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Proximate Context of HIV Stigma and Its Association with HIV Testing in Sierra Leone: A Population-Based Study

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Abstract

The extent to which HIV stigma at the community level remains a barrier to greater uptake in HIV testing services is poorly understood. We used nationally representative data from the 2008 Sierra Leone Demographic and Health Survey. The primary outcome was HIV testing (past 12 months). Our explanatory variable was HIV stigmatizing attitudes (5-item scale). After multivariable adjustment, HIV testing had an inverse association with HIV stigmatizing attitudes measured at the individual [adjusted odds ratio (AOR) 0.94; 95 % CI 0.87–1.01] and community level (AOR 0.70; 95 % CI 0.58–0.85). HIV stigma had a stronger negative association with HIV testing when modeled at the community rather than individual level.

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Acknowledgments

We would like to thank Measure DHS for access and authorization to the 2008 Sierra Leone Demographic Health Survey data files for research purposes. The authors received no specific funding for this study. ACT acknowledges salary support through the U.S. National Institutes of Health K23MH096620 and the Robert Wood Johnson Health and Society Scholars Program. SDW acknowledges salary support through the Hellman Family Foundation and Burke Family Foundation.

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Authors and Affiliations

  1. Division of Infectious Diseases, Department of Medicine, University of California at San Francisco (UCSF), 513 Parnassus Ave., S-380, San Francisco, CA, 94117, USA

    J. Daniel Kelly

  2. Division of HIV/AIDS, Department of Medicine, San Francisco General Hospital at UCSF, San Francisco, CA, USA

    Sheri D. Weiser

  3. MD Division of Global Psychiatry, Center for Global Health and Chester M. Pierce, Massachusetts General Hospital, Boston, MA, USA

    Alexander C. Tsai

  4. Harvard Medical School, Boston, MA, USA

    Alexander C. Tsai

  5. Mbarara University of Science and Technology, Mbarara, Uganda

    Alexander C. Tsai

Authors
  1. J. Daniel Kelly
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  2. Sheri D. Weiser
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  3. Alexander C. Tsai
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Corresponding author

Correspondence to J. Daniel Kelly.

Appendix

Appendix

See Table 2.

Table 2 Summary statistics for respondents who had heard of HIV (n = 8052)
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Kelly, J.D., Weiser, S.D. & Tsai, A.C. Proximate Context of HIV Stigma and Its Association with HIV Testing in Sierra Leone: A Population-Based Study. AIDS Behav 20, 65–70 (2016). https://doi.org/10.1007/s10461-015-1035-9

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  • DOI: https://doi.org/10.1007/s10461-015-1035-9

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