Temporal trends in self-reported HIV stigma and association with adherence and viral suppression in the African Cohort Study

on behalf of the AFRICOS Study Group

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

HIV stigma is a major barrier to HIV care and treatment among people living with HIV (PLWH). Evidence suggests that expansion in antiretroviral therapy (ART) may reduce stigma. However, there are limited longitudinal studies examining temporal trends in HIV stigma in sub-Saharan Africa in the Undetectable = Untransmittable (U = U) era. We longitudinally assessed temporal trends in self-reported experienced stigma and the association of experienced stigma with ART adherence and viral suppression among PLWH enrolled in the African Cohort Study (AFRICOS). AFRICOS is an ongoing cohort study enrolling PLWH in Uganda, Kenya, Tanzania, and Nigeria. As of 1 March 2020, 2937 PLWH enrolled in AFRICOS and had available data. In 2013, 22% of participants reported stigma at the enrollment visit and by 2018 the prevalence decreased to 1% overall and was below 2% for all countries. However, there was not a statistically significant change in stigma prevalence in our longitudinal models. In adjusted models, experiencing stigma was associated with a 0.67 decreased odds of ART Adherence (95% confidence interval (CI): 0.56–0.80) and a 0.64 decreased odds of viral suppression (95% CI: 0.73–0.99). HIV-associated stigma was associated with poor self-reported ART adherence and unsuppressed viral load.

Original languageEnglish
Pages (from-to)78-85
Number of pages8
JournalAIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
Volume34
Issue number1
DOIs
StatePublished - 2022
Externally publishedYes

Keywords

  • Africa
  • HIV
  • Stigma
  • viral suppression

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