95% CI: 60.2, 60.7%). In the multivariable multilevel analysis; participant’s older age, being married, increased poverty, HIV knowledge, risky sexual behavior, and being covered by health insurance were positively associated with HIV testing coverage among men. However, men with higher community illiteracy levels, residing in rural settings, age at first sex ≥20 years, and higher stigmatized attitudes towards HIV/AIDS had lower odds of being tested for HIV.ConclusionThe overall prevalence of HIV testing among men in eastern Africa was relatively higher than the previous studies. The study revealed that age, marital status, residence, age at first sex, community poverty level, community illiteracy level, HIV knowledge, HIV stigma indicator, risky sexual behavior, and health insurance were significantly associated with HIV testing coverage among men. Therefore, all the concerned stakeholders need to develop an integrated strategic plan through providing special attention to the factors that affect the uptake of HIV testing to raise awareness about the importance of HIV testing and to prevent HIV/AIDS transmission.

Associations between HIV stigma and social support for people living with HIV in Hyderabad, India

AbstractThe present study examined the association between social support and Human Immunodeficiency Virus (HIV) stigma through a survey of 150 people living with HIV (PLWH) in Hyderabad, India. Survey items to assess social support were adapted from the HIV Cost Services and Utilization Survey. HIV stigma was measured using Zelaya and Jeyaseelan scales that were previously validated in India. Multiple linear regression analysis revealed an inverse association between social support and HIV stigma across both stigma scales. Depression further intensified the level of stigma faced by PLWH who had lower levels of social support. Third‐gender individuals experienced significantly higher HIV stigma and lower social support than cisgender men. Social support must be used as a protective factor in current HIV stigma reduction interventions. Findings highlight the need to adopt a gender‐sensitive social support framework in HIV care policies to better address HIV stigma in the Indian context.

'Diagnosis, disclosure and stigma: The perspectives of Indonesian children with HIV and their families'.

This grounded theory study aimed to explore the subjective experiences of children living with Human Immunodeficiency Virus (HIV) from the perspective of children and their families in Indonesia. Twenty participants were interviewed, consisting of 12 children aged 9-18years and eight family members. Using grounded theory analysis, this study identified three categories: 'coping with diagnosis', 'disclosing their status' and 'living with the stigma of HIV'. Participants responded with shock, denial, sadness, secrecy and often had misconceptions about the virus to the diagnosis of themselves or their children. After diagnosis, children with HIV and their families continuously lived with stigma stemming from individual and societal beliefs about the virus. This stigma manifested in actions such as isolation, disclosure avoidance, secrecy, deception and social rejection. Because of these stigmatisations, many of the participants decided not to disclose the child's HIV status and used status strategies such as telling lies, keeping secrets and keeping their distance. The participants offered insight into the need for comprehensive programs to address care gaps. This study highlights that health professionals need to develop practical guidelines to support families during the disclosure process, provide psychosocial care for children, and create stigma reduction interventions for children with HIV.

Stigma, perceived family support, and post-traumatic stress experienced by seropositive HIV patients in Pakistan

&lt;p&gt;&lt;strong&gt;Background and Objective: &lt;/strong&gt;Stigmatization and discrimination are phenomena familiar to all human immunodeficiency virus (HIV)-positive patients, which create a significant amount of stress; little is known about the role of family support in alleviation of this stressful condition. The current study aims to investigate the relationship between the perceptions of family support, stigmatization, and symptoms of posttraumatic stress in HIV-positive patients in Pakistan.&lt;br /&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A total of 100 seropositive patients, aged between 18 and 50 years, were approached through professional organizations in Lahore, Pakistan, based on purposive and snowball sampling strategies. The magnitude of stigma experienced by the patients was assessed by administering the Berger HIV stigma scale. The multidimensional scale of perceived social support and post-traumatic stress disorder checklist were used to assess post-traumatic stress symptoms (PTSS) and perceived family support (PFS).&lt;br /&gt;&lt;strong&gt;Results: &lt;/strong&gt;The study identified a positive relationship between experiencing stigma and the development of PTSS. Also, a significant inverse relationship between PFS and PTSS was observed, whereas a consequential negative association between experiencing stigma and PFS was evident in patients who disclosed their illness to their families.&lt;br /&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The current study documents that HIV seropositive patients in Pakistan experience high levels of stigma, especially in relation to the disease&amp;nbsp; disclosure to their families and other social contacts. An already immune compromised status and stigmatization leads to significant stress symptoms which ultimately decrease the perception about accessibility of social support in the times of crisis.&lt;/p&gt;