title: Perceived stigma among patients receiving antiretroviral treatment: a prospective randomised trial comparing an m-DOT strategy with standard-of-care in Kenya.
abstract: HIV and AIDS remain highly stigmatised. Modified directly observed therapy (m-DOT) supports antiretroviral treatment (ART) adherence but little is known about its association with perceived stigma in resource-constrained settings. In 2003, 234 HIV-infected adults enrolled in a two-arm randomised trial comparing a health centre-based m-DOT strategy with standard self-administration of ART. Data on perceived stigma were collected using Berger's HIV stigma scale prior to starting ART and after 12 months. This was a secondary analysis to examine whether perceived stigma was related to treatment delivery. Perceived stigma scores declined after 12 months of treatment from a mean of 44.9 (sd=7.6) to a mean of 41.4 (sd=7.7), (t=6.14, P<0.001). No differences were found between the mean scores of participants in both study arms. Also, no difference in scores was detected using GLM, controlling for socio-demographic characteristics and baseline scores. Findings indicate that a well managed clinic-based m-DOT does not increase perceived HIV-related stigma.
authors.affiliation: University of Waterloo, Department of Health Studies and Gerontology, Canada. skaai@uwaterloo.ca
authors.forename: Susan
authors.initials: S
authors.lastname: Kaai
authors.forename: Sandra
authors.initials: S
authors.lastname: Bullock
authors.forename: Avina
authors.initials: A
authors.lastname: Sarna
authors.forename: Matthew
authors.initials: M
authors.lastname: Chersich
authors.forename: Stanley
authors.initials: S
authors.lastname: Luchters
authors.forename: Scott
authors.initials: S
authors.lastname: Geibel
authors.forename: Paul
authors.initials: P
authors.lastname: Munyao
authors.forename: Kishorchandra
authors.initials: K
authors.lastname: Mandaliya
authors.forename: Marleen
authors.initials: M
authors.lastname: Temmerman
authors.forename: Naomi
authors.initials: N
authors.lastname: Rutenburg
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy; D000293:Adolescent; D000328:Adult; D000554:Ambulatory Care Facilities; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D023801:Directly Observed Therapy / Q000379:methods; D005260:Female; D006678:HIV / Q000302:isolation & purification; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007630:Kenya; D008297:Male; D055118:Medication Adherence; D010044:Outpatient Clinics, Hospital; D010465:Perception; D011446:Prospective Studies; D012646:Self Administration / Q000379:methods; D013240:Stereotyping; D011795:Surveys and Questionnaires
chemical_list: D019380:Anti-HIV Agents