Universal Access to Antiretroviral Therapy and Hiv Stigma in Botswana
Bibliographic Data
We welcome the insights provided by Wolfe et al1 into the impact of access to antiretroviral therapy on HIV stigma in Botswana. It is an important subject for investigation as HIV stigma affects compliance with HIV treatment and community attitudes worldwide.2 We particularly commend the authors for using anticipated stigma as a second measure of attitudes toward HIV, because social desirability will affect those attitudes reported by respondents.3 We question how the respondents to the study were selected, particularly because the authors mention that they were not able to access “more remote” areas. There might be greater stigma associated with HIV infection among populations who live further away from health services and therefore who have less access to antiretroviral therapy. We recognize that the decision not to question respondents about their personal HIV status may have had valid methodological reasoning, for example, to maximize participation or rapport during the interviews. However, it would have been helpful if the authors had discussed in more detail the cultural context for admitting stigma. For example, the study participants might have been reluctant to admit negative attitudes toward people with HIV infection unless generally these attitudes were acceptable. To further the study findings and our understanding of HIV stigma and treatment in Botswana, we believe it would be beneficial to know how many people are aware of the national treatment program; it would also be helpful to use qualitative methods of inquiry to investigate attitudes toward the program. Furthermore, barriers to treatment access could be identified, particularly among vulnerable groups such as widowed women, because these could be related to stigma issues
Antiretroviral therapy · Environmental health · Family medicine · Human immunodeficiency virus (HIV) · Psychiatry · Social stigma · Stigma (botany) · Universal design · Viral load · Adolescent Sexual and Reproductive Health · Computer Science · HIV, Drug Use, Sexual Risk · HIV/AIDS Research and Interventions · Medicine · Virology
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