The influence of AIDS stigma and discrimination and social cohesion on HIV testing and willingness to disclose HIV in rural KwaZulu-Natal, South Africa

Abstract

Abstract This study aims to understand the influence of AIDS stigma and discrimination, and social cohesion to HIV testing, and willingness to disclose an HIV status. A cross-sectional, interviewer administered survey (N=594) was conducted. Independent sample t-tests explored the mean differences between sex and age groups on stigma, discrimination, and social cohesion measurement. Logistic regression models were fitted with the above independent variables, and the binominal dependent variables: having had a test, willingness to have a test and disclose a positive status. The mean age of participants was 25.3 years and 60% were women. Only 28% had an HIV test, 63% were willing to have a test, and 82% reported a willingness to disclose an HIV status. High levels of stigma and discrimination were anticipated from the community, less so from their partners, and very little from families. Low levels of social distance exist towards people with HIV/AIDS, membership to social networks seems limited, and inadequate social support for people with HIV/AIDS was reported. The analysis indicates that AIDS stigma and discrimination, and inadequate social cohesion, limit access to voluntary counselling and testing (VCT), inhibit disclosure, and are, thus, barriers to care, support and prevention. Interventions need to extend the focus on information and education to strengthen social capital within a participatory and sustainable development framework. Keywords: AIDS stigma and discriminationsocial cohesiondisclosureVCT Acknowledgements The study was supported by the Joint Oxfam HIV/AIDS Program (JOHAP), OAus Ref: ASSAJOHKG, Project title: Positive HIV status disclosure and antiretroviral treatment outcome in patients participating in an AIDS treatment project in rural KwaZulu-Natal, South Africa and the Presidents Emergency Program For AIDS Relief (PEPFAR) through Centers for Disease Control (CDC), Contract SSF750-05-C-0008; Project Title: HIV acquisition in young women, promotion of HIV testing and disclosure of HIV status in rural KwaZulu- Natal.