Stigma in the HIV/AIDS epidemic: a review of the literature and recommendations for the way forward
Open accessAbstract
Although stigma is considered a major barrier to effective responses to the HIV/AIDS epidemic, stigma reduction efforts are relegated to the bottom of AIDS programme priorities. The complexity of HIV/AIDS-related stigma is often cited as a primary reason for the limited response to this pervasive phenomenon. In this paper, we systematically review the scientific literature on HIV/AIDS-related stigma to document the current state of research, identify gaps in the available evidence and highlight promising strategies to address stigma. We focus on the following key challenges: defining, measuring and reducing HIV/AIDS-related stigma as well as assessing the impact of stigma on the effectiveness of HIV prevention and treatment programmes. Based on the literature, we conclude by offering a set of recommendations that may represent important next steps in a multifaceted response to stigma in the HIV/AIDS epidemic.
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Key populations such as pregnant mothers, sex workers, users of injection drugs, and men who have sex with men are at higher risk for HIV infection.
“Key populations -- such as pregnant mothers, sex workers, users of injection drugs, and men who have sex with men -- are not only at higher risk for HIV infection, but are also less likely to access standard treatment and the other related HIV health services due to stigma and discrimination they face from the general population as well as providers [64-70].”
From mHealth for HIV Treatment & Prevention: A Systematic Review of the Literature (2013) · cites this paper as [64]
Key populations are less likely to access standard treatment and other related HIV health services due to stigma and discrimination they face from the general population as well as providers.
“Key populations -- such as pregnant mothers, sex workers, users of injection drugs, and men who have sex with men -- are not only at higher risk for HIV infection, but are also less likely to access standard treatment and the other related HIV health services due to stigma and discrimination they face from the general population as well as providers [64-70].”
From mHealth for HIV Treatment & Prevention: A Systematic Review of the Literature (2013) · cites this paper as [64]
Literature from other disciplines suggests stigma can have a significant detrimental impact on lives of individuals and if not adequately addressed can impede effectiveness of programmatic solutions.
“literature from other disciplines suggests that stigma can have a significant detrimental impact on the lives of individuals and if not adequately addressed can impede the effectiveness of programmatic solutions [50].”
From A qualitative exploration of menstruation-related restrictive practices in Fiji, Solomon Islands and Papua New Guinea (2018) · cites this paper as [50]
Stigma is a well-documented global barrier to health-seeking behavior, engagement in care, and adherence to treatment across a range of health conditions.
“Stigma is a well-documented barrier to health seeking behavior, engagement in care and adherence to treatment across a range of health conditions globally.”
HIV stigma is associated with greater HIV risk behaviors among people at risk of or living with HIV.
“Outcomes of HIV stigma for people at risk of or living with HIV include engagement in greater HIV risk behaviors, lower rates of HIV testing, worse engagement and retention in HIV care, and worse initiation and adherence to medication [3, 44, 111].”
HIV-related stigma has downstream effects on HIV incidence, morbidity, mortality, and quality of life for PLHIV.
“Finally, HIV-related stigma has downstream effects on HIV incidence as well as morbidity, mortality, and quality of life for PLHIV [3, 109].”
HIV stigma is associated with worse engagement and retention in HIV care among people at risk of or living with HIV.
“Outcomes of HIV stigma for people at risk of or living with HIV include engagement in greater HIV risk behaviors, lower rates of HIV testing, worse engagement and retention in HIV care, and worse initiation and adherence to medication [3, 44, 111].”
HIV stigma is associated with worse initiation and adherence to medication among people at risk of or living with HIV.
“Outcomes of HIV stigma for people at risk of or living with HIV include engagement in greater HIV risk behaviors, lower rates of HIV testing, worse engagement and retention in HIV care, and worse initiation and adherence to medication [3, 44, 111].”
HIV stigma is associated with lower rates of HIV testing among people at risk of or living with HIV.
“Outcomes of HIV stigma for people at risk of or living with HIV include engagement in greater HIV risk behaviors, lower rates of HIV testing, worse engagement and retention in HIV care, and worse initiation and adherence to medication [3, 44, 111].”
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“Evidence of the impact of menstruation-related shame and stigma is lacking, however literature from other disciplines suggests that stigma can have a significant detrimental impact on the lives of individuals and if not adequately addressed can impede the effectiveness of programmatic solutions [50].”
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Misir, P. (2015) · Journal of the International Association of Providers of AIDS Care (JIAPAC) · doi:10.1177/2325957412463072 · Cited by 23 · see citing works
Vetrova, M., Lodi, S., Rateau, L., Patts, G., Blokhina, E., Palatkin, V., Yaroslavtseva, T., Toussova, O., Bushara, N., Bendiks, S., et al. (2022) · International Journal of Drug Policy · doi:10.1016/j.drugpo.2022.103600 · Cited by 11 · see citing works
The Discrepant visual representation of inflammatory bowel diseases in the internet and media
Kahn-Boesel, O., Araka, E., Anyane-Yeboa, A., Ufere, N. N., & Kochar, B. (2024) · Gastroenterology · doi:10.1053/j.gastro.2024.06.001 · Cited by 2 · see citing works
- Authors
- Mahajan, A. P., Sayles, J. N., Patel, V. A., Remien, R. H., Sawires, S. R., Ortiz, D. J., Szekeres, G., & Coates, T. J.
- Affiliations
- University of California, Los Angeles (US)
- New York State Psychiatric Institute (US)
- Charles R. Drew University of Medicine and Science (US)
- Corresponding author
- Mahajan, Anish P
- Venue
- AIDS
- Published
- 2008-08
- Volume
- 22
- Issue
- Suppl 2
- Pages
- S67-S79
- ISSN
- 0269-9370 (ISSN-L)
- PMC
- PMC2835402
- OpenAlex
- W1974975401
- Cited by
- 1,404
- References
- 87
- Citations by year
- 2026: 53 · 2025: 93 · 2024: 59 · 2023: 60 · 2022: 75 · 2021: 79 · 2020: 89 · 2019: 91 · 2018: 92 · 2017: 90 · 2016: 110 · 2015: 118 · 2014: 104 · 2013: 120 · 2012: 62
- FWCI
- 3.80
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- AIDS (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (P30MH043520)
- Topics
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › HIV/AIDS Impact and Responses
- Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
- Keywords
- stigma reduction, stigma measurement, HIV prevention programs, HIV treatment programs
- MeSH terms
- Attitude of Health Personnel, Female, Humans, Male, Patient Acceptance of Health Care, Pregnancy, Prejudice, Risk-Taking, Social Alienation, Stereotyping, HIV Infections
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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