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.
Identifieur interne : 000636 ( PubMed/Checkpoint ); précédent : 000635; suivant : 000637Gender, 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.
Auteurs : Sarah Treves-Kagan [États-Unis] ; Alison M. El Ayadi [États-Unis] ; Audrey Pettifor [États-Unis] ; Catherine Macphail [Afrique du Sud] ; Rhian Twine [Afrique du Sud] ; Suzanne Maman [États-Unis] ; Dean Peacock [Afrique du Sud] ; Kathleen Kahn [Afrique du Sud] ; Sheri A. Lippman [États-Unis]Source :
- AIDS and behavior [ 1573-3254 ] ; 2017.
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.
DOI: 10.1007/s10461-016-1671-8
PubMed: 28058565
Affiliations:
- Afrique du Sud, États-Unis
- Californie, Caroline du Nord, Gauteng
- Chapel Hill (Caroline du Nord), Johannesbourg
- Université de Caroline du Nord à Chapel Hill, Université du Witwatersrand
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El Ayadi</name><affiliation wicri:level="2"><nlm:affiliation>Department of Obstetrics, Gynecology and Reproductive Sciences, Bixby Center for Global Reproductive Health, University of California, San Francisco, San Francisco, CA, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Obstetrics, Gynecology and Reproductive Sciences, Bixby Center for Global Reproductive Health, University of California, San Francisco, San Francisco, CA</wicri:regionArea><placeName><region type="state">Californie</region></placeName></affiliation></author><author><name sortKey="Pettifor, Audrey" sort="Pettifor, Audrey" uniqKey="Pettifor A" first="Audrey" last="Pettifor">Audrey Pettifor</name><affiliation wicri:level="4"><nlm:affiliation>Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Gillings School of Global Public Health, 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Witwatersrand</orgName><placeName><settlement type="city">Johannesbourg</settlement><region type="region" nuts="2">Gauteng</region></placeName></affiliation></author><author><name sortKey="Twine, Rhian" sort="Twine, Rhian" uniqKey="Twine R" first="Rhian" last="Twine">Rhian Twine</name><affiliation wicri:level="4"><nlm:affiliation>MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.</nlm:affiliation><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg</wicri:regionArea><orgName type="university">Université du Witwatersrand</orgName><placeName><settlement type="city">Johannesbourg</settlement><region type="region" nuts="2">Gauteng</region></placeName></affiliation></author><author><name sortKey="Maman, Suzanne" sort="Maman, Suzanne" uniqKey="Maman S" first="Suzanne" last="Maman">Suzanne Maman</name><affiliation wicri:level="4"><nlm:affiliation>Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC</wicri:regionArea><placeName><region type="state">Caroline du Nord</region><settlement type="city">Chapel Hill (Caroline du Nord)</settlement></placeName><orgName type="university">Université de Caroline du Nord à Chapel Hill</orgName></affiliation></author><author><name sortKey="Peacock, Dean" sort="Peacock, Dean" uniqKey="Peacock D" first="Dean" last="Peacock">Dean Peacock</name><affiliation wicri:level="1"><nlm:affiliation>Sonke Gender Justice, Cape Town, South Africa.</nlm:affiliation><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Sonke Gender Justice, Cape Town</wicri:regionArea><wicri:noRegion>Cape Town</wicri:noRegion></affiliation></author><author><name sortKey="Kahn, Kathleen" sort="Kahn, Kathleen" uniqKey="Kahn K" first="Kathleen" last="Kahn">Kathleen Kahn</name><affiliation wicri:level="4"><nlm:affiliation>MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.</nlm:affiliation><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg</wicri:regionArea><orgName type="university">Université du Witwatersrand</orgName><placeName><settlement type="city">Johannesbourg</settlement><region type="region" nuts="2">Gauteng</region></placeName></affiliation></author><author><name sortKey="Lippman, Sheri A" sort="Lippman, Sheri A" uniqKey="Lippman S" first="Sheri A" last="Lippman">Sheri A. Lippman</name><affiliation wicri:level="2"><nlm:affiliation>Department of Medicine, Center for AIDS Prevention Studies, University of California, San Francisco, San Francisco, CA, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Medicine, Center for AIDS Prevention Studies, University of California, San Francisco, San Francisco, CA</wicri:regionArea><placeName><region type="state">Californie</region></placeName></affiliation></author></analytic><series><title level="j">AIDS and behavior</title><idno type="eISSN">1573-3254</idno><imprint><date when="2017" type="published">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">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.</div></front></TEI><pubmed><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">28058565</PMID><DateCreated><Year>2017</Year><Month>01</Month><Day>06</Day></DateCreated><DateRevised><Year>2017</Year><Month>07</Month><Day>14</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1573-3254</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2017</Year><Month>Jan</Month><Day>05</Day></PubDate></JournalIssue><Title>AIDS and behavior</Title><ISOAbbreviation>AIDS Behav</ISOAbbreviation></Journal><ArticleTitle>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.</ArticleTitle><ELocationID EIdType="doi" ValidYN="Y">10.1007/s10461-016-1671-8</ELocationID><Abstract><AbstractText>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.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Treves-Kagan</LastName><ForeName>Sarah</ForeName><Initials>S</Initials><Identifier Source="ORCID">http://orcid.org/0000-0003-0369-6288</Identifier><AffiliationInfo><Affiliation>Department of Medicine, Center for AIDS Prevention Studies, University of California, San Francisco, San Francisco, CA, USA. kagan.sarah@gmail.com.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. kagan.sarah@gmail.com.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>El Ayadi</LastName><ForeName>Alison M</ForeName><Initials>AM</Initials><AffiliationInfo><Affiliation>Department of Obstetrics, Gynecology and Reproductive Sciences, Bixby Center for Global Reproductive Health, University of California, San Francisco, San Francisco, CA, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pettifor</LastName><ForeName>Audrey</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Wits Reproductive Health and HIV Institute (WRHI), Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>MacPhail</LastName><ForeName>Catherine</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Wits Reproductive Health and HIV Institute (WRHI), Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>School of Health, University of New England, Armidale, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Twine</LastName><ForeName>Rhian</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Maman</LastName><ForeName>Suzanne</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Peacock</LastName><ForeName>Dean</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Sonke Gender Justice, Cape Town, South Africa.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kahn</LastName><ForeName>Kathleen</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Umeå Centre for Global Health Research, Division of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, 90187, Umeå, Sweden.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lippman</LastName><ForeName>Sheri A</ForeName><Initials>SA</Initials><AffiliationInfo><Affiliation>Department of Medicine, Center for AIDS Prevention Studies, University of California, San Francisco, San Francisco, CA, USA.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><GrantList CompleteYN="Y"><Grant><Agency>Wellcome Trust</Agency><Country>United Kingdom</Country></Grant><Grant><GrantID>R01 MH087118</GrantID><Acronym>MH</Acronym><Agency>NIMH NIH HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>R21 MH090887</GrantID><Acronym>MH</Acronym><Agency>NIMH NIH HHS</Agency><Country>United States</Country></Grant></GrantList><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2017</Year><Month>01</Month><Day>05</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>AIDS Behav</MedlineTA><NlmUniqueID>9712133</NlmUniqueID><ISSNLinking>1090-7165</ISSNLinking></MedlineJournalInfo><CommentsCorrectionsList><CommentsCorrections RefType="Cites"><RefSource>AIDS Behav. 2016 Jan;20(1):65-70</RefSource><PMID Version="1">25771909</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Glob Public Health. 2011;6 Suppl 3:S293-309</RefSource><PMID Version="1">21745027</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>PLoS Med. 2006 Jul;3(7):e261</RefSource><PMID 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Version="1">15933833</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>J Acquir Immune Defic Syndr. 2005 Aug 1;39(4):446-53</RefSource><PMID Version="1">16010168</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>AIDS Behav. 2012 Apr;16(3):564-70</RefSource><PMID Version="1">22080386</PMID></CommentsCorrections></CommentsCorrectionsList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Community</Keyword><Keyword MajorTopicYN="N">Gender</Keyword><Keyword MajorTopicYN="N">HIV</Keyword><Keyword MajorTopicYN="N">Rural</Keyword><Keyword MajorTopicYN="N">South Africa</Keyword><Keyword MajorTopicYN="N">Stigma</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pmc-release"><Year>2018</Year><Month>07</Month><Day>05</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2017</Year><Month>1</Month><Day>7</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2017</Year><Month>1</Month><Day>7</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2017</Year><Month>1</Month><Day>7</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>aheadofprint</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">28058565</ArticleId><ArticleId IdType="doi">10.1007/s10461-016-1671-8</ArticleId><ArticleId IdType="pii">10.1007/s10461-016-1671-8</ArticleId><ArticleId IdType="pmc">PMC5498263</ArticleId><ArticleId IdType="mid">NIHMS841272</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Afrique du Sud</li><li>États-Unis</li></country><region><li>Californie</li><li>Caroline du Nord</li><li>Gauteng</li></region><settlement><li>Chapel Hill (Caroline du Nord)</li><li>Johannesbourg</li></settlement><orgName><li>Université de Caroline du Nord à Chapel Hill</li><li>Université du Witwatersrand</li></orgName></list><tree><country name="États-Unis"><region name="Californie"><name sortKey="Treves Kagan, Sarah" sort="Treves Kagan, Sarah" uniqKey="Treves Kagan S" first="Sarah" last="Treves-Kagan">Sarah Treves-Kagan</name></region><name sortKey="El Ayadi, Alison M" sort="El Ayadi, Alison M" uniqKey="El Ayadi A" first="Alison M" last="El Ayadi">Alison M. El Ayadi</name><name sortKey="Lippman, Sheri A" sort="Lippman, Sheri A" uniqKey="Lippman S" first="Sheri A" last="Lippman">Sheri A. Lippman</name><name sortKey="Maman, Suzanne" sort="Maman, Suzanne" uniqKey="Maman S" first="Suzanne" last="Maman">Suzanne Maman</name><name sortKey="Pettifor, Audrey" sort="Pettifor, Audrey" uniqKey="Pettifor A" first="Audrey" last="Pettifor">Audrey Pettifor</name></country><country name="Afrique du Sud"><region name="Gauteng"><name sortKey="Macphail, Catherine" sort="Macphail, Catherine" uniqKey="Macphail C" first="Catherine" last="Macphail">Catherine Macphail</name></region><name sortKey="Kahn, Kathleen" sort="Kahn, Kathleen" uniqKey="Kahn K" first="Kathleen" last="Kahn">Kathleen Kahn</name><name sortKey="Peacock, Dean" sort="Peacock, Dean" uniqKey="Peacock D" first="Dean" last="Peacock">Dean Peacock</name><name sortKey="Twine, Rhian" sort="Twine, Rhian" uniqKey="Twine R" first="Rhian" last="Twine">Rhian Twine</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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