Understanding HIV Transmission and Illness Stigma: A Relationship Revisited in Rural Rwanda

Abstract

Integrating an understanding of HIV transmission with structural-behavioral prevention approaches remains a priority in low prevalence rural regions in Africa. Many national indicators use categorical survey responses which do not capture the cultural nuances of HIV transmission knowledge that potentially reify stigmatizing treatment of persons living with HIV (PL-HIV). We examined the relationship between quantitative and qualitative measures of HIV knowledge and four forms of stigma (individual attitudes, felt normative, social distance, and stigma perceived by PLHIV) among 200 rural residents in Rwanda. Forty-two percent qualitatively reported concurrent accurate and partial knowledge of HIV transmission. Being more knowledgeable about HIV transmission was associated with less desire for social distancing from PLHIV. Our findings highlight the continued importance of reinforcing an accurate understanding of HIV transmission and correcting misinformation by drawing on quantitative and qualitative assessments of HIV knowledge as critical arms of HIV stigma reduction programs in low prevalence rural regions.

Psychometric Properties of the Berger HIV Stigma Scale: A Systematic Review

“…The included studies recruited a total of 68,933 participants, with individual sample sizes ranging from 14 in Rwanda [ 98 ] to 2987 in China [ 187 ]. The recruited participants included diverse samples of PLWH, including adolescents and young adults living with HIV in 12 studies [ 22 , 23 , 38 , 62 , 72 , 80 , 83 , 125 , 126 , 129 , 163 , 178 ], adolescent girls and young women living with HIV in four studies [ 33 , 54 , 68 , 117 ], pregnant women living with HIV in one study [ 31 ], older women living with HIV in one study [ 151 ], older adults living with HIV in seven studies [ 44 , 61 , 63 , 77 , 81 , 139 , 161 ], women living with HIV in 19 studies [ 25 , 42 , 50 , 57 , 58 , 59 , 89 , 90 , 110 , 123 , 135 , 136 , 138 , 141 , 157 , 158 , 168 , 169 , 179 ], men living with HIV in six studies [ 46 , 75 ,…”

“…In 23 of these studies [ 36 , 39 , 40 , 69 , 70 , 91 , 92 , 94 , 95 , 97 , 107 , 111 , 118 , 121 , 125 , 126 , 129 , 132 , 137 , 156 , 159 , 162 , 184 ], the scales were adapted to the local contexts following forward and back-translations and review by experts and/or feedback from participant interviews and discussions. Ten of the studies [ 22 , 82 , 98 , 103 , 104 , 105 , 118 , 127 , 136 , 164 ] just translated the scale to the target native languages, while one study [ 122 ] adapted a scale that had already been translated in the study setting. Nine studies [ 23 , 35 , 61 , 88 , 116 , 147 , 160 , 170 , 175 ] did not adapt the scale but used previously adapted versions.…”

Do perceived contraception attitudes influence abortion stigma? Evidence from Luanda, Angola

“…The indirect questioning was employed due to reduce social desirability bias due to the illegality of abortion in Angola ( Fisher, 1993 ). Similar questions have been employed to examine stigma among people living with HIV, measuring individual attitudes, social distance, felt normative and stigma perceived by people with HIV ( Kang, Delzell, & Mbonyingabo, 2017 ). There are no abortion attitude-focused interventions currently in place in Angola, and given the legal framework, the likelihood of such interventions is low.…”