Stigma, AIDS, and HIV Prevention in Africa: Reports from Community Organizations Providing Prevention Services

ABSTRACT

The AIDS epidemic in Africa remains a serious health crisis. Nongovernmental organizations (NGOs) in Africa play a critical role in the delivery of HIV prevention services. An important barrier to their HIV prevention efforts is stigma directed at persons living with HIV/AIDS. In order to understand how stigma affects HIV prevention programming, we conducted in-depth qualitative interviews with NGO directors in 29 African countries. Qualitative analytic approaches were used to identify key themes. Substantial discrimination and stigmatization of HIV-positive persons was reported. HIV-positive women were particularly likely to suffer negative social and economic consequences. The stigma associated with HIV interfered with disclosure of HIV status, risk-reduction behaviors, and HIV testing, creating significant barriers to HIV prevention efforts.

Interventions to reduce AIDS-related stigma in Africa are urgently needed. Reducing the burden of stigma is critical to fighting the epidemic in Africa and could play an important role in global HIV reduction.

KEYWORDS:

• Stigma
• HIV prevention
• Africa
• community psychology
• nongovernmental organizations

Notes

Acknowledgments: This research was supported by Grants R01-MH62982, RO1-MH57226, and P30-MH57226 from the National Institute of Mental Health. The authors extend appreciation to Werasit Sittitrai and Bai Bagasao from UNAIDS, Geneva, Switzerland, and to Timothy L. McAuliffe, Steven D. Pinkerton, Yuri Amirkhanian, and Allan C. Hauth for their assistance.