HIV-Related Stigma and Its Associated Factors Among Adults With HIV in Botswana, China, Colombia, Kenya, Nigeria, South Africa, Thailand, and the United States: A Cross-Sectional Quantitative Study

HIV-related stigma diminishes efforts to contain the HIV epidemic, as it compromises testing and access to quality services. Various HIV prevention and control measures have been put in place, including antiretroviral medications. However, HIV-related stigma still compromises human rights for people with HIV. We used the social ecological model to examine HIV-related stigma in a cross-sectional and multinational sample of 1, 598 people with HIV. We found moderate HIV-related stigma, mainly related to concerns about HIV status disclosure and negative attitudes of the public. Overall HIV-related stigma and its dimensions were associated with factors at the individual, community, and structural levels of the social ecological model, with patterns of association depending on a given dimension of HIV stigma and contextual factors. The findings suggest that efforts to address HIV-related stigma need a comprehensive approach that considers not only people with HIV but also their immediate and distal social ecological environment.