Universal HIV testing and treatment and HIV stigma reduction

A comparative thematic analysis of qualitative data from the HPTN 071 (PopART) trial in South Africa and Zambia

Bibliographic Data

ID2249825
AuthorsLario Viljoen (0000-0003-4039-6639, Department of Paediatrics and Child Health Faculty of Medicine and Health Sciences Desmond Tutu TB Centre Stellenbosch University Stellenbosch South Africa, corresponding author), Virginia Bond (0000-0002-6815-4239, Zambart School of Public Health Ridgeway Campus University of Zambia Lusaka Zambia, corresponding author), Lyn Reynolds (0000-0003-4980-6876, Stellenbosch University, corresponding author), Lindsey J Reynolds (Department of Sociology and Social Anthropology Stellenbosch University Stellenbosch South Africa), Constance Mubekapi‐musadaidzwa (0000-0003-4430-7461, Department of Paediatrics and Child Health Faculty of Medicine and Health Sciences Desmond Tutu TB Centre Stellenbosch University Stellenbosch South Africa, corresponding author), Dzunisani Patience Baloyi (0000-0003-3315-0411, Department of Paediatrics and Child Health Faculty of Medicine and Health Sciences Desmond Tutu TB Centre Stellenbosch University Stellenbosch South Africa, corresponding author), Rhoda Ndubani (Zambart School of Public Health Ridgeway Campus University of Zambia Lusaka Zambia, corresponding author), Anne Stangl (0000-0001-9325-5077, International Center for Research on Women Washington DC USA, corresponding author), Janet Seeley (0000-0002-0583-5272, Global Health and Development Department Faculty of Public Health and Policy London School of Hygiene and Tropical Medicine London UK, corresponding author), Triantafyllos Pliakas (0000-0002-7242-6479, Department of Public Health, Environments and Society Faculty of Public Health and Policy London School of Hygiene and Tropical Medicine London UK, corresponding author), Peter Bock (0000-0003-3211-6078, Department of Paediatrics and Child Health Faculty of Medicine and Health Sciences Desmond Tutu TB Centre Stellenbosch University Stellenbosch South Africa, corresponding author), Sarah Fidler (0000-0003-1676-7583, Imperial College NIHR BRC Imperial College London London UK, corresponding author), Renée Hayes (0000-0002-1729-9892, Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Public Health London School of Hygiene and Tropical Medicine London UK, corresponding author), Helen Ayles (0000-0003-4108-2842, Zambart School of Public Health Ridgeway Campus University of Zambia Lusaka Zambia, corresponding author), Julian Hargreaves (0000-0002-3509-3572, Department of Public Health, Environments and Society Faculty of Public Health and Policy London School of Hygiene and Tropical Medicine London UK, corresponding author), Graeme Hoddinott (0000-0001-5915-8126, Department of Paediatrics and Child Health Faculty of Medicine and Health Sciences Desmond Tutu TB Centre Stellenbosch University Stellenbosch South Africa, corresponding author)
Year2021
Volume43
Issue1
Pages167-185
Publication date2021-01-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueSociology of Health & Illness (JOURNAL)
Journal identifiersISSN: 0141-9889 • E-ISSN: 1467-9566
PublisherWiley (PUBLISHER • GB)
DOI10.1111/1467-9566.13208
PMID33085116
OpenAlexW3093867342
LanguageEN
Citations received8
References cited66

Despite continued development of effective HIV treatment, expanded access to care and advances in prevention modalities, HIV-related stigma persists. We examine how, in the context of a universal HIV-testing and treatment trial in South Africa and Zambia, increased availability of HIV services influenced conceptualisations of HIV. Using qualitative data, we explore people's stigma-related experiences of living in 'intervention' and 'control' study communities. We conducted exploratory data analysis from a qualitative cohort of 150 households in 13 study communities, collected between 2016 and 2018. We found that increased availability of HIV-testing services influenced conceptualisations of HIV as normative (non-exceptional) and the visibility of people living with HIV (PLHIV) in household and community spaces impacted opportunities for stigma. There was a shift in community narratives towards individual responsibility to take up (assumingly) widely available service - for PLHIV to take care of their own health and to prevent onward transmission. Based on empirical data, we show that, despite a growing acceptance of HIV-related testing services, anticipated stigma persists through the mechanism of shifting responsibilisation. To mitigate the responsibilisation of PLHIV, heath implementers need to adapt anti-stigma messaging and especially focus on anticipated stigma

Business · Context (archaeology · Family medicine · Focus group · Geography · Human immunodeficiency virus (HIV · Psychiatry · Qualitative property · Qualitative research · Sociology · Stigma (botany · Thematic analysis · Adolescent Sexual and Reproductive Health · HIV, Drug Use, Sexual Risk · HIV/AIDS Research and Interventions · Medicine · Psychology