Proximate Context of HIV-Related Stigma and Women's Use of Skilled Childbirth Services in Uganda.
HIV-related stigma compromises both HIV prevention and treatment and has recently been described as a barrier to utilization of skilled childbirth services in sub-Saharan Africa. This study uses the 2011 Uganda Demographic Health Survey to estimate the associations between HIV-related stigma, measured both at the individual and community level, and use of facility delivery among women. Consistent with theoretical predictions, higher levels of stigma are associated with reduced likelihood of facility delivery. The negative relationship between stigma and facility delivery is especially pronounced when stigma is measured at the community level, highlighting the importance of understanding the proximate context of HIV-related stigma and its potential effects on behavior. Reducing the stigma of HIV will be critical to achieving the twin goals of reducing overall maternal mortality and preventing mother-to-child HIV transmission.
Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 665 Huntington Ave, 11th Floor, Boston, MA, 02115, USA. cng@mail.harvard.edu.
Courtney K
CK
Ng
MGH Global Health, Massachusetts General Hospital, Boston, MA, USA.|Harvard Center for Population and Development Studies, Cambridge, MA, USA.
Alexander C
AC
Tsai
D000293:Adolescent; D000328:Adult; D005260:Female; D015658:HIV Infections / Q000517:prevention & control / Q000523:psychology*; D006268:Health Facilities / Q000706:statistics & numerical data*; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control; D008427:Maternal Health Services; D008428:Maternal Mortality; D008875:Middle Aged; D036801:Parturition; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000523:psychology*; D057545:Social Stigma; D011795:Surveys and Questionnaires; D014454:Uganda; D055815:Young Adult
HIV stigma; Maternal health; PMTCT; Skilled childbirth services