Why education is key to stamping out HIV stigma

Researchers have assessed the attitudes of women in Gabon, Kenya and Tanzania who took part in recent Demographic and Health Surveys. Its findings suggest HIV education is key to stamping out HIV stigma. 

What is the research about? 

The level of discriminatory attitudes against people with HIV among women in Gabon, Kenya and Tanzania. 

Researchers looked at the responses of 56,690 women (ages 15–49 ) who took part in Demographic and Health Surveys in 2021 and 2022. 

In the surveys, women were asked to respond to the following statements:  

• Children with HIV should be allowed to attend school with children without HIV.  

• Would you buy vegetables from vendors with HIV? 

If they answered no to both questions they were considered to have a discriminatory attitude. 

Why is this research important? 

HIV-related stigma and discrimination affects people’s health and well-being. It stops people getting tested for HIV, starting or staying on HIV treatment if they need it, using PrEP and sometimes even condoms. People with HIV can also face social exclusion, gossip, verbal and physical harassment, and can be denied housing, healthcare and employment due to discriminatory attitudes.  

A lot of work has been done to reduce HIV-related stigma and discrimination. Understanding what types of people still hold stigmatising attitudes can help to target future stigma-reduction work at those who need it. 

What did they find out? 

Just under one-third of women surveyed (28%) had a discriminatory attitude towards people with HIV.  

Women with certain characteristics were more likely hold discriminatory views then other women. 

Age 

The odds of having discriminatory attitude among young women (age 15-35) was around 1.5 times higher than older women (aged 45-49). 

Location 

The odds of having a discriminatory attitude was 1.4 times higher among women in rural areas than in women in urban areas. 

Internet use 

The odds of having a discriminatory attitude were 1.3 times higher among women who didn’t use the internet compared to those who did. 

HIV knowledge  

The odds of having discriminatory attitudes was more than 2 times higher among women with no knowledge of HIV compared to women with full knowledge of HIV. It was 1.8 times higher among women who had never tested for HIV, compared to women who had. 

What does this mean for HIV services? 

The findings that women with good knowledge of HIV are less discriminatory shows just how important HIV education is. Knowing about HIV, including how it is spread and what it means to live with HIV, can help people ignore stigmatising myths and misinformation. Learning about HIV and meeting people with HIV who are on effective treatment can help others understand that HIV is simply a health condition that some people have, and that people with HIV can lead long and healthy lives. 

The finding on testing also suggests that providing accurate, easy-to-understand pre-test HIV education and post-test counselling can help to challenge discriminatory views. People who have tested may also feel more able to recognise the fact that anyone can get HIV, and that people with HIV are not especially bad or immoral. 

Women under the age of 35 and women in rural areas may particularly benefit from HIV education. To be effective, this should be co-designed and delivered with women from these groups so that it is presented in ways that their peers will engage with, understand and trust.