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The dynamic relationship between social support and HIV-related stigma in rural Uganda.

ABSTRACT: Cross-sectional studies show that human immunodeficiency virus (HIV) stigma is negatively correlated with social support.The purpose of this study is to examine the bidirectional relationship between social support and HIV stigma.We collected quarterly data from a cohort of 422 people living with HIV in Uganda, followed for a median of 2.1 years. We used multilevel regression to model the contemporaneous and 3-month-lagged associations between social support and both enacted and internalized stigma.Lagged enacted stigma was negatively correlated with emotional and instrumental social support, and lagged instrumental social support was negatively correlated with enacted stigma. Internalized stigma and emotional social support had reciprocal lagged associations.Interventions to reduce enacted stigma may strengthen social support for people living with HIV. Improved social support may in turn have a protective influence against future enacted and internalized stigma.

SUBMITTER: Takada S

PROVIDER: S-EPMC4104218 | biostudies-literature | 2014 Aug

REPOSITORIES: biostudies-literature

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The dynamic relationship between social support and HIV-related stigma in rural Uganda.

Takada Sae S Weiser Sheri D SD Kumbakumba Elias E Muzoora Conrad C Martin Jeffrey N JN Hunt Peter W PW Haberer Jessica E JE Kawuma Annet A Bangsberg David R DR Tsai Alexander C AC

Annals of behavioral medicine : a publication of the Society of Behavioral Medicine 20140801 1

<h4>Background</h4>Cross-sectional studies show that human immunodeficiency virus (HIV) stigma is negatively correlated with social support.<h4>Purpose</h4>The purpose of this study is to examine the bidirectional relationship between social support and HIV stigma.<h4>Methods</h4>We collected quarterly data from a cohort of 422 people living with HIV in Uganda, followed for a median of 2.1 years. We used multilevel regression to model the contemporaneous and 3-month-lagged associations between s ...[more]

PMID: 24500077

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Project description:BackgroundStigma is a formidable social structural barrier to HIV testing, and yet the effect of stigma on HIV testing is rarely examined at the community level. We aimed to examine the geospatial relationships of perceived HIV stigma and HIV testing among men and women living in rural Uganda.MethodsWomen and men (aged ≥18 years or emancipated minor) residing in rural areas of Uganda who self-identified as HIV negative completed interviews that included measures of HIV testing history and how participants perceived HIV stigma. We used geospatial cluster analyses to identify areas of higher perceived stigma and lower perceived stigma and the geographical dispersion of these areas. We used Poisson regression models stratified by gender to test individual-level and community-level perceived stigma in relation to frequency of HIV testing in the previous 2 years.FindingsBetween Nov 25, 2015, and May 26, 2017, we interviewed 9740 participants (4359 [45%] men and 5381 [55%] women]), among whom 940 (9%) had never been tested for HIV, and among those who had been tested, 1131 (12%) had not been tested in the previous 2 years. Men (3134 [72%] of 4359) were less likely to have been tested in the past 2 years than women (4535 [84%] of 5381) were (p<0·001). We used Poisson regression models, reporting B coefficients, to test study hypotheses regarding the effects of individual-level and community-level stigma on HIV testing frequency counts. Multilevel modelling showed that women showed significant individual-level (B=-0·173, p<0·001) and community-level (B=-0·223, p<0·001) associations between lower stigma predicting higher rates of HIV testing. For men, lower individual-level perceived stigma was also associated with higher testing frequency (B=-0·030, p=0·018), whereas higher community-level perceived stigma was associated with higher testing frequency (B=0·077, p=0·008).InterpretationOur results suggest that perceived HIV stigma at the community level exerts a differential influence on testing for women and men. HIV testing campaigns that are targeted to men and women in rural Uganda will require gender tailoring to fit local contexts.FundingUS National Institute of Mental Health.

Dataset Information

The dynamic relationship between social support and HIV-related stigma in rural Uganda.

Publications

The dynamic relationship between social support and HIV-related stigma in rural Uganda.

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