Stigma rises despite antiretroviral roll-out: a longitudinal analysis in South Africa

dc.contributor.authorMaughan-Brown, Brendan
dc.date.accessioned2016-07-06T16:49:30Z
dc.date.available2016-07-06T16:49:30Z
dc.date.issued2010
dc.date.updated2016-05-26T07:38:11Z
dc.description.abstractStigma is a recognised problem for effective prevention, treatment, and care of HIV/AIDS. However, few?studies have measured changes in the magnitude and character of stigma over time. This paper provides?the first quantitative evaluation in Africa of the changing nature of stigma and the potential determinants?of these changes. More specifically, it evaluates the dynamic relationship between stigma and (1)?increased personal contact with people living with HIV/AIDS and (2) knowing people who died of AIDS.?Panel survey data collected in Cape town 2003 and 2006 for 1074 young adults aged 14-22 years were?used to evaluate changes in three distinct dimensions of stigma: behavioural intentions towards people?living with HIV/AIDS; instrumental stigma; and symbolic stigma. Individual fixed effects regression?models are used to evaluate factors that influence stigma over time. Each dimension of stigma increased?in the population as a whole, and for all racial and gender sub-groups. Symbolic stigma increased the?most, followed by instrumental stigma, while negative behavioural intentions showed a modest increase.?Knowing someone who died of AIDS was significantly associated with an increase in instrumental stigma?and symbolic stigma, while increased personal contact with people living with HIV/AIDS was not?significantly associated with any changes in stigma. Despite interventions, such as public-sector provision?of antiretroviral treatment (which some hoped would have reduced stigma), stigma increased?among a sample highly targeted with HIV-prevention messages. These findings emphasise that changes?in stigma are difficult to predict and thus important to monitor. They also indicate the imperative for?renewed efforts to reduce stigma, perhaps through interventions to weaken the association between?HIV/AIDS and death, to reduce fear of HIV/AIDS, and to recast HIV as a chronic manageable disease.en_ZA
dc.identifierhttp://dx.doi.org/10.1016/j.socscimed.2009.09.041
dc.identifier.apacitationMaughan-Brown, B. (2010). Stigma rises despite antiretroviral roll-out: a longitudinal analysis in South Africa. <i>Social Science and Medicine</i>, http://hdl.handle.net/11427/20239en_ZA
dc.identifier.chicagocitationMaughan-Brown, Brendan "Stigma rises despite antiretroviral roll-out: a longitudinal analysis in South Africa." <i>Social Science and Medicine</i> (2010) http://hdl.handle.net/11427/20239en_ZA
dc.identifier.citationMaughan-Brown, B. (2010). Stigma rises despite antiretroviral roll-out: A longitudinal analysis in South Africa. Social Science & Medicine, 70(3), 368-374.en_ZA
dc.identifier.issn0277-9536en_ZA
dc.identifier.ris TY - Journal Article AU - Maughan-Brown, Brendan AB - Stigma is a recognised problem for effective prevention, treatment, and care of HIV/AIDS. However, few?studies have measured changes in the magnitude and character of stigma over time. This paper provides?the first quantitative evaluation in Africa of the changing nature of stigma and the potential determinants?of these changes. More specifically, it evaluates the dynamic relationship between stigma and (1)?increased personal contact with people living with HIV/AIDS and (2) knowing people who died of AIDS.?Panel survey data collected in Cape town 2003 and 2006 for 1074 young adults aged 14-22 years were?used to evaluate changes in three distinct dimensions of stigma: behavioural intentions towards people?living with HIV/AIDS; instrumental stigma; and symbolic stigma. Individual fixed effects regression?models are used to evaluate factors that influence stigma over time. Each dimension of stigma increased?in the population as a whole, and for all racial and gender sub-groups. Symbolic stigma increased the?most, followed by instrumental stigma, while negative behavioural intentions showed a modest increase.?Knowing someone who died of AIDS was significantly associated with an increase in instrumental stigma?and symbolic stigma, while increased personal contact with people living with HIV/AIDS was not?significantly associated with any changes in stigma. Despite interventions, such as public-sector provision?of antiretroviral treatment (which some hoped would have reduced stigma), stigma increased?among a sample highly targeted with HIV-prevention messages. These findings emphasise that changes?in stigma are difficult to predict and thus important to monitor. They also indicate the imperative for?renewed efforts to reduce stigma, perhaps through interventions to weaken the association between?HIV/AIDS and death, to reduce fear of HIV/AIDS, and to recast HIV as a chronic manageable disease. DA - 2010 DB - OpenUCT DP - University of Cape Town J1 - Social Science and Medicine LK - https://open.uct.ac.za PB - University of Cape Town PY - 2010 SM - 0277-9536 T1 - Stigma rises despite antiretroviral roll-out: a longitudinal analysis in South Africa TI - Stigma rises despite antiretroviral roll-out: a longitudinal analysis in South Africa UR - http://hdl.handle.net/11427/20239 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/20239
dc.identifier.vancouvercitationMaughan-Brown B. Stigma rises despite antiretroviral roll-out: a longitudinal analysis in South Africa. Social Science and Medicine. 2010; http://hdl.handle.net/11427/20239.en_ZA
dc.languageengen_ZA
dc.publisherElsevieren_ZA
dc.publisher.departmentAids and Society Research Uniten_ZA
dc.publisher.facultyFaculty of Humanitiesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.sourceSocial Science and Medicineen_ZA
dc.source.urihttp://www.sciencedirect.com/science/journal/02779536
dc.titleStigma rises despite antiretroviral roll-out: a longitudinal analysis in South Africaen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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