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. 2017 Sep;21(9):2579-2588.
doi: 10.1007/s10461-016-1671-8.

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

Sarah Treves-Kagan  1   2 , Alison M El Ayadi  3 , Audrey Pettifor  4   5   6 , Catherine MacPhail  5   6   7 , Rhian Twine  6 , Suzanne Maman  4 , Dean Peacock  8 , Kathleen Kahn  6   9 , Sheri A Lippman  10   6
Affiliations

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

Sarah Treves-Kagan et al. AIDS Behav. 2017 Sep.

Abstract

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.

Keywords: Community; Gender; HIV; Rural; South Africa; Stigma.

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Conflict of interest statement

Compliance with Ethical Standards

Conflict of Interest: The authors declare that they have no conflicts of interest.

Ethical approval: Research procedures were approved by the Institutional Review Boards at the University of North Carolina-Chapel Hill and the University of California, San Francisco, and the Human Research Ethics Committee at the University of the Witwatersrand in South Africa. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent: Informed consent was obtained from all individual participants included in the study.

Figures

Figure 1
Figure 1
Proportion of females and males testing for HIV under various community anticipated stigma scenarios using g-computation algorithm, Agincourt sub-district, Mpumalanga province, South Africa
See this image and copyright information in PMC

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