title: Proximate Context of HIV Stigma and Its Association with HIV Testing in Sierra Leone: A Population-Based Study.
abstract: The extent to which HIV stigma at the community level remains a barrier to greater uptake in HIV testing services is poorly understood. We used nationally representative data from the 2008 Sierra Leone Demographic and Health Survey. The primary outcome was HIV testing (past 12 months). Our explanatory variable was HIV stigmatizing attitudes (5-item scale). After multivariable adjustment, HIV testing had an inverse association with HIV stigmatizing attitudes measured at the individual [adjusted odds ratio (AOR) 0.94; 95 % CI 0.87-1.01] and community level (AOR 0.70; 95 % CI 0.58-0.85). HIV stigma had a stronger negative association with HIV testing when modeled at the community rather than individual level.
authors.affiliation: Division of Infectious Diseases, Department of Medicine, University of California at San Francisco (UCSF), 513 Parnassus Ave., S-380, San Francisco, CA, 94117, USA. dan.kelly@ucsf.edu.
authors.forename: J Daniel
authors.initials: JD
authors.lastname: Kelly
authors.affiliation: Division of HIV/AIDS, Department of Medicine, San Francisco General Hospital at UCSF, San Francisco, CA, USA.
authors.forename: Sheri D
authors.initials: SD
authors.lastname: Weiser
authors.affiliation: MD Division of Global Psychiatry, Center for Global Health and Chester M. Pierce, Massachusetts General Hospital, Boston, MA, USA.|Harvard Medical School, Boston, MA, USA.|Mbarara University of Science and Technology, Mbarara, Uganda.
authors.forename: Alexander C
authors.initials: AC
authors.lastname: Tsai
mesh_terms: D000328:Adult; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000523:psychology*; D015438:Health Behavior; D006306:Health Surveys; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D015999:Multivariate Analysis; D016017:Odds Ratio; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D011159:Population Surveillance / Q000379:methods*; D012111:Residence Characteristics; D012424:Rural Population; D012807:Sierra Leone; D057545:Social Stigma; D012959:Socioeconomic Factors; D013240:Stereotyping
keywords: HIV stigma; HIV testing; Population-based; Sierra Leone; Sub-Saharan Africa