TABLE 4.
The Association Between Experienced and Perceived HIV Stigma and Viral Suppression at PC24 in 21 Communities in Zambia and South Africa
| Variable | Categories | n/N (%) | aRR* (95% CI) | aRR† (95% CI) |
| Self-report HIV status‡ | SR HIV positive | 3162/3963 (79.8%) | 1.00 | 1.00 |
| Did not self-report HIV positive | 751/1699 (44.2%) | 0.59 (0.56 to 0.63) | 0.59 (0.56 to 0.63)‡ | |
| Any stigma (n = 3963) | No stigma experienced | 2223/2763 (80.5%) | 1.00 | 1.00 |
| Any stigma experienced | 939/1200 (78.3%) | 0.97 (0.93 to 1.00) | 0.97 (0.93 to 1.00) | |
| Experienced stigma in health service settings (n = 3963) | Never | 2995/3753 (79.8%) | 1.00 | 1.00 |
| At least once | 167/210 (79.5%) | 1.00 (0.93 to 1.07) | 0.99 (0.93 to 1.06) | |
| Experienced stigma in the community (n = 3963) | Never | 2512/3144 (79.9%) | 1.00 | 1.00 |
| At least once | 650/819 (79.4%) | 0.98 (0.94 to 1.02) | 0.98 (0.94 to 1.02) | |
| Current internalized stigma (n = 3963) | Disagree | 2687/3330 (80.7%) | 1.00 | 1.00 |
| Agree | 475/633 (75.0%) | 0.94 (0.89 to 0.98) | 0.94 (0.89 to 0.98) | |
| Disclosed HIV status (n = 3963) | No | 358/506 (70.8%) | 1.00 | 1.00 |
| Yes | 2804/3457 (81.1%) | 1.13 (1.06 to 1.20) | 1.11 (1.05 to 1.18) | |
| Did not self-report HIV positive | 751/1699 (44.2%) | — | — | |
| Have you ever hidden your ART pills? (n = 3963) | No | 2334/2660 (87.7%) | 1.00 | 1.00 |
| Yes | 591/686 (86.2%) | 0.97 (0.94 to 1.01) | 0.97 (0.94 to 1.00) | |
| Self-report HIV positive but never started ART | 237/617 (38.4%) | — | — | |
| Population group receiving the extended stigma questionnaire | Not receiving the perceived stigma questions | 3112/4508 (69.0%) | 1.00 | 1.00 |
| Random 20% sample of the PC | 801/1154 (69.4%) | 1.00 (0.96 to 1.05) | 1.01 (0.97 to 1.05) | |
| Perceived stigma in health service settings (n = 1154)§ | Do not agree | 628/905 (69.4%) | 1.00 | 1.00 |
| Agree | 173/249 (69.5%) | 1.05 (0.96 to 1.15) | 1.05 (0.96 to 1.15) | |
| Perceived stigma in the community (n = 1154)§ | Do not agree | 352/513 (68.6%) | 1.00 | 1.00 |
| Agree | 449/641 (70.0%) | 1.03 (0.95 to 1.12) | 1.01 (0.94 to 1.10) |
Bolded, P < 0.05.
*
Model adjusted for age group, sex, and community with robust standard errors.
†
Model adjusted for age group, sex, education, marital status, time of diagnosis, and community with robust standard errors.
‡Model adjusted for age group, sex, education, marital status, and community with robust standard errors.
§
Stigma items captured by PLHIV who completed the extended questionnaire (random 20% sample of the PC).
n, number of individuals that are virally suppressed; N, total number of individuals within groups.