Abstract:
HIV/AIDS-related stigma and discrimination have a substantial impact on people living with HIV/AIDS
(PLHA). The objectives of this study were: (1) to determine the associations of two constructs of HIV/
AIDS-related stigma and discrimination (negative attitudes towards PLHA and perceived acts of
discrimination towards PLHA) with previous history of HIV testing, knowledge of antiretroviral therapies
(ARVs) and communication regarding HIV/AIDS and (2) to compare these two constructs across the five
research sites with respect to differing levels of HIV prevalence and ARV coverage, using data presented
from the baseline survey of U.S. National Institute of Mental Health (NIMH) Project Accept, a four-country
HIV prevention trial in Sub-Saharan Africa (Tanzania, Zimbabwe and South Africa) and northern
Thailand. A household probability sample of 14,203 participants completed a survey including a scale
measuring HIV/AIDS-related stigma and discrimination. Logistic regression models determined the
associations between negative attitudes and perceived discrimination with individual history of HIV
testing, knowledge of ARVs and communication regarding HIV/AIDS. Spearman’s correlation coefficients
determined the relationships between negative attitudes and perceived discrimination and HIV prevalence
and ARV coverage at the site-level. Negative attitudes were related to never having tested for HIV,
lacking knowledge of ARVs, and never having discussed HIV/AIDS. More negative attitudes were found in
sites with the lowest HIV prevalence (i.e., Tanzania and Thailand) and more perceived discrimination
against PLHA was found in sites with the lowest ARV coverage (i.e., Tanzania and Zimbabwe). Programs
that promote widespread HIV testing and discussion of HIV/AIDS, as well as education regarding and
universal access to ARVs, may reduce HIV/AIDS-related stigma and discrimination.
