title: Assessing the Impact of Food Assistance on Stigma Among People Living with HIV in Uganda Using the HIV/AIDS Stigma Instrument-PLWA (HASI-P).
abstract: HIV-related stigma among persons living with HIV/AIDS (PLHIV) is prevalent throughout sub-Saharan Africa. There is limited evidence, however, on which interventions are effective in reducing it. We used data from a prospective impact evaluation of a 12-month food assistance intervention among 904 antiretroviral therapy (ART)- naïve PLHIV in Uganda to examine the program impact on stigma. Stigma was measured using the comprehensive HASI-P scale, which demonstrated good internal consistency (Cronbach's alpha = 0.87) and was correlated with several related constructs including physical and mental health-related quality of life, disclosure, and physical health symptoms in the sample. Using quasi-experimental difference-in-difference matching methods to better infer causality, we tested whether the intervention improved the overall stigma scale and its subscales. The food assistance intervention had a significant effect on reported internalized (but not external) stigma of approximately 0.2 SD (p < 0.01). The HASI-P stigma scale is a useful tool for measuring and tracking stigma. Food assistance interventions, embedded in an HIV care program, can reduce internalized stigma.
authors.affiliation: Department of Economics, Middlebury College, 14 Old Chapel Road, Middlebury, VT, 05753, USA. maluccio@middlebury.edu.
authors.forename: John A
authors.initials: JA
authors.lastname: Maluccio
authors.affiliation: Department of Economics, Middlebury College, 14 Old Chapel Road, Middlebury, VT, 05753, USA.
authors.forename: Fan
authors.initials: F
authors.lastname: Wu
authors.affiliation: Department of Economics, Middlebury College, 14 Old Chapel Road, Middlebury, VT, 05753, USA.
authors.forename: Redwan B
authors.initials: RB
authors.lastname: Rokon
authors.affiliation: Poverty, Health, and Nutrition Division, International Food Policy Research Institute (IFPRI), Dakar, Senegal.
authors.forename: Rahul
authors.initials: R
authors.lastname: Rawat
authors.affiliation: Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Suneetha
authors.initials: S
authors.lastname: Kadiyala
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy / Q000523:psychology*; D000223:Adaptation, Psychological; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D003906:Developing Countries; D005260:Female; D063105:Food Assistance; D015658:HIV Infections / Q000188:drug therapy / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011594:Psychometrics; D011788:Quality of Life / Q000523:psychology; D012803:Sick Role; D057545:Social Stigma; D011795:Surveys and Questionnaires; D014454:Uganda
chemical_list: D019380:Anti-HIV Agents
keywords: Food assistance; Food security; HIV infection; Stigma; Uganda